ARCHIVED - Preparing for and Responding to Trauma in the Workplace : A Manager's eGuide

Table of Contents

• Foreword
• 1. Introduction
  • 1.1 Purpose of the Manager's eGuide
  • 1.2 Health and Safety of Federal Employees
    
• 2. Traumatic Events
  • 2.1 What Is a Traumatic Event?
  • 2.2 Traumatic Events in the Workplace
  • 2.3 Traumatic Events at Home
  • 2.4 Traumatic Events in the Community
  • 2.5 Emotional Impacts of Traumatic Events
• 3. Get Ready Now for Trauma in the Workplace - Emergency Preparedness and Planning
  • 3.1 Emergency Planning Tips
• 4. Managing the Immediate Response to a Major Traumatic Workplace Event
  • 4.1 If Employees Have Been Injured or this is a Health Emergency
  • 4.2 If Employees Have Died
  • 4.3 If this is a Mass Casualty Incident and Numerous Employees Have Been Killed or Injured
  • 4.4 If this is a Criminal Incident
• 5. Once the Immediate Danger Is Over
  • 5.1 If Employees Have Been Killed or Seriously Injured
  • 5.2 If No One Was Killed or Seriously Injured and the Workplace Is Safe
  • 5.3 Providing Emotional Support to Employees
  • 5.4 Managing the Media
    
• 6. Managing the First 24 Hours of a Traumatic Event
  • 6.1 Meeting with Families of Deceased and Seriously Injured Employees
• 7. Managing the Short-term Response (from 24 to 72 hours)
  • 7.1 The Workplace: A Comforting and Healing Cocoon
  • 7.2 Funeral Arrangements
  • 7.3 If a Memorial Service Is Held at Work
  • 7.4 If Employees Were Seriously Injured
  • 7.5 When an Injured Employee Is Ready to Return to Work
• 8. Managing the Emotional Needs of Employees the First Few Weeks After a Traumatic Event
  • 8.1 Stress Reactions in the First Few Weeks
  • 8.2 General Emotional Support Guidelines
  • 8.3 Practical Administrative Guidelines
  • 8.4 Helpful Emotional Support Measures
  • 8.5 Delayed Reactions
  • 8.6 When an Employee Appears Overwhelmed
  • 8.7 Resources to Help You Support Employees
• 9. Taking Care of Yourself
  • 9.1 Stressors That Can Affect You
  • 9.2 Stress-relieving Activities
• References
• Emergency Phone Numbers

Foreword

This e-guide for public service managers was produced by the Employee Assistance Services (EAS) Bureau with Treasury Board funds. Preparing for and Responding to Workplace Trauma: A Manager's eGuide is intended to help managers develop and maintain a supportive environment for employees who experience a traumatic workplace event and to support the delivery of critical services to Canadians during and after a major traumatic event. The information offered is based on current knowledge and practice derived from research and case reports, the practical experiences of human service workers and the personal experiences of disaster victims.

The EAS Bureau provides a comprehensive Employee Assistance Program (EAP) which includes trauma response, wellness and organizational development expertise and services (for more information go to Employee Assistance Services). EAS can assist you in developing an emergency response plan for your workplace, as well as in training your employees in emergency preparedness and response.

EAS serves employees of 140 public and parapublic organizations, including most federal government departments across Canada. These employees have access to confidential, professional counselling services 24 hours a day, 365 days a year via our toll-free bilingual telephone service at 1-800-268-7708 or 1-800-567-5803 (TTY). For information about EAS, or for assistance in developing a psycho-social emergency response plan for your workplace, call the EAS Bureau at 1-888-366-8213.

Preparing for and Responding to Workplace Trauma: A Manager's Handbook, an abbreviated version of this document can be found at Employee Assistance Services

1. Introduction

On September 11, 2001, North Americans awoke to a new reality. The terrorist attacks on the World Trade Center, the Pentagon and the resulting plane crash in Pennsylvania shocked people far and near. That the attack killed an estimated 3,000 people, many of them employees of various financial companies or federal agencies, raised the awareness of many employers about the potential impact a traumatic event can have on the physical and emotional well-being of their employees.

Few managers expect to deal with a major traumatic event such as a terrorist attack. What is more common is dealing with a sudden heart attack, the death or serious injury of one or more employees following an accident, the physical attack by an employee against other employees, or the effects of traumas employees bring from their personal lives to their workplaces. Less commonly, a manager may have to deal with the consequences of a major fire, earthquake or tornado that strikes the workplace during business hours or devastates an employee's community.

If a tragedy or life-threatening event happened in your workplace,

• How would you respond?
• How would you protect your employees?
• How would you help them recover from emotional trauma, the deaths of co-workers or injuries?
• How would you help your employees get back on track?
• How would you take care of yourself?

1.1 Purpose of the Manager's eGuide

This e-guide is intended to help managers actively promote a culture of support, understanding and caring toward employees who experience a traumatic workplace event.¹

The guide provides managers with practical guidelines on:

• How to get ready for a traumatic event in the workplace
• How to manage the immediate response to a traumatic event
• Providing emotional support to employees affected by trauma
• Managing the first 72 hours of a traumatic event
• Helping employees recover and tap into useful resources
• Returning to regular business activities
• Taking care of oneself.

1.2 Health and Safety of Federal Employees

1.2.1 Occupational Health and Safety Legislation in Canada

As an employer, the Government of Canada abides by the Canada Labour Code. Under Part 2, Occupational Health and Safety, Section 124 of the Canada Labour Code, it is the responsibility of employers to "ensure that the health and safety at work of every person employed by the employer is protected." Section 125 spells out the specific duties of the employer which include (but are not limited to):

• Complying with prescribed standards relating to fire safety and emergency measures
• Providing each employee with the information, instruction, training and supervision necessary to ensure his or her health and safety at work
• Taking steps to prevent and protect against violence in the workplace
• Posting the names, workplace telephone numbers and work locations of all of the members of workplace committees or of the health and safety representative.

