Hazardous materials, weapons of mass destruction, intraosseous infusions, ultrasounds and global information systems are just a few of the technical knowledge requirements of the fire service. A new firefighter or EMT is unlimited in the potential areas of technical skills in which he or she can specialize. However, for the last few years we have seen a need for a back-to-the-basics approach in training.

What exactly is meant by “basic” skills? Forcible entry, ladders, search and rescue, and patient-packaging are some basics that might come to mind. But perhaps the most important basic skill is communication.

What happened to that skill? EMT textbooks include chapters on the traits of a good EMT, and fire textbooks discuss the firefighter's role in dealing with the public, but most textbooks don't teach what that means. A fire inspector is taught how to professionally approach business owners and investigators are taught how to interrogate witnesses. Shouldn't the lessons of interpersonal communication be taught to everyone in the fire service?

The answer is yes because every member, from the new volunteer in a rural department to the career chief of a metro department, has the potential of being asked a question by any member of the community. And how that question is answered may affect that person's opinion of the fire department forever.

Basics of human need

Consider a fire department that responded to a vehicle accident in which the driver was trapped and critically injured. The firefighter/paramedic attending to the injured driver noticed that when he's physically touching the patient, she relaxes and is more cooperative. When he takes his hands off the patient to set up an IV or retrieve a piece of equipment, she grabs the steering wheel tightly, making her more difficult to treat. As the patient is removed from the car, she screams in pain until she grabs the firefighter's hand, and he notices that she bears the pain quietly as long as he's holding her hand.

Back at the station, the crew discusses their findings and they are astonished at what they have forgotten about their basic training. The medical care they provided was according to protocol, the extrication process was standard operating procedure and the landing zone was set up as the helicopter service had specified. What they had forgotten was a very basic concept — the value of human touch. Despite their best technical skills, the crew did more for the patient by simply holding her hand. The crew sat in silence for a moment and wondered how something so simple could escape them.

Think about another call in a small community where the majority of the fire service members are longtime citizens. In this town, the “everyone knows everyone” concept is alive and strong. On an early-morning EMS call, the shift commander — a native of the community — arrives before the rest of the crew. Half awake, he meets the patient's wife at the door and asks what the problem is. Approaching the patient, he asks for the patient's name. Surprised, the wife replies, “You know him. It's Jack Stevens.” Shocked, the shift commander fully awakens and apologizes, blaming the early hour for the confusion. The patient's wife chuckles and says, “I guess you've done this so long you can do it in your sleep.”

Afterwards, the shift commander contemplates the comment. Can we really do our jobs in our sleep? Considering the amount of time put into training fire service personnel, one might expect so. Is that good or bad? Is it possible to be mentally asleep while physically awake? When that happens, are things being missed? What skills are we truly providing when we are “sleep working”?

Those who can, do

The fire service needs to make room in the training schedule for courses focusing on the most basic skills. Take a look at conference programs from the last few years. Among the classes offered you'll find topics like search and rescue, thermal imaging and investigations. Will a class be found titled, “The Art of Talking to Your Patient” or “Hold the Little Old Lady's Hand While Her House is Burning”? Some classes might include some information, but none truly focuses on basic human needs and nature.

Some departments have a liaison who stays with the family and explains what is happening while their house is burning. Other departments have a staff vehicle to transport the elderly spouse or young child of a patient to the hospital. These departments stand out because they are covering the basics better than others. Whether it's considered good customer service or just being nice, the departments that provide basic assistance are literally holding the hands of those who need it.

Due to budgetary or personnel constraints, it's not possible for every department in the country to provide such services. But every department can afford to make a patient feel more relaxed or to assure a homeowner that everything possible is being done to save his or her house. It doesn't cost anything to hold someone's hand, yet it is a priceless gesture.

Countless articles have been written for and against increasing the amount of responsibility being placed on the fire service. Each time a major disaster happens, the fire service examines and critiques its response and, when needed, resolves to develop better technique of handling such a disaster. Sept. 11 alone created another realm of danger, and the fire service is working diligently to do its part in preparing for the possibility of future attacks. Textbooks are getting thicker and shelves are starting to sag under the weight of the newly added technical manuals. Are any of those books devoted to better communication? Let's hope so.

This is not an attack on advanced and specialized skills. We certainly need them to combat evil as it's presented. Specialized skills will never go away, and perhaps the beauty of the fire service is that we are always learning new things. But let's not forget the basics: human touch and speech.

Talk — and listen — to the people we serve, hold their hands when they need it and look them in the eye. Instead of being able to “sleep-work,” wake up completely and look around. Maybe this is a reminder of the Golden Rule. Then again, maybe that should be considered a skill of its own.

Capt. Krista Wyatt has been with the Lebanon (Ohio) Fire Division for 18 years. She holds an associate's degree in fire and EMS administration, a bachelor's degree in education, and is enrolled in the Executive Fire Officer's Program at the National Fire Academy. She teaches fire and EMS courses at the Warren County Career center and is an instructor in the “Can You Take the Heat?” program at the Ohio Fire Academy.