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A traumatic incident is any event that can be considered to be outside of an individual's usual experience and causes physical, emotional or psychological harm.

People all respond to traumatic incidents in different ways, and the feelings they experience are perfectly normal – it is the nature of the stressful incident that is not normal. Predicting those of us that may be more vulnerable to experiencing trauma is difficult, as the evidence is not conclusive and because our psychology is complex and, in many ways, different in each of us. That said, we know that your staff may be more vulnerable if they have experienced a clear and diagnosable trauma in the past, or equally if they have never experienced any major hardship. People may also be more vulnerable if they:

  • are currently experiencing a major depressive episode or an acute anxiety disorder (OCD, Health Anxiety or PTSD)
  • if they have very high personal standards and if they heavily rely on feeling in control or struggle to tolerate strong emotions.

However, having these experiences or characteristics is no guarantee that they will be vulnerable in the future, so there is no need to become overly concerned. The most useful approach is to be pragmatic and aware of both your staff’s vulnerabilities, needs and also the protective resources available to them - for example, being socially isolated is a greater risk factor than past experience of trauma.

It is important to support people who gone through a traumatic experience and to recognise that they might need to talk through what has happened. Peoples’ emotional responses to a traumatic incident can centre on challenges to their core beliefs about themselves or how they see the world. It is also important to remember that other factors in their life may contribute to their vulnerability to any traumatic incident they are involved with, and its impact on them.

Reactions to a critical incident are likely to be worse if;

  • There has been a death
  • There is a feeling of wanting to have done more
  • There is little or no perceived support from colleagues, family or friends
  • The incident follows closely on top of other stress creating events in people’s lives

Reactions may include:

  • Sadness especially if there have been deaths, injuries or losses of every kind
  • Guilt for not having been able to do more
  • Anger at what has happened/whatever caused it/the injustice of it all
  • Shame for not having reacted as they would have wished or for having been seen as helpless, emotional or needing others
  • Fear that they may break down or lose control or of a similar event happening again
  • Memories or feelings of loss or of concern for other people in their lives or of past or similar events
  • Disappointment which can alternate with hope.

It is normal for people to experience a range of distressing symptoms for up to 4 weeks after an untoward experience. These may include, nightmares, poor sleep, hyper vigilance (being easy to startle), increased emotionality and tearfulness, reliving and or replaying the experience in their mind, experiencing intrusions of the experience (visual memories, smell, sounds), and having a strong desire to avoid things related to the experience that they didn’t beforehand. If your staff continue to experience these symptoms after 4 weeks, they need to seek help.

What you can do to support staff following a traumatic incident

To support a person who has been exposed to traumatic events it may be useful to employ the following steps:

  • Offer your assistance and a listening ear even if they have not asked for help and to reassure them
  • Spend time with a traumatised person
  • Listen carefully and without judgement
  • Offer help to them for everyday routine tasks
  • Allow them some private time
  • Do not take their anger or other feelings personally
  • Do not tell them that they are lucky it was not worse, or ‘you will get over it’, or to pull yourself together - these statements do not console traumatised people.
  • Tell them that you want to understand and assist them.
  • Be gentle and calm with the individual.
  • Understand other people’s cultural diversity

Be aware of any other support is available for staff that you can signpost them to e.g. Occupational Health, Employee Assistant Programmes etc.

It may be worth getting people to consider the impact of being exposed to chronic traumatic stressors - they will need to keep an eye on the wider symptoms including avoidance and emotional numbing behaviour such as alcohol use, risk taking, or other changes to what they would consider normal behaviour.

Useful questions you can use:

  • How do you feel?
  • Do you want to talk about what has happened?
  • Are you alright?

Supporting yourself following a traumatic incident

People working in a healthcare setting can sometimes witness or become involved in a traumatic incident/s and whilst we are all trained to deal with such incidents, they can sometimes affect us. It is important to recognise your reactions to a traumatic incident and to know that you are not alone.

A traumatic incident is any event that can be considered to be outside of an individual's usual experience and causes physical, emotional or psychological harm.

People all respond to traumatic incidents in different ways, and the feelings experience are perfectly normal – it is the nature of the stressful incident that is not normal. Predicting those of us that may be more vulnerable to experiencing trauma is difficult, as the evidence is not conclusive and because our psychology is complex and, in many ways, different in each of us.

Your emotional responses to a traumatic incidents can centre on challenges to your core values and beliefs about yourself and how you see the world and whether there are any other factors in your life that may contribute to your vulnerability in any traumatic incident you are involved with, and therefore its impact on you.

