16. LGOM 016 – Psychological First Aid

Introduction
The ALSQ operates in an environment which is prone to the occurrence of traumatic events. These can include many types of incidents both at the beach/lagoon and within the surrounding areas. Lifeguards may experience many different reactions to these events, and the ALSQ offers support to lifeguards to ensure they are looked after in a fair and reasonable manner.

The ALSQ offers different avenues of support for Lifeguards depending on individual needs. Peer Support Officers within Surf Life Saving Queensland are able to offer both individual and group support to lifeguards at any stage. Alternatively, if immediate psychological first aid is more appropriate a psychologist or other professional can be accessed in the first instance.

Lifeguards requiring peer support / psychological first aid are to contact their Lifeguard Supervisor as soon as possible (or if the Lifeguard Supervisor cannot be contacted they can contact the Chief Lifeguard). The Lifeguard Supervisor or Chief Lifeguard can then assist the Lifeguard to access to a psychologist &/or a SLSQ Peer Support Officer.

Peer Support Process

Trauma – Definition
A traumatic event, by definition is physically and emotionally overwhelming eg where emotion overwhelms rational or logical thought processes. This disrupts the basic personal belief systems of the survivor – including trust, security, predictability and controllability.

People may experience a range of differing reactions to traumatic events including shock, fear, anger, helplessness, sadness and shame. These are all completely natural reactions to an event that may be considered extraordinary.

Other effects may include tension, sleep disturbances, dreams and nightmares, fearfulness, intrusive memories and feelings, numbing, irritability, depression, social withdrawal, physical sensations, mental reactions and self-medication. Usually these reactions are only experienced for a few weeks, and by utilising the support offered by Peer Group Support Officers members can rapidly decrease the time taken in coming to terms with their experience.

What is Peer Support?
Peer Support is part of the Workplace Health and Safety Program in which people within Surf Life Saving Queensland are trained to assist members who are affected by highly stressful events or have been subjected to stressors that are having adverse effects on their daily coping and operational functioning.

Who are Peer Support Officers?
A Peer Support Officer is a person who shares the same or similar work environment and provides first contact support to lifeguards, referring on anyone who requires more specialised assistance. These people will have received specialised training in stress management.

The Peer Support program is a confidential process, which means not disclosing personal or identifying information, except in very rare circumstances where it is thought a person may cause harm to themselves or others. In this instance immediate support from an appropriate source should be obtained. In all other situations before any information is disclosed, permission must be obtained from the individual concerned. The Peer Support process assists people to set realistic expectations and develop effective coping strategies to manage the impact of exposure to stressful events. The goal is to return lifeguards to pre-incident levels of wellness and performance as soon as possible and without long term detrimental effect. This is achieved by providing knowledge and a series of strategies to prevent and alleviate the impact of stress associated with traumatic events.

Peer Support Officer must have received appropriate training, organised by Surf Life Saving Queensland if necessary and have these skills updated by attending a refresher course at least once every three (3) years.

Role of a Peer Support Officer
Following exposure to stressful events the Peer Support Officer may

• Provide initial support to lifeguards and their ‘Significant Others’ to alleviate symptoms and encourage a prompt return to independent functioning and coping in their lives
• Assist lifeguards to understand the impact of a stressful event (Group Process)
• Educate lifeguards on stress reactions and natural coping mechanisms and strategies they possess
• Assist in the referral process to mental health professionals for further counselling for lifeguards when required via the members G.P.
• Provide educational material to lifeguards
  

The types of interventions employed by the Peer Support Officers may include, but are not restricted to: -

• Psychological First Aid
• Family/Significant Other support
• Follow up/ Referral
  

Peer Support Process
Incident occurs
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Psychological First Aid
Role of the Lifeguard Supervisor and Peer Support Officer
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Referral as required

STEP 1 – Incident Occurs
When Peer Support may be needed
Within the ALSQ environment there are many types of extraordinary incidents that can occur. The following situations may be times that the support of a Peer Support Officer can be of assistance to lifeguards:

