Risk Management for Your Own Sanity

Beth Krah

As I am writing this, the Queen is being laid to rest, the disastrous effects of September 11th are still fresh on our minds, and our son is desperately trying to reach a friend who texted a suicide note to him in the middle of the night.

On the global scale – the live feed announces its Final Farewell to Queen Elizabeth. The world mourns, and she will be missed deeply. More locally – ever since the attacks from 9-11, America has been in mourning. Some are already forgetting, but we never will. We mourn the loss of loved ones from the attacks and from rescue efforts. We continue to grapple with losing many of our close friends and family as they fall victim to cancer. On a personal level, you may continuously question your self-worth – mourning the loss of who you once were and that haunting emotional distress that may never go away. Have you become a shell of the vibrant hero you appeared to be early in your career as you put on a façade of confidence and strength yet silently wither away inside?

Our son woke up to a string of texts from a friend several states away mentioning suicide, how he would do it, and a lot of details that had our son not had his phone on silent, he would’ve read at 3 am. He couldn’t get through to his friend and eventually reached the local PD to do a well-check. After an hour of going back and forth with the suicide prevention hotline, 911, and the local PD, he finally got a call from his friend barking, “You called the cops on me??” He didn’t remember sending the texts, and of course, he’s “fine.” He shouted back, “What do you think I’m gonna do when you send texts like that?!” Some may cry out, and we listen and support them. But far too many aren’t saying a peep as it’s not proper in a “suck it up Buttercup” world. It takes much more strength and guts to admit you’re struggling with your thought process than to ignore it all, trust me.

In the previous issue, Capt. Dena Ali (Raleigh FD) wrote about therapy being awesome and how to find the proper fit in a therapist or counselor. If you’ve not read it, please do – it’s incredibly important to have a solid support system around you as you deal with the public and their worst day ever – every single day. I was fortunate enough to find someone who was perfect for me, albeit in Colorado. We Zoomed every few weeks until I was able to move past some things that were significantly interfering with my work and personal psyche. She had me do a few exercises to nail down the lies I was telling myself, and I was able to bounce back better than ever. Those burdens were weighing so heavy on me that I ended up in the hospital… a few times. Nervous about how my health was declining, I finally reached out to a friend who recommended someone, and I can’t tell you how freeing that was. Yes, definitely worth it!

Non-Intimidating Coping Mechanisms (for now)

If you’re backed into a corner and defensive about seeking a professional or just can’t seem to get out of bed, there are some things you can do until you’re ready to talk to a professional. 

1. Verbalize in Private: Just verbalizing what happens each day (out loud) and what impact it may have had on your outlook makes a big difference in how we handle the constant barrage of worst days. If you’re shy about talking to someone else, start with your dog. That faithful best friend will not judge you, look down on you or call you weak, and this will aid in allowing you to process the day’s events so you can more readily handle the following day.

2. Be careful what you listen to: What lies are you telling yourself? Are you getting on your own case for struggling like you are, or are you able to look in the mirror and realize the amazing gift you are to so many people? Feed yourself the truth, and if you’re having a tough time trying to figure out what that is, ask those who know you best. I am constantly amazed at the gap between what I tell myself vs. the truth others tell me. I’m trying harder to believe them. Dr. Seuss said it best: To the world you may be one person; but to one person you may be the world.1 Know your worth – it’s a hell of a lot more than you may think.

2. Reaching out before signs appear: About 80% of PTSD issues show up before PTSD does. Ask your crew how things are going and build that camaraderie on the front end so it’s easier to talk on the back end. For me, it’s easier to get others to open up when I reveal the vulnerabilities in my own life (and I’m much more screwed up than they are), and we start to build a more solid friendship grounded in trust, vulnerability, and the freedom to be oneself. It’s tough to just listen when you want to fix the problem. But the idea of having someone in your corner just to listen to you ramble can make all the difference in the world. I can’t figure out issues unless I verbalize them. The process of talking it out allows me to work through it better, and I often figure out the solution before the other person has a chance to respond. I thank them, they look puzzled, and we move on. Good chat.

