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.
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.
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 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 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.
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.
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 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.
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.