Workplace trauma in healthcare and social assistance

Overview

How this helps your business

Workplace trauma can affect people in different ways, at different times. Frontline staff are not the only people at risk.

In addition to the potentially traumatic incidents that could happen in any workplace, staff in aged care, community support, disability and health roles are often exposed to the suffering of others. This indirect exposure to client/patient trauma can affect staff as they take on the issues they witness. Caring for people during distressing times can lead to compassion fatigue, which can result in emotional withdrawal and decreased empathy. If left untreated, compassion fatigue can turn into vicarious trauma or burnout which has a negative impact on employee health, wellbeing, job satisfaction and productivity. Implementing preventative measures in your workplace is key to managing this risk.

Step 1

Learn more on this topic

Different people find different events traumatic and this means that all staff are at risk of experiencing workplace trauma. For some, a once off event such as the death of a client/patient could trigger a traumatic response. For others, it might result from repeated exposure to distressing events over time (cumulative trauma).

The nature of your field can also mean exposure to the distressing situations clients/patients have experienced, and could result in indirect trauma for your staff, known as vicarious trauma. Both of which can have a negative impact on staff.

Some examples of potentially traumatic events in your industry could include:

• Involvement in or witnessing serious car or transport accidents
• Physical and/or sexual assault by a client/patient
• Exposure to gruesome or graphic injuries
• Death of a client/patient
• Client/patient disclosing distressing accounts of abuse
• Indirect exposure such as reading or hearing about an event e.g. 000 and call centre staff
• Hearing or reading about the assault of a colleague
• Working during a pandemic, such as the outbreak of Novel Coronavirus (COVID-19)

Watch the Phoenix Australia two minute video about trauma.

Potential contributing factors for staff in disability, health, aged care and community support settings include increased time around people experiencing trauma and feeling insufficiently resourced to help. Inadequate supervision and support structures can also impact how staff respond to distressing cases, as can competing demands from the workplace, client/patient, and own needs.

Large scale unexpected events, such as COVID-19, can expose people in your industry to distressing situations they may not have experienced before. As with all experiences of trauma, the outbreak of COVID-19 is likely to affect everyone differently, and as time passes, the way people respond and cope will change too. Watch the Phoenix Australia two minute video about looking after your workforce during COVID-19.

You're not expected to be the counsellor or sole support for your staff. What you can do is put policies and procedures in place for prevention, and early intervention.

Step 2

Consult your staff

It's important to have a broad approach to prevention and support at the workplace because trauma is not limited to those working in client-facing areas. Engage your staff to get a strong sense of what the key issues are that impact on them, and how best to support each other.

A safe workplace is more easily achieved when employers and employees talk to each other about potential problems and work together to find solutions.

There are many ways you can talk with your employees about occupational health and safety:

• through your health and safety representatives
• through your health and safety committees
• having OHS as an agenda item at your regular meetings. These may be 'toolbox talks', production meetings, staff meetings or any way your organisation communicates with each other.
• one-on-one discussions with your managers and employees
• when you casually walk around your workplace with your staff

Step 3

Assess the risk

Now that you've got some insights from your staff about potentially traumatic events in your workplace and their impacts, take a look at your risk assessment and add trauma as a risk to psychological health. Remember to consider different groups of staff and the potential impacts of working with people experiencing trauma (vicarious trauma) and repeated exposure to trauma over time (cumulative trauma).

In the links below, WorkSafe Victoria has outlined detailed information about managing the risk of exposure to COVID-19 in clinical and non-clinical settings in your industry.

Step 4

Manage the risks

To keep your staff (and their clients/patients) safe you need an organisational approach to prevent and manage exposure to trauma.

You may be familiar with the 'Hierarchy of Control' for managing physical risks in your workplace where the most effective action is to eliminate the risk altogether. If this is not practical then the next most effective control is to reduce the risk, for example altering the environment to ensure appropriate placement of clients/patients with specialty behavioural needs in specific wards or sections of your workplace. The least effective controls rely on people changing. For example, attendance at training sessions to cope better with the hazard or the use of personal protective equipment. For mental health risks including exposure to trauma, the same hierarchy of control principles apply.

Choose and implement 2 or 3 strategies that address the highest risks you have identified in your workplace. Here are some suggestions:

• Allocate caseloads that are appropriate and diverse, as agreed by both the employee and employer.
• Be transparent about possible exposure to trauma during recruitment and induction.
• Include assessments of how people react to highly emotional situations in your selection process.
• Support senior leaders to acknowledge the impact of trauma and encourage employees to seek support.
• Implement structured peer support systems, particularly for graduates and new employees. Take a look at the case study (no. 6 in the booklet) from St Vincent’s Hospital in Melbourne.
• Review your EAP (Employee Assistance Program) and check if additional support such as post-trauma psychological first aid is available.
• Provide appropriate supervision for staff.
• Support supervisors to understand workplace trauma and their role in preventing and managing exposure to trauma in their teams. See the tipsheets from Performance Science below to understand how organisations and leaders can support their staff during a pandemic, such as COVID-19.
• Investigate workplace factors that lead up to incidents to prevent similar events from occurring again, and to help staff feel safer knowing preventative action has been taken. See the OVA incident investigation tool below and consider how you could adapt it for different contexts in your workplace.
• In the event of a pandemic, such as COVID-19, provide staff with definitive advice about the relevant pandemic disease, and the risks and control measures in place to address the risks at workplace. See the WorkSafe Victoria guide below for information on managing the OHS risks associated with an infectious disease pandemic.
• Facilitating an early return to work is best practice. Sometimes that could mean changes to workload, such as reduced client load, or rostering shorter shifts and ensuring minimum breaks as well as other adjustments.

Check the Workplace Trauma resource from Workplace Strategies for Mental Health for even more ideas on preventative measures in your workplace.

Make sure staff at all levels of your workplace are aware of the strategies and initiatives that you put in place.

If your workplace frequently provides services to clients/patients who have experienced trauma, consider becoming a trauma-informed workplace - the resources from Blue Knot Foundation provide more information.

Step 5

Review and keep improving

Once you've made a change, you should review it regularly to see whether it's working as well as you'd hoped, and make notes on where you could improve.

This helps you make better decisions and shows you are committed to improving the business.

The list below has some handy tips on how to do this.

It's important to ask your employees their opinion when implementing a new strategy. It also gets your workplace involved and on board, passes on a sense of personal responsibility and collaboration, and allows for continued improvement.

• Ask employees the right questions: are we doing things right, or are there better ways it can be done?
• Have regular conversations with all employees and keep them engaged. If something didn't work, tell them that and get them involved in ways to improve things
• Review regularly - set a date and stick to it
• Look to see if your goal has been achieved. If not, why? Was it a lack of understanding?
• Make a specific person responsible for monitoring and evaluating so they can keep track of how things are changing over time