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Preventing traumatic stress

May 30, 2003
A worker, distraught over his wife's announcement of wanting a divorce, absentmindedly walks into a posted prohibited area and is crushed between stacks of heavy barrels by the unsuspecting forklift operator.

A well-respected senior manager has a severe stroke and is unable to respond to the strong efforts of nearby staff members.

A malfunctioning cherry picker goes up swiftly and the painter at a refinery is immediately struck by the thick pipes directly above him.

In each of these cases, a number of people might suffer from traumatic stress due to the impact of the "critical incident." Plus, the incident has an enormous effect on supervision and management in the work setting. Various factors help determine how affected all of these individuals may be. One of the most important is how we respond to help them.

What is a critical incident?

Workplace violence, natural disasters such as floods or tornadoes, cardiac arrests, suicides, and industrial accidents resulting in death or emergency hospitalization are some examples of critical incidents that greatly affect employees. Many times, these events trigger previously experienced feelings of loss or depression that had not been dealt with at that time in an effort to "move on"with life. Now these individuals are more prone to experiencing symptoms of critical stress.

A different type of trauma in the business world might involve a "business decision." Examples may include suddenly having to stop work on an important research and development project, downsizing and loss of jobs, increased deadlines and competition, and doing more with less.

Managing the stress

Workers distressed by these kinds of incidents might benefit significantly from Critical Incident Stress Management (CISM). CISM is not psychotherapy and does not "cure"people's stress responses. It is, though, a very useful crisis intervention system that reduces the severity and length of time in which they experience symptoms. This obviously helps your employees return to their previous level of functioning much sooner.

Debriefings and defusings are two very important parts of CISM. Sometimes only one of these interventions is needed in response to a particular event.

Defusing is usually conducted within eight hours of a traumatic event. It's primarily aimed at employees more seriously affected and provides an opportunity for quick release of their emotions. Two of the main purposes of defusing: to check for symptoms of critical stress and to decide whether or not a debriefing is needed.

Debriefing is a more extensive, structured group discussion in which employees are given the chance to talk about their involvement in the critical incident, as well as their thoughts and feelings or reactions. It's preferable to conduct debriefings from one to three days after the incident, but they can be effective even up to ten days after the event. The goal: help employees begin to bounce back into their pre-crisis way of life.

Education is provided regarding critical incident stress symptoms and reactions that may be expected from themselves, their co-workers, supervisors, and any family member that has been affected by the incident. Survival techniques are taught and encouraged. Debriefings usually help people see that some of their co-workers are also experiencing the same reactions. This makes them realize that what they are feeling is "normal."

Timing is crucial

It's not enough to simply ask people how they are doing after a traumatic event. Many of them are uncomfortable expressing to management what they are going through and will almost automatically say they are "fine." A delay in identifying those who are experiencing severe critical stress will slow down the process of emotional healing and could affect that of the co-workers around them as well.

Employees typically have a lot of questions about the incident that need to be addressed by management. "How did this happen? Why did this happen? Is the company doing everything it can to protect its workers? Is our workplace safe anymore?"

When a traumatic event occurs, you need to respond to your employees within a short time frame to provide psychological support. Research has shown that trauma may be contained if appropriate help is provided within a certain window of time, thus possibly preventing post traumatic stress disorder (PTSD).

Remember this: if affected employees feel neglected by seeing a lack of response from management acknowledging the impact of a critical stress incident, their loyalty and commitment can be completely drained. And if an employee develops post traumatic stress disorder without having had the benefit of crisis intervention assistance, the healthcare costs to your company will be extensive.

SIDEBAR: How does it feel?

Some common stress symptoms arising from critical incidents are: inability to sleep, loss of appetite, intrusive images or nightmares, increased startle reflex, fatigue, confusion in thinking or decision-making, anger, poor concentration or memory, increased alcohol consumption, and many more.

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