To see the full text, go to http://laws.justice.gc.ca/en/L-2/16951.html

1.2.2 Federal Workplace Health and Safety

Health Canada's Workplace Health and Public Safety Programme (WHPSP) is mandated by the Department of Health Act (4.2.f) to promote and preserve the physical safety and psycho-social well-being of federal employees. WHPSP administers the Public Service Health program for Treasury Board, provides health and safety services for federal public servants, and provides an Employee Assistance Program (EAP) through the Employee Assistance Services (EAS) Bureau to some federal departments and agencies.

Treasury Board requires that all federal departments and agencies provide an EAP to their staff. For example, the EAS Bureau serves employees of 140 public, and parapublic organizations, including most federal government departments across Canada. These employees have access to confidential, professional counselling services 24 hours a day, 365 days a year via our toll-free bilingual telephone service at 1-800-268-7708 or 1-800-567-5803 (TTY). For information about EAS, or for assistance in developing a psycho-social emergency response plan for your workplace, call the EAS Bureau at 1-888-366-8213.

Regardless of the EAP provider, services must be requested by employees or their family members directly, on a confidential basis. While managers can encourage staff to contact their EAP, they cannot make appointments on behalf of anyone but themselves. In situations where a manager arranges a group session, employees must be free to attend voluntarily.

EAPs can be a valuable resource for managers who want to increase their effectiveness in managing staff who have been exposed to a traumatic event. Some departments/units have specialized response teams (e.g., Critical Incident Stress Management teams). For information about what kinds of services are available, contact your EAP directly; if you are unsure who your EAP provider is, contact your Human Resources Advisor.

1.2.3 Federal Government Public Security and Anti-terrorism

As a consequence of the September 11, 2001 acts of terrorism in the United States and subsequent threats to use chemical, biological, radiological or nuclear (CBRN) weapons, the Government of Canada has identified public security and anti-terrorism as a priority.

One component of this initiative, Psycho-Social Emergency Preparedness and Response (P-S EPR), naturally falls within WHPSP's mandate, and as such is being administered through the EAS Bureau. The goal of P-S EPR is to provide information to federal managers to help them plan and prepare for, as well as respond to, their employees' and their own psycho-social needs in the event of a major traumatic workplace incident. An "all-hazards approach" has been adopted to address emotional and social needs resulting from a broad range of intentional or accidental disasters. In this context, an all-hazards approach means planning for any, rather than for a specific, event.

2. Traumatic Events

2.1 What Is a Traumatic Event?²

Traumatic events can take many forms and occur anywhere. A traumatic event can be defined as any extreme event which:

• A person is subjected to or witnesses
• Falls outside the range of normal experience
• Is life threatening or could result in serious injuries
• Exposes the person to shocking scenes of death or injuries
• Could lead a person to experience intense fear, helplessness, horror or other reactions of distress.

2.2 Traumatic Events in the Workplace

Examples of potential traumatic workplace events include:

• Death or serious injury of a person
• Witnessing a person die
• Violent physical attacks
• Physical threats
• Bomb threats, explosions, fire
• Intentional or unintentional release of chemicals or infectious agents
• Search and rescue activities
• Body recovery and site investigation following a major accident or disaster
• Attempted or completed suicide

2.3 Traumatic Events at Home

Employees also experience traumatic events in their personal lives. Managers need to be caring and supportive to employees who, for example:

• Lose a loved one
• Are experiencing relationship or parental difficulties
• Have lost their housing due to fire
• Are victims of domestic violence

2.4 Traumatic Events in the Community

In the last 25 years, Canadian communities have had to respond to a growing number of natural and human-caused catastrophes, including floods, forest fires, tornadoes, hurricanes, transportation accidents, mine disasters and terrorist acts. Traumatic events such as these cause deaths and injuries, destroy or seriously damage homes and workplaces, and trigger emotional distress. Federal employees may be victims of these events or may, as part of their work, have to respond by providing a wide range of community services.

Management has to plan for such events as part of their responsibility to:

• Protect employee health and safety
• Ensure that services are maintained
• Assist with community recovery.

2.5 Emotional Impacts of Traumatic Events³

Since traumatic events are life-jarring experiences, few people walk away from them without being affected both physically and emotionally. Individuals affected by a traumatic event have to adjust to major changes in their lives. They may have to grieve for their losses, perhaps find new jobs, cope with physical or mental disabilities or injuries, or deal with physical or personal crises. Disruption in relationships, roles and routines can make life unfamiliar or less predictable.

Employers can play an important role in facilitating the physical and emotional recovery of employees, whether the traumatic event occurs in the workplace, at home or in the community.

3. Get Ready Now for Trauma in the Workplace--Emergency Preparedness and Planning

The best way to protect employees' physical and emotional well-being from a traumatic workplace event is for you and your employees to be prepared. Having a well thought out emergency response plan will allow you and your employees to respond promptly and effectively to a traumatic event.

3.1 Emergency Planning Tips^{(1, 4-10)}

Here is a series of emergency planning tips to help you and your employees get ready:

(1) Prepare now. Find out if there is an all-hazards building emergency response plan specific to your office. If such a plan has not been developed, it may be possible to adapt another office's plan for your workplace. In the absence of either of these, create a plan now for your workplace. Knowing what life-saving measures to take will help reduce fear and anxiety and promote a sense of safety and control should a traumatic event occur. Your Departmental Security Officer (DSO) may be able to provide advice and offer generic planning models or response guidelines. Examples include:

• Fire Emergencies
• Bomb Threat Response
• Occupational Illness and Injury
• Demonstrations and Occupations
• Utility Failures
• Workplace Violence
• Handling Suspicious Packages
• Business Continuity Planning

(2) Make it a priority. Finding time in a busy office schedule to develop building emergency plans can present some challenges. Many people prefer not to think that something terrible, something which could endanger their lives, could happen "here." Although the likelihood is small, it is always better to be prepared. As a manager, your first task is to assess risks and initiate a planning process in your workplace based on identified risks.

