Important Points About Trauma

• Trauma can be personal or professional
• past experiences can contribute to current reactions
• reactions may seem disproportionate at the time
• behaviours may change, this may be temporary or permanent
• a person may change

Reactions to a Traumatic Event

Reactions to traumatic events vary. It has nothing to do with a persons level of experience in a job, it has more to do with their own experiences as a person. Every person’s reaction is personal to them.

It is not unusual to experience the following after a traumatic event:

• Feelings of anxiety,stress, or feeling overwhelmed
• physical symptoms such as stress, palpitations, trembling or sweating
• psychological symptoms such as aggression, confusion, excitement or panic
• flashbacks or recurrent thoughts
• mood swings
• feelings of guilt
• sleep disturbance and frequent waking
• poor concentration
• feelings of negativity

How do Individuals Deal with Stress?

Following a traumatic event in the workplace individuals can often feel conflicted. ‘It’s not my grief to have’ ‘It’s so much worse for…’ and the perceived need to remain professional in a challenging situation can all conflict with perfectly natural reactions to stressful events.

It is important to recognise that when a traumatic incident occurs everyone reacts differently and people are affected in different ways.

Some common reactions to stress include:

• alcohol excess
• smoking
• disordered eating
• using drugs
• reckless behaviours
• ignoring it!

While individuals feel these may help the situation initially, they are not effective ways of managing stress and can be harmful.

Healthy ways to Deal With Stress – advice for those affected by a traumatic event

• Within first 24-48 hours periods of appropriate physical exercise, alternated with relaxation will alleviate some of the physical symptoms
• Structure your time and keep busy
• Remember you are experiencing  normal reactions. They are temporary and will pass
• Beware of numbing the pain with overuse of alcohol or drugs
• Reach out – people do care
• Spend time with others
• Give yourself permission to feel low for a period of time
• Don’t make big life changes
• Eat well balanced and regular meals
• Help others and be involved as much as possible by checking how they are

Remember:

• Recurring thoughts, dreams and flashbacks are normal
• Don’t try and fight them
• Accept them as a part of the recovery process, however uncomfortable
• They will lessen over time and become less painful

Who can help me?

• Your friends and family can provide valuable support
• Your senior team will be able to help. Most Trusts have support services/counselling that can be accessed through the Occupational Health Service
• Self help tools – https://www.selfhelpservices.org.uk/
• Each other. Sharing experiences with your colleagues means you have support from people who understand

How Can I Support Someone?

If someone you know is experiencing a reaction following a traumatic event there are things you can do to help.

• It is important to remember that front line staff see and experience things that most other people won’t ever see
• front line staff are very good at normalising traumatic events
• listen carefully. Allow the person to to share how they are feeling
• do a welfare check, a quick text or phone call can sometimes make all of the difference
• spend time with the traumatised person outside of the work environment
• offer your assistance and a listening ear
• give them some private time
• remind them these feelings are temporary and will pass

Don’t say:

• ‘’You’re lucky it wasn’t worse’. Traumatised people are not consoled by these statements
• It’s not my fault’- don’t take their anger or other feelings personally
• ‘You need to talk about it’ – forcing people into talking about a traumatic event may well do more harm than good. People’s feelings are their own, and they are entitled to them.

Do say:

• ‘I’m here for you’ – if you say it, mean it
• ‘I won’t judge you’ – it is important that the person can speak freely
• ‘It takes as long as it takes’ – recovery after a traumatic event takes time
• ‘Lets do something nice together’ – think of something the person enjoys doing and make positive plans, and see them though

Guidance for Managers

 

Be aware of what are natural responses to trauma

Reassure staff that what they are experiencing is temporary and natural and it will pass.

Be alert to staff who might be especially vulnerable

Past experience or particularly close involvement with the incident may leave some staff more vulnerable or sensitive to this.

Talk to employees individually, and check if extra support is needed. Be aware of where to signpost staff to within your organisation

Be as present as you can be

People need to spend time talking to each other as they work, and it helps for the manager to join in casually and encourage this by example. This applies not only to those directly involved in the traumatic incident, but also those who witnessed it, had friends or colleagues involved, etc.

Communicate about what is happening to your team

Face-to-face meetings allow managers to gauge body language and reactions to information sharing. Informing staff of what has happened, and of unfolding events, should be carried out sensitively and quickly.

Staff huddles may be helpful before a shift in the morning and before a night shift in the aftermath of a traumatic event. Repeating this over several days ensures you are more likely to include staff on different shift patterns.

It is best to keep such meetings brief, factual and information sharing, practical rather than emotion focused.

Repeat or update information by email, but this should not be a substitute for personal communication.

Do not necessarily send people involved in an incident home

As far as possible, immediate psychological first aid is best provided by being with and sharing experiences with work colleagues and friends, rather than removed to talk to a stranger.

If you feel this is the right decision to make for an individual, check they will not be alone.

Wherever possible, re-establish normal working routines as soon as possible, albeit gently and flexibly, and enable people to talk about what has happened as they work, thereby avoiding any onset of denial.

Do not normally encourage staff to ‘go home for a few days to get over it’

It is preferable to encourage staff to carry out usual routines and be surrounded by the team. Colleagues are a valuable source of support and comfort.

If you feel as a manager individuals would benefit from counselling this should be facilitated within working hours as much as possible, leaving the team and returning to it.

Evidence suggests where possible maintaining normal work patterns and routines to encourage and reinforce a normal identity is far better than encouraging “victim” or “ill” identities by putting someone on sick leave.

This will often require tolerance and support for a period of time when staff may not be as productive as normal, part-time working is better than not working at all. It may be helpful to adjust roles, this should always be discussed with the individual concerned and provides a valuable opportunity to present options and communicate concerns.

Keep in touch with staff not present

In the weeks that follow an incident, GPs may sign people off work on sick leave “to get over it”; occasionally it may be important to do so.

However, line managers should keep in touch by telephone, visiting and/or getting colleagues to visit. Encourage a rapid return to work, even part-time, etc. as being back at work among colleagues is normally the best possible therapy for preventing long-term complications. Refer to local policy, try not to force the issue and consider reasonable adjustments to roles to facilitate recovery. After a recovery period, it is appropriate to gradually re-instate the boundaries of normal working.

Be aware of cultural differences in reactions to shock and grief

 Familiarise yourself with cultural differences in the reaction to a traumatic incident and grief.

These tend to be special situations which tend to bring to the surface fundamental cultural issues. Different cultural and religious attitudes to death, disaster and trauma are one of the areas where this is to be expected. An effective manager will respect a range of responses to traumatic events. Be aware of staff from overseas and look into their support networks outside of the workplace. It may be that there is reduced support, so staying in the workplace environment may be especially important to avoid feelings of isolation. Rearranging periods of leave may be appropriate to allow overseas staff members the opportunity to be with family if that is what they wish to do. Seek guidance from your Human Resources department and refer to Occupational Health as necessary.

Help for Managers

Managers are equally affected by traumatic incidents at work and while you will be thinking about your employees do not forget to look after yourself. Look to your peers and your own line manager for support. You may wish to talk through the ways you are supporting your staff but also as a sounding board for any personal difficulty you may be having following an event.

If needed, the sources of help are also available for you.