Firefighter Down: Who is Responsible
BY Mike Morgan
A 36-year-old paramedic is promoted to emergency medical services captain shift commander. He is a seven-year veteran, married, and the father to two teenagers. His pinning ceremony is scheduled at the next meeting of the Board of County Commissioners, but before the ceremony can be held, he is dead.
Line-of-duty deaths (LODDs) are part of the culture of the fire service. Fire departments across the country have taken steps to lower the number by providing training to ensure that members understand the most prevalent causes of these deaths and how to prevent them. The National Fallen Firefighters Foundation has initiated programs such as “Courage to be Safe” to ensure that the firefighters know that such tragedies should not be accepted as part of the job.
However, in this instance, it was not a LODD that took his life. He was on his way home from an evening of playing pool with some friends when his motorcycle ran off the road and struck a tree. Does that make it any less tragic? Should the department care about the cause of death when he wasn’t on duty?
Let’s take a closer look at this case. The subject is driving home from a bar at approximately 0130 hours. His next shift starts at 0700, just five and a half hours later. The investigation reveals that his blood alcohol level was 0.285 at the time of the accident. As studies have shown, alcohol stays in your system for from four to six hours. This makes one wonder what shape he would have been in had he reported to work that morning.
This is not brought up to condemn this person or any other responder mentioned in this article. We will look at a major problem among first responders to enlighten others and offer some solutions. Departments lose employees all the time. Is it our responsibility when it is not a LODD? Certainly, a family grieves just as much no matter how the member died.
Our department is not the only one facing this type of situation. With 28 full-time shift employees and 12 part-timers, you would think this was a one-time thing. Less than two weeks after the accident above, a part-time firefighter/paramedic, who happened to be slated for full-time hire to replace the person who died, got arrested for driving under the influence while off duty.
The argument can be made that every department has members who go out drinking occasionally. But, what is the difference between occasionally and an addiction? Is it only alcohol? Three months previous to the above instances, a captain notified me that his engine driver was not acting appropriately–driving erratically, sleeping during the daytime more than usual, and several other indicators.
When approached by the chief with his suspicions and told he was being sent for a drug screening, the firefighter stated, “That isn’t necessary. I’m dirty.” He thanked the chief, saying that he has wanted to do something about his problem for a long time. He admitted an addiction to prescription pain medication. Under our department policies, the admission does not change the action, which, in our case, is employee assistant program (EAP) and further random tests.
Let’s look at a few case studies.
• A major municipal department loses two members in a commercial fire; both are veterans and both are in their 50s. Reports are that one had a blood alcohol level more than three times the legal limit and the other had traces of cocaine in his system.
• An all-volunteer department loses several members in a tragic industrial fire and explosion. Three of the members are shown to have been impaired at the time of their LODDs.
• A driver/paramedic, mother of two, wife of a captain in the same department, reports for her self-contained breathing apparatus mask fit test when on duty riding up as a captain. The mask technician smells alcohol. She tests 0.14 while on duty, six hours into her shift.
• A driver/paramedic is called at home and offered overtime before 1000 hours. He drives to the station from two counties away. His captain for the day observes odd behavior; the battalion chief is called. The member’s test results well exceed the legal limit for alcohol.
Many more examples could be noted. We have all heard the stories, and many of us have witnessed the results of substance abuse.
IDENTIFY THE PROBLEM
The International Association of Firefighters (IAFF) states that an estimated 25 percent of the 18-25 year-old workforce abuse or are dependent on alcohol and an estimated 15 percent of the 26-35-year-old workforce abuse or are dependent on alcohol.
Although these statistics deal with the entire workforce, too many of us feel that the fire service is exempt from such problems. We must understand that problems exhibited by other work groups also exist in the fire-rescue service. We need to know how to identify the problem in our department and in any individual working or volunteering.
CONFRONT THE PROBLEM
At a minimum, your department policy should address substance abuse testing when there is reasonable suspicion. Volunteer or career fire officers must have the authority to send someone for a drug screening when it is deemed there is a possible problem. Whether covered in a collective bargaining agreement, a personnel manual, or department standard operating procedures, all ranks should know the proper procedure for identifying a problem
Many departments have procedures calling for automatic drug screening for an occurrence such as a line-of-duty injury or a motor vehicle accident while driving a department vehicle. I have had the complaint, “It wasn’t his fault.” or “How can you blame a firefighter if the drywall collapsed on him?” Your policy should be clear on these issues; use the term “any” occurrence, so there is no misunderstanding when the employee or member is sent for testing.
All supervisors should be trained to recognize the signs and symptoms associated with substance abuse, and there should be a policy that clearly states what they should do when they notice the following signs:
• A sudden change in behavior.
• Mood swings: being irritable and grumpy and then suddenly happy and bright.
• Withdrawal from people.
• Carelessness in relation to personal grooming.
• Loss of interest in hobbies, sports, and other favorite activities.
• Changed sleeping pattern: up at night and sleeping during the day.
• Red or glassy eyes.
• Sniffles or a runny nose.
Policies should also address what members are expected to do when a supervisor confronts them with these criteria.
Random testing is still controversial in some departments. Members argue that they are not impaired; however, it is the department’s responsibility to ensure that competent responders will respond to the citizens when they call for assistance.
Should substance abuse be considered a job-related problem? There are documented cases of firefighters suffering from post-traumatic stress disorder following a response and turning to substance abuse, thinking it will solve their problem. However, there may be other reasons for substance abuse in our departments. Firefighters are not exempt from the same things that cause substance abuse in the “outside world.” We need to understand that the investment we have in our members is great, and, in most cases, that it is worth the effort to assist our members in returning from this dangerous addiction.
TESTING FOR THE PROBLEM
Thought should be given to testing before an incident occurs and a member must be referred. Your agency should identify the lab that will be used and the type of testing that will be done. Our department discovered that our local health department, which had been used for drug screening for new employees as well as those identified as meeting our suspicious criteria, was not testing for alcohol or prescription drugs. Know the difference between a five-, nine-, and 10-panel test. Make sure that alcohol level testing is added to the procedures. Testing for all substances that can impair a member is fair game.
You must also have in place policies that state what will be done if a member tests positive; supervisors must know where to go next. Sending the individual to EAP for further evaluation is a common step; this is what our department does. Make sure your procedure includes a waiver for the counselor to discuss the individual’s needs with a preidentified member of administration, a human resources member or a chief officer.
Our department’s stance is that we want to identify any problem so it can be cured, not to imply separation from the department. Your plan needs to include what action to take after identifying an individual with a need.
Most labs can produce a result of positive or negative in 24 hours. Testing for substance levels and the types of substances might take longer. Your policies must cover this situation as well.
Do you place the member on paid leave or, if a volunteer, ban the member from running calls? After what period of time would the individual be allowed to return to work? Who can clear the member to return to duty? It is strongly recommended that any return to work agreement include periodic and random drug testing for an extended time.
What does your policy state about the member who tests positive for prescription pain pills but has a doctor’s verification that the medication is needed for a diagnosed condition? Do you allow the member to work while on the meds? Do you test for the levels to ensure the member is not taking more than prescribed? Does a doctor’s note suffice to allow the member to continue responding, or must the member be cleared by a department physician?
Whether a one-station volunteer department or a large metropolitan department, you will face the problem of substance abuse. You must decide whether to ignore it or face it and keep the members of the department and the citizens you protect safer.
MIKE MORGAN is the chief of Wakulla County (FL) Fire Rescue. He has an associate degree in fire administration from St. Petersburg College and a bachelor’s degree in business from St. Leo University. He has worked in the fire service for more than three decades.