We've called it wellness. We've given it an assigned position on our responses and it's always our “first operational priority.” Some departments even elevated it to branch/section level, but despite all the talk statistics tell us that we are not making progress in becoming healthy and staying safe.

I have a mentor who frequently tells me that “the main thing is to keep the main thing — the main thing.” As chief officers and training managers, the buck starts and stops with us. It is up to us to make health and safety the main thing. First and foremost, get your own house in order. Abraham Lincoln paraphrased St. Matthew when he warned that “a house divided against itself cannot stand.” We need to use all the tools at our disposal to change our daily routines (and the routines of those around us) so that health, safety and wellness are the planned, consistent outcomes of our activities.

I frequently say that training is a tool to change behavior. How can we use what we learned on the drill ground and in managing the training department to have an impact at the greatest point of need in our profession?

Firefighters are forever trying to fix some part of the system. We are always looking to revise some policy or procedure. If we could only get that bureau or division to change its approach, we might have some success. These external players negatively affect our ability to train and improve, but as usual, we deflect the personal responsibility to change our world. It isn't about them, it's about us. The choice to change our world is in our hands.

Health and safety are critical priorities that we have let slide along with other rules, regulations and standards that we used to abide by. With recruit training, we hammer them on the basics. They must perform every evolution by the numbers, with all the details and all the rules, and with no excuses. But we are too busy and too tired to focus on personal wellness.

This is a symptom of complacency that creeps into our lives, and we negatively reinforce it on a regular basis. Every time a fire company dodges the bullet with an unsafe act or omission, they reinforce the inappropriate behavior. This is the same psychological mechanism that tells us an alarm call is a false alarm long before we get up to the panel and check the offending floor. How many times have we done this check without an SCBA? We get away with it so often that we don't see the risk and its detrimental effect on our safety mindset.

Complacency has lowered our guard and turned our focus away from that first operational priority. The same mechanism allows us to stop working out and stop eating right, allowing those daily irritations and pressures to build up until we are candidates for stroke or heart attack.

When we want to evaluate the condition of our trainees, we often conduct a needs assessment. Are you coping with stress well? Has your attitude turned critical and negative? Are you in a complaining and whining mode every day? What about your health? How's your blood pressure? What about your cholesterol? Are you overweight? Do you have digestive difficulties, headache or muscle pain regularly?

Answer those questions for yourself and do it honestly. They are tough, but they will reveal the condition of your body. These questions are our needs assessment and they tell us that we are on track, that we may need some behavior modification or that we are the next disaster waiting to happen. One study states that stress-related illnesses account for 70% of doctor visits.

Very much like personnel accountability, success in health and safety comes from within. It's an attitude first and an operational priority second. It's a critical outcome of everything we do. We can make choices to keep ourselves safe and to get healthy each and every day. Part of this process is finding balance so that we can develop a new mindset about it. All change starts in the mind. We must apply our energies at the leverage point where it will do the most good with the least effort.

Human nature is such that when we decide to do something new, we often go to extremes when implementing it. Firefighters are worse than most. When we take up hiking or fishing, we have every little gadget known to man. We clean out the Bass Pro shop or the shelves at REI, and after our first experience we may use our stuff twice a year. When we decide to clean out the garage, we are ripping out sheetrock by the end of the day — new cabinets, storage loft, finished ceiling, the works.

When we decide to start an exercise program, we buy the top-of-the-line home gym, park the car and ride the bike to work, give up all red meat, start eating rabbit food, and we doom ourselves to failure within three weeks! When we start out too strong, it's easy to burn out quickly. The path to health and safety is a marathon, not a sprint.

The same is true with department health and safety programs. We don't know how to find balance. We have developed accountability systems, integrated PASS devices and safety officers, yet firefighters are still dying from heart attacks and leaving friends and comrades in offensive positions at defensive fires. We eat high-fat diets, pour caffeine into our system by the gallon, allow every little irritation to become stressful, and then we are floored to find out that our resting blood pressure is sky high and we have stress-related ailments from head to toe.

