IC Scream Prevention Program

BY ALAN BRUNACINI

During my career, I have had a ringside seat to closely watching the birth of two brand new fire service characters: the paramedic and the incident commander (IC). The paramedic was the product of our developing the modern emergency medical response system. Since the beginning of our service, we have delivered very primitive first-aid services to the community. Mrs. Smith called us when she was out of balance for a variety of reasons that in some way involved her physical safety: fire, rescue, medical, or any unplanned emergency physical disruption. We make very rapid house calls, so who else would she call? When I was a young firefighter, we responded mostly to structure fires; occasionally, we would respond to “resuscitator calls.” We had a toolbox full of bandages and a gigantic resuscitator that weighed 95 pounds that was too large to fit in a big foot locker. We would arrive, start working, and then continue treatment until the local mortician who operated the ambulance system showed up and transported the customer to the closest hospital. We responded quickly and were gentle with Mrs. Smith, but we were not very medically skillful.

Parallel Between the Paramedic and the IC

Starting in the 1970s, we watched how the military provided battlefield medical support, developed training and service delivery programs, and we imitated, adapted, and applied those systems to our community. We historically and currently have a very trainable workforce; a long-standing emergency service delivery system; and a very positive, trust-based relationship with the Smith family. We sent our firefighters to paramedic school, and they learned very practical and effective advanced life support (ALS) skills. Before the advent of paramedics, we delivered very basic medical services a lot like we had been doing for the past 250 years. The major difference between pre-paramedic and post-paramedic was that a certified paramedic physically appeared at Mrs. Smith’s front door and could do basically in her living room most of the emergency treatments that the hospital down the street could do. Our paramedic students were selected directly out of our workforce – they did not come from Mars. The whole experience was a lesson that we could positively revolutionize a critical service delivery capability by increasing the knowledge, skills, and abilities of a single person.

Starting at about the same time when we started paramedicine, we began to develop an improvement in how we commanded incident operations. Historically, we had been led on the fireground by a chief officer we called the fireground commander (FGC). That person was generally an experienced officer who typically had been promoted to a command level based on being a respected, rugged, smart, no-nonsense decision maker. In most urban departments, the job title of that person is battalion or district chief. He was dispatched as a regular part of a structural fire response, and his job (pretty much all men in the FGC era) was to take command of incident operations and control those operations mostly on the strength of his personality. The system was composed of nine parts of charisma and one part of system, and that one-system part was mostly tactical techniques, not organizational management. When we look at historic fire service pictures, we see an impressive, bold, very determined boss with a dramatic eagle on the front of a white helmet shouting through a speaking trumpet gallantly leading the troops from the front.

Leading from the front was a highly valued and respected practice. The FGC who was the command leader worked many years at every level below the rank of chief officer and proved his tactical ability as an aggressive follower. Becoming the head fire boss required a person to operate in a way that matched 150 years of prior cultural “lead from the front” momentum. The organizational system was very powerful, changed very slowly, and was built around habitual cultural norms that maintained stability and kept everyone “in line.” There is an interesting dynamic in looking at the invention of the paramedic program compared with the process of converting the FGC into the IC.

The “paramedic” position (and program) was brand new to us; and although it was mysterious, there was not much internal resistance because the new position did not involve changing any existing personal or organizational habits. Responding on “resuscitator” calls was a very low-profile, minor activity we engaged in only because no one else did it. We welcomed the new paramedic program because we were very happy that we did not have to go to these calls, and we appreciated that Mrs. Smith would be cared for by someone (the paramedic) who was truly qualified to medically help her. At the time, no one could predict the future of emergency medical services (EMS) in our service. (Wow!)

Last month, we began this discussion by describing something I hear a lot in my fire service travels. During incident command classes, where we discuss how critical the personal behavior of the IC is to effective strategic leadership, the students would describe fireground leaders screaming on the radio. They always said how dysfunctional and disruptive command screaming is and would then tell a recent war story about the negative effect of being screamed at.

