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Archive for August, 2015

Administrators’ Immediate Action Steps Following a Critical Incident

August 14th, 2015

Q: I wanted to check in with you to ask if you have any ideas on where I can find some basic beginning steps on how administrators can act the first moments after a critical incident. Not about the debriefing, not the referrals to EAP. Rather what steps should be taken in the first 1-30 minutes of an event?

After talking with someone who was recently assaulted by a client, it really hit me that so many administrators just don’t know what to do. So they avoid the situation – they freeze rather than act. I don’t think this is done on purpose; it’s like a reflex, automatic. I feel if we can begin sharing ideas with all department heads on how to even respond to the incident just after it occurred (for example, don’t have them continue to see more clients on that day!! Duh! But so many do to make sure the job is getting done), we can begin to help show the importance of administration being involved in the addressing of the problems.

A: Thank you for your commitment as an administrator to keep moving the corrections profession forward by looking for effective ways to respond to potentially traumatized staff. Appropriate supportive responses can reduce the toxic effects of occupational hazards in corrections work, such as a staff assault.

Please note that this response only addresses ways to respond to the assaulted staff member, not the need to lock down units, arrest clients, take offenders to segregation, etc.

In a nutshell, the focus immediately after the incident needs to be on ensuring staff safety, tending to staff’s urgent needs, and beginning the process of staff re-stabilization.

The first step is a medical examination to assess the employee’s condition, and to provide them with immediate medical care as needed. This is to be followed by access to higher-level emergency medical treatment as their condition requires, which may include transportation to a hospital by ambulance. In that case, administrators should visit the staff member at the hospital as soon as their condition allows, to offer them emotional and moral support.

After a medical checkup, and if no further medical care is recommended or is deemed to be warranted, the next step consists of the removal of the assaulted employee from the area of the incident. This is done in order to secure their physical safety, to reduce the likelihood of their exposure to possible ongoing threat, and to reduce the risk of them being re-victimized. That may mean getting them away from all offenders/clients, and also from trauma reminders (such as the location, certain items, or individuals.) There will be time to “get back on the horse” again later. Immedi-ately after the event, the person needs to be able to begin calming down. Distancing themselves from threats and reminders—the perception of danger—is one way to do that.

Make it possible for the assaulted staff member to change clothes, and get cleaned up ASAP, if they have been soiled (such as by having body fluids thrown on them), or if their clothes have been torn. That will reduce their exposure to triggers (incident reminders) and get them to feel like they are regaining their dignity. Indeed, some facilities stock care packages for staff that have been assaulted. These may include a pair of sweats, socks, a shirt, a towel, shampoo, toothpaste, and a token for a snack or beverage from a vending machine.

Have the assaulted staff member come to your office or go where they are and spend some time with them one-on-one. Offer them water to drink. Sit down with them in an area where you can close the door. If they come to your office, get around from behind your desk and sit in a chair next to them. Make eye contact. Express to them your caring about what they just went through, and your concern about their welfare. Absolutely do not drill them about details of the incident. Just listen. Listen empathically—that is, listen with a frame of mind of putting yourself in their shoes, trying to understand what the experience was like for them. If they froze, remind them that this is an involuntary and unpredictable brain-based reaction. Absolutely do not reprimand them for it. Point out what they did well, and what went well overall.

The employee, pumped full of adrenaline, may be angry at this point, perhaps blaming themselves and/or others, including administrators. Give them space to vent. Listen, acknowledge, and validate the horror of what they’ve just experienced. Suggest that they most likely did the best they could at the time, under the circumstances, and that, like in every situation, lessons will be learned from this incident as well. Reassure them that their immediate reactions are understandable and to be expected/normal.

Absolutely refrain from arguing with the employee, or threatening them with discipline for being disrespectful. Do not tell them to correct their attitude or watch what they are saying if they want to keep their job. The general stance of administrators needs to be supportive—not judgmental, critical, angry or blaming. At this point self-control needs to be exercised by administrators if their own buttons are getting pushed by the assaulted staff’s angry reactions.

I personally know of one such a situation that was handled in an exemplary fashion. The assaulted CO went “off” on his warden who met with him after the medical check. The latter, having come up through the ranks, and having experienced being assaulted himself, remained calm and quiet during the employee’s tirade. When the CO finally ran out of words, the warden gently expressed to him his understanding of the CO’s state of mind, and verbalized to him his sincere compassion for what he’d just been through. In turn, the CO took it all in, waited for a few moments, and then apologized for coming unhinged.

The next step of “being there” for the assaulted employee is tapping into their support network by having their friends at the facility be relieved of their duties so they can come to express their support to the staff member. In some cases, staff may not be comfortable talking extensively to an administrator, but they will talk to a friend. If you have trained peer supporters, call on them to come by as well and talk to the employee.

Ask the assaulted staff member if they want to make a phone call to family members and/or significant others in their community, and make it possible for them to do so privately.
If the assaulted staff member wants to make a round of the office or unit to show the clients/offenders that they “are keeping it together” and have their head up in spite of the assault, honor them by accompanying them in doing so.

Additionally, as part of the support you offer, have the assaulted staff member be checked confidentially by a mental health provider at the facility, or allow them access to a room where they can shut the door and call your EAP hotline. These professionals can check for safety concerns, assess the employee’s current functioning level and frame of mind, remind the staff member that acute reactions after an incident are normal, and tell them what signs might indicate that additional care/treatment is needed. They can give/email/fax them handouts with relaxation exercises and other coping strategies, and remind them to avoid using substances to cope, as these can destabilize their mood further.

Relieve the assaulted staff member of their duties for that day. Ask them if they’d like to take a day off of work. If they decline that, allow them to spend time as needed with peer supporters and/or mental health providers. If they insist on working, assign them to an area where they are likely to have minimal client/offender contact. When they come back to work, do another round of the unit/office with them, to visibly express your support of them.

If they are asked to write up their incident report immediately after it happens, keep in mind that the reported order of events may be jumbled or unclear. (Remembering details of a traumatic incident is a subject that will be addressed in one of the webinars to be offered through Desert Waters’ Resilience Academy.) Therefore, this initial report should be regarded as part 1 or incomplete, with the understanding that material may be added a few days later. This may be controversial to some, primarily for legal reasons, yet we are dealing with realities of the neurobiology of human memory following exposure to a traumatic event. The brain is not a video camera.

When it is time for the assaulted staff member to leave the office/facility, arrange for someone to drive them home, and for another employee to drive their vehicle to their house.

And remember, it may not only be the assaulted staff member who needs your immediate attention. Those who witnessed the incident and those who responded are also likely to require your expressions of caring, consideration, validation, and support.

Note: Dr. Susan Jones was consulted on this piece, and she offered several comments and suggestions which helped shape this article.