On affinity group medic trainings

29 Nov 2016 08:03

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Dave P and I taught an Affinity Group Medic (AGM) training in Atlanta as part of the convergence against the Klan last April. Hopefully these reflections will contribute to the larger conversation about trainings that's been happening among street medics over the last year or so.

What is an Affinity Group Medic?

The purpose of an AGM training, as I see it, is to promote the assembly of affinity groups. I would wager that self-organization into affinity groups does more to improve health and political power than any other intervention we make.

The way the training promotes self-organization is by promoting a circumscribed goal. The AGM doesn't attend to the health of strangers; only the health of friends. In order to be useful in an AGM role, she has to assemble an affinity group.

I believe that, unlike street medics, AGM is not a basic scope of practice. It is a role, like comms or police liaison. I teach that the only requirements to be an AGM are the desire to fill that role and the consent of the group. The AGM training may make one a better AGM, but is not a prerequisite for the role.

In an action, an affinity group has a goal. That goal might be to cut a fence, block a road, provide safer space, do clinical support, carry water, do media, be marshals, spiral dance, scout, drop a banner, make lots of noise, cook and serve food, do childcare, do jail support, or whatever. The AGM's job is to help them achieve that goal without injury or illness. It is a before, during, and after role.

What are the core skills?

During a human barometer, people arrange themselves from "strongly agree" to "strongly disagree" in response to the statement "People come to me for help." This identifies natural AGMs, and leads to good conversations, especially between the agreers and the disagreers, about things like referrals and healthy boundaries.

I see the core of the ideal AGM skillset to be SAMPLE and confidentiality. When I taught an AGM training in Ferguson, we spent a lot of time on confidentiality. Unfortunately we breezed by it in Atlanta. This is in contrast to what I see as the core of the street medic skillset: initial assessment and consent. The difference: AGMs care for friends; street medics care for strangers.

SAMPLE helps the AGM start health conversations, build trust, and assess risks faced by group members before the action. If the medic knows group members' allergies, medications, and past pertinent medical history in advance, she can better assist when group members are trying to balance personal needs with group actions. Confidentiality is the ethical response to the trust that affinity group members extend to their medic.

During the post-training evaluation, students said they liked

  • PEARL1 buddy check-in
  • HALTS and "What did you do to take care of yourself today?"/"What do you need to do?"
  • Local resources: alternative to 911 mental health crisis line, peer support warmline, others.

I don't have the eval notes in front of me, but I remember people saying they had concrete situations in which they could immediately apply those assessments and resources.

A student raised how AGMs are prepared for acute first-aid, but recovery is a prolonged process. Some students wanted to improve their skillset for supporting post-action/post-crisis recovery. That stuff won't be included in the 6 or 8 hour AGM training as I teach it, but would be good to flesh out into a good-length training for the populations we serve.

The agenda for the 7-hour training in Atlanta

  • 2 hour health and safety (open to people who don't want to stay for the rest)
  • Affinity groups lecture, SAMPLE practice, and confidentiality discussion
  • Scene assessment and communicating about a scene practice sessions and debriefs
  • First aid lectures, demonstrations, and practice sessions (no initial assessment)
  • Lecture and discussion on local referral options.2

If we'd been able to do it on Thurs, the plan was to support AGMs in teaching the Health and Safety training Friday.

The 2 hour health and safety is is similar to this outline (which I use as a handout): Ferguson health promotion training outline. That whole training is fun and works well. Students do human barometers, paired buddy check-ins, eyeflushes, and a really fun "best-dressed protester" exercise.

The affinity groups lecture, SAMPLE practice, and confidentiality discussion used Sophia's SAMPLE training sheets

The scene assessment and communicating about a scene practice sessions and debriefs used Dick R's style of communicating about a scene: Scene safety training exercise) and a scene awareness exercise led by Dave P that I think I've seen Charles and Leah do in the past. Both exercises were hits.

For the first aid lectures, demonstrations, and practice sessions we worked through Colorado Street Medics' 2010 first aid zine,3 which all students got a copy of. We dumped fake blood on each other, students practiced gloving up, using roller gauze, walking assist, putting each other in shock position, etc. CSM's zine is pretty good because it has pictures. I'd like to start sending students to Where There Is No Doctor's new first aid chapter and Buttaravoli & Stair's Common Simple Emergencies on their phones during future trainings.4 I feel like otherwise they'll forget to look at it when they need it.5

There were no activities during the lecture and discussion on local referral options.

Four final comments

1. We should have integrated SAMPLE more deeply into scene assessment (give people cards with AMPs of their fictional affinity group before going outside for the exercise), first aid, and referral options. As it was we taught SAMPLE then never referred back to it.

2. Street medic trainings (because of the centrality of consent) provide lots of opportunity for practicing communication. AGMs don't need that much practice, but could use some. It should be adapted to mimic communication with someone the AGM knows.

3. We taught privacy circle but didn't emphasize how intensely a crowd mobs a casualty; wanting to help or protect the casualty, or just curious. I remembered this crowd behavior when, during the anti-Klan action, a person with a breathing difficulty was mobbed by a crowd (including two street medics who didn't recognize that a nurse was already on scene). The paramedics arrived promptly with oxygen, but that poor person needed space.

4. Scenarios adapted for caring for known friends instead of randos would be great.

Hope these reflections help someone :)

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