“I was a grief mop,” murmurs burnt-out paramedic Frank Pierce in Martin Scorsese’s drama Bringing Out the Dead.
Working long nights, deprived of sleep, confronted by people’s misery and haunted by people he has been powerless to save, Frank is traumatised by his profession – and has few to turn to for help. The film was based on the account of former paramedic Joe Connelly, who wanted to convey the chaos, stress and emotionally-draining experiences that came with the job.
A paramedic is just one example where professionals are regularly confronted by extreme sights or situations.
You can’t cope with something by putting it out of your mind forever. It will probably come back to haunt you, so you need to have a process to deal with it.
According to a recent report conducted by the Health and Safety Executive, the health and social work industries have the highest estimated cases of workplace stress. And previous research by The University of Manchester’s Institute of Science and Technology found a prison officer to be the most stressful job (followed by police officer and social worker) – all careers that can potentially subject employees to physical danger and verbal abuse, and expose them to other people’s feelings of pain.
This stress and psychological trauma can impact on an individual’s wellbeing, sometimes leading to long-term sick leave. It can also have a knock-on effect on performance – potentially putting the lives of patients and service users in danger.
The key to coping with jobs like these is emotional resilience and a strong sense of purpose, says Matt Smeed, a psychologist at wellbeing specialists Robertson Cooper. He says it’s up to leaders to make sure the right training and support mechanisms are built into the job.
“Organisations can do this by equipping managers with techniques to build up the resilience of their teams,” he says. “Managers should be encouraged to get to know their staff and recognise any changes. If the most reliable employee starts turning up late with an unironed shirt and a hangover – things completely out of character – something may be wrong.”
It’s vital for managers to take time to get to know their team in order to spot how they’re affected by their experiences, agrees Alex Davda, a psychologist and resilience expert at Ashridge Business School – especially if they are new.
“You need to be aware of how they are managing the everyday pressure of their new role,” he says. “This information can be used to assess if they have the confidence, ability and energy to deal with more extreme situations. They may need further training, support or mentoring to help them cope with future challenges.”
While it is unrealistic to stop and process a traumatic incident in a hospital ward or on the battlefield, Smeed says it’s important to have a long-term plan to confront something that has been particularly traumatic.
“You can’t cope with something by putting it out of your mind forever,” he says. “It will probably come back to haunt you, so you need to have a process to deal with it. Organisations need to make sure the support is in place for staff to do this.”
One way that organisations can help staff cope with upsetting situations is establishing support networks.
“Leaders have a role in encouraging positive relationships,” says Davda. “They can create the space for people to come together, such as comfortable coffee areas, informal meeting spaces and social activities. They can also set up support groups where people can share experiences.
"New employees are unlikely to have developed a support network, so line managers may need to help instigate this by integrating that person into an existing network, identifying experienced mentors and bringing newly qualified staff together to share early experiences.”
Thanks in part to a growing recognition of the performance benefits of a resilient and happy workforce, organisations such as the military, nursing and the police tend to have much better support mechanisms in place now than 20 years ago.
This includes having welfare departments who can talk about employees’ experiences in confidence as a matter of routine and an emphasis on physical exercise.
“There’s certainly more understanding now,” agrees Davda. “The approach to managing pressure is now proactive rather than reactive, and organisations have identified the support mechanisms needed to create the conditions for a resilient workforce.
"For instance, we conducted research with NSPCC employees, who identified several effective support mechanisms in place at the charity, including clear objective-setting, informal meeting spaces, newsletters that discuss change and celebrate success, and flexible working.”
If the right support networks, culture and training are in place, there is perhaps no reason that these extreme jobs should be any more stressful than others. Robertson Cooper’s ASSET survey, which measured workplace wellbeing across professions, showed that the occupations most affected by stress include call centre workers and customer service staff.
“There are office jobs around the world with high levels of suicide, and things like bullying or overwork can affect many industries,” says Smeed.
“A lot comes down to organisational culture: what have they done to build up the resilience of employees? Just because someone does a job that includes traumatic sights, it doesn’t necessarily mean it will have a long-term psychological impact. If your staff have a sense of purpose and the organisation offers the right support, then employees may be better able to cope than someone who works in another environment but doesn’t have those things.”