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Body, mind and spirit: implementing a holistic health program

Four years ago, the Oak Bay Fire Department (OBFD) in British Columbia implemented a health and wellness strategy. The basis of the program is the International Association of Firefighters (IAFF) and International Association of Fire Chiefs (IAFC) joint health and wellness fitness initiative and Oak Bay has tweaked the program to better suit its members’ needs.

It has been well documented that industrial athletes such as firefighters are at significant risk of health challenges related to their specific line of work. The IAFF and IAFC’s Fire Service Joint Labor Management Wellness Fitness Initiative – Third edition states that, “High levels of stress, intense physical demands, arduous work, and short and long-term exposure to chemicals and infectious disease contribute to heart disease, lung disease, and cancer; which are the three leading causes of death and occupational disease disability.” In addition to this, anxiety, depression, and post-traumatic stress disorder (PTSD) are pressing issues for first responders, due to the stressful and/or traumatic nature of some calls. Situations that elicit acute, intense stress responses are repeated in a chronic, long-term fashion. The human body was never meant to operate at these high adrenalin levels for such extended time periods.

Health and wellness training is critical to help firefighters build necessary resilience and resourcefulness, thorough proactive activities that assist in managing. The training gives them new tools to handle the physical, mental, and emotional demands of the profession. The overall health and performance potential of a firefighter depends on how they eat, move, sleep, and think on a consistent basis. Most training and support for firefighters is primarily reactive, taking a downstream approach, meaning resources are deployed and made accessible after, and in response to, incidents. Action is necessary, but departments should be taking a more upstream approach to reduce, and even prevent, mental and physical injury and disease.

Firefighters are a fire department’s No. 1 asset. It is important that departments do as much as possible to provide holistic, proactive programming to help members maintain good personal health, to prevent and mitigate disease and injury. It is equally important that each firefighter takes personal ownership by looking after their health and well-being. As the old saying goes: “An ounce of prevention is worth a pound of cure.” A more modern quip suggests, “pay now or pay later,” which seems very appropriate, especially in relation to the significant costs (physical, mental, emotional, and financial) of disease and injury.

The following is an overview of how OBFD has been providing this programming to help its members counter the unique mental, spiritual, and physical health challenges firefighters can face. The results that the program yields – in terms of improving each firefighter’s physical health, mental and spiritual well-being, and quality of life – is inspiring. A surprising benefit is that these changes have been accomplished while saving tens of thousands of dollars each year. The OBFD program provides a blueprint for departments, using an upstream and holistic approach.

Union members identified a need and brought forward their idea of introducing a health and wellness program to the department aimed at improving members’ overall health and well-being in 2013. With management’s full support, the OBFD’s health and wellness program was introduced in February 2014. Now in its fourth year, the program was founded on the guiding principles as outlined in the Fire Service Joint Labor Management Wellness Fitness Initiative – Third edition. The Oak Bay initiative has been further tailored to meet the unique needs of the department, using five strategic building blocks to ensure a sustainable and easy-to-maintain program (subsequent articles will delve further into each building block).

■ Program building blocks

1. Buy-in and participation: From the outset, it has been important that all members buy into and participate in the program. A health and wellness committee was established with management and union representation to get everyone talking about the program and any other health and wellness related issues. Changes to the shift structure were made to incorporate daily health and wellness activities without sacrificing standard operations. As the program has evolved both union and management recognize the importance of the health and wellness initiative and with ever-changing workplace demands and competing priorities they endeavour to keep this aspect of the program at the forefront.
2. Body, mind, and spirit: With strategic guidance, facilitation by a registered nurse, and the integration of the fire chaplain’s role, the program incorporates all facets of a holistic and upstream approach. On-site training and education sessions (approximately every six weeks) focus on helping firefighters improve how they eat, move, sleep, and think. The tools and strategies provided are simple and practical, and they are cross-contextual, meaning they can be used in a firefighter’s personal and/or professional life. Recent topics have also included leadership-skill development, improving communication, and team building. The fire chaplain’s role is to provide a supportive, caring, and compassionate spiritual care. The chaplain is committed to supporting firefighters and their families, helping them experience and maintain complete spiritual wellness. The chaplain service is non-denominational. The chaplain provides, builds and maintains caring relationships, while offering encouragement, assistance, and emotional and spiritual support to all department members and their families.
3. Healthy rivalry: The OBFD program has leveraged a healthy level of competition among its members by incorporating cross-platoon challenges. Each crew is tasked to come up with a department-wide challenge every few months. The challenges are encouraged to be inclusive, simple, team-oriented, while integrating previous health and wellness lessons. Challenges encourage camaraderie. For example, a challenge that eliminated cell phones in the kitchen encouraged conversation and sharing meals. Crews have also spent time together hiking in local parks during time off (the four-peaks-in-four-weeks challenge), and participated in a combat challenge, where each crew was put through a course that incorporated drills with firefighter-specific demands. Since the program’s inception, a crew has been awarded a “Healthiest Platoon Award” each year for work, improvements, and overall participation in the program. This recognition comes with bragging rights, while ensuring there remains a healthy rivalry within the department.
4. Ownership and leadership: Each year the registered nurse meets with each crew to brainstorm, assess successes, and consider potential improvements to the program. These sessions provide firefighters with an opportunity to put forward ideas to help shape the program for the following year. Each crew has a platoon health leader who acts as a conduit for communicating facets of the program between the crew and the nurse. The platoon leaders also help to encourage members to participate in the program and cross-platoon challenges.
5. Sustainable and measurable: Both management and the union wanted a program that would ensure all firefighters continue to improve their health, resilience, and quality of life. The department tracks and measures progress and adjusts the program through member feedback as well as through conducting health risk assessments, which provide quantitative data on the overall health of the fire department and its members. This confidential assessment screens for nutritional habits, movement patterns, and psychosocial factors; it also provides necessary data to help the registered nurse to ensure the program continues to give members what they want, need, and deserve. All of this has been achieved while meeting budget restrictions.

When it comes to health and wellness there is no such thing as ‘one size fits all’ and that is why a tailored approach is necessary. Firefighters are a fire department’s No. 1 asset, so departments should do as much as possible to provide holistic, proactive, and preventative programming to help members maintain personal health. Incorporating a health and wellness program in your department can decrease the incidence of mental and physical health injuries. Healthy firefighters – body, mind, and spirit – are resilient firefighters. So, think big; start small; and act now.

Chief Dave Cockle has been a career firefighter with the Oak Bay Fire Department for 30 years. Contact him at dcockle@oakbay.ca

Sara Wegwitz is a registered nurse who specializes in mental fitness and resilience training. She is the primary facilitator of the Oak Bay Fire Department’s wellness program. Contact her at sara@tailormakinghealth.ca

Ken Gill is a retired Oak Bay Fire Department captain/inspector who currently serves as the department chaplain. Contact him at obfdchaplain@shaw.ca