The DOI matches its Crossref record; 28 of the 30 references it cites were found in a registry or an index.
What makes an incident critical for ambulance workers? Emotional outcomes and implications for intervention
Abstract
Ambulance workers use the term “critical incident” to refer to a category of workplace stressor. Developing an evidence-based approach to critical incident stress begins with identifying what makes incidents critical. The aim of this qualitative study was to characterize critical incidents as well as elicit suggestions for interventions. We interviewed 60 ambulance-based workers, both front-line and supervisors, and analysed interview transcripts. Having presented their suggestions for interventions more fully elsewhere (Halpern et al, 2009), here we characterize the incidents that emerged as critical and the emotional responses evoked by them. We found they suffered considerable distress from critical incidents and would welcome interventions. Incidents that were identified as critical commonly involved patient death, often combined with poignancy. These events appeared to evoke vulnerable feelings of inability to help and intense compassion, which led to further emotional, cognitive, and behavioural responses. Difficulty in acknowledging distress and fear of stigma presented significant barriers to accessing support. These barriers may be overcome by educating both ambulance personnel and their supervisors to recognize and tolerate the vulnerable feelings often evoked by critical incidents. While gender and length of service did not seem to impact on evoked emotions, recent recruits may be more open to this type of education.
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“Other symptoms can manifest following chronic exposure to stress and common occupational challenges (extended shift times), such as fatigue, headaches, and gastrointestinal disturbances (E. Donnelly & Siebert, 2009; Halpern, Gurevich, Schwartz, & Brazeau, 2009; Klimley, Van Hasselt, & Stripling, 2018; Knutsson & B¿ggild, 2010; Rice, Glass, Ogle, & Parsian, 2014; Sterud et al.,”
From Understanding the Occupational Factors that Influence Paramedic Health and Wellbeing (2024) · cites this paper as Halpern, Gurevich, Schwartz, & Brazeau, 2009
In the citing paper
“and PSP concerns with stigma may have contributed to underreporting.74–76”
From Mental Disorder Symptoms among Public Safety Personnel in Canada (2018) · cites this paper as [76]
In the citing paper
“Emergency responders report stigma and privacy concerns regarding seeking care for mental health symptoms related, at least in part, to occupational stress (16, 71–74).”
From Pilot outcomes and exploration of treatment mechanisms using a culturally adapted version of the unified protocol for transdiagnostic treatment of emotional disorders to improve mental health symptoms, alcohol misuse, functional outcomes, and sleep quality in emergency responders (2025) · cites this paper as [73]
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Metadata
- Authors
- Halpern, J., Gurevich, M., Schwartz, B., & Brazeau, P.
- Affiliations
- Mount Sinai Hospital (CA)
- Toronto Metropolitan University (CA)
- University of Toronto (CA)
- Corresponding author
- Halpern, Janice
- ORCID
- Halpern, Janice
- Venue
- Work & Stress
- Publisher
- Informa UK Limited
- Published
- 2009-04
- Volume
- 23
- Issue
- 2
- Pages
- 173-189
- ISSN
- 0267-8373 (ISSN-L)
- 1464-5335
- OpenAlex
- W1970644865
- Cited by
- 124
- References
- 30
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 11 · 2023: 9 · 2022: 15 · 2021: 13 · 2020: 13 · 2019: 7 · 2018: 6 · 2017: 6 · 2016: 6 · 2015: 3 · 2014: 6 · 2013: 6 · 2012: 6
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Work & Stress (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Burnout
- Keywords
- critical incidents, ambulance personnel, emergency medical services, occupational stress, emotional responses, compassion, patient death, stigma, helplessness, distress, supervisor education, workplace interventions
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