These words of wisdom from Bob Fields, Manager of Emergency Services, Santa Clara County, California, should be adopted as a mantra by all emergency planners:

"The only thing tougher than planning for a disaster is explaining why you didn't."¹¹

(3) Get employees involved. A building emergency plan needs to be developed by all those who will be affected by it - not by a manager in isolation. Planning together will prepare people physically and mentally to respond to a traumatic event. It will enhance work team cohesiveness, employee coping skills and reduce negative and counterproductive responses when a traumatic event does occur.

(4) Consult with your Departmental Security Office. Do a risk assessment, identifying the types of traumatic events that could occur in your workplace, such as the ones listed above or the hazards that exist in your workplace. Developing a list of potential dangers will help raise your awareness of potential dangers.

Potential dangers in the workplace:^{4, 6}

• Fire hazards
• Evacuation risks
• Services offered which may pose a risk to employees
• Clients who may pose a risk to employees
• Physical access of clients to employees
• Working with valuables or drugs in isolated areas
• Working with controversial issues or policies including animal experiments, environmental clean-up, enforcement of government regulations, compensation policies, revenue taxation, apprehension of criminals, guarding prisoners.

Identify measures to help eliminate or reduce potential risks in the workplace, such as:^{4, 6, 12}

• Redesigning work space or processes
• Installing protective screens or barriers
• Installing silent alarms
• Installing electronically controlled doors
• Installing ticketing systems that allow customers to enter
• Providing seating for clients rather than having them stand in line
• Providing training to enhance employees' abilities to defuse and manage aggressive clients or disruptive situations.

Detailed lists of workplace risks and hazards, as well as preventive measures are available at: www.afscme.org/health/bio-chem09.htm.

(5) Prepare a list of emergency resources available in the workplace and building, including:

• First Aid and CPR supplies and trained personnel
• Floor emergency evacuation officers
• Fire extinguishers and other fire-fighting equipment
• Sprinkler and alarm systems
• Building emergency response team
• Security systems and personnel.

Employees should be referred to the information notice boards on each floor where much of this information should be provided. If not, contact your Occupational Health and Safety Committee or your Departmental Security Office.

(6) Prepare a list of external emergency resources. Keep the information current. Each employee should have a copy handy. Include names, phone numbers and other contact information for:

• Fire department
• Police department
• Ambulance services
• Nearby medical facilities
• Building security personnel
• Building emergency response team
• Other community resources as determined by the group.

(7) Rehearse the plan with all staff. If possible, include Departmental Security Officers. Exercising the plan increases people's sense of safety, competence and control. Think beyond fire and evacuation drills. What about the possibility of a bomb threat, a hostage-taking incident or a violent confrontation with a client? What if a colleague suffers a heart attack or serious injury? Rehearse your response to each of the risks you have identified for your workplace. Involving in the plan all those who will be affected also builds cohesion and shared responsibility.

An ounce of prevention ... One of the first reactions people often have after a traumatic event is to blame themselves and others, especially management, for not having prepared, or not having seriously taken, building emergency drills. Exercising your response plan regularly can help reduce employee's anger and guilt after a traumatic event.

(8) When danger threatens, expect people to react calmly and rationally. Research has shown that people do not panic when danger threatens. In fact, expect people to protect and help one another reach a safe location. (See Coping with Workplace Trauma: A Self-Help eGuide for Employees for a detailed description of reactions in the face of danger, coming to Employee Assistance Services (EAS) in the Spring of 2005.)

(9) Communication is the heart of a good emergency plan. When a traumatic event occurs in the workplace, employees expect to be informed immediately about the nature of the event and the measures to take to protect themselves. To respond to this vital need for information, lines of communication must be established ahead of time between you and:

• Your employees
• Your senior manager
• The workplace health and security team on your floor
• Your Departmental Security Officer
• Others as appropriate.

Do you and your employees know the names and telephone numbers of those listed above? If this information is not readily available, precious time may be lost. Finding vital information in the middle of a crisis can be complicated by anxiety and fear.

(10) Set up a warning system (code) so co-workers can alert one another if urgent help is required. Possible scenarios include a physical assault, or the presence of a disgruntled employee or an angry client in the workspace. The building's security response team is responsible for deciding the types of code to be used. The warning system should be standardized and all employees should be informed. Colour codes can be used, for example, to describe various dangers. This will help reassure employees that help can be accessed quickly in case of danger.

(11) Warning messages. In addition to increasing fear and anxiety, waiting for a warning message can lead to confusion and disorganization. Insist that the building's security response team know how to write brief, clear and accurate warning messages. Standard warning messages need to be written ahead of time and kept on file so people can access them readily when danger threatens. They also need to be updated periodically.

The goal of a warning message is to empower people by providing accurate and appropriate information on what has happened, where it has happened and what protective measures people need to take immediately. If exits are blocked or filled with smoke, or there is a chemical substance in the ventilation system, employees need to know immediately what measures to take (i.e., whether to exit or stay in the building, when to leave, how to protect themselves).

Keep people informed. Provide updates every few minutes. Let them know what has happened. If you do not have accurate information about the incident, let your employees know. When you do receive the information, immediately tell them what has happened and what is being done to combat the threat.

Do not hesitate to tell people if their lives are in danger. People will handle the information rationally and take the necessary steps to save their own and co-workers' lives.

