This has been a week of emergencies which have attracted national attention. No doubt 911 operators/dispatchers were busy dealing with a torrent of phone calls and radio transmissions after the Boston Marathon bombings and the West, Texas, fertilizer plant explosion, (follow the links to listen to samples). Telecommunications professionals play a key role in every reported emergency.

Not only was April 14-20, 2013, a traumatic week, it was National Public Safety Telecommunications Week. We should say thank you to the people who are there to take our calls when we need help.

Originally, switchboard operators handled emergency calls. Then callers dialed numbers directly...a different number for each police, fire, EMS agency. In 1937, the 999 emergency phone system began in the United Kingdom. "In the United States, the first 911 call was placed in Haleyville (Alabama) on February 16, 1968," (PoliceOne.com).

The 911 system gradually spread to most places in the U.S. While many locations have the enhanced E911, some locations still have no 911 service.

Emergency operators take many calls of every variety. "In a 25-year career in a metropolitan area, the call total can be around a million...Many are mundane, many are a glimpse into hell," (Policeone.com).

Keep in mind that the operator/dispatcher has no visual on the scene. He/she must imagine what is happening, try to calm frantic callers and officers, wait patiently during the silences, and sometimes dive into the next call without knowing how the last was resolved. They hear fear and chaos on the other end of the phone or radio but can't physically do anything to end the emergency.

"Being a 9-1-1 operator/dispatcher is overwhelming. There are half a dozen screens, immense amounts of information, beeps and chirps and whatnot in our ears that all mean different things, codes to remember, directions and locations, names, call-signs, jurisdictional lines, policies and procedures, etc., etc., etc," (Officer.com, 1-9-2013).

Listen to a series of recorded calls and radio transmissions of a shooting in progress that occurred in Glendale, California (Select "Glendale Shootout Part 1" and "...Part 2"). Multiple reports of a man shooting a weapon from inside his apartment flood the call center. First, callers report hearing about 20 shots followed by more and more. Then a series of radio transmissions with officers describes a shootout with the gunman.

Public safety operators are the cruicial first step to any emergency response, yet they are often unappreciated by the public and the officers they dispatch.

According to Jeff Troyer, Executive Director, Calhoun County 911 Consolidated Dispatch Center (Michigan), "Less than 1 percent of the population can actually do this job," he said. "It's not an easy thing to be able to do. It's an environment where multi-tasking is needed, and a position that takes multi-tasking to a whole other level," (Advisor-Chronicle.com).

In what may have been the fist study looking at PTSD among 911 dispatchers/operators, 300 dispatchers were questioned about their worst calls and the effects of stress (Chicagotribune.com). Their most difficult calls are listed below:

                                    WORST CALLS

1. 16.4%    Unexpected death/injury of a child
2. 12.9%    Suicidal callers
3.   9.9%    Officer involved shooting/unexpected death of an adult

Although dispatchers only visualize the scenes described to them by others, they face many of the same emotional distresses that officers experience on scene. "Study respondents experienced 'one or two symptoms' of PTSD while as many as 3.5 percent had symptoms serious enough to qualify for a full PTSD diagnosis," (Chicagotribune.com).

Regardless, the call taker must remain composed. He or she must use techniques to try to calm the person on the other end of the line. Operators and dispatchers jump from one unique call to another.

"We get calls from parking complaints and barking dogs and then you have the extremes — suicides, shootings, homicides — everything you hear on the news," said Jim Jones, training coordinator for Tri-Com Central Dispatch in Kane County, Illinois, (Chicagotribune.com).

Call takers may want to reach through the phone to comfort a terrified child or help barricade the door for a trapped victim. But they can only fight crimes and crises with words.

"[They] suffer from the hypervigilance, that physiological fight, flight or freeze, without the ability to do anything about the circumstances at all. To me, this creates the most amount of stress of the occupation...9-1-1 operators/dispatchers are unsung heroes " (Officer.com, 1-10-2012).

Like other emergency personnel, their shift may go from bordeom to chaos in a moment. We cannot dismiss the importance of their role in public safety.

For those who ask the questions and dispatch the helpers when we call 911--Thank you!


Resources:

• Boston EMS, "Listen: 911 Call for Aid of Boston Marathon Bombings," CBSnews.com, 4-15-2013.
• Investigation Discovery, "Call 911 Videos: Glendale Shootout Part 1" and "Part 2," Discovery.com, (accessed 4-18-2013).
• Kellogg, Corinne, "A Day in the Life of a 911 Dispatcher," Advisor-Chronicle.com, 2-24-2013.
• KMOV.com, "911 Calls Released in West, Texas Explosion," KMOV.com, 4-20-2013.
• McCarthy, Jack, "Feeling the Stress of the Job," Chicagotribune.com, 6-6-2012.
• Perin, Michelle, "911 Call Takers are Behind-the-Scenes Heroes," Policeone.com, 4-16-2013.
• Perin, Michelle, "Just a Dispatcher?" Officer.com, 1-10-2012.
• Perin, Michelle, "Training a Dispatcher," Officer.com, 1-9-2013.