Some of us hesitate to be vulnerable because we assume that means exposing our “secrets.” We assume that being vulnerable means spilling our hearts to strangers, and as [Brené] Brown puts it, “letting it all hang out.” But vulnerability embraces boundaries and trust, she says. “Vulnerability is about sharing our feelings and our experiences with people who have earned the right to hear them. Being vulnerable takes courage.”2

Risk management is any activity that involves the evaluation of or comparison of risks and the development, selection, and implementation of control measures that change outcomes. How does that play into the health of your crew? Gordon Graham said it best:

In any occupation, in any profession, in any tragedy, rarely is it a single event that generates the tragedy. Usually, it’s a cascade of events over a period of time that go uninterrupted. We have a triggering event, in the world of risk management, we call that the Proximate Clause. [Anyone] can identify the proximate clause of the tragedy, but if you are building your control measures based on proximate clause alone, as so many organizations do, you are dooming yourself [and] your organization to future tragedies. Real risk managers don’t stop at the proximate clause. Real risk managers go back in time and ask this question: were there related causes, were there contributory causes… were there associated causes, were there root causes, what were the conditions, were there problems lying in wait that people knew about, or should have known about, and nobody did a darn thing about it?

Take a look at your span of control, your sphere of influence, every day and ask this question, “Do I have problems lying in wait…that everybody knows about and nobody’s doing a darn thing about it?” Sooner or later, all the holes in the Swiss cheese will get lined up… you’ll have your triggering event, followed by the tragedy, and then the lawyers get involved… [and when] they peel back the layers of the onion [they’ll] identify these problems lying in wait, sometimes for years, that everybody knows about and nobody’s doing a darn thing about it.3

3. Start looking for someone you respect and trust: The sooner you’ll be able to talk to someone else, the better until you find that perfect fit for a counselor; reach out to your chaplain, a co-worker, or someone far away. I’ve heard of departments connecting with other departments across the state who deal with the same things but don’t know the people who are ticking you off right now, and that’s a good thing. At least 80% of first responders are going through the exact same thing. Know what that means? It means you’re normal.

4. There’s an app for that: I discussed with Gordon Graham his recent acquisition. There’s a wellness app from Cordico (now owned by Lexipol) specifically designed to support first responders and emergency personnel. From the palm of your hand, you can discretely research 60 topics, including fatigue, suicide prevention, alcohol abuse, mental health, and more. Anonymous self-assessments and wellness tools are available, and when you’re ready to take your conversation from puppy to professional (which is extremely important for moving forward), they’ve got a therapist finder along with peer support. Chief Billy Goldfeder affirms Cordico’s strategy:

Assuring firefighters and other responders are emotionally prepared to take care of the public, when the public is having the worst day of their lives, is what keeps fire chiefs up at night – this unique and very affordable solution from Cordico benefits the firefighters, the responders, the public, and the community’s leadership. It’s truly a win-win.4

As I conclude, our son is now dealing with a potential active shooter situation and the many kids under his care. The challenges will never stop, but please take care of yourselves as well as you take care of your patients, and through that, maybe realize new coping skills that allow you to keep showing up, keep serving, and keep saving. Y’all are in our prayers every day.

Important Info 

Suicide & Crisis Lifeline: 988

Cordico: https://www.cordico.com

NCSFA PTSD Grant: https://ncsfa/post-traumatic-stress-counseling-reimbursement-program

Firefighter Behavioral
Health Alliance:
https://www.ffbha.org/resources/clinician-resources/

 BethKrah2Beth Krah is founder and CEO of The Krah Corporation (dba Krah Health Solutions). She has served the healthcare community for over a decade providing non-toxic infection prevention measures with a special focus on EMS, Disaster Preparedness/Response, Medical Care Facilities and the Military. Previously employed by Solvay Pharmaceuticals in their Quality Assurance/Quality Control group, her passion to serve is of utmost importance for her and her team’s role in serving their customers and keeping them healthy so they can focus on the pressing needs of saving the lives of others. She can be reached at beth@krahcorp.com.

References:

1. Geisel, Theodore Seuss, Children’s author and cartoonist.

2. Williams, Ray quoting Brené Brown, (2019) Why The Best Leaders View Vulnerability as a Strength. Retrieved from https://raywilliams.ca/best-leaders-view-vulnerability-strength/

3. Graham, Gordon (2022) Risk Management, General Session. FDSOA Fire Apparatus, Safety and Equipment Conference, Scottsdale, AZ

4. Chief Billy Goldfeder, Former Chair of the IAFC’s Safety, Health, and Survival Section, Loveland-Symmes (OH) Fire Dept. Retrieved from https://www.cordico.com

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