My protective armour

Why  I cope well most of the time

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The basic components of my protective armour

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“Psychological injury isn’t inevitable. Most responders most of the time will cope well”

LIFELINES ESSENTIALS #5

Why is it that most people working in high pressure roles cope well most of the time? Is it because you’re stronger or braver than the average person? Perhaps. Is it because you’re cynical and burned out? Not necessarily. Is it because you’re hard hearted? Unlikely. 

It’s because you’re wearing protective armour, some visible and some not.

We all recognise the kit that keeps us physically safe at work but we’re going to think about the things that protect you psychologically as you encounter hazardous experiences.

It’s important you have the correct armour for your role and that you understand how it works. With this knowledge you'll be able to make sure you and your colleagues are wearing it correctly and recognise when it might get breached.

The basic components of your protective armour...

Your identity as a responder

When you join the ambulance service you become a public servant. You work for a service that helps people when they are in need and the pride you feel about this is a core part of your Protective Armour. Uniforms, badges, lanyards are all ways of reinforcing this shared identity and purpose.

This is especially important for those of you working at the “frontline” where there is exposure to potentially traumatic events. You will have frequent contact with people who are physical and mental distress, who are seriously ill, injured or dying. This may be face to face or over the phone. You might be in physical danger yourself from assault, infection or by attending a major incident.

Whatever your role, you will have a job to do and procedures to follow. You won’t be a passive or helpless observer. Instead you will have an active and positive role in the face of trauma exposure, and this will protect you.

  • Jobs where you’re not actively involved and/or are in an observing role (e.g. waiting at the hospital to handover a patient or taking calls from people who are distressed at the time taken for an ambulance to attend)
  • When you’re unhappy with decision-making of senior colleagues or partner agencies
  • When you're off-duty and get involved in an incident
  • Times when your professional or organisational pride is challenged (e.g. by negative media coverage or the actions of others bring the service into disrepute)
  • When you're retiring and losing your identity as a responder
Being able to distance yourself

Your identity as a responder, your training and even your uniform allow you have a professional rather than a personal response to the situation you face.

You have a job to do and your focus is on doing it to the best of your ability. Whether you’re dealing with a casualty, giving instructions to someone over the phone or recovering a body, your focus is on the task at hand rather than on people’s experiences and suffering.

Being able to distance yourself doesn’t mean you’re hard hearted and often the emotional impact will come later when you reflect on what happened. Instead, the ability to focus on the job you must do is an important part of your Protective Armour. You’re using your brain more than your heart.

  • When you know the victim or they remind you of someone close to you
  • When a colleague is involved     
  • When an incident involves children
  • When you’re concerned that your work role may place your own of your loved ones health at risk
  • When the incident happens in your community
  • When you're off duty get involved in an incident
Expectation and readiness

When you join the ambulance service you have a good idea what the job will involve. It’s not a surprise to find yourself dealing with people who are seriously ill or at the end of their lives. You know what to expect and this sense of readiness is protective.

Readiness allows you to prepare physically, psychologically, and emotionally and helps you can focus on what you need to do. It doesn't prevent you being affected (see When it might be breached) but it helps.

See also preparation and training below.

  • When there is something unusual or unexpected about the incident
  • When the volume of work calls means there’s no time to recover in between and prepare for the next job
Preparation and training

When you encounter stressful and hazardous situations your instinctive survival responses kick in (see Understanding my Response to Trauma and Stress). Your brain defaults to instinctive or learned responses and that’s why training is key to the emergency responder role; the more you rehearse, the easier it is to carry out the required actions in the crisis situation.

Training tells you what to expect and helps you prepare, reinforcing your sense of readiness. It builds your confidence that you’ll be able to work effectively. (See also Sense of competence below.)

Preparation and training are a crucial part of your Protective Armour.

  • When the incident isn’t something you've rehearsed or is an unusual or rare occurrence
  • When you forget what you’ve learned
  •  At the start of your career when you’ve had limited practice of new skills
  • When instinct overrides training and you freeze
Sense of competence and expertise

Knowing what your job is and feeling able to do it effectively links with the other protective factors, it reinforces your identity as a responder and helps you focus on the professional role you’re trained to deliver.

Feeling competent
, even expert, acts like a protective shield in the face of trauma exposure. It allows us to retain a sense of control and self-confidence, keeping us active and positive rather than passive and helpless.

  • When things go wrong    
  • When you don’t have the resources or equipment you need
  • When you or your colleagues don’t perform well, or errors are made
  • At the start of your career
  • When you’re first promoted or move into a specialist role
Social support

Social support is at the heart of human wellbeing and the strong bonds you have with your colleagues are an essential component of our Protective Armour. We rehearse together, respond together and sometimes spend our downtime together. You’ve got each other’s backs.  

This means that when you’re in a hazardous situation you have confidence in the knowledge and skills of your colleagues. You can do our job safely because they’re doing theirs and you’re pulling together professionally and personally. You trust each other and have a shared goal.

The support of peers is central to responder wellbeing. Your colleagues are the people who share your experiences at work (good and bad), who usually share your sense of humour (good and bad!) and who you can talk to after difficult jobs. ( See Talking about it afterwards.)

  • When you’re isolated or unsupported
  • Bullying
  • Poor management
  • Low morale
  • When an incident affects the team
  • When the things the team normally do to defuse things don’t work, e.g. banter
Talking about it afterwards

When we’re involved in hazardous or intensely distressing experiences the priority for our brain and body is our survival. The reason we do so much preparation and training is to help us channel these instinctive responses and carry out our professional duties.  

The memory and meaning-making parts of our brain work differently when we’re in danger and so when the threat has passed, there’s a lot of catching up work to be done. We think about what happened and maybe dream about it as our brain processes the experience, taking any learning from it, before filing it away in our memory.

Talking is a great way to do this processing.  Whether that’s over a cuppa with colleagues or an operational debrief to reflect on what went well or what can be learned. Feeling able to share your thoughts and feelings, and having the opportunity to do so, is a key part of your Protective Armour.

  • When you tend to suppress your thoughts and feelings
  • When you’re isolated, unsupported or blamed
  • Poor management
  • Bullying
  • Shame and self-stigma
Knowing ourselves and being willing to seek help

Would you recognise if your armour had been breached and you’d been injured? And if you did, would you take time to dress the wound and repair the chink in your armour? Or would you ignore it and carry on?  

Understanding and looking after our Protective Armour will help us stay safe and well. It gives a better chance of predicting the situations and times when it might not work so well. It is important to remember that our armour won’t absorb or deflect every attack. We’re not invincible.  

It's a bit easier for us to ask for help if we recognise that we’ve been injured. We’re often OK at recognising physical injuries but less good at spotting psychological ones. And if we do spot them, we often misunderstand what they mean. We worry we’ll never recover which is like assuming we’ll never walk again when we tear an Achilles tendon.  

Find out more about common warning signs and how to provide psychological first aid on the When I might need some help pages. Look after yourself and your Protective Armour.

  • High expectations and perfectionism
  • Shame and self-stigma
  • Culture of silent coping
  • Culture that prevents help-seeking, e.g. negative attitudes about people with mental health problems
  • Scepticism about the value of support systems

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