• When the event is extraordinary
• Occurrence of a serious incident
  • Death/Drowning
  • Failed resuscitation
  • Injury to the Lifeguard
  • Rescued person known to Lifeguard
  • Rescued patient with extensive injuries
  • Shark attack rescue
  • Lifeguard in danger (surf etc.)
• Strong media involvement and interest
• A large number of people are involved
• Lifeguard/s appear distressed by the event
• There is evidence of distress or adverse behaviour
• On request
• Coronal
• Police Investigation
• Workcover Investigation
  

Note– An incident that may be considered small or minor may trigger a large reaction in some lifeguards due to a previous Incident they may have experienced, or an accumulation of smaller incidents and life pressures that cause a buildup effect. Therefore, different people will have differing levels of reactivity to the same event. Lifeguards who seek guidance of counselling from a Peer Support Officer must feel free to express their emotions and feelings in a safe and supportive environment. This environment has to be confidential and non-critical.

How this is accomplished
By being able to provide: -

• Education about crisis events and stress management
• Psychological First Aid
• Practical assistance
• One on one support
• Telephone support
• Facilitating a Defusing
• Referring on
• By being available
  

Role of the Lifeguard Supervisor
Carry out a Primary Review and Assessment of Lifeguard(s) e.g.:

• Change in personality
• Withdrawal behaviour (most dangerous)
• Excessive talking of incident
• Avoidance behaviour after incident
• Lifeguard numbed by experience
• Lifeguard aggravated/agitated
  

Refer to Peer Support Officer
A list of names and contact details of Peer Support Officers can be obtained by contacting your Lifeguard Supervisor (or if the Lifeguard Supervisor cannot be contact the Chief Lifeguard) who will arrange for the Lifeguard/s to see an appropriately trained Peer Support Officer. Regions need to ensure that they have a Peer Support Officer and that Lifeguards are aware of how to contact them.

STEP 2 – Psychological First Aid
Role of the Peer Group Support Officer Post-Incident
Psychological First Aid needs to be implemented as soon as possible after the incident has occurred to ensure that lifeguards’ needs are well looked after.

Psychological support is extremely important for traumatised people in the aftermath of a traumatic event. The Peer Support Officer can aid in this process by providing human comfort and support. It is important to convey recognition of their suffering in a compassionate and respectful manner – this is one of primary stages in their recovery process.

Glossary

STEP 3 – Referral
Lifeguards may need to be referred to a trained councillor for follow up assistance in dealing with the incident. Lifeguards can take up these sessions at any time, through SLSQ’s Employee Assistance Program provider Access EAP on 1800 818 728 or 02 8247 9191 Access EAP

Psychological First Aid Guidelines

Many important tasks must be completed following a major incident involving first aid or resuscitation. These tasks are collectively referred to as ‘psychological First Aid’. There are many purposes for psychological First Aid, and the style of the process will vary with every case and be determined locally. Certain aspects, however, must be considered, even if only briefly.

ALSQ’s psychological First Aid’ review generally requires you to: -

• Assess the reactions and welfare of the lifeguards and all others involved.
• Review the effectiveness of all the procedures carried out and makes recommendations, where appropriate, on the lessons learned.
• Review the use of special and routine equipment that was used, whether it was appropriate, whether it was in a proper state of repair and whether different equipment could or should have been made available.
• Review all aspects of the call for instance and the help given by outside organisations, such as the police or ambulance service etc.
• Consider the need for formal written reports. Some incidents require a great deal of paperwork and this should be given to a person familiar with the case so they can prepare formal reports and complete log books such as the Daily Report Log.
• Consider the value of seeking reassurance from people, such as the club medical officer, whether everything possible was done during the emergency.
• In some cases appoint a person or persons to liaise with the media.
• Seek follow up information from other sources such as hospitals, police, the coroner etc., in cases where it is warranted.
  The ALSQ’s review should be carried out by the Lifeguard Supervisor or Regional Manager in a confidential and non-critical manner.
  

Notes

• Be vigilant for the need for Peer Support among anyone involved with the incident.
• Statements may also be required from key individuals involved in the incident. Although sometimes not a nice experience, these are best written immediately after the event while important information is still fresh in your mind. Peer Support Officers should be available for those who are making statements.
• If follow up information is required, one person should be nominated to fulfil this role.