Anyone can suffer from fatigue, but those working shifts may be plagued by its effects. However, some who work shifts, including police officers, have learned to adjust their routines to their work schedules.

"When all goes well the outcome is 3 shifts of equally alert and physically prepared officers ready to provide for the health and safety of the community. When all is not well, alertness decreases, vehicle and other equipment accidents are more likely and the potential for serious injury, disability or death looms larger" (drjohnconlin.blogspot.com).

Fatigue can catch up to all of us, but don't let it become a dangerous pattern for you. (Policeassn.org.nz).

Signs of Fatigue

• Daydreaming
• Slow reaction times
• Increased risk-taking
• Poor communication
• Poor judgment of distance and time
• Sore or tired eyes; blurred vision
• Nodding off for a fraction of a second
• Impatience, restlessness, irritability; and taking safety shortcuts

Before my husband started working night shifts, we prepared a small bedroom in the basement by putting aluminum foil over the windows. No...nothing stylish about it, but it did help block out sunlight that would keep him awake during the day. I suppose he could've worn a sleep mask, but he wasn't enthusiastic about that idea. We also placed a fan in the room to function as white noise that helped block out the sounds of traffic and dogs.

Dr. John Conlin, police psychologist, offers these additional suggestions for being sleep healthy during shift work.

1. Aim for one, uninterrupted 8-hour sleep period daily.
2. Keep sleeping environment dark and noise free.
3. Maintain same sleep-wake schedule on off days. (If you are rotating shifts, pick a schedule that gets you up two hours before your shift.)
4. Take melatonin supplement 2 to 3 hours before desired sleep onset. (A hormone that induces sleep)
   
5. A 20 to 60 minute nap prior to the start of night shifts for those who wake up 8 or more hours before their shift.
6. Replace a meal break with a 20 minute nap during a night shift.
7. Increase the available light inside the station or work area during night shifts. (Available light should exceed a minimum of 1000 Lux. Additional lighting is recommended during night shifts).
   
8. Balance your use of caffeine. Save it for the difficult 0300 hour time period. Eliminate caffeine several hours before desired sleep onset. "If you drink it only when you need it to stay awake you'll require less than the officer who drinks it all the time" (PoliceOne.com).
   
9. Avoid sedative hypnotic sleep agents/sleeping pills.
10. Only use your bed for sleep and physical intimacy. Avoid watching TV, surfing the Internet, or eating food.

"If you do not fall asleep within 20 minutes or so; get up and do something until you feel you can fall back to sleep" (Drjohnconlin.blogspot.com). The other big factor in adjusting to shift work is diet.

If you work shifts, you really need to plan your meals so you don't end up eating junk on the job. "Working shifts means that the body requires energy at times that it expects to be resting, which makes it more difficult for us to be able to digest food at night and to produce energy at the right time for night work" Policeassn.org.nz.

If you sleep in the morning/daytime, the meal before bed should be rich in carbohydrates (cereal, toast, fruit, rice). After you sleep, you should eat your main meal with a combination of protein and carbohydrates. Examples include lean meats like chicken and fish, pasta, vegetables, dairy products, eggs, yogurt, breakfast drinks or fruit smoothies, and fresh fruit.

During a night shift, avoid high-fat foods, but don't skip meals. Instead, eat frequent, small snacks with protein or fruit to stay alert. Try these healthy choices: nuts, dried fruit, lean meat, wholegrain bread sandwiches, breakfast drinks or fruit smoothies, lowfat yogurt, beans, wholegrain toast, eggs, fresh fruit, and plenty of water.

Adapting to shift work requires healthy sleep patterns and eating habits. "If you're tired your brain starts telling your body to eat--especially foods that are starchy, sweet and high in carbohydrates" (Policeassn.org.nz). These are the wrong foods to eat if you want to avoid feeling fatigue. Coffee and donuts will never replace a good eight hours of sleep.

Resources:

Conlin, John, "10 Steps to Staying Sleep Healthy During Rotating Shift Work," Blogspot.com, 4-14,2012.
New Zealand Police Association, "What You Can Do to Stop the Shiftwork 'Blues'," Policeassn.org.nz, March 2010.
Wolfe, Duane, "5 Practical Sleep Tips for Shift Workers," PoliceOne.com, 4-29, 2011.

