Post incident factors

These factors occur during the following days, weeks and months. They play an important role in the recovery process after the incident.

post incident

 

Feelings of being chosen by the victim

This factor was identified from the crew members’ analysis and understanding of the event in the hours or days after the event, from information they collected or from their perception of the situation. This feeling of being chosen can induce:

Risk Protection

Helplessness that becomes a risk factor for increased traumatic reaction

Anger that becomes a protective factor against other negative feelings

 

Knowing that the death could have been prevented

In their analysis of the event, crew members often feel that the fatality in which they had been involved in could have been prevented, both accidents or suicides.

Risk Protection

This feeling reduces the ability to make sense of the event and induces more sadness, helplessness and anger towards “the system” that put the employee in this situation. This, in turn, fuels rumination about the event and all related circumstances.

 

 

Ability to make sense of the event

Being able to understand why things happened seemed to play a part in lessening the trauma.

Risk Protection

The death of a young person never makes sense for employees They could not develop an acceptable explanation of the event. The “why...” questions remain almost constantly present in the crew member’s mind. These were the most difficult incidents to live with.

Making sense of things helps crew members come to terms with the event. Somehow being able to explain why these fatalities occurred helped them to accept what had happened.

 

 

Cumulative effect

Cumulative effects can be considered both as an effect of fatalities and as a risk factor for increased symptoms. In this section, we will explore the role of accumulation of events as a risk factor (click here to access the description of symptoms of accumulation). In our sample, people experienced between one and more than 20 fatalities in their careers (mean number of fatalities: 4.5), with varied impacts.

Risk Protection

A majority of crew members report a negative cumulative effect. They say that the more fatalities they were involved in, the harder it becomes to return to normal.

In our study of the impact of railway fatalities on crew members, we found that of the 7 persons with PTSD, only two developed PTSD after their first fatality. In two cases, the repercussions of the last event lead the person to stop working completely

Some people respond to one incident at a time and do not show signs of a cumulative effect. Once the effect of the first incident had time to recede, the next one is experienced separately.

A small number of people indicate that the accumulation of incidents has hardened them.

Some crew members say that having experienced previous incidents familiarises them with various aspects of incidents and incident management. This familiarity, in turn, makes it easier to cope on site.

 Cumulative effects are not always easy to identify. They may appear as long term mood shifts, in changing perceptions about life or work, flash backs in varied circumstances, general edginess, as well as fatigue and long recovery periods for minor incidents. Another sign of a cumulative effect is loss of commitment to work and hope that they will live to retire.

Cumulative effects have been documented before (Malt et al;., 1993, Karlehagen et al., 1993, Theorell et al., 1992), but they were limited to their assessments of acute stress and PSTD. In this study, we found that the cumulative effect can be insidious for crew members, affecting them in more subtle ways in the long term (for example in changing moods, fatigue, etc.) that do not necessarily appear when only Acute Stress Disorder (ASD and post Traumatic Stress Disorder (PTSD) are measured.

Working the same route

 

After they return to work, most crew members have to drive trains along the tracks where the incident took place.

Risk Protection

Being confronted with the same area, especially when memorials have been put up, reminds crew members of the incident. They may experience uneasiness, flashbacks, physiological reactions (shaking, sweat, heart race), momentary loss of concentration.

These effects can last from a few minutes to hours and may be experienced for a few days to years after the event.

In the context of the study on Canadian crew members, half of the interviewees experienced long term effects of working on the same route after incidents.

 

 

Knowing about the victim's circumstances

In some cases, crew members obtained information about the victim, either because it was available on site or because they looked for it. The effects of this knowledge varies according to the story and the crew member.

Risk Protection

Obtaining information that emphasises the helplessness and innocence of the victim (age, physical or mental impairment for example)

Obtaining information that emphasises the responsibility of the victim (recklessness, substance abuse, for example)

Information that helps understand the despair of the suicide victim (for example knowing that the person was terminally ill may help certain crew members accept that this person wanted to die

Implementation of the Critical Incident Response Programme (CIRP)

 

Some actions take place after the crew members returned to their home terminals. These activities vary from employer to employer but also by region.

Risk Protection

When the expected actions are not taken in the critical incident response method, these failed expectations have an important negative effect on crew members’ recovery and relationship with their employer

Pressure to return to work before people feel ready increases long term negative effects. Pressure can be financial or brought on by managers.

Disputes over time taken off and salary for missed trips is an issue. When people feel they have to fight to obtain rest or income, this increases negative perceptions of employers, mistrust and has a long term impact.

Arguing with employers about time off work is linked to long term turmoil, rumination and traumatic reactions after a critical incident

A return to work plan designed in collaboration with the manager brings about a sense of being taken care of, trust and control

Having a predefined period of rest, during which no long term decision is made, is beneficial. It gives time to rest, deal with the shock and plan for further actions that are needed.

This is a major issue for railway employees and ultimately for companies. When people feel they have to fight their employer for recognition of their work related hardship, and that they should make sacrifices to accommodate the productivity demands of their employer, this combination makes for poor work relations that can have a long term effect on both personnel and employers.

Work relations

During the course of the study of the impact of critical incidents on crew members in Canada, there was a generalised complaint from crew members that their employers did not seem to care about their difficulties in handling the fatalities. They felt pressure to come back to work as soon as possible. They felt that they were sometimes blamed for incidents and for their difficulties in dealing with them. They often did not feel supported in their ordeal. That provoked anger and resentment. This feeling of being “betrayed” by their employer remained for a very long time after the incident, and may be the factor that has the longest negative impact on the employees over the years.

Lack of empathy, concentration on productivity, lack of knowledge of what happened and lack of hands-on experience of train driving were seen as the main reasons why managers did not offer the needed support when incidents occurred.

Some workers felt that they had to fight for the support they needed from their employer, who did not want to spend money to help them overcome work-related trauma. This perception damaged their trust and their relationship with their employer in the long term.

The way professional regulations are handled can upset employees. The consequences of taking some time off or going to see a doctor may not be clear. In the context of difficult work relationships, and when people feel they are not supported by their employer, those regulations were seen as a nuisance and a way to hurt them more. Here again, this feeling of being mistreated lasts for a very long time and negatively colours all subsequent dealings with the employer, making recovery even more difficult.

The feeling a lack of support from the employer at the different stages of incident management is one of the strongest predictors of a long-term negative impact from an incident. Indeed, 22 of the 35 incidents where management was said to be inadequate were accompanied by mid-term effects that lasted in 17 out of 35 cases for more than 3 months. All seven persons who had PTSD felt no support from their employer in the aftermath of the incident.