Emergency dispatchers are exposed to demanding duty-related events in a profession that requires maintaining a calm and reassuring voice in their dispatching of medical assistance, alerting police and fire, coordinating unit response, and going on to the next call without knowing the outcome of the former call. While they may never see the incidents in person, they live vicariously through each one, hundreds and hundreds of times over their career.
The effects are individual, although stress is a common commodity.
Stress—its recognition, its management, its effect on a work/life balance—was a topic covered extensively at NAVIGATOR 2022 in educational sessions, conversations, and the research poster competition. But the catch is that stress directly related to calls is not necessarily the fulcrum tipping an emergency dispatcher into leaving a profession experiencing chronic high turnover. Stress is a consequence of what comes over the phone but not a means to the end.
“We never know the call, or whenever it happens, that will stay with us,” said Dawn Bennett, Director, Brownsville-Haywood County Central Dispatch, Dyersburg, Tennessee (USA). “We stay because we love what we do. We help people.” Bennett was among a stream of emergency dispatchers at NAVIGATOR 2022 telling their stories during a live broadcast of “Within the Trenches,” hosted by Ricardo Martinez II. She said talking in the company of fellow dispatchers helps to blow off steam. “We make each other laugh and forget about what we go through every day.”
Bureaucracy, inadequate leadership, and work overload were cited as impediments to job satisfaction, although the availability of resources and a sense of connection help to alleviate job demands, according to a study summarized in poster research accepted for NAVIGATOR 2022 from Andre V. Jones, Ph.D., Assistant Executive Director – Communications, Healthcare Coordination Centre, Ambulance Service Group, Hamad Medical Corporation, Doha, Qatar.
Jones has presented at conferences and written editorials about turnover and retention, as they pertain to leadership; however, a study conducted at the Orleans Parish Communication District, New Orleans, Louisiana (USA), was his first attempt at evidence-based research.
“Arguably, our profession is not without job demands by nature, but there are those which can be reduced to improve retention,” Jones said. “I know many colleagues focus on the occupational stress or rather job stress of working in 911 centers, but these are an outcome in my opinion. We need a holistic view of those underlying job demands that influence turnover and put in place the job resources required to improve retention.”
Resources recommended, and gathered as part of his study, include greater transparency about the roles and responsibilities of the job during the recruitment process, proper onboarding of staff so they feel like they belong to the organization and effectively contribute to its shared sense of purpose, and better health and wellness initiatives to support staff so they can thrive, not just survive.
Jones was not surprised that job resources, in general, mitigate job demands; however, the extent to which leadership influenced job demands—a factor brought to light in the study—was enlightening, he said. The results concluded that continuous quality and service delivery improvements for New Orleans 911 staff under Executive Director Tyrell Morris are at the forefront of what they collectively provide their community and responders.
“As the literature suggests and the participants confirm, where support exists, commitment exists, and job demands are immaterial,” said Jones, who plans to pursue a qualitative study that specifically focuses on emotional and mental demand on a larger scale.
Growing up with a father in emergency communications influenced Paul Bourgeois’ interest in researching stress, self-care, and well-being among emergency dispatchers. Ted Bourgeois is a shift supervisor in Waltham, Massachusetts (USA). Paul Bourgeois, Ph.D., is an assistant professor and coordinator of the clinical mental health counseling graduate program at the University of New Haven, West Haven, Connecticut (USA).
A study Paul Bourgeois presented at NAVIGATOR 2021 suggested that emergency dispatchers endure a great deal of work-related stress in a variety of domains within the profession. These areas included stressful/traumatic calls, challenges related to supervision and management, inadequate staffing, high call volumes, and interpersonal difficulties between co-workers and non-dispatcher first responders.
As a researcher, Paul Bourgeois said the greatest “take home” was an increased awareness of the limited stress management options provided to emergency dispatchers. “It’s become increasingly clear there is a lack of information about how these first responders experience their role and access or utilize educational and training experiences related to stress management and self-care,” he said.
Paul Bourgeois recommended establishing clear and well-defined workplace policies related to stress management and employee well-being, in addition to increasing awareness and access to employee assistance programs (EAPs) and reducing mental health stigma in the 911 community.
Physiological reactions are not confined to external causes, according to Michelle M. Lilly, Ph.D., Professor, Northern Illinois University, DeKalb, Illinois (USA). Distress is a demon that comes from within. Distress is a clash of personal values against the action taken. The result can cause devastating moral injury potentially more injurious than the emotional duress due to hearing the traumatic experiences of another individual told firsthand.
“Distress is a level of stress exceeding our coping capacity,” said Lilly, who published a groundbreaking study on 911 telecommunicators in the Journal of Traumatic Stress in April 2012 titled “Duty-Related Trauma Exposure in 911 Telecommunicators: Considering the Risk for Post-traumatic Stress.” “The moral injury upends values core to our sense of the world and challenges the assumptions we have about ourselves.”
Helping people as part of a team is a major motivator. What if the system fails? For example, COVID-19 caused many issues for emergency health care. Was the team in it together if emergency dispatchers did not have access to the appropriate protocol and PAIs, or paramedics did not have sufficient personal protective gear? Moral injury is more than things gone wrong. There is cognitive imbalance—a feeling of total disruption. Help was beyond personal control.
Symptomatic distress accompanying moral injury goes beyond physical manifestations such as headaches and fatigue or altered moods and behaviors such as restlessness or overeating. Moral injury punctures self-worth. Affected individuals tend to withdraw into a shell and suffer pangs of guilt and punishment.
“The self-doubt and self-sabotage hold them back from seeking help,” Lilly said. “They [feel as if] they don’t deserve support from their community.”
What does the expanse of stress discussion say about the profession and future perspective?
Stress specific to calltaking and dispatch might not be a primary factor in decisions to leave 911, but without support it may be the impetus to go elsewhere. People feel better when they are part of a community that listens and understands. Alliance and empathy and effective leadership are essential.
A long career in emergency dispatch also takes the desire to help the public and those sharing space within the PSAP, said Tammy Tolson, EMD/EFD, Master Communications Officer, Stafford County Sheriff’s Office, Stafford, Virginia (US). “We should be empowering each other all the time,” she said.
