© 2018 by Drew Prochniak, LPC, LMHC

Post Critical Incident

Critical incidents impact people in a variety of ways and are rarely a cut-and-dry experience. Sometimes complicating recovery, mandatory post-incident  administrative leave may prevent one from obtaining any sort of debrief or helpful information for an undetermined amount of time. This can be one of the most troubling experiences for some. 

 

Below you will find information about the different kinds of stress reactions you may encounter, expected onsets, durations and what to do if these reactions last longer than their anticipated timeframe. Information for families is also included. 

TYPES OF STRESS REACTIONS - All of these are connected to the fight-or-flight survival  response we experience when we are put in danger.  It is our body's way of preparing us for action. It is completely normal to experience some or all of the items in each category. It is also normal to have no reaction, whatsoever. Remember, we each experience stress differently. 

Acute Stress reaction

  • Begins on-scene or within 24 hours of the CI and may last up to several days

  • Shaking or trembling - caused by blood being shunted to your heart, lungs and major muscle groups in arms and legs 

  • Vomiting, loss of bladder or bowel control

  • Irritability, difficulty sleeping, replaying of images, decreased appetite, grief, guilt, shame

  • Reduced ability to think, analyze, reason, make decisions and remember SOPs

Delayed Stress reaction

  • An Acute Stress response which occurs days, weeks or even months after a CI. May be particularly upsetting because it feels as though it "comes out of nowhere".

Cumulative Stress (Burnout, the "death of a thousand paper-cuts")

  • Chronic fatigue

  • Anxiety 

  • Forgetfulness/ impaired concentration

  • Loss of interest in job, relationships, enjoyable activities

  • Chronically cynical attitude toward job

  • Feeling only comfortable at home OR only comfortable at work

A more complete list of potential stress reactions may be found here. Remember, these are all normal responses to abnormal events. 

FOLLOWING A CRITICAL INCIDENT

  • Exercise

  • Remain hydrated, nourished and rested. If you are having trouble sleeping at night, take naps when you can. 

  • Moderate use of caffeine and alcohol. The chance for receiving a DUI/ DWI  increases after a CI. 

  • Stay connected with friends and loved ones. 

  • Time away from work or your detective's interview may be more difficult than you anticipate.

 

THE 1-2 GUIDELINE*

Within one week: Things should start returning back to normal for you. While you may still have some images and troubling thoughts about the event, they should start to fade. Rumination should be decreasing. Diet, sleep and routines should begin to stabilize. This event should start to feel as though it is in the past. 

Within two weeks: Images, thoughts about the event and rumination should be back to baseline along with diet, sleep and routines (barring other abnormal circumstances). This event should feel as though it is in the past.

 

If at the end of two weeks elements of the CI still feel very present, then call a CULTURALLY COMPETANT professional (one who works with first responders) for assistance. Do not brush this off. This is about your health, career longevity and performance. 

*This timeline is approximate. Remember, everyone processes stress differently. 

ADDITIONAL INFORMATION POST-CRITICAL INCIDENT:

  • You may be away from work for undetermined period of time with limited information about the event, decreased interaction with co-workers and regular routine. Plan a routine and build a daily structure. 

  • Interviews, hearings and reviews may be significantly stressful. 

  • A sudden and unplanned lack of overtime pay may cause financial stressors. Plan accordingly. 

  • Media coverage may be inaccurate and intrusive. Limit the exposure to your family of the stories related to this event. 

  • An abundance of people reaching out may be overwhelming and people may not always know what to say. It's ok to not return text messages, voicemails or answer every phone call. 

  • Spend time with those people who care about you. Reach out to those who are supportive and understanding. 

  • Don't forget about loved ones and significant others. This event may be affecting them, too. Consider asking coworkers and their spouses to check in with your significant other and assist with your family, as appropriate. 

FOR FAMILY MEMBERS

  • Your loved one has gone through something potentially life and career-changing. While the event itself may be over, do not expect things to go "back to normal". There may now be a "new normal". 

  • Detailed information about normal stress reactions is above. 

  • There may be an abundance of media attention, depending on the nature of the event. 

  • Discuss sharing age-appropriate information with children with your loved one. Children will have questions and will want to know what is going on. Consider sharing information as appropriate. 

  • Your loved one may be home more as a result of administrative leave. 

  • Your loved one may not know what s/he needs from you. Be an open listener and supportive in whatever way is helpful and healthy. Do not take it personally if s/he needs time away or time with coworkers. 

  • Be as objective as possible in your feedback and observations for your loved one. 

  • Consider reaching out to the spouses and significant others of your loved one's coworkers for support. 

EMPLOYEE ASSISTANCE PROGRAMS

As a benefit of your employment, many departments and agencies provide counseling sessions through a third-party EAP in order to maintain confidentiality. These services are free and completely confidential. No identifying information is shared with your department. 

If you choose to utilize this benefit, it is suggested you contact your preferred provider and arrange an initial appointment prior to contacting your EAP. This helps ensure you will be placed with the provider of your choice and it may help simplify the process for you, overall. Many departments and peer teams maintain a list of mental health professionals who have been vetted by members of their department as being "culturally competent" and who "get it". 

Cascade Centers . . . . . . . . . . . . . (503) 639-3009

BDA Morneau Shepell . . . . . . . .  (888) 327-0024

Reliant Behavioral Health . . . . .  (866) 750-1327