Frozen moments: flashback memories of critical incidents in emergency personnel

Abstract

BackgroundEmergency Department personnel regularly face highly stressful situations or critical incidents (CIs) that may subsequently be recalled as unbidden intrusive memories. In their most extreme form, such memories are reexperienced as if they were happening again in the present, as flashbacks. This study examined (1) which CIs are associated with flashback memories; (2) candidate person and work-related features that predict flashback memories; and (3) the association between flashback memories and anxiety, depression, and emotional exhaustion.MethodsEmergency nurses (N = 91; 80.2% female) were recruited from two urban teaching hospitals and filled in self-report questionnaires.ResultsA majority (n = 59, 65%) experienced intrusive memories; almost half of the sample reported that their memories had flashback character. Those involved in resuscitations in the past week were at a fourfold risk for experiencing flashbacks. Having worked more consecutive days without taking time off was associated with a somewhat lower incidence of flashbacks. Moreover, older individuals who reported more work-related conflicts were at greater risk for experiencing flashback memories than their younger colleagues with heightened work conflict and flashback memory scores, respectively. Flashback memories were associated with heightened symptoms of anxiety, depression, and emotional exhaustion.ConclusionsThe present findings have implications for evidence-based health promotion in emergency personnel and other individuals regularly exposed to CIs.

Connecting the dots: A network approach to post‐traumatic stress symptoms in Chinese healthcare workers during the peak of the Coronavirus Disease 2019 outbreak

“…were predictive for higher occurrence of reliving the traumatic event (Kleim, Bingisser, Westphal, & Bingisser, 2015). Work conflicts are more likely to occur under situations of high work pressure.…”

Effectiveness of Expressive Writing in the Reduction of Psychological Distress During the COVID-19 Pandemic: A Randomized Controlled Trial

“…Therefore, our study does not necessarily suggest abandonment of EW interventions as such, but rather recommends tailoring specific EW intervention modalities in accordance with individual needs, and using EW interventions as a part of a comprehensive stress management approach. EW may help people to better understand a stressful experience, be mentally prepared for the trauma-related difficulties, or prevent rumination (Kleim et al, 2015;Sloan et al, 2008). However, its usage as a stand-alone intervention for the reduction of psychological distress during pandemic was not supported by our study.…”

Digitalizing a Brief Intervention to Reduce Intrusive Memories of Psychological Trauma for Health Care Staff Working During COVID-19: Exploratory Pilot Study With Nurses

“…In our previous work, we have seen indication that intrusive memories can have a significant impact on people's perception of their ability to concentrate [7,32]. Second, when the content of intrusive memories is of work-related traumatic events (eg, a difficult resuscitation, a typical situation reported by nurses as cause for intrusions [12]), the triggers for these intrusions are typically in work-related environments. This means that health care staff might be more likely to find work settings in which psychological trauma has occurred difficult, as those settings can trigger distressing memories, which could potentially lead to increased absentee rates due to avoidance of such work and reminders.…”

“…Exposure to psychologically traumatic events presents a problem for health care staff working in the pandemic and will continue to be a problem once the pandemic is over. Before the pandemic, experiencing different traumatic events (either as a direct threat to themselves or a witnessed threat to patients) could lead to mental health difficulties such as PTSD in health care staff [8] as shown in studies including rescue workers [9], obstetricians [10], critical care nurses [11], and emergency nurses [12,13]. During the COVID-19 pandemic, health care staff have experienced much higher levels of exposure to potentially traumatic events and already reported increased posttraumatic stress symptoms [2,14,15].…”

“…We have proposed intrusive memories of trauma as a targeted single symptom [4,6]. For example, intrusive memories were reported by 65% of emergency nurses [12]. Drawing on cognitive science (eg, on mental imagery [25] and memory consolidation and reconsolidation), we have developed a behavioral intervention aimed to limit the occurrence or recurrence of intrusive memories.…”