Workplace safety - coping with a critical incident

A critical incident is any event or series of events that is sudden, overwhelming, threatening or protracted. This may be an assault, threats, severe injury, death, fire or a bomb threat.

Critical incident stress (CIS) management aims to help workers deal with the normal physical and emotional reactions that may result from involvement in or exposure to critical incidents in the workplace.

Exposure to a critical incident can lead to a stress response

A critical incident can be overwhelming and threatening and may lead to distress. This can be harmful when a person has demands and expectations that are out of keeping with their needs, abilities, skills and coping strategies. Distress can result in a decline in performance and in overall levels of wellbeing.

Involvement in, or exposure to, abnormal workplace incidents can lead a person to experience distress. It is normal to react emotionally to a critical incident. This may involve recurrent thoughts about the event, feeling uneasy or anxious, mood changes, restlessness, feeling tired and disturbed sleep.

Critical incident stress management

Critical incident stress management provides support to assist the recovery of normal individuals experiencing normal distress following exposure to abnormal events. It is based on a series of comprehensive and confidential strategies that aim to minimise any adverse emotional reaction the person may have.

Critical incident stress management strategies in the workplace include:

• Preparing workers for a possible critical incident in the workplace
• Demobilisation (rest, information and time out – RIT)
• Defusing (immediate small group support)
• Debriefing (powerful event group support)
• One-on-one support sessions
• Follow-up support.

Preparing workers for a possible critical incident

Strategies include:

• Develop positive working relationships (employee/supervisor, between employees).
• Develop workers’ morale in the workplace.
• Establish contacts with suitably trained internal or external debriefers.
• Provide training for workers in the provision of Psychological First Aid (PFA)
• Assess the work environment for the potential for critical incidents.
• In consultation with workers, develop procedures for responding to identified critical incidents.
• Make sure that workers are familiar with these procedures.

Demobilisation

Critical incidents may trigger a wide range of physical and psychological symptoms, including increased heart rate, high blood pressure and anxiety. Demobilisation (rest, information and time out) is a way of calming workers following a critical incident and ensuring that their immediate needs are met. A supervisor or manager who was not involved in the incident, or affected by it, carries out the demobilisation.

A demobilisation takes place before the end of a shift or before those involved in the incident disperse. Strategies include:

• Convene a meeting for those involved as soon as possible.
• Summarise the incident and clarify uncertainties.
• Invite questions and discuss issues of concern.
• Show care and support, including the provision of Psychological First Aid.
• Draw up a plan of action, taking into account the needs of the workers.
• Make short-term arrangements for work responsibilities.
• Offer information on defusing and debriefing.

Defusing

Defusing (immediate small group support) is conducted by a trained staff member and is designed to bring the experience of the incident to a conclusion and provide immediate personal support. The aim is to stabilise the responses of workers involved in the incident and provide an opportunity for them to express any immediate concerns. This step should take place within 12 hours of the incident.

Strategies include:

• Review the event.
• Clarify workers’ questions and concerns.
• Encourage workers to talk about what happened.
• Identify current needs.
• Offer workers advice, information and handouts on referrals and support agencies.
• Arrange debriefing and follow-up sessions to provide additional information about the event when available.

Debriefing

Debriefing (powerful event group support) is usually carried out within three to seven days of the critical incident, when workers have had enough time to take in the experience. Debriefing is not counselling. It is a structured voluntary discussion aimed at putting an abnormal event into perspective. It offers workers clarity about the critical incident they have experienced and assists them to establish a process for recovery.

Trained debriefers help the workers to explore and understand a range of issues, including:

• The sequence of events
• The causes and consequences
• Each person’s experience
• Any memories triggered by the incident
• Normal psychological reactions to critical incidents
• Methods to manage emotional responses resulting from a critical incident.

Follow-up support

Stress responses can develop over time and follow-up support may be required by some workers or groups. Perspectives may change after the first debriefing session and additional sessions may need to focus on new aspects of the incident or stress reactions.

It is also common for critical incidents to bring up a range of personal issues for workers. Short-term counselling may be required to prevent further difficulties. Where counselling sessions identify other or more complex needs, it may be important to refer a worker to an appropriate service for additional support.

Where to get help

• Your supervisor or manager
• Human resources manager or officer
• Occupational health and safety officer
• Health and safety representative
• Your GP (doctor)