Support following a serious incident By Keri Fickling
They say things happen when you least expect them and never more can that be true when you are called to attend an incident with a tragic ending.
10 hours into a busy night shift and the body is drained, the mind has wondered to the clock and how long it is until finish time, when the radio bleeps into life, delivering the news that I am to attend a child not breathing……........
I feel sick, my heart begins to race and I can only describe what I feel as a tremor from my stomach rapidly reverberates through my entire body. Yet I still need to get my legs to move towards the ambulance, follow the instructions on the sat nav to assist my colleague who is driving and then look to identify the property. The physical reaction my body is expressing at this point is the fight or flight response, it is heightened to what is happening and what I am about to face. Part of me wants to run and hide, to not go into what I think is behind that door. Then the other part of me wants to go and help, the reason I do the job I do, but that doesn’t mean I’m not anxious, scared or effected by the things I see and hear…. What I was about to face that day was one of the saddest, heart-breaking incidents I have ever been to and something that will live with me always.
It brings about feelings of guilt feeling upset and effected by an incident when it is not your family or people you know, but regardless, we are talking about tiny human life and I think it would be more worrying if an incident like this didn’t affect you in some way. It’s how we manage those feelings and help those around us with similar feelings.
For me as a Paramedic at the scene, seeing what I see, hearing what I hear, I have the information I need to make informed decisions about treatment for patients and I also have face to face contact with families and loved ones when breaking bad news or broaching difficult subjects. Whilst this is at times the most taxing and challenging part of the job, I cannot begin to imagine how difficult a job my colleagues in the control room have; to hear what they hear, only have the information of the caller, to hear screams and cries but not see what’s happening. I’m sorry to the call taker who was on the phone when I arrived that morning and I simply said we are here and put the phone down, I appreciate the not knowing what happened next must be hard and to rely on that code I input on the data terminal is not how you should find out the outcome. I should have called you back and thanked you for the support you gave and answered your questions.
Unfortunately, in these situations when we have completed our clinical work we often find ourselves being dragged around by the procedures to follow and do not give ourselves time to think about looking after our health and well-being along the way.
Less than one week after I attended this incident, my colleagues attended a second incident that way just as sad and tragic as the one I attended. How can that be fair, for such a small location, 2 such sad incidents in such a short spell of time. I knew straight away on my next night shift that this was affecting me more than I realised as I felt on edge all night, every time the radio went I was seeking out the age of the patient before anything else, when a call came in with a name and no other information I convinced myself there was a child in trouble and when we got stood down I wanted to argue and say no we need to go we need to check, but the rational side of my brain knew this was the impact of my previous shift. Needless to say after a diversion call to 111 we got the call back and the patient was a lovely lady who really lifted my spirits at 3am. Despite the fact she was facing terminal illness, her attitude and approach to life even in this weird world we currently live in was amazing and it’s like she re-set my inner balance.
I think what I learnt from speaking to colleagues within SAS and other services involved in these cases is that we all manage these things differently but we also need to ensure everyone feels supported in the right way.
So I guess my advice to staff, front line and ACC, managers and support staff after a difficult job;
Give people time: A cup of tea and a chat after these jobs is so important, to get the initial adrenaline out of the system, allow the brain to start processing. I guess the official term would be Hot debrief, but for me these are always better with Hot Tea!
Realise that not everyone will want to talk straight away (and not everyone will want to talk)
ACC staff need support and follow up for tragic jobs just as much as front line staff
A cold debrief after some time has passed with a supportive colleague is really important and can really help process the incident especially if significant interventions have been carried out.
Some people use dark humour to cope, they do not mean to be insensitive it is a coping mechanism
If your line manager’s phones and asks if your OK, it’s OK to say you are not
If you phone a crew and they say they are not OK, its Ok for you not to know what to say or do, offer a listening ear and ask what they need from you at that time.
Operationally – Whilst we are all under pressure, it is better to lose a crew or call taker for half a shift than it is to have them off sick for a few weeks. If people say they need time, don’t pressure them to reset before they are ready.
Offer additional support or intervention in a considerate and sensitive way
We have become much more aware of asking for help over recent months, especially with all things covid related, but still we see so many of our colleagues struggling, so above anything I would ask you all to keep an eye on your colleagues, you know them best, some of you probably spend more time with your crew mate a week than you do your spouse, so check in with them, buy them a coffee and provide opportunity for discussion without pressure.
Lifelines Scotland have launched some great resources for all emergency services, their friends and family check it out at: https://www.lifelines.scot/
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