Frequent and honest communication:

• Builds trust, even when there is little information to share (trust is essential in traumatic situations)
• Reduces uncertainty, fear, anxiety and feelings of being out of control⁵
• Delivers "not only information but reassurance."¹³

(12) Alarm systems. Whenever there is a test of a building's alarm systems, employees often moan and groan: "not another test." Acknowledge the frustration and the seeming "waste of time," but also insist that testing emergency plans saves lives. Employees need to know what alarm measures have been adopted for their building. In some federal buildings, a slow sounding alarm is a signal to get ready to evacuate. A faster sounding alarm is a signal to evacuate. Know what the alarm tones mean in your particular facility. Participating in the planning process will help to convince employees to take alarms seriously and increase their sense of readiness to respond.

(13) If employees have to work late at night or in isolated areas, develop safety plans with them so they can be better prepared in case of an accident or a threat. Providing employees with cell phones, having building security personnel accompany them to their car or bus stop late at night, or providing taxi service are some ways to protect employees.

(14) Prepare a workplace emergency pack¹⁴ if your workplace is located in an area prone to earthquakes, tornadoes or other disasters. If your building is severely damaged during an earthquake, you may not be able to evacuate without assistance. An emergency pack consisting of a first-aid kit and a three-day supply of water and food could sustain you and your staff while you await help. Employees working in an earthquake area zone may also find it handy to have stored in their desk a whistle which they could use to alert rescuers if trapped. (For a detailed list of what to include in an emergency pack, check Health Canada's Registration and Inquiry Manual, Appendix I, Emergency Survival Checklist, available at: www.hc-sc.gc.ca/pphb-dgspsp/publicat/ris-sir/index.html

(15) Know the typical stress reactions you and your employees may experience before, during and after a traumatic event, and the steps you and your employees can take to manage them by reading Coping with Workplace Trauma: A Self-Help eGuide for Employees, coming to Employee Assistance Services (EAS) in the Spring of 2005.

(16) Develop a plan on how to help your employees recover from emotional trauma. Consult with Human Resources personnel and your EAP provider about the emotional support services available to assist employees immediately after a traumatic event and during the recovery period.

(17) Benefits to employees and employers of being prepared. The threat of workplace emergencies, traumatic events and terrorist attacks can erode employees' sense of safety and security and lead to poorer personal and organizational performance. A well-planned, well-exercised emergency response plan, to which employees have contributed, can instil a sense of safety, confidence and control in employees.

Knowing that they and their employer have done everything reasonable to plan for a traumatic event, employees are reassured that they would be ready to act rapidly and effectively if something were to happen. A workplace free of uncertainty fosters peace of mind, well-being and allows employees to go about their daily tasks safely and productively.⁵

(18) Encourage employees to develop family emergency plans so that if something were to happen while they were at work, their loved ones would know how to protect themselves. This will increase employees' well-being and peace of mind.

(19) Commitment and credibility of managers. Responsibility for workplace emergency planning is often assigned by managers to employees such as floor safety officers. This is appropriate as long as the manager demonstrates a personal commitment to emergency planning by, for example:

• Attending key planning meetings
• Being present at staff meetings where emergency planning is discussed
• Being involved in finalizing the emergency response plan, and
• Remaining involved in keeping the emergency response plan up to date.

Manager involvement lends credibility to the emergency planning process and underscores to all staff the need to be prepared for an emergency. For assistance in developing a psycho-social emergency response plan for your workplace, call 1-888-366-8213.

4. Managing the Immediate Response to a Major Traumatic Workplace Event

One of the characteristics of traumatic events is that they occur suddenly, often without warning. Examples include the sudden death of an employee, an employee who suffers a heart attack, the armed threat or shooting of employees by a disgruntled co-worker, the suicide of an employee, a fight between employees or a terrorist event.

The following guidelines will help you manage the incident, as well as the emotional effects of a traumatic event for the first few minutes and up to 24 hours.

• Find out what has happened.
• Assess danger.
• Have designated response team members:
  • call local authorities to assist, such as fire, police or ambulance;
  • call the Departmental Security Officer;
  • check stairways and exits in case employees have to evacuate;
  • call senior management.
• Account for your employees.
• If appropriate, initiate the emergency workplace response plan.
• If you believe staff are in danger, let them know immediately what has happened and what protective measures to take (e.g. take cover, stay out of the area, evacuate the workplace area or building, or wait for police, fire or ambulance to arrive).
• If you believe staff are not in danger, let them know what has happened. Let them know they are safe and the situation is under control. Inform them of the measures being taken to deal with the traumatic event or injured persons. Let them know if they need to evacuate.
• Reassure employees that you and the response team are doing all you can to deal with the event. This will help relieve some anxiety and fear.

4.1 If Employees Have Been Injured or this is a Health Emergency

• Initiate emergency response plan.
• Have designated response team members:
  • locate your floor's first aid team
  • call local authorities to assist, such as ambulance, fire, police
  • call building security response team and Departmental Security Officer
  • call senior management
  • if appropriate, wait by the elevator to guide first responders to the scene.
• If possible, designate an employee to accompany the injured employee(s) to the hospital.
• Call family members as soon as possible to let them know that their loved one has been transported to the hospital. Provide them with the hospital's name and address. Do not discuss the person's health condition. Reassure them that everything is being done to help their loved one.

In implementing your emergency response plan, your subsequent response will be guided by the measures appropriate to this particular event or to similar events. These response plans will often involve various kinds of first responders (e.g., fire, police, ambulance) appropriate to the event that has occurred. They will offer expert advice to assist you in managing the situation. First responders are experienced in these events, will take over the emergency management of the actual event, and will mobilize whatever additional emergency response they deem appropriate.

