I handled the call just like I handle all of them. But when I finished, I went to the bathroom, vomited, and then I took the next call.
—Anonymous emergency dispatcher
I found this quote while I was doing research on the effects of leadership on organizational commitment with emergency dispatchers. It is one of the most poignant and truthful statements that can describe a day in the life of an emergency dispatcher.
Personnel associated with the world of first responders know the job of the emergency dispatcher is very complex. As complex as it is, though, the requirements are relatively standard across communities. The website of the Red River Regional Dispatch Center, Fargo, North Dakota (USA), explains the job parameters as follows:1
Being a telecommunications operator can be a very rewarding and fulfilling profession. It requires a variety of knowledge, skills, and abilities, both physical and mental. A dispatcher must be able to make decisions and act on them with limited time and information in situations where there is an element of danger. He or she must be able to deal with people in a variety of emotional or mental states, while remaining calm and professional. Rigorous entry standards are absolutely necessary to ensure that dispatchers are able to meet the physical and mental demands of the job.
But do we really understand what the demands of the job are? Do we really know what stress is?
Stress can be defined as a state of high general arousal—a negatively tuned but unspecific emotion that appears because of stressors acting upon individuals. Stressors are the stimuli or conditions found in an environment that cause stress. Among others, stress is associated with nervousness, tension, strain, anxiety, exhaustion, depression, burnout, headaches, gastrointestinal disorders, hypertension, cold/flu episodes, sleep problems, cognitive ability, irritation,
annoyance, anger, sadness, and grief. Recent figures from the United States suggest that stress has caused as many as one million people to miss work on a single day, which costs organizations an estimated $125 billion to $190 billion a year in healthcare spending, loss of productivity, and employee turnover.2
How does this play into the emergency dispatch profession?
An emergency dispatcher makes life-or-death decisions in minutes, while also managing the emotions of callers and communicating quickly and accurately with field responders. Emergency dispatchers have been dubbed the “forgotten victim” because they face much of the same trauma as the responders they dispatch even though they are not physically at the scene. Due to not fully understanding the job of an emergency dispatcher, some consider the position to be clerical, which puts emergency dispatchers in a category offering fewer benefits, less formal support, and less recognition for the work accomplished.
Emergency dispatchers are challenged by acute and chronic workplace stressors: tense interactions with citizen callers in crisis, overtime, shift work, ever-changing technologies, and negative work culture, including co-worker conflict.3 The emergency dispatch workforce is also subject to routine exposures to secondary traumatization while handling calls involving emergencies and making time-urgent, high-stake decisions over the phone.4
The adverse outcomes associated with exposure to acute and chronic occupational stressors are costly and include physical and mental diseases and impaired work performance, which can threaten the attainment of an organization’s critical mission(s). This exposure may lead to many unhealthy habits that can then lead to burnout.
Roberta Troxell was one of the first to study emergency dispatchers and reported high peritraumatic distress (i.e., responses occurring at the time of trauma and immediately after) and a positive relationship between peritraumatic distress and compassion fatigue in emergency dispatchers.5 Heather Pierce and Michelle Lilly added to these findings by assessing traumatic call exposure, peritraumatic distress, and post-traumatic stress disorder (PTSD) symptoms in emergency dispatchers, reporting high levels of peritraumatic distress and a moderate, positive relationship between peritraumatic distress and PTSD symptom severity.6 Lilly and Christy Allen found that of 808 emergency dispatchers surveyed, 24.6% acknowledged symptoms consistent with a diagnosis of PTSD.7
In addition to trauma exposures, emergency dispatchers are subject to those stressors commonly encountered by non-emergency call center workforces, including fast-paced and time-urgent decision-making; tense interactions with distressed and sometimes abusive callers; time pressure to meet call processing requirements; and a negative work culture, which can include co-worker conflict and a lack of appreciation or recognition from supervisors.
Almost 43% of emergency dispatchers exhibit high levels of burnout across all measures, and these rates are high relative to those found among other frontline occupations, including nurses, physicians, and teachers. Recent studies report high levels of alcohol abuse, PTSD, and depression among this population.8 In qualitative interviews, emergency dispatchers and their supervisors noted that burnout was commonly discussed as “part of the job,” but it was also a common reason why people leave the job.
