Make the investment in your people

In 2019, the Boston EMS Peer Support Unit, realizing members’ needs were growing exponentially during the pandemic, tossed the playbook they had used for years, and called an audible in how they delivered services to their membership, according to Lt. Patrick Calter, BEMS PSU coordinator.

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Boston EMS implemented a Health and Wellness Program, initially focusing on psychological first aid and suicide prevention, and then expanding to address members’ resiliency and sustainability for members after any time on the job. “Our new goals were to provide the tools for a successful and healthy career with the department.”

Calter explains the program’s efforts – incorporating training in toxic stress reduction, trauma informed care, fitness classes, stretching and yoga – are the “fourth leg of the stool” in peer support. Supporting the members requires recognition, intervention and postvention, and then caring for the folks who have done the work and preparing them to go back into the workforce and be the most resilient responders they can be, Calter explained. He defines success as teaching members how to be resilient responders who “get out healthy and live for as long as possible, retired and happy.”

Leaders from the Boston EMS Health and Wellness Program shared what they’ve learned as they’ve grown in an EMS1 webinar, sponsored by Zoll.

The panel included:

• Lieutenant Patrick Calter, state EMS instructor/coordinator, coordinator of the Boston EMS Peer Support Program, suicide prevention instructor, addiction recovery coach and ICISF certified trainer
• Felicia Hickey, NRP, lead field training officer assigned to the Boston EMS academy, certified Crossfit Level I trainer, and ICISF certified in group and individual peer support
• Nicholas Mutter, BS, NRP, Boston EMS union secretary, ICISF certified in group and individual peer support, a certified recovery coach, and certified in psychological first aid and with veteran-related suicide prevention
• Chrissy Snyder, NREMT, certified yoga and meditation instructor, and ICISF certified in group and individual peer support

Following are tips Boston EMS offered for creating a successful health and wellness program.

1. Get buy-in

Lieutenant Calter noted the biggest question he gets about the health and wellness program is, unsurprisingly, “how do you build it?” followed by, “how do you fund it?”
First and foremost, you need buy-in from the decision makers, Calter explained. “We at Boston EMS are very fortunate that this was an easy sell,” he noted. Boston EMS has a long-standing (since 1989) peer support program. When approaching decision makers about adding fitness and wellness initiatives, the chief was the first person to sign on.

As for funding, money was obviously tight, Calter said. Amidst the pandemic impact on resources, “money was going out the door, without a whole lot coming in.” But leadership recognized this was an investment the department needed to make and was willing to make. The initial request: at least one full-time person assigned to health and wellness to get the program off the ground, was asked and answered with a yes.

That was a great message to send to the membership, Calter noted, of “we see there is a need here, and you matter.”

The department was also fortunate to receive a donation from a group of attorneys after an associated press interview about the program. Though they couldn’t accept the funds as a municipal agency, the donation inspired the Boston EMS Foundation, a nonprofit organization that can accept donations earmarked for members’ health and wellness and peer support needs. That original generous donation was the start of funding that is now allowing the department to build a gym and academy home for the program. “I wouldn’t say it’s easy, but the pillar of it is buy-in,” Calter said.

2. Customize training to individual fitness levels

As with any group, Boston EMS members’ abilities and strengths vary. As a CrossFit instructor, Felicia Hickey is able to adapt members’ workouts to meet their fitness levels.
Hickey ranks members from an initial fitness test and separates groups into different levels. One room will offer cardio, and another more weight and strength training, she explained, whatever that group needs the most to succeed.

It’s also important to create a holistic, supportive environment where people feel safe, Snyder said, noting they avoid pressure and competition that can push people away.

“Any sort of movement is better than no movement at all,” she noted. “If you’re going to start somewhere, start a program off fresh by trying to start events that involve movement, involve socializing.”

3. Combine stretching and strengthening to prevent injuries

One class Boston EMS offers is barre. While sometimes stereotypically thought of as a class for dancers or females, Boston EMS incorporates barre classes to help members strengthen their hips, thighs and back, Snyder explained.
Without a balance, overstretching or lifting will lead to injury. Combining the two creates healthy, supple muscle groups that are less likely to be injured by strenuous activity, like lifting and carrying, Synder reported. Teaching a range of motion through different exercises decreases injuries out in the field.

Hickey explained how the instructors start with the proper mechanics of each movement and demonstrate functionality. “So if we’re going to do wall ball squats, I relate to them how the squat carries over into your daily routine, picking up the stretcher or picking up patient, or just the green bag or anything that we do. If we do step ups, it’s just like stepping into a truck ... whatever it is that it relates to in the daily life,” she said.

“We push them as much as they can, so they can do the job properly without getting hurt,” Snyder said. “Because that’s the most important part ... so once you get to the street, you don’t hurt yourself, your partner or your patient.”

4. Incorporate yoga and holistic approaches to improve performance

According to Snyder, the team has noticed that members who continue to join the fitness classes have tackled issues with substance abuse and depression, in addition to looking and feeling better. In addition, they’ve noticed an increase in performance level, something she attributes, in part, to incorporating stretching and yoga into fitness programs.
“When you’re able to clear your head and move your body in a way to increase endorphins and cannabinoids in your body to make you just feel better overall, you end up performing better also in the field,” she said. “So, you leave your job feeling better, and then you also perform better as well. You make better decisions. You make less mistakes than you do when you’re stressed.”

Snyder believes if every single first responder department focused on holistic, physical and mental wellness, it would result in a huge increase in overall health and resiliency, helping members to keep their relationships healthier and to be stronger and able to stay on the job longer.

5. Foster camaraderie to create a psychologically healthy workplace

In addition to fitness classes, including barre and yoga, the group also organizes activities like races and even jewelry making. These classes have resulted in a growing camaraderie. Hickey noted the classes help form bonds between new and tenured providers. “Everyone finds someone they can relate to,” she noted.
And those bonds are not limited to members. Boston EMS has opened up classes to members’ family members as well. Pandemic stress wasn’t just impacting members, Hickey noted. It was also impacting their families, and this provided a way for providers to spend time with their loved ones, even when working overtime.

Spouses, significant others, even children who could follow along can come to the classes and meet the people their provider works with, and the rest of the members could meet the people they were going home to. It builds a family, Hickey said.

Snyder noted the fitness classes often begin a few minutes late as member chat about what they’ve experienced at work as people arrive. What could, in the wrong environment, turn into a toxic conversation about coworkers, in these cases gives people the space to talk about a difficult call and decompress with others who understand.

Treat your people right

When asked, “what is your challenge to EMS leaders?” Calter was clear: “Make the investment.”
He noted it’s not realistic to believe there’s not a need for health and wellness initiatives, and that members are doing OK after the last 2 years. “It’s not the case,” he said. “Folks are struggling. Mental health is the silent killer of our profession and to take it out of the darkness – the stigmatization of it – you need to put it in the forefront of how you lead and how you grow and how you train.”

“Your folks are going to fight how they train, and it’s important for them to know that from Day 1, when they’re being onboarded, that this is not something that we hide behind,” Calter stressed. “We don’t hide mental health, we don’t hide struggles, although it’s confidential, you know we’re going to treat this and we’re going to treat it right, and we’re going to treat you right.”

Make it your legacy to improve the wellness of your people, Calter advised. “Make the investment in your folks, you know, it’s probably the best thing you will do.”