If the event is of sufficient magnitude, first responders and their command structure may invoke your community's emergency/disaster response plan. Emergency Medical Services (i.e., ambulance and paramedic) personnel would be assigned to treat and transport injured personnel to the nearest medical facility. Employees with minor or no physical injuries may be evacuated to one or more Reception Centres operated by the municipal Emergency Social Services. There, employees would be provided with first aid; basic needs (blankets, food, water); emotional support and comfort. The Registration and Inquiry (R&I) Service operated by Emergency Social Services would assist in locating missing persons through their links with hospitals and the coroner's office. Notification of next of kin is the responsibility of medical and public safety employees. Many municipalities across Canada, as part of their emergency response plans, have a Psycho-Social Services Response Team which assists citizens affected by a major traumatic event. These teams have well-trained responders who can also assist you in case of a traumatic event.

4.2 If Employees Have Died

• Notification of next-of-kin and other decisions regarding the release of the names of people who have died is the responsibility of official authorities such as the coroner's office or police, or health authorities if the person died at the hospital.
• Liaise with official authorities so loved ones can be informed as soon as possible and learn first hand about the incident. Families that receive information about their loved one's fate from the media can become enraged. This anger can persist and delay their recovery.
• Plan ahead about how death notifications will be handled and by whom. A member of the clergy or a police chaplain can accompany officials to offer emotional support to family members who are informed of the death of a loved one. Consult with your EAP for advice on how to proceed.

4.3 If this Is a Mass Casualty Incident and Numerous Employees Have Been Killed or Injured

• Initiate emergency response plan.
• Have designated response team members:
  • locate floor first aid team to assist injured
  • call local authorities to assist, such as ambulance, fire, police
  • call building security response team and Departmental Security Officer
• If appropriate, evacuate employees who are uninjured or have minor injuries.
• In the event of a mass casualty incident, first responders are responsible for mitigating the situation. If the incident is beyond the capability of the agency in charge, the most senior official may request that the municipality activate their emergency plan to further assist in the response. Emergency Medical Services personnel would be assigned to treat and transport injured personnel to the nearest medical facility.
• Employees with minor or no physical injuries are usually evacuated to one or more Reception Centres operated by the municipal Emergency Social Services. There, employees would be provided with:
  • first aid
  • basic needs (blankets, food, water)
  • emotional support and comfort.
• If your workplace was damaged and employees have been affected, immediately attempt to account for all your employees.
• If some employees are unaccounted for, check with the Registration and Inquiry (R&I) Service operated by Emergency Social Services. One of R&I Services' roles is to assist in locating missing persons through their links with hospitals and the coroner's office.
• If employees have been killed or injured, follow the procedures as outlined above.
• Once employees have been accounted for, contact senior management and provide them with a status report.
• You may want to remain with employees at the Reception Centre until all have returned home.

4.4 If this Is a Criminal Incident

Police will want to question employees if this is a criminal incident. This may be a problem if employees are in shock, are experiencing acute reactions, or are afraid of retaliation. Call your Departmental Security Officer, senior management and Human Resources for advice.

5. Once the Immediate Danger Is Over

5.1 If Employees Have Been Killed or Seriously Injured

• If safe, arrange for the remaining employees to meet in an alternate location within the building where they work or in a building or facility nearby.
• Ensure privacy so employees can discuss the event and share their feelings openly.
• Arrange for them to call loved ones to let them know they are safe if electrical power is unaffected.
• Immediately meet with staff and provide them with information about the condition of colleagues and the most recent information you have about the event. Provide basic reassurance and emotional support. In these situations, employees usually console and support one another.
• If possible, contact your EAP provider to arrange a session for staff to meet, on a voluntary basis, with a counsellor to learn about the types of reactions to expect in the next 72 hours and how to best manage them, or refer to Coping with Workplace Trauma: A Self-Help eGuide for Employees, coming to Employee Assistance Services (EAS) in the Spring of 2005.
• If this is a criminal event, or if injuries have occurred, police officers or occupational health and safety personnel will want to question employees about the circumstances surrounding the event. Paperwork will need to be completed and submitted, including Workplace Safety and Insurance Board forms available at: www.wsib.on.ca/wsib/wsibsite.nsf/public/FormsOverview
• Keep employees together. If they are experiencing acute stress reactions, remain with them while they are being questioned or seek assistance from senior management or Human Resources personnel.
• If police insist on interviewing an employee privately, make sure there is someone waiting to meet the employee after the interview.
• If there is no immediate investigation, and if possible, give employees the choice to remain at the office or go home.
• Employees experiencing strong stress reactions and wanting to go home should be asked if someone is at home. If not, ask a co-worker to accompany them until family members or friends arrive.
• Employees may have strong reactions, yet want to stay at work. They should not be left alone.
• Have EAP promotional materials, including contact information, handy to disseminate to staff. Encourage employees to contact your EAP provider if they need support.

5.2 If No One Was Killed or Seriously Injured and the Workplace Is Safe

Once the immediate danger is over and, if no one was killed or injured and the workplace is safe to return to:

• Suggest to employees that they all return to the workplace.
• Bring those affected by the event together as soon as possible.
• Provide employees with whatever accurate information you may have about the incident.
• If some employees are experiencing strong emotional reactions following the incident, offer basic emotional support and encourage them to contact your EAP provider for assistance.
• Some employees may prefer to go home. If they are emotionally upset, ask if there is someone at home to assist them. Give them an opportunity to call a loved one. Ask a co-worker to accompany them and to remain with them until a family member or friend arrives. If they live alone, provide them with the contact information for your EAP provider.

5.3 Providing Emotional Support to Employees

If this is a major traumatic event and employees have been killed or injured and the situation is now under control, have co-workers provide emotional support to employees affected by the event until EAP counsellors or the community Psycho-Social Response Team arrives.

