Emergency Service Worker’s (ESW’s) can experience excitement from saving property from destruction and the ultimate satisfaction of saving a life, but the exhilaration and thrills can come to a holt when ESW’s are faced with an occupational hazard called Critical Incident Stress (CIS).(Mitchell 86).
A critical incident does not have to be a major disaster, but is any situation faced by Emergency Service Worker’s (ESW) that causes them to experience strange reactions which may have the potential to interfere in their performance of duties’s either at the scene or later. Every year there is a high turnover of ESW’s i.e. Police, Ambulance, Fire Brigade and volunteer organisation’s because of CIS.
It would be stupid to believe that ESW’s can walk amongst broken bones, burning bodies’s, handle body part’s, assist with the distraught survivor’s and view terrible destruction without being effected in some way by such graphic exposure. People suffering from this experience physical, emotional and cognitive effects.(Mitchell 86).
CIS reaction’s are incident specific. They may be either Acute or Delayed.(Mitchell 81)
An acute CIS reaction begins while the ESW is engaged with on scene operations. It is an incident that is often very disturbing for ESW’s and may become physically ill as a result of the intense stress level associated with the event.(Bush Fire Services 92). Under particularly stressing circumstances some maybe unable to function properly at the scene or at a later date. This happens for example in the case of a death of a fellow worker in the line of duty and cannot return to his normal duties’s. CIS at times can be so powerful as to cause mental and emotional breakdown in extreme case’s death.(Mitchell 83).
The most common cognitive or mental symptom’s of an acute stress reaction are impaired thinking and decision making, poor concentration and confusion, memory problem’s, flashback’s of previous scene’s and poor attention spans.(Mitchell 81).
The emotional reactions to an acute stress situation include anxiety and fear, grief and depression, feeling lost and abandoned, withdrawal from other’s anger and resentment, feeling numb, shocked and overwhelmed.(Mitchell 81).
The signs and symptoms of a stress reaction may last a few days to as long as a few months and occasionally longer depending on the traumatic event. Occasionally the traumatic event is so painful that professional assistance from a counsellor may be necessary.
Delayed Response Syndrome (DRS) may begin minute’s, hours, days or even week’s and in some circumstance’s year’s after the incident.(Mitchell 81). The ESW’s that are involved in critical incident’s may experience a variety of symptoms which are similar to an acute reaction.
The most common cognitive or mental symptoms are increased anxiety, depression and irritability. These symptoms are characteristic of a condition called Delayed Stress Response Syndrome (DSRS). Its not uncommon for ESW’s to experience sleep Disturbance’s, change’s in eating habits and loss of emotional control.(Mitchell 81). There are 3 main factor’s of DSRS. Intrusive mental image’s such as dream’s, nightmare’s, flashbacks. These maybe exact representations of the event or maybe completely altered by mental image’s developed in the worker’s mind. Fear of repetition of the event. The fear can be fantasised or real, but it remains powerful and often cause’s ESW’s to avoid activities associated with the event.(Mitchell 83). Physical and emotional problems such as fatigue, depression and irritability are often the most common symptoms, but in some case’s it is difficult to associate directly to the emergency event.(Mitchell 86). An example of that would be the Grafton bus crash where a Police officer could not cope with the stress that he experienced from attending the accident and took his own life some time after the incident. This was a delayed reaction, but also a build up of other incident’s that the police officer had attended.
There is a way to help cope with such incident’s and this is called Critical Incident Stress Debriefing (CISD).(Bush Fire Service’s 92). CISD is a process designed to control the impacts of a critical incident, and accelerate recovery, by allowing ESW’s attending such incident’s to discuss their personal reactions in a confidential and supportive environment.(Bush Fire Service’s 92)
The purpose of CISD is to stabilise ESW’s so that they can be returned to their normal duties or allowed to go home. There are a number of ways to deal with CIS but CISD is found to be the most effective.
In Australia and America 86% of all ESW’s suffered from cognitive, physical and emotional symptom’s after exposure to a major incident. Only 50% of those people drop their symptom’s without having counselling and one quarter of the 86% drop their symptom’s over a period of six months up to a year.(Mitchell 86).
People working under intense stress make more mistake’s. Therefore Emergency Service Worker’s working under intense stress get injured more frequently.
Department Of Bush Fire Services.Background To Critical Incident Stress and Critical Incident Stress Debriefing.Discussion Paper,Sydney,1992.