James Thalman

James Thalman

Best Practices

James Thalman

SALT LAKE CITY—Dramatic call replays at the 2013 NAVIGATOR conference were a chilling reminder of how dispatchers never know how an event is going to play out and how stress can ripple through a calltaker’s life long after the incident is over. The infamous Columbine shooting—a half-hour aural ordeal in real time was cut down to five minutes in Shawn Messinger’s course, Active Assailant Incidents—The Telecommunicator’s Role. The fraction of the call was more than enough for the veteran SWAT team members and calltakers on hand to discuss the new Active Assailant (Shooter) Protocol.

The replaying of part of the 9-1-1 call for the Aurora, Colo., movie theater shooting started with a confusing account about a kid with The Joker haircut and quickly turned into the surreal/all-too-real events happening inside. The review of this call immediately captivated those in attendance for the post-mortem Active Shooter Incidents for Telecommunicators taught by Melissa Alterio and Anthony Weed.

Almost the entire unedited version of that call was dissected again in a course that said it all in its title: MAYDAY, MAYDAY, MAYDAY!!! The Three Words You NEVER Want to Hear! The description was not an exaggeration as veteran dispatch supervisors Nancy Lockhart and Charlene Monges led a discussion on what happens when a call comes in as one thing and suddenly turns into another, altogether worse thing.

In the Aurora mass shooting, for example, responding police are initially as cool as snow cones over the radio. Within a few minutes field responders are yelling for “three more ambulances right now,” and the trickle of information is suddenly coming through the headset like a flood and almost everybody at the scene is “overmodulating.”

Except one group of people: the dispatchers.

In Aurora, dispatchers were in the hub of the incident wheel when suddenly rolling out of its center yet is the eye—or rather the ear—of the storm. The dispatchers are a model of how to deal with a suddenly turbo-charged incident, Lockhart notes several times to the group, pointing out that although on-scene personnel are asking essentially for the moon as the mayhem unfolds, they calmly repeat every request and give every impression that they are fully in control no matter how things twist and turn.

“Our job is to be ready for things going every which way,” Lockhart said. “And no matter how much you practice mayday calls, it’s all academic until you’ve got one sitting in your lap.”

But what about after, when the high tide of violence of both man-made and natural disasters subsides, three attendees ask in succession, citing incidents when a lightning strike at an outdoor rock concert arcs into a fire that within five minutes is fully engulfing the stage and in another five is collapsing it as if it were made of toothpicks.

There are a hundred scenarios of how that could have been different, and far less deadly, Monges said. “We could have had a boom (fire truck) already on hand. We could have had more ambulances closer by; we could have had better exits. But that’s a bit like saying we should have also ordered better weather. That’s our job, to expect the unexpected, but you can’t plan for everything.”

The members of the class, which was standing room only, were most interested in the psychological trauma that tends to come after the physical incident and how having a debris of feelings and emotions that cannot be doused and hauled away can sometimes seem bigger than the incident itself.

While everyone else is being bucked off, the dispatcher has to stick with it. The point of reviewing the calls isn’t to stir up the long-settled emotional debris, Monges points out, but dispatchers are exquisitely adept at thinking that just because they hear an incident but don’t see it, the ripple effects of such dramatic events are somehow not quite as real for them as they are for folks in the field whose fives senses are red-lining.

Dispatchers are the link to the course of any event, a new study presented at the conference pointed out. Dispatchers are routinely exposed to events that should be considered traumatic, it concludes: “People think of the job as stressful, but not really traumatic.”

Heather Pierce, a former 9-1-1 dispatcher married to a police officer, analyzed surveys completed by 171 emergency dispatchers from 24 states. The survey takers were asked to describe the worst calls they had handled. The group was comprised of predominantly white women just under the age of 39 with nearly 12 years on the job, according to the study published today in the Journal of Traumatic Stress.

Most said their worst experiences involved imperiled children or sending firefighters, police officers, or emergency medical technicians who were friends and loved ones into harm’s way.

Michelle Lilly, a psychology professor at Northern Illinois University in DeKalb, Ill., who co-authored the study with Pierce assessing the psychological impact of the crises dispatchers experience from afar, told The Journal in July that she “was blown away” by how upsetting some of (the incidents) were, in particular, a dispatcher talking parents through CPR after they discovered their child has drowned in the pool.

A news media account of the research stated that Lilly was particularly shaken by a call involving two young siblings, one of whom had a mental health problem. The child without the mental health problem called 9-1-1 and locked himself in a room for protection, but the dispatcher “could hear the sibling trying to take the hinges off the door and intending to attack.”

All the dispatcher could say was, “Help is on the way. We’ll get there as fast as we can,” Lilly said.

Such situations can engender feelings of fear, helplessness, and horror which, when unaddressed, can set the stage for PTSD. Lilly and Pierce found that 3.5% of the survey respondents reported symptoms “severe enough they probably would qualify for a diagnosis of PTSD,” Lilly said.

After these critical incidents it’s important for all of those involved with the incident to conduct an After Action Review (AAR) to learn what they can from the event, and a Critical Incident Stress Debriefing to provide full on support when necessary, Messinger said.

“This process and continuing support can literally save lives in the emergency services ranks,” he said. “These debriefings and reviews are commonly done by field personnel, but they should include the calltakers and dispatchers as well. While not physically on the scene of the incident, the calltakers and dispatchers can be dramatically affected by critical incidents.

“They wouldn’t be human if they were not affected, and we want real people to help us through a crisis,” Messinger continued. “Get the call and the emotional aftermath out on the table, and take it down to the smallest detail and learn whatever you can from it. We can’t stop much of what goes on out there, but we can learn something almost every single time and be better for it.”