Currently, there is a nationwide shortage of emergency dispatchers. This shortage results in a lower level of service to the public and a higher amount of tax dollars spent on staff time for recruiting, testing, hiring, and training new emergency dispatchers. Overtime money is used to cover staffing shortages.
Back in 2009, the Association of Public-Safety Communications Officials (APCO) completed a study called Project RETAINS (Responsive Efforts to Assure Integral Needs in Staffing), which found that the national turnover rate in PSAPs was 19%, which is higher than the turnover rate for nurses and teachers.9 This study also found that retention rates were higher in centers where employees were more satisfied with their supervisors and managers.
Leadership must always realize the lives of others depend on the ability of emergency dispatchers to work effectively and efficiently, and there is a significant need for stress reduction within this population.10 Ty Wooten, Director of Governmental Affairs for the International Academies of Emergency Dispatch® (IAED™) said, “Remember, people call 911 on the worst days of their lives. And it is one day after another for the operators, and that is when we start to see an accumulation of stress.”
Now that we know some of what stress can do, how are we going to work at reducing it? So, the question for you as emergency dispatchers is how are you going to learn to cope with the stressors of this much-needed profession? Supervisors, administrators, and emergency dispatchers must be part of the solution. Let’s work together to lessen the stress and remove the harmful stereotype of asking for help. This community and the people who work in it are too
important to lose to burnout. We have the ability to make this happen. As I often remind my naval aviation students, “Asking for help is not a sign of weakness.”
Sources
1. “Employment at RRRDC.” Red River Regional Dispatch Center. http://rrrdc.com/employment/ (accessed Nov. 5, 2021).
2. “42 Worrying Workplace Stress Statistics.” Stress.org. 2019; Sept. 25. https://www.stress.org/42-worrying-workplace-stress-statistics (accessed Nov. 5, 2021).
3. Meischke H, Lilly M, Beaton R, Calhoun R, Tu A, Stangenes S, Painter I, Revere D, Baseman J. (2018). “Protocol: a multi-level intervention program to reduce stress in 9-1-1 telecommunicators.” BMC Public Health. 2018; May 2. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-5471-0 (accessed Nov. 5, 2021).
4. See note 3.
5. Troxell RM. “Indirect Exposure to the Trauma of Others: The Experiences of 9-1-1 Telecommunicators.” APCO International. ProQuest LLC. 2008. https://www.apcointl.org/~documents/report/trauma-exposure-the-experience-of-911telecommunicators?layout=default (accessed Nov. 5, 2021).
6. Pierce H, Lilly MM. “Duty-related trauma exposure in 911 telecommunicators: considering the risk for posttraumatic stress.” Journal of Traumatic Stress. 2012; March 29. https://doi.org/10.1002/jts.21687 (accessed Nov. 5, 2021).
7. Lilly MM, Allen C. “Psychological Inflexibility and Psychopathology in 911 Telecommunicators.” Journal of Traumatic Stress. 2015; May 11. https://doi.org/10.1002/jts.22004 (accessed Nov. 5, 2021).
8. Lilly MM, London MJ, Mercer MC. “Predictors of Obesity and Physical Health Complaints Among 911 Telecommunicators.” Safety and Health at Work. 2015; Sept. 12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4792921/ (accessed Nov. 5, 2021).
9. “Telecommunicator Turn-Over Rate Reaches 19 Percent.” PRWeb. 2009; Feb. 23. https://www.prweb.com/releases/apco/project_retains/prweb2165464.htm (accessed Nov. 5, 2021)
10. Kerr DC, Ornelas IJ, Lilly MM, Calhoun R. Meischke H. “Participant Engagement in and Perspectives on a Web-Based Mindfulness Intervention for 9-1-1 Telecommunicators: Multimethod Study.” Journal of Medical Internet Research. 2019; Jan. 20. https://www.jmir.org/2019/6/e13449/ (accessed Nov. 5, 2021).
