Rehabilitation: Bridging the Gap between Illness and Wellness
Paid or Volunteer, Firefighting is a very dangerous business. For some it’s a Job, for others a passion and for many, it’s both. Regardless of those variations, risk levels remain high. Despite the highest level of Training, Physical Conditioning and Protective Gear, it is inevitable that Fire Service injuries and illnesses will continue to exist. Countless unforeseeable unavoidable incidents and accidents await Firefighters /1st Responders at every call to duty. Firefighting is truly a hazardous occupation.
One thing I have learned over the years is that the majority of Fire Service Personnel do not let the risks deter them, nor do they allow the injuries/illnesses to sideline them from Duty any longer than necessary. Whatever initially drove them to enter The Fire Service is not easily squashed or even curtailed. In fact, many of them come back with even more passion and drive than before. There’s something special about the tried and true that put that gear on, and there always will be.
That being said, the one thing that has been difficult for Fire Service Personnel to do is bridge the gap between illness and wellness. Once sidelined, members are often expected to take “time off”. “Time off from Work. Time Off” from exercise. “Time off” from everything. Initially, this makes perfect sense. Healing takes time. Healing takes patience and healing takes rest. The problem facing most is that they are expected to heal completely and then simply return to work. In many instances there isn’t anything in between to ease them back into that return.
In order to do so, it is important to address the needs and abilities of the injured/ill. You must also address any liability issues. For some this may just be a re-classification for the individual so that they are able to be present within the Firehouse for any suitable activities without violating any liability/insurance issues. This certainly is not an area where you want to skirt the rules. The stakes are of course too high. Check your SOP’s and if they need to be adjusted, go through proper channels to make the adjustments.
I have seen many Fire companies institute a “Lite Duty” category where tasks are limited and then increased until a return to “Full Duty” is possible. Still others place Firefighters on Medical Leave or “Out of Service” banning them from participating in any activities or duties(even classroom) until they can return to full duty. Perhaps a better alternative is a safe and effective course of action – medically based and monitored - with the intention of gradually and fully preparing the firefighter to enter back into service as strong and as ready as possible. Rehabilitation is an important step in the healing process and should not be overlooked. The result can be a physically/mentally stronger and better prepared individual. That should always be the goal. After all this is a job that requires exactly that.
To take it one step further, the same should be true regarding participation in physical fitness programs. Many individuals are not eligible to participate in Fire Company sponsored Fitness programs when they are ‘Out of Service’. Please understand, I am not suggesting a reckless call to have firefighters participate in strenuous and/or inappropriate exercise programs without regard for health, wellness or safety. Surely a Firefighter with a broken Finger can use the exercise bike even though he cannot operate at the fire scene. A broken foot can absolutely keep you off a Fire Truck, but it is likely you can still perform a limited workout with your upper body. The key is Medical intervention/clearance and individualization.
Working together, The Physician, Physical Therapist and other Health and Fitness professional can gradually and more fully prepare Fire Service Personnel for return to Full Duty. Smaller, continuous carefully calculated and monitored steps provide a greater foundation than making one giant jump from inactive to fully involved.
Ease Back into action. Come Back Strong. Come Back Ready. Most of all Come Back. You are a Special Group. I’ve seen it. I’m amazed by it. I’m grateful for it.
I wish you Safety Always.