That said we know that you may be more vulnerable if you have experienced a clear and diagnosable trauma in the past, or equally if you have never experienced any major hardship.

You may be more vulnerable if you:

  • are currently experiencing a major depressive episode, an acute anxiety disorder (OCD, Health Anxiety or PTSD)
  • have very high personal standards and if you heavily rely on feeling in control, or if you struggle to tolerate strong emotions.

However, having these experiences or characteristics is no guarantee that you will be vulnerable in the future so there is no need to become overly concerned. The most useful approach is to be pragmatic and aware of both your own vulnerabilities, your needs, and your protective resources - for example being socially isolated is a greater risk factor than past experience of trauma. An active management approach is the best strategy so be aware of what is normal for you, and which symptoms indicate the need to be concerned, and if you are concerned seek help and support.

It is important that we support people who have gone through a traumatic experience and to recognise that they might need to talk through what has happened.

Reactions to a critical incident are likely to be worse if

  • There has been a death.
  • There is a feeling of wanting to have done more.
  • There is little or no perceived support from colleagues, family or friends.
  • The incident follows closely on top of stress creating events in your life.

Reactions may include:

  • Sadness especially if there have been deaths, injuries or losses of every kind
  • Guilt for not having been able to do more
  • Anger at what has happened/whatever caused it/the injustice of it all
  • Shame for not having reacted as they would have wished or for having been seen as helpless, emotional or needing others
  • Fear that they may break down or lose control or of a similar event happening again
  • Memories or feelings of loss or of concern for other people in their lives or of past or similar events
  • Disappointment which can alternate with hope.

Support following a traumatic incident:

Remember that reactions are a natural process and that our bodies and minds will look after themselves - nature will heal if you allow feelings to come out into the open and that concealing feelings can prolong the recovery period.

Your mind's defence mechanism may be to not let you feel the full impact of an incident straight away - sometimes you may be in shock and your feelings will slowly unfold as the days go by. You may feel numb if your feelings are blocked and the event may seem unreal, almost dreamlike, and you may even wonder if it ever happened at all.

It is normal to experience a range of distressing symptoms for up to 4 weeks after an untoward experience. These may include, nightmares, poor sleep, hyper vigilance (being easy to startle), increase emotionality and tearfulness, all the emotions you mention, reliving and or replaying the experience in your mind, experiencing intrusions of the experience (visual memories, smell, sounds), and having a strong desire to avoid things related to the experience that you didn’t beforehand. If you continue to experience these symptoms after 4 weeks you need to seek help.

There are some strategies you can use to help yourself following being involved in a traumatic incident. You may need to consider the impact of being exposed to chronic traumatic stressors, and to keep an eye on the wider symptoms including avoidance and emotional numbing behaviour such as alcohol use, risk taking, or other changes to what they would consider normal behaviour.

Some DOs and DON'Ts of dealing with your feelings:

  • Don't bottle up your feelings, tell someone how you feel.
  • Don't avoid talking about what happened.
  • Don’t isolate yourself, others may have had a similar experience and have wisdom they can share with you
  • Don't be too hard on yourself, give yourself a bit of ‘slack’ whilst you adjust to what has happened.
  • Don't expect the memories to go away immediately, they may be with you for quite some time.
  • Don’t resort to drinking or smoking excessively or risk taking
  • Do express and share your emotions and feelings with someone like your manager.
  • Do accept support that is offered to you including opportunities to share your experience with others - they may have something to offer.
  • Do make time to reflect of your experience but be kind to yourself
  • Do take the time to be with your family and friends.
  • Do try and tell your family, close friends, colleagues and managers how you feel.
  • Do try to keep to your routines as much as possible.
  • Do look after yourself, eat well and exercise
  • Do drive with greater care, your concentration may be impaired.

Where can I find additional help?

  • Your lineā€manager, your colleagues or someone else you trust in your department or organisation
  • Occupational Health Department.
  • Welfare and Counselling Services.
  • Your GP.

Additional information that might help you:

It is important at these times to look after yourself. Remember that your reactions are part of a natural process and that your mind is primed to heal itself, and that by letting your feelings out and talking to your manager or a trusted colleagues, you can help to reduce the time it takes to recover.

There is information in this guide on how you can self-care, specifically with regards to your own

  • Physical wellbeing
  • Psychological and emotional wellbeing
  • Social Connectivity