The First, First Responder: The Neglected Needs and Unique Challenges of Work as a 9-1-1 Telecommunicator

Introduction

The health and safety of the general public depends largely on the efficiency and proficiency of emergency responders. From securing a dangerous scene, to delivering a baby, to saving a life while an injured person is rushed to the emergency department, the performance of emergency responders can make the difference between life and death. What is often obscured in the emergency response chain is the vital role played by 9-1-1 telecommunicators (TCs). As the first, first responder, 9-1-1 TCs answer calls placed by individuals who are often in extreme distress or in significant peril. The caller may be hysterical or may be suffering from an injury that makes it difficult to provide critical information to the 9-1-1 TC, such as location or nature of their injuries. The 9-1-1 TC must calm distressed callers while simultaneously securing the information needed to dispatch field responders. Field responders are provided crucial information about the caller and scene so that they can be prepared upon arrival. In some instances, the 9-1-1 TC may hear a caller’s final breaths while they wait for field responders to arrive.

While many calls of an erroneous nature are made to 9-1-1 (e.g., asking what the time is), a 9-1-1 TC may handle multiple calls across a single shift in which there is a major medical emergency, including emergencies that involve children or possibly their own family members or friends. Over the course of a year, a 9-1-1 TC may be exposed to thousands of calls in which they are confronted with trauma and the suffering of others. The cumulative effects of such recurrent exposure to duty-related trauma enhances risk for a host of adverse psychological outcomes, including posttraumatic stress disorder (PTSD), depression, alcohol or substance abuse, and anxiety. In addition, the recurrent exposure may wear down the physical health of 9-1-1 TCs over time, leading to physical health complaints, obesity, and disease. Though limited, research on the psychological and physical health of 9-1-1 TCs will be reviewed in the next section.

While recurrent exposure to duty-related trauma enhances risk for a host of adverse outcomes, additional factors associated with the 9-1-1 work environment also enhance risk for stress-based pathology. Greater detail regarding the stressors associated with the 9-1-1 work environment are covered in this chapter. Briefly, 9-1-1 TCs are masters of multi-tasking, often having to integrate information from multiple screens in order to dispatch appropriate personnel while also receiving and recording information from callers. As a 24/7 industry, 9-1-1 TCs often encounter mandatory overtime if the call center is understaffed (which is a common occurrence in the industry) or if a colleague calls in sick. Shifts are often long and may be on a swing schedule. All of these factors can lead to exhaustion and difficulty achieving balance between the duties of work and home. Misconceptions among the general public regarding the work of 9-1-1 TCs and encountering the abuses of the 9-1-1 system by phony callers add to the stress and frustrations of work in the 9-1-1 industry.

In addition to these environmental factors, the nature of 9-1-1 calls amplifies the stress burden. Across many contexts, research suggests that the following four factors are among the strongest predictors of stress: novelty, lack of control, lack of predictability, and social evaluation. That is, events that present with novel features not previously encountered, events over which a person has limited control, events that are unpredictable, and events in which a person might be negatively evaluated or judged by others are often associated with the highest levels of stress. For 9-1-1 TCs, these factors are essentially a job description. This is especially true following the Freedom of Information Act (FOIA) in which a recording of a 9-1-1 call can be requested by anyone in the general public at any time. To ensure adequate performance, 9-1-1 centers emphasize the importance of quality assurance, which may be beneficial to the general public, but results in TCs being under the constant scrutiny of call center managers.