Basic measures you or co-workers can take to comfort and support employees experiencing strong emotional reactions³ include:

• Protect employees from shocking or gory scenes. These will only add to their distress. Move them to a separate area where they can regain control over some of their stress reactions. Ask other employees to assist by providing support, being careful not to overwhelm those affected with more support than they need.
• If this is a violent traumatic event--such as a shooting, fire or explosion--and if employees are out of danger, suggest they phone their loved ones to let them know they are safe.
• If some employees are experiencing acute stress reactions, such as severe anxiety, fear, shock or show signs of confusion, let them know what has happened, what is happening now and what is going to happen in the next few minutes. Ask colleagues to help by sitting with them. Shock is an adaptive, protective mechanism which prevents individuals from being overwhelmed by the acute reactions they are experiencing as a result of the event. People usually recover within a short period of time.
• Validate employees' reactions to the event. Let them know that it's okay to experience fear, anxiety, shock, disbelief, anger or strong feelings of helplessness or powerlessness. Reassure them that these are typical reactions. Share your own reactions with them; since you can function rationally in spite of your reactions, they can do likewise.
• Provide comfort and reassurance to those who are upset. Being with people who are understanding and supportive is most important for those affected.
• Listen attentively to employees who want to share their reactions to the event. Acknowledge their reactions. Reassure them that these are common reactions to what has happened. Avoid empty promises such as: "Everything will be fine." Instead, acknowledge their feelings. It's also okay if people do not want to talk about the event. Everyone has their own way of dealing with stressful situations.
• Call your EAP and arrange to have a counsellor on site, or encourage employees and their family members affected by the traumatic event to contact your EAP directly.
• Referrals. If you are concerned about an employee's reactions, encourage the person to seek emotional or medical support. Suggest that the person take advantage of EAP services.
• If your EAP does not have the capacity to respond, Employee Assistance Services (EAS) is available on a cost-recovery basis. For more information, call 1-888-366-8213.

5.4 Managing the Media³

If this is a major traumatic event, the anguish and grief of survivors will become the subject of media attention. The media can play an important role in informing people when danger threatens. However, in the immediate period after a traumatic event, the needs of the media run counter to the needs of survivors who are experiencing acute reactions.

In the first few hours after a traumatic event, survivors need privacy so they can work through, and gain control over, strong emotional reactions triggered by the event.

All media requests to meet with you or your employees should be referred to your department's communication personnel.

6. Managing the First 24 hours of a Traumatic Event

Once employees have returned home after a major traumatic event, affected workplace managers may want to meet with senior managers, Human Resources, Pay and Benefits personnel as well as EAP advisors to discuss the following issues:

• Assisting and supporting employees traumatized by the event
• Assisting police or occupational health and safety personnel in the investigation of the event
• Business Continuity Planning (BCP)
• Planning for the return of employees to the workplace
• Arranging for employees to attend funerals, if close colleagues were killed
• Providing contact information for your EAP and encouraging employees to use the services offered by them once they return to work, or to assist and support injured employees in the hospital or at home
• Communicating with the media and police; keep in mind that union representatives and/or Legal Services may be involved.

6.1 Meeting with Families of Deceased and Seriously Injured Employees

If employees have been killed or seriously injured, it is important for the employer to meet with family members as soon as possible. Families usually appreciate being the first to receive information on how their loved ones died or were injured, as well as meeting the employer and receiving condolences and comfort.¹⁵

Do not underestimate the intensity of family members' anger that can be triggered when employers avoid families or do not provide them with ongoing information about their loved ones and the event. Families often resent being informed through the media first.

When meeting with loved ones:^{15, 16}

• Offer your sympathy and ask how you may help.
• Listen to people's concerns about their loved one or about themselves. Let them know how sad it must be for them and that you are sorry about what happened to their loved one.
• Provide them with as much accurate information as possible. This will help build trust.
• If possible, provide them with the names and phone numbers of a Human Resources employee and a Pay and Benefits Advisor to assist them or answer their questions regarding employee benefits.
• If possible, appoint a benefits person to work with families full time. This will facilitate requests for compensation or disability information and demonstrate employer concern for their well-being.

7. Managing the Short-term Response (from 24 to 72 hours)

The following suggestions vary depending on the severity of the event, the number of employees killed or seriously injured, and if the workplace is safe to return to.

7.1 The Workplace: A Comforting and Healing Cocoon

Federal employees can refuse to return to their workplace if it is deemed unsafe. For certification that a workplace is safe to return to, contact the Workplace Health and Public Safety Programme's Physical Emergency Preparedness and Response Team at 1-800-268-7708.

The workplace may be the best place for employees to return to following a traumatic event as it provides co-workers with an opportunity to:⁹

• Meet in a familiar place, surrounded by familiar colleagues
• Talk about what happened with people they know who shared the experience and are trying to make sense of what happened
• Meet, on a volunteer basis, with an EAP counsellor
• Initiate the grieving process
• Console, comfort and reassure one another
• Plan a workplace memorial ceremony for those killed
• Arrange to visit injured co-workers and meet with their families
• Arrange to attend colleagues' funerals
• With the permission of the family, perhaps prepare a eulogy
• Set up a relief fund for the families of those killed or injured.

If some uninjured employees have not returned to work and the workplace is safe and operational, contact them to provide any new information, see how they are doing and advise them to return to work.¹⁷ Should they require emotional support, encourage them to contact your EAP.

7.2 Funeral Arrangements

Once funeral arrangements have been made, if possible:

• Arrange for temporary help so co-workers can attend the funeral(s)
• Arrange for senior departmental staff to attend
• Attend reception(s) after the funeral(s) to comfort family members; remind them that you are available to answer questions
• Arrange to meet with your employees after the funeral(s)
• Remind employees of the need to look after themselves. Provide them with Coping with Workplace Trauma: A Self-Help eGuide for Employees, coming to Employee Assistance Services (EAS) in the Spring of 2005.
• Plan the return to regular office routine with them; ask for their suggestions on how to best honour the deceased colleague(s).

