Looking after each other in a crisis-Lessons from Novichok and the parallels with Covid-19.
Covid-19
Novichok
PTSD
psychologist
resilience
Journal
Nursing in critical care
ISSN: 1478-5153
Titre abrégé: Nurs Crit Care
Pays: England
ID NLM: 9808649
Informations de publication
Date de publication:
01 2023
01 2023
Historique:
revised:
25
05
2021
received:
15
07
2020
accepted:
07
06
2021
pubmed:
30
7
2021
medline:
1
2
2023
entrez:
29
7
2021
Statut:
ppublish
Résumé
In March 2018, three patients were admitted to the Emergency Department of a District General Hospital. Originally suspected of having suffered an opiate overdose, it became clear that they were the victims of anti-cholinesterase poisoning-the Soviet era poison Novichok. Twenty-five days later, two further patients were admitted with the same symptoms. One of these patients died 8 days later and the second remained in hospital for 3 weeks. A Clinical Psychologist was present on the unit throughout the major incident and all staff directly involved received psycho-educational support regarding self-care. To examine the psychological impact of the longest running major incident in NHS history on the staff directly involved. A cross-sectional design was used, with structured questionnaires administered retrospectively. A link to an electronic survey was emailed to every member of staff in the organization. The survey included the Hospital Anxiety and Depression Scale, the Maslach Burnout Inventory, the Impact of Events Scale-Revised (to both the March and June events). 540/4000 hospital staff responded (13.5% response rate) with a 29/59 (49%) response rate in intensive care staff. Frontline staff had significantly lower scores on anxiety (P < .05 for the June incident), depressive symptoms (P < .05 March and June) and subscales of burnout than managers (depersonalization P < .05). On the remaining two burnout subscales and on anxiety scores for those involved in March, results trended towards significance (P < .1). Staff in management roles during major incidents may experience higher levels of psychological distress than staff in front line clinical roles and should be encouraged to seek psychological support. This article informs teams of the psychological impact of major incidents on staff in intensive care settings.
Sections du résumé
BACKGROUND
In March 2018, three patients were admitted to the Emergency Department of a District General Hospital. Originally suspected of having suffered an opiate overdose, it became clear that they were the victims of anti-cholinesterase poisoning-the Soviet era poison Novichok. Twenty-five days later, two further patients were admitted with the same symptoms. One of these patients died 8 days later and the second remained in hospital for 3 weeks. A Clinical Psychologist was present on the unit throughout the major incident and all staff directly involved received psycho-educational support regarding self-care.
AIMS
To examine the psychological impact of the longest running major incident in NHS history on the staff directly involved.
DESIGN
A cross-sectional design was used, with structured questionnaires administered retrospectively.
METHODS
A link to an electronic survey was emailed to every member of staff in the organization. The survey included the Hospital Anxiety and Depression Scale, the Maslach Burnout Inventory, the Impact of Events Scale-Revised (to both the March and June events).
RESULTS
540/4000 hospital staff responded (13.5% response rate) with a 29/59 (49%) response rate in intensive care staff. Frontline staff had significantly lower scores on anxiety (P < .05 for the June incident), depressive symptoms (P < .05 March and June) and subscales of burnout than managers (depersonalization P < .05). On the remaining two burnout subscales and on anxiety scores for those involved in March, results trended towards significance (P < .1).
CONCLUSIONS
Staff in management roles during major incidents may experience higher levels of psychological distress than staff in front line clinical roles and should be encouraged to seek psychological support.
RELEVANCE TO CLINICAL PRACTICE
This article informs teams of the psychological impact of major incidents on staff in intensive care settings.
Identifiants
pubmed: 34323345
doi: 10.1111/nicc.12677
pmc: PMC8447438
doi:
Substances chimiques
novichok
0
Types de publication
Journal Article
Langues
eng
Pagination
30-35Informations de copyright
© 2021 British Association of Critical Care Nurses.
Références
NHS England National Emergency Preparedness, Resilience and Response Unit. NHS England Emergency Preparedness, Resilience and Response Framework; 2015:9
Mitchell J, Everly G. Critical Incident Stress Debriefing: An Operations Manual for the Prevention of Traumatic Stress among Emergency Services and Disaster Workers. Ellicott City, MD: Chevron Publishing; 1995.
Alexander D, Klein S. Ambulance personnel and critical incidents. Br J Psychiatry. 2001;178(1):76-81.
De Boer J, van Rikxoort S, Bakker A, Smit B. Critical incidents among intensive care unit nurses and their need for support: explorative interviews. Nurs Crit Care. 2013;19(4):166-174.
Zigmond A, Snaith R. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361-370.
Weiss D. The impact of event scale-revised. In: Wilson J, Keane T, eds. Assessing Psychological Trauma and PTSD: A Practitioners Handbook. 2nd ed. New York: Guildford Press; 2007:168-189.
Maslach C, Jackson S, Leiter M. Maslach Inventory Manual. 3rd ed. Palo Alto, CA: Consulting Psychologists Press; 1996.
Survey Monkey Inc. San Mateo, CA, www.surveymonkey.com
Microsoft Corporation. Microsoft Excel; 2010, www.office.microsoft.com/excel
Borrill C, West M, Wall TD, et al. Mental Health of the Workforce in NHS Trusts. Sheffield, England: University of Sheffield; 1996.
Skakon J, Kristensen T, Christensen KB, Lund T. Do manager experience more stress than employees? Results from the Intervention Project on Absence and Wellbeing in Danish managers and their employees. Work. 2011;38(2):103-109.
Adult Psychiatric Morbidity Survey. Office for National Statistics; 2014
Karanikola M, Giannakopoulou M, Mpouzika M, Kaite C, Tsiaousis G, Papathanassoglou E. Dysfunctional psychological responses among intensive care unit nurses: a systematic review of the literature. Rev Esc Enferm USP. 2015;49(5):847-857.
Laposa J, Alden L, Fullerton L. Work stress and posttraumatic stress disorder in ED nurses/personnel (CE). J Emerg Nurs. 2003;29(1):23-28.
Wong A, Olusanya O. Burnout and resilience in anaesthesia and intensive care medicine. BJA Educ. 2017;17(10):334-340.
Vincent L, Brindley P, Highfield J, Innes R, Greig P, Suntharalingam G. Burnout syndrome in UK intensive care unit staff. J Intensive Care Soc. 2019;20(4):363-369.
Mealer M, Shelton A, Berg B, Rothbaum B, Moss M. Increased prevalence of post-traumatic stress disorder symptoms in critical care nurses. Am J Respir Crit Care Med. 2007;175(7):693-697.
Mealer M, Burnham E, Goode C, Rothbaum B, Moss M. The prevalence and impact of post-traumatic stress disorder and burnout syndrome in nurses. Depress Anxiety. 2009;26(12):1118-1126.
Mealer M, Jones J, Newman J, McFann KK, Rothbaum B, Moss M. The presence of resilience is associated with a healthier psychological profile in intensive care unit (ICU) nurses: results of a national survey. Int J Nurs Stud. 2012;49(3):292-299.