Hospital social workers’ appraisal of, reaction to, and coping with a critical incident in their work environment: a descriptive study

• Main Author: Plante, Rodney S.
• Language: English
• Published: 2009
• Subjects: Medical social work > British Columbia > Lower Mainland Region; Critical incident technique > Case studies; Job stress > Case studies
• Online Access: http://hdl.handle.net/2429/7654

The intensity and emotional demands of the health care environment place exceptionally high performance expectations and stress on hospital social workers. Critical Incident Stress (CIS), a specific type of stress associated with dramatic, emotionally overwhelming situations, known as Critical Incidents (CIs), produce several emotional and physical reactions that can threaten the well-being of the hospital social worker. CIS, as experienced by hospital social workers, is absent from the literature and not well understood. The purpose of this study was to describe how hospital social workers appraised, reacted to, and coped with CIs in their work environment. Lazarus and Folkman's (1984) theoretical framework of stress appraisal and coping was used to guide this descriptive study. A sample of 30 hospital social workers was recruited from two Vancouver tertiary care hospitals. Four instruments (Participant Information Sheet, Critical Incident Information Form, Emotional Appraisal Scale, and Ways of Coping Scale) were used to gain knowledge on how hospital social workers appraised, reacted to, and coped with CIs in their work environment. Quantitative data were coded, qualitative data were subjected to content analysis, and descriptive statistics calculated. Data revealed that hospital social workers encountered CIs in their work environment and that the majority of CIs centred on death-related events. The primary traits of events appraised as CIs were novelty, suddenness, and uncertainty. Respondents reacted to the CI with a variety of emotional (anxiety, fear, frustration, worry, anger) and physical reactions (feeling overwhelmed, fatigued, withdrawn, anxious, difficulty with sleeping), and although they experienced some discomfort, these reactions were not debilitating. Most hospital social workers indicated that their personal beliefs had been challenged by the CI and revealed that they were unsure as to what their social work role or function should have been during the event. However, despite this, respondents remained confident and comfortable with the decisions they made. Hospital social workers appeared to cope well with CIs, used a variety of emotion- and problem-focused coping strategies, and reported few negative effects on their professional and/or personal lives. The top four coping strategies utilized by respondents were seeking social support, planful problemsolving, positive reappraisal, and self-control. The implications of the findings for hospital social work administration, social work training and education, hospital social work practice, and future research are discussed.