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A "revamped" support system for firefighters is being rolled out nationwide, partly to address the added stress crews experience attending more serious medical events.
Whanganui firefighter Shane Dudley said there are two support services available, one is a peer support network and the other is formal counselling.
The peer support system was remodelled partly in response to added stresses crews face by attending more of "code purple" callouts, he said.
"The underpinning concept of it is it's basically self-help," Dudley said.
The system involved having crew members set up systems to recognise for themselves when they were struggling, and learn how to combat it.
A code purple call relates to when ambulance staff are notified of a person suffering cardiac or respiratory arrest and there is significant threat to their life.
When a 111 call is made for these patients, both ambulance and fire staff are dispatched to the scene. If fire crews arrive first, they are able to give medical care to the patient until paramedics arrive.
For Dudley, this work goes even further. If paramedics are working on administering medicines, firefighters may assist with chest compressions, or even look after the family members present.
"That will quite often fall to me or anyone from the crew to talk to the family, to get patient history, to tell them, despite what the outcome is, everything's going to be okay."
For me, personally, it's probably the hardest thing, to deal with the family.
Dudley might find himself making cups of tea with children, trying to keep them calm. Sometimes, the job involves indirectly warning family their loved one might not survive.
The number of these calls he attended had increased since a Memorandum of Understanding between St John and the Fire Service was signed in late 2014, he said.
In 2015 firefighters were called to 5793 code purple incidents, and in 2016, they were called to 6024. Those figures did not show whether or not crews were stood down from the call.
But Dudley said he now goes to every one, if only to help manage the scene.
"For me, personally, it's probably the hardest thing, to deal with the family. Because the ambulance officer is too busy, they're administering drugs and doing their life-saving processes, I'm kind of left to manage the overall scene and deal with the family.
"It can be really hard.
"My process is talking about it with my peers... I find that conversation is kind of enough."
Every time we go to do something, we offset that by saying 'hey, look, it's not all bad. We're helping people out'.
The calls could sometimes add to existing stress, for example if a firefighter was having trouble at home or wasn't doing particularly well in work.
"You bring that to work, then all of a sudden at nine o'clock in the morning you're doing CPR on someone," he said.
There was evidence some people had left the job due to the accumulated stresses, he said, but he said the struggles were made worth it by the knowledge more patients were surviving thanks to help from the Fire Service.
"Every time we go to do something, we offset that by saying, 'Hey, look, it's not all bad. We're helping people out'.
"In the long run, it's worth this little bit of pain that we sometimes have to deal with."
'No shame' in struggling to cope with stress.
Senior Station Officer Paul Smith said he and his crew in Newtown have been attended code purple calls for the last 20 years. Photo/supplied
Wellington firefighter Paul Smith has a few code purple callouts that have stuck with him over the years.
The Newtown Senior Station Officer cast his mind back 16 or 17 years.
It was not long after his own father had died. He and the other emergency crew had just decided to stop performing CPR on a man.
"The daughter of the guy who passed away wasn't that keen on us stopping CPR," he said.
"I just remember her reaction and her sort of getting in our way... encouraging us to keep going.
"Sometimes these sort of things can bring up personal experiences as well."
The Fire Service has always been open about dealing with the traumas involved in the jobs, Smith said.
"There's no shame in someone sort of struggling with these types of incidents in our organisation."
After his very first code purple call, he remembers sitting in the truck on the way back from the job and talking about it with the other members of the crew.
The MoU has not changed anything for him, since he started in the job about 20 years ago, Smith's crew has always attended code purples.
The hard part for him was dealing with loved ones of the patient. There were a variety of reactions from people, he said, ranging from silence, to "quite vocal", and even physical. - Additional reporting by Sieska Verdonk of Local Focus.
By the numbers:
- 67 per cent of cardiac arrests happen at home, and 21 per cent happen in public
- For every minute without CPR or defibrillation, a patient's chance of survival falls by 10-15 per cent.
- Applying CPR and using an AED can increase a patient's chance of survival by up to 40 per cent.
- 70 per cent of cardiac arrest incidents were co-responded by the Fire Service and paramedics in the 2015/16 financial year.
- The Fire Service were first on the scene for 15 per cent of incidents and was fundamental in the defibrillation of 95 patients; 38 per cent survived to hospital handover and 28 per cent survive to hospital discharge.