7.3 If a Memorial Service Is Held at Work^{10 ,16}

A memorial service can provide employees with an opportunity to express their grief and honour the deceased. Memorial services can take several forms; for example, employees can get together to:

• Observe a moment of silence
• Hold a prayer service
• Plant a tree
• Take a collection for colleagues and their families
• Place a tribute in the newspaper
• Donate to a favourite charity of the deceased.
• Keep the memorial personal by having friends and close associates of the deceased plan and carry it out rather than "management" who may want a more polished ceremony.
• Friends could be invited to speak about the qualities they admired in the deceased, the person's contributions to the work and the morale of the group. Poetry or music reminiscent of the deceased may be shared.
• Invite family members to the memorial. Rituals, such as a workplace memorial, offer appropriate opportunities for people to express their grief openly and freely in a safe environment. Ask family members if they would like to participate in the memorial.
• If family members do not attend the memorial, ask if they would like to visit the office to retrieve their loved ones' personal items. If they do come to the office, arrange a reception for the family where their loved ones' colleagues can meet them. Arrange for senior managers to be present to offer their sympathy and support. Should family members choose not to come to the office, reassure them that you or a designate will deliver their loved ones' personal items to them. Ask if they would welcome calls or visits from co-workers.
• Offer to telephone the affected families. If your offer is accepted, ask how often they would like to hear from you or your co-workers. Contacts such as these are important healing activities.
• Ensure that families of the deceased have contact information for federal or municipal psycho-social support outreach programs.

7.4 If Employees Were Seriously Injured

• Maintain contact with them throughout their absence and keep them informed about news and developments at work. This will show them that you are concerned and give you a chance to assure them that you look forward to their return to work.
• Ask them what information, if any, they want shared with co-workers and colleagues outside the workplace.
• Ask if they would welcome calls or visits from co-workers.
• Assure them that you welcome hearing from them. Building a relationship based on trust and mutual respect during their absence will carry over when employees return to work. Also, employees who feel appreciated are much more likely to return to work promptly and to participate actively in the return-to-work process.
• If possible, accelerate the provision of disability benefits. Assistance from management with compensation claims, disability benefits and sick leave may lessen the after-effects. Experience demonstrates that having a one-stop human resources or benefits claim centre, or having the same person assist individuals or families over time, is appreciated by employees and contributes positively to their recovery. Human Resources personnel may need additional information on the emotional needs of employees and their families, especially if they are unaccustomed to working with people experiencing strong emotional reactions.¹⁵

7.5 When an Injured Employee Is Ready to Return to Work

• Encourage the person to return to work. Returning to a regular routine and being with colleagues can contribute to a person's recovery.
• A return to work on a gradual basis may be required, along with a suitable work plan and reorientation. This should be agreed to by the Workplace Health and Public Safety Programme's Occupational Health Medical Officer who is responsible for conducting the Fitness to Work Evaluation (FTWE) and Medical Assessment for the employee's return to work. Additional suggestions include:
  • an initial meeting with the employee's supervisor to discuss workload, returning to work part-time, adjustments to office equipment or furniture
  • a different assignment at first, or the assignment of a co-worker to help the employee overcome anxiety and gain confidence
  • a staff meeting to welcome the employee back
  • consultation with your EAP provider or Human Resources personnel.

Having a plan increases the likelihood of a smooth reintegration of employees.

8. Managing the Emotional Needs of Employees the First Few Weeks after a Traumatic Event

8.1 Stress Reactions in the First Few Weeks

As employees return to their workplace following a traumatic event, the initial numbness, disbelief and bewilderment start to wear off and the reality of the losses experienced begins to set in. According to trauma experts, this is an important phase in the recovery process, as survivors:

• Begin working through their recent experience
• Try to understand its meaning
• Examine key learning points
• Make it part of their life experience.¹⁸

Following are some common reactions you and your employees may experience in response to traumatic events, the impacts of which can be decreased through effective emergency preparedness and planning.

Physical: fatigue, headaches, dizziness, stomach problems, increase or decrease in appetite, neck and back aches, or sleep difficulties.

In how you think: memory problems, have difficulty concentrating, find it hard to stop thinking about the event, find it hard to remember day-to-day things, feel disorganized at work and at home, or have flashbacks.

Emotional: fear that a similar event may reoccur, sadness for deaths and injuries, grief for colleagues, guilt for being alive, anger at the injustice and senselessness of the event, feeling vulnerable and fragile or anxious about the future.

In how you act: overly vigilant to environment, isolated, impatient, irritable, change in communication patterns (talk a lot more or less), or use more alcohol, drugs or tobacco.

8.2 Some General Emotional Support Guidelines

Following are key emotional support guidelines you need to keep in mind as employees settle back into the workplace and start integrating the traumatic event they experienced.

