Stress Mitigation for Volunteer Employee Emergency Workers
- Published on Sunday, 28 October 2007 23:05
Many corporations are adopting 'stand-alone' emergency response and recovery operations because experience has taught us that professional rescue services (fire department, EMS) may not be able to respond to all sites of need in the event of a regional disaster.
Corporate programs that recruit and train employees in emergency response and recovery activities can benefit from recent research findings. These findings elucidate measures which protect their volunteer response and recovery personnel from stress-related injury during emergency work.
A common misconception is that pre-existing individual variables determine much of the actual capabilities of employees who volunteer for such tasks. Some people believe that there are those of us who panic under stressful circumstances, or that there are those of us who keep a cool head; this personality characteristic is a critical predictor of emergency performance.
Some believe that certain individuals are prone to injury because they lack a kind of stress-resistant hardiness; crisis consultants have even recommended to company managers that they identify such individuals immediately and remove them from harm's way.
The research on earliest reactions to catastrophic events contradicts commonly-held views such as these.
Cheryl Koopman, Catherine Classen, and David Spiegel,. pioneers of the research basis for the inclusion of a new diagnostic category of Acute Stress Disorder for mental health professionals to assess individuals affected by stress during the earliest hours following a traumatic event, describe accounts of severaldisasters, including the 1981 Kansas City Hyatt Regency Hotel skywalk collapse, the 1983 Ash Wednesday bushfires in Australia, the 1987 London underground railway fire, and the 1988 Madison, Florida tornado.
According to Koopman, the people who experienced these horrific circumstances did not react with panic. In fact, the survivors more often appeared stunned, bewildered, overly polite, and deferential. In the immediate aftermath, they seemed less talkative, less emotional, and less reactive than usual. She concluded that this set of reactions, referred to as dissociation, is the most common, first reaction to an assaultive environmental event.
This finding is supported by research on the earliest reactions of survivors of the Loma Prieta, California earthquake and the Oakland/Berkeley firestorms. In these disasters researchers discovered that the greater the exposure to damage and loss, the greater the degree of dissociation, a defense mechanism which protects us from the emotions associated with extraordinary threat.
In fact, those persons who experienced greater dissociation were under-responsive to the risks. Instead, they actively engaged in more dangerous behavior. In the case of the Oakland/Berkeley firestorms, these individuals crossed police barricades to get closer to the fire, or refused to evacuate, or refused to water down the roofs of their homes to mitigate the fire's spread.
A renown Harvard psychiatrist, Bessel van der Kolk, has researched the biochemical correlates of psychological trauma. His revolutionary discovery has shed light on why people react as they do when besieged by fright. He found that when terror is acute, brain biology changes, the sensory organs become so overwhelmed and over-stimulated that they shut down.
Incoming information cannot make it through the usual channels to the higher cognitive functions of synthesis and integration. Conscious and verbal memory become suspended. The traumatic event becomes stored in somatic memory as visual snapshots or physical sensations, and is recalled through 'flashbacks.'
Van der Kolk has also uncovered the work of earlier scientists who have studied attachment behavior in primates under conditions of threat. The consensus of this research is that at humans, like other primates, have evolutionarily-determined attachment schema that predispose them to respond automatically to others in need of rescue. In other words, people will do everything they can to help their neighbor in an emergency, and never stop to question why. In circumstances of threat, we are more likely to help one another than to run away in panic, even if it means risk of injury.
This response was evident in the nurse who lost her life in an attempt to rescue survivors of the Oklahoma City bombing. She rushed in to save others without the proper equipment and became another casualty.
Psychological hardiness does not protect any one of us in the event of an extraordinarily stressful event. If the conditions are severe enough, the reaction we will suffer is a dangerous closing-off of our ability to evaluate our circumstances correctly and to act in ways to protect ourselves. The second most natural reaction will be to respond automatically to others in need of rescue, in possibly reckless ways.
There are, however, systemic protections which can be used to mitigate and positively channel these reactions.
It is important that managers recognize that employees, in the event of a disaster, will experience biochemical changes that can affect cognitive evaluation and will cause them to experience an inborn urge to respond to others in need, whether they are trained as emergency responders or not.
Managers can protect the company's workforce by designing their emergency operations system to take human reactions into account. It is the emergency operations' system design that will protect individuals from harm, regardless of the personality differences of the individuals involved.
An emergency organization which utilizes the most basic natural human reactions in their favor can mitigate psychological injury to employees and can channel employees' desires to help in the recovery process.
The following are critical mitigations for the direction and protection of human resources in the event of a disaster:
1) Structure emergency operations according to clear-cut tasks and relies. Although flexibility in assignment of tasks and roles is important, clarifying and delimiting responsibilities protects emergency personnel from the natural urge to do everything.
2) Train volunteer response teams in how to provide psychological first aid. There is a 'window of opportunity' immediately after the event in which responders trained in a proactive, contact approach can encourage employees to verbalize their reactions and direct them to safety. This helps employees overcome the cognitive paralysis (or dissociation) associated with a traumatic event. This also prevents the development of acute stress and posttraumatic disorders.
3) Train response and recovery team leaders and managers in a communications chain of command for first-aid debriefing. Communication models for gathering information while simultaneously de-escalating stress reactions can be taught and practiced. Everyone involved in the emergency operations can be connected through this pre-planned network; the corporation's executive leadership will have a pulse check on reactions of the workforce as well as all the information they will need to make decisions about resource allocation.
4) Train EOC managers in crisis management functions that protect the company's functional relationships. More than at any other time, employees, customers, suppliers, media and the community will look to the company for leadership in how to partner for recovery from a disaster which affects an entire region. Public relations are successful if the crisis management organization has integrity and viability.
Dr. Killorin Riddell works for Trauma Intervention Specialists a Beverly Hills consulting firm that specializes in Crisis Management.