The bottom line in finding balance is incremental, continuous improvement. What are the things that kill firefighters on an annual basis? Stress is the number-one killer in this profession. It seldom happens at the big fire, either. It's the compounding of a hundred little irritations per day, years of unspent adrenalin from answering alarms and poor restorative sleep, all working together to elevate the blood pressure, putting more demand on the heart and vessels.

What are some approaches to incremental, continuous improvement against this threat? The battle begins in the mind. Take inventory of your own talk. Is it positive or negative? Incorporate positive messages in your own behavior modification program. Replace the negatives until the positives sound like your own.

The next step is to check the attitude. For change to be successful and permanent, your attitude has to be right. Develop a mindset that says I choose to respond positively to my circumstances. I will opt out of the “whining at the table club.” I understand that I can only change the things that directly touch me: my attitude, my relationships, my station and my shift. I can't get caught up in the victim mentality that often develops in the firehouse. Be less critical and more encouraging to those people and things that you come in contact with. It really is a choice. You can choose to react positively or negatively.

Deep breathing at least once every hour you are awake has shown promising results. Students who take a deep, cleansing breath every three or four questions during test have measurably better performance.

So how do we approach an exercise program? Easy does it, that's how. Don't try and run a mile because you're excited about getting in shape. Try walking up the stairs instead of taking the elevator several times a day. Walk on a treadmill for 30 minutes three times a week. Take a slow, leisurely, relaxing walk for 40 minutes on your off-duty days. Start a program of full-body stretching both morning and night. Work on your flexibility. You will get more results from these little changes for a long period of time than from over-exertion and burning out. It is not about losing 100 pounds or bench-pressing 260. The goal is continuous, incremental improvement. Add time, distance or resistance as you continue to improve. Think balance.

Diet is where we completely blow it. We make this one more difficult than it has to be, especially for those on shift who have little control over what we eat and with whom we eat. You can get some pretty good results by simply choosing to reduce the bad stuff and increase the good stuff. Don't have dessert every night. Try twice a week. Watch the between-meal choices. Try something like fruits, vegetables and low-fat yogurt. Celery, carrots, apples or pears make a great mid-day or evening snack.

The optimum is diet is low fat, low carbohydrate and high fiber. This is the way we are wired. Again, find balance and avoid extremism. Note that I did not say no fat, no carb and all fiber. Increase your intake of things that are colorful: fruits and vegetables. If you are eating no fruit, try eating some at breakfast and something in the afternoon or evening as a snack. Limit your portions of meat and carbs when you can. Look for whole-wheat and seven-grain breads with low sugar for your fiber choices.

Staying hydrated is another easy thing to incorporate. Keep a tumbler of cold water with you all day long. On the West Coast, we are constantly telling our firefighters to “pre-hydrate” so that when the fire du jour arrives, they can retain much of their body fluid needs. The same is true for general health and stress reduction, as well.

Chief officers are the example to the organization. You are the leadership. You are the mentor whether you want to be or not. You can (and will) set the direction in these areas that have become epidemic in our ranks: the negativity, the complaining, the lack of encouragement, the stress-related symptoms and illnesses. The failure to follow the rules and SOPs can have catastrophic consequences. We can take charge of our own world, and we can set an example for others to follow. That's how we get healthy and that's how we stay safe. It starts with developing a safety and wellness mindset. Avoid the extremes and look for balance through continuous, incremental improvement.

These are what you should be telling your self throughout the day and throughout the shift:

• Slow down.
• Listen.
• Stay hydrated.
• Have a great day.
• Follow the rules.
• Walk.
• Relax.
• Choose to be positive.
• It's not worth it.
• Stay together.
• Get some help.

Read these aloud and try to make them become your thoughts. Post these sayings in your office, car and work areas.

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John Linstrom is a senior associate with Citygate Associates, a municipal consulting practice in Sacramento, Calif. He's an adjunct faculty member for Texas A&M University and the National Fire Academy. Linstrom currently serves as a battalion chief/paramedic in Apple Valley, Calif. He also serves as commander of the DHS/FEMA DMORT for Region IX and has been involved in the national US&R program since 1996.