Is the scene safe?

It may seem odd, but my journey to child welfare started in an ambulance. Specifically, in the back of an ambulance where, in my 20s, I worked as a paramedic. This is where I first became interested in things like the effects of trauma exposure, mental health crisis, and the complexity of our care delivery systems. It’s also where I learned the importance of teams, teamwork, and team culture.

Culture has been described in a variety of different ways. But one idea that’s common to all definitions is that culture is what we teach. An organization’s culture lives and breathes in the way it approaches problem solving. It gets passed down as we train (formally and informally) our new professionals.

In Emergency Medical Services (EMS) culture, there is a simple problem solving approach to safety that gets taught and passed down.  EMTs and paramedics are expected to ask “is the scene safe” before attempting a rescue.  The obvious reason for this moment to pause and take stock is that if it’s not safe you and your team will be at risk. If, for example, in the classic example of a noxious gas poisoning you run recklessly to the aid of a group of unconscious citizens without realizing that the room they are in is filled with poisonous gases you will quickly be overcome… and dead.

The genius of scene safety is in how it works on two levels. It is, in fact, a simple memory tool to help you stay safe. But, it’s also a tool used to connect you with your team and instill a sense of shared responsibility. The power of scene safety is that when it’s taught to new first-responders the emphasis is not on how it protects the individual but on how it protects the team. If I rush into the burning building and get myself trapped, I have put my entire team at risk because now I need to be rescued. So, everyone on my team now has the responsibility of rescuing me added to their need to render care to the original victims.

In child welfare, we know our professionals are expected to work in any number of unsafe “scenes.” Entering a poorly lit home, interviewing and engaging with violent men, and driving late into the night are routine events.  But, they also put themselves at risk when they heroically push beyond the limits shared by all us humans.  An equally pervasive but more insidious threat to health and well-being comes from chronic stress, exposure to trauma, and fatigue from long and unpredictable work hours.

We spend a lot of time talking about our professionals' personal safety and “hero behavior” in our system. In our culture heroes are celebrated, but they may actually make our care delivery system less safe.  Our professionals routinely put concern for vulnerable children and families ahead of concern for their personal safety.  And, importantly, they do this without an awareness for how their heroism puts their team at risk. What we find too often is that contrary to a culture that promotes scene safety we have a culture that promotes individual heroism. In fact, we very likely select for it and reward it in the Social Services. 

Professionals in child welfare have limits that have nothing to do with their passion, commitment, or preparation. When we’re tired, stressed, and unfortunately, affected by secondary trauma, we’re less effective. In child welfare, less effectiveness means less safety.

Imagine the power of intentionally questioning the safety of our situation. If I pick up my third severe child abuse case this week, is it safe for me to take a fourth? Is it safe for my team to have me at less than 100%? Is it safe for the child I’m charged to protect if my physical and emotional reserves are stretched beyond the breaking point?

Child welfare should embrace scene safety.  How often do our professionals put themselves at risk? how often are they asked to push beyond their capacity? How often are they asked to make impossible decisions? How often do we - their team - pause to take stock and question if it’s safe?