When we look at command behavior historically by looking at fire service art as we described earlier, the commander is using a speaking trumpet. These objects are very symbolic and are now a standard part of fire nostalgia and memorabilia. In the range of my current vision (sitting at my desk), I can see at least four such trumpets. When we discuss the effective voice dynamics of a current IC, a very simple communications tool designed to project screaming historically set the stage for today. A speaking trumpet is not designed for the commander to communicate to the troops by whispering.

Examining old fire art may describe where we came from; but, the current performance of an IC managing an incident is directly connected to the investment the organization has made in the command capability of that person. There is a direct connection between boss ability and boss behavior. The basic way the organization can create a functional level of personal boss behavior (how he acts) is to create a functional level of performance (how he does). The major reason a boss screams is that he is in over his head. That person has not developed the ability to outperform incident management stress with personal behavior performance, so, when the chips are down, he screams.

There is a parallel example between the paramedic and the IC. We can respond to an EMS call with all the regular basic life support response resources available, all staffed with EMTs (fine people), but no ALS will begin until and unless Johnny and Roy physically come through the front door: that level of treatment must be delivered by a paramedic. Before we developed the IC position, we had fire apparatus, tools, equipment, and all the other physical resources needed to apply water and physically manipulate stuff, but, we did not have the current level of incident command capability. The only difference between the old days and the new days is that one person shows up in an SUV and performs the standard command functions that creates a strategic level of command. We have the very natural history, inclination, and habits to perform at the task level (fire companies) and at the tactical level (command from the front); but, there will not be a strategic level of command until and unless a modern IC shows up. That person has been trained to use current communications equipment and techniques, and command screaming is not in the command training curriculum.

Standard Performance Management Model for the IC

In our monthly get-together, we have often referred to a standard performance management model. The positive effect of doing the steps in the model becomes the universal antidote that, first, corrects performance problems and, then, uses high-fidelity training sets and reps to develop standard performance habits and skills. The steps in the model (standard operating procedures/train/apply/critique/revise), each a special activity, integrate to create a system that is basic, simple, and effective and necessitates a ton of effort for the student, teacher, and program boss.

For our fireground IC scream prevention discussion, the eight standard street-oriented functions of command must create the basic performance plan for the IC. These functions directly connect to the performance management model and become the training curriculum for preparing an effective strategic level incident command boss. The outline of the functions forms the job description for the IC. The functions have been around for a long time, are widely practiced, and are applied to manage local-level incidents; doing them produces safe and effective operations.

Evaluating how critical each function is to a total command plan is simple: Just skip one, and you will quickly see what happens. The functions are deployment, assumption, evaluation, communications, strategy and incident action plan, review and revision, continue, and terminate. If we want to produce a permanent behavior change (prevent screaming) during difficult times, we must displace dysfunctional behavior with functional behaviors produced by authentic, practical training experiences built around what to do and how to act while we do it.

When we look at the process of the IC acting in an effective way that reduces, rather than adds to, the level of incident chaos, it creates the need for us to describe positive IC behavior characteristics. If we don’t want the IC to scream, how do we expect him to act? The list of these characteristics is closely connected to the command functions. If the IC cannot maintain an effective level of self-control, he will not be able to control virtually anything or anybody else, including the command functions. When we observe effective ICs commanding a difficult situation, they are Calm, Composed, Patient, Organized, Decisive, Resilient, and Personally aligned.

These abilities are not complicated, but they are critical. Before we plop an IC down inside a command post and expect him to manage an active, expanding, high-risk incident, the system must have developed the personal behavior abilities required to perform the basic command job functions. If an organization has not produced and supported positive IC role models who are competent, any person attempting to develop his personal command skill is at a distinct disadvantage because there is no one to look up to (very bad). In the absence of such positive models, the change agent leaders must support their members in, first, unlearning old bad personal and positional habits and, then, learning new, positive ones.

During my career as a boss, it took me a long time to understand that it was far easier to create the EMS system (that has evolved into more than 80 percent of our total response activity) than it was to get everyone to consistently come to a complete stop at a red light. What I finally learned was that the louder I screamed about stopping, the faster they went through the intersection. It seemed that the troops hit the brakes after I lowered my voice.

Retired Chief ALAN BRUNACINI is a fire service author and speaker. He and his sons own the fire service Web site bshifter.com.

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