sometimes it's hard dealing with the citizens or the patients and the families.
>> Right. >> And that can get to you.
And that gets back to one of the things that we want to talk about, too.
Is, critical incident stress management.
One of the things we've seen in the city is, our public safety department has
taken the approach where if we have
a house fire, where we've lost three children.
>> Mm-hm.
>> Or we had an incident where we lost three public safety personnel.
Our public safety department has said,
okay, call critical incident stress management team.
Have them go to the station. And waiting
for the crew so in case they need to talk to somebody, or at least they
can give them the information on, on what to do, or in case it does bother them.
because some public safety people and medical
people are like sponges, you can take
this call, this call or this situation,
this situation but eventually the sponge gets full.
>> Right
>> And we see that if you have someone just there to
offer you know, a bottle of water or say how you doing,
you know here's a pamphlet on the signs and symptoms of
stress and you know, let us know if we can help you.
That's all they need.
They don't really need anything, they need to know someone cares.
And having that person there as in
some disasters they'll, they'll call you a couple
weeks later after the disaster and say how
are you doing, you know, is everything okay.
And it's knowing that someone cares about you as an individual can be a big help.
>> You know, another thing
for, for people working in disasters is, you know, and, and
Roy is certainly much more involved with the CISM kind of stuff.
You know, when you look at the personal, occupational,
and organizational stressers that people have, where my frustration
comes in, and where my stress in a disaster
comes in is not personal and occupational, its organizational.
You know, because I'll get in, I'll see something that I need to be done and
I have to wait for mission assignment.
Or I have to, I, I need to do this,
but I'm waiting on logistics to come through for me.
So, I get stressed in a disaster situation because things
aren't going as fast as I want them to go.
where some people get stressed because its going too fast.
The other thing that we run into with
disaster responders, and this is a personal choice,
>> Mm hm.
>> If you are a hospital person or a public safety person,
you have no choice.
You're going to be involved in a disaster sometime.
>> Right. >> But if you're going to join a
[UNKNOWN],
or a D Mat team. Or, you know?
Get involved with one of the non profits, or something like that.
you have to, you have to make some hard decisions.
>> Mm hm.
>> You know?
I may be.
You know some sort of surgeon and that's where my skills lie.
But the situation doesn't require those skills.
That doesn't mean that you sit back and say well this is below me.
>> Right.
>> And I'm not thinking about surgeons, I'm just choosing that as an extreme.
>> No, no. >> You know this is, no.
You know this and, and a doc that we know and love you know a well respected
emergency physician, retired navy commander a captain you know, is, is not
beyond, you know, going over and taking care of, you know, you know, some
sort of minor issue; or, or going and setting up a tent; or lifting boxes.
Or, you know,
you know, yeah this is not a medical emergency that
I need to take care of, but there's, you know, my
job right now has nothing to do with me being a
doc or me being a pharmacist or me being a whatever.
It has, this is what the need is right now.
This is what, this is what we're expected to do.
And those are the people that work well.
worked with a nonprofit that had nurses
that were, that were part of the structure.
And we had nurses that, you know, said, you know what,
I don't want to go out on a disaster as a nurse this time.
Can I go out on logistics?
You know
>> you know, I want to drive a forklift today.
and >>
>> you know, that's fine.
That's fine. >> Yeah.
>> you know, what did you do for a living?
you know, I was a corporate CEO.
What are you doing now? Well, I'm making lunch.
>> Making lunch.
[LAUGH]
. >> Making coffee.
>> Yeah.
>> Yeah, setting up a tent. >> Right.
>> That gets into cross training, which is important.
>> Yeah. >> And we're seeing more and more
>> Absolutely.
>> That you know the nurse needs to be able to do this and this
and we were trying to do that with DMAT, we wanted to train EMS people
to be pharm techs and then they changed the pharm tech exam to be the
pharmacist exam and we're like, we're still
trying it we're going to give it a shot.
It's trying to train different people to do different jobs is a challenge.
>>Yeah.
>>Yeah, and you know and again looking at, at all the teams
within the national disaster medical system,
it doesn't matter what your specialty is.
You have to know how to put up a tent. >> That's right.
>> And you're go figure out how to put that sink unit together.
Or the, you know, what's in tote 206, and things like that.
So, you know, there are, there are some equalizers and, you
know, if you're going to be involved in any of those systems.
And MDMS is just one example.
Any of the non profits, non governmentals any of the FEMA teams you need to realize
that, you know, the job that needs to be done may not be what your specialty is.
>> Right.
And, even within your, your field you
know, physicians, in a hospital setting, or in
a disaster where they're responding as medical
personnel, may have to act like a nurse.
Or a nurse
>> No.
>> May have to act, may have to step up and
act more like an advanced practice or some other type of practitioner.
You, you have to be able to adjust, and. >> Yeah.
>> And I think that's, that's the attitude that I'm getting at.
Those who aren't able to do that,
those who want that normalcy, they're not helpful.
>> And I think creativity is another thing.
Like, when we're taking care of patients in
a medical tent that's remote to the disaster.
Remembering you have to maintain sepsis and have clean hands.
Well, that might not be as easy to do, but you still have to strive for it.
Whether its wipes, or, you have to go the extra mile
to still maintain patient safety and patient contact in a safe manner.
>> Do no harm still applies.
>> Exactly. But a sterile,
>>
[CROSSTALK]
>> but a a sterile dressing change >> Right.
>> may not be >> Right.
Right.
You might have to come up with another way.
>>absolutely possible.
Yeah. >> And like Rob was saying, first aid.
I think the way we, we can be better prepared as
a country and as, as an agency is think back to basics.
I think everyone needs a good first aid course.
Because you need to know how to treat
people and do things creatively with what you have.
And that's in a disaster where I think
we would really suffer is. Okay, no gas.
How do you do things? Or, no electricity, well, no water, no.
>> Right. How do you make due.
>> Right. >> How do you make due.
And how do you be happy while you're making due.
>> Right.
>> I mean, you don't have to be miserable.
It's a disaster May not be comfortable, but you don't have to be miserable.
You know, I, you know, I, I've, I've traveled all
around on, on, on various disaster assignments, different types of disasters.
And I have seen such extremes.
I have
seen, what are you going to give me? >> Yeah.
>> And then, I was on a, a, on a tornado.
It struck this small town, and it just so
happened that the, the day that the tornado struck.
The, the pastor of the local church had, had died.
So the fam, the, the community was upset about that,
the community was, you know, certainly upset about the tornado.
I got there a couple of days later.
and you know he, he didn't have a house, you know what, what can we do?
You know what go take care of Mrs so and
so down the street, you know she really needs help.
Or, "Hey, our interim pastor is here.
Can you go down and check on him and make sure he's okay"?
You see the best in the, in the community.
We had one in the city of Pittsburgh. We had a flood.
There was a guy that didn't fit into the neighborhood.
He had on a anklet.
He was on some sort of release. >> yes.
>> So we're walking down the street, John
[UNKNOWN]
and I were walking down the street, and
this guy came out, he's mucking out his basement,
and he'd get out there and throw the
bucket down and then run back in the house.
And, we're watching this, and, you know, what the heck's going on here?
So, every time that he went out to the curb, the anklet
went beyond how far he was allowed to go, because he was a.
>>
[LAUGH]
>> So you know, he, him just trying to clean my house
[INAUDIBLE]