Most municipalities demand police protection around the clock; therefore, shift work is an integral part of law enforcement. Agencies differ in the length, times, and rotation of shifts required of their officers. Some shift work leaves police in a state of fatigue that ultimately endangers them and the public they protect.

Beyond their scheduled shifts, officers may work overtime on cases, court appearances, or special assignments. "Roughly 40 percent of the nation's 861,000 police officers work more than 12 hours a day -- and a similar proportion suffer from a sleep disorder such as insomnia or excessive sleepiness" (APA.org). Sleep disorders and fatigue affect moods, cognitive abilities, physical reflexes, social interactions, and immune systems. That is bad for performing routine functions like driving and high-level decision making, "especially when officers must make decisions about whether to use deadly force -- often in ambiguous, fast-paced, high-risk situations" (APA.org).

Length of Shift

Traditionally, police were scheduled to work five 8-hour shifts per week. Many departments have experimented with four 10-hour shifts or even three 12-hour shifts.

Karen Amendola and her colleagues at the Police Foundation conducted a study of 275 officers working various lengths of shifts over six months. The officers were randomly assigned to work 8-, 10-, or 12-hour shifts.  It turned out that officers working 10-hour shifts tended to get more sleep than those working 8-hour shifts--an average of 30 minutes more per night (NIJ.gov). Those working 10-hour shifts worked the least amount of overtime and also reported having a "higher quality of work life than those on 8-hour shifts" (NIJ.gov).

In contrast, "officers working the 12-hour shifts reported greater levels of sleepiness and lower levels of alertness at work" (NIJ.gov). They worked 3 times as much overtime as those on 10-hour shifts, but less than those working 8-hour shifts.

From limited data, the 12-hour shift seems to be the least conducive to optimum police effectiveness on the job while 10-hour shifts hold possible benefits over the traditional 8-hour system. More research is needed.

Time of Day

Let's compare working a night shift to a more traditional day/evening shift. We may all have 24 hours in a day, but people who work a night shift tend to get less sleep than those who work other schedules. They get stuck between living a nocturnal existence in which they sleep during the day and participating in social circles that gather during the day. Many function on less than four hours of sleep daily. "This could lead to individual health problems, as well as poor work performance" (Jimston Journal).

Even if they get ample sleep, they still face a difficult battle. "People who work the night shift must combat their bodies' natural rest period while trying to remain alert and high functioning" (APA.org). Your body is designed to slow down and cool off at night--not what you want when responding to an emergency call.

Officers may adopt bad eating and drinking habits in an effort to boost their energy levels, but this leads to other health problems.

Alternative Work Patterns

There are three ways that shift work tends to be assigned: dedicated (permanent) shifts; slow rotation; and rapid rotation (Jimston Journal).

Dedicated Shifts: Set work hours make it easier for departments to schedule officers and for officers to adjust their habits to their work hours. Individuals at least have the opportunity to physically adjust to their schedules. However, night shift workers are still less likely to get a full seven to eight hours of sleep. Problems of sleep loss and fatigue are exacerbated when the assigned shift is a 12 hour, overnight shift.

Slow Rotation: Some departments choose to share the burdens and opportunities of working various shifts across the workforce. They may switch shifts slowly over time. It is best for the health of workers that they not have to "change shifts for at least 4-5 weeks at a time. This allows for minimal disruption of the circadian cycle" (Jimston Journal).

Rapid Rotation: Within as little as one week, police may be required to change from afternoon to day to night shift. This is the most disruptive of all patterns, giving individuals no chance to adjust their biological clocks to a set of wake/sleep hours. Animal experiments have shown that rapid rotation left circadian rhythms undetectable. "Body temperature and blood chemistry of these animals were in a constant state of flux" (Jimston Journal). 

It is imperative that departments use either dedicated shifts or a slow rotation. "Research has found that people deprived of normal sleeping patterns can actually fall into microsleep for a few seconds and be unaware that they aren't performing the task before them" (Jimston Journal).

Even if we go with dedicated, 10-hour shifts, some officers must be assigned to the night shift. Next week, I will look into ways to adjust your biological clock and avoid the sleep and health issues often associated with working the night shift.

Resources:

• Pearsall, Beth, "Sleep Disorders, Work Shifts and Officer Wellness," National Institute of Justice, NIJ.gov, 06/2012.
• Price, Michael, "The Risks of Night Work," American Psychological Association, APA.org, 01/2011.
• Violanti, John M., "Shift Work may be Hazardous to Your Health," Jimston Journal, (accessed 12-26-2012)