• Various reactions are natural in situations of stress. It is reassuring to know that most reactions to a very stressful event are common and that most people do not disintegrate in response to a traumatic event.
• People are resilient and strong and most will recover within a short period of time. Indeed, stressful events, even major crises, are part of life. In most cases, our life experience has given us the strengths and skills we need to gradually work through our feelings and reactions.
• Contact with colleagues and others whom they feel close to is important when adjusting to a traumatic event. It encourages co-workers to share stories, to put their experiences into words and slowly and naturally achieve some understanding and integration of their experience.¹⁸
  
  
• Reassuring employees about their safety at work and explaining what measures are being taken to protect them is an important step in helping them cope.¹⁷
  
  
• Responding to employees' emotional needs in a timely and sensitive manner will foster a sense of loyalty and trust, facilitate employees' reintegration in the workplace and reduce absenteeism.
• Work has a healing value. "Getting back to the daily routine can be a comforting experience."¹⁰ Getting up in the morning, returning to a safe environment, being surrounded by colleagues, and having meals at a regular time all contribute to increasing a person's sense of control, thereby reducing distress and restoring a sense of safety and security. It is important to remember that most people can work productively while still dealing with grief and trauma.¹⁰

8.3 Practical Administrative Guidelines

You can assist employees by taking practical measures that can help in preventing or reducing work-related stress. For example:

• Recognize that the weeks following a traumatic event may be less productive.¹⁷
  
  
• Request that pending deadlines be delayed or assigned to another group.
• Ask superiors to provide temporary help with administrative work. Use caution in getting additional help. If employees have been seriously injured or killed, co-workers may consider immediate replacements as disrespectful. It is good to discuss staffing needs with employees before making a decision.

8.4 Helpful Emotional Support Measures ^{(3 ,5,8, 10, 16-23)}

Here are some emotional support measures to help you support your staff as they adjust and start absorbing their experiences:

• Being there with and for your employees and listening to their stories and concerns in a caring way are the most helpful measures you can take in providing emotional support.
• Meet with staff regularly. Check with each one individually and privately and also meet with them as a group. Ask them how they are doing. Find out their concerns. Contacts should be supportive and caring. You represent the organization to your employees, and your caring presence and genuine interest can mean a great deal in helping them feel supported.
• Build on the strengths of the group. Encourage employees to take care of one another through such simple measures as listening to those in distress, offering practical help, visiting hospitalized co-workers, or going with an employee on a first visit to a feared site.¹⁰ Encourage them to check with each other at work. "The more you have done to build a cohesive work group and to foster self-confidence in your employees, the better your staff can help one another in a crisis."¹⁰
• Feel free to share your own natural reactions with your employees. Knowing that you also experience anxiety, fear, anger or grief will help normalize and validate what they are experiencing. Showing you can function effectively in spite of your reactions may help them do likewise. Sharing your own reactions is not a sign of weakness; rather, it gives permission for employees to talk about their own pain. On the other hand, be careful not to turn conversations into forums for your own experience. Each person experiences events in a unique way. Acknowledge their feelings. Avoid statements like "I know exactly how you feel" or "You shouldn't take it so hard." Also, steer clear of pronouncements that minimize a person's pain (e.g. "It could be worse" and those that reject people's feelings, such as "You have to pull yourself together").¹⁰
• Try to answer questions as best you can. If you don't know the answers to their questions, it's okay to say that there are some things you don't know or understand.
• Be accessible and supportive. Listen attentively to what people are saying and respond in a caring and non-judgmental manner. Let people know it's okay to cry.
• Alert them to expect to feel sad in the weeks after the event and to not rush recovery. Normalize and validate these reactions. Suggest they read Coping with Workplace Trauma: A Self-Help eGuide for Employees, coming to Employee Assistance Services (EAS) in the Spring of 2005.
• Talk about everyday issues and activities. Refrain from letting the traumatic event take over every conversation.
• Review your building emergency plan with all employees. Ask staff to share lessons learned from the recently experienced traumatic event. Include these in your response plan.
• Ask to attend a training session on stress management so you can better understand employees' reactions and how to best help them manage their reactions.

If the traumatic incident was due to a workplace accident or criminal incident, employees, including managers, may:

• Be interviewed by the police, departmental security officials, the Department of Human Resources and Skills Development and/or an Occupational Health and Safety Committee
• Have to appear at a coroner's inquest or in court.

Any one of these events may trigger a wide range of stress reactions as employees are asked to recall what happened. Inquests or court appearances may last several weeks. Additional emotional support will probably be required at this time. Encourage employees to make use of help and services provided by your EAP.

8.5 Delayed Reactions

Some people react strongly as stressful events are happening; others react a few days, a few weeks or even a few months later. Delayed reactions can be confusing as people start experiencing reactions they had at the time or immediately after the traumatic event. Remember, not everyone reacts the same way and at the same time.

8.6 When an Employee Appears Overwhelmed

With the support of family and friends, most victims of a traumatic event see their stress reactions diminish over a period of time and they gradually recover from the emotional effects. For a small minority, however, the symptoms triggered by the traumatic event may not resolve themselves so quickly. This is particularly true for individuals:

• Whose lives were threatened
• Who experienced greater terror, horror or fear
• Who may have been more vulnerable because of concurrent stressful life events.

In some cases, a person's reactions to the event may become so intense that they:

• Have trouble functioning at home or at work
• Frequently cry unexpectedly long after the event
• Are depressed or anxious a lot of the time
• Withdraw from others
• Eat a lot more or less
• Appear tired and lethargic
• Complain of nightmares and insomnia
• Abuse drugs or alcohol.

If you suspect that an employee is experiencing distressing reactions, encourage the person to consult your EAP and ask for assistance.

8.7 Resources to Help You Support Employees

8.7.1 Internal Resources

Federal employees have access to a number of programs and resources which will be of assistance in the days and weeks following a traumatic event. These include:

(1) Employee Assistance Program

Ask your EAP to present information and education sessions to staff on stress reactions and stress management following a traumatic event. Sessions could be offered:

• A few weeks after the event, as employees grieve losses brought on by the event
• A few months after the event when stress reactions can start affecting employee's health, predisposing them to e.g., flu, colds, high blood pressure
• Close to the anniversary date when reminders of the event may cause distress.

Encourage staff to take advantage of EAP services at any time. Provide them with the name and telephone number of your EAP provider.

(2) Critical Incident Stress Management

Critical Incident Stress Management (CISM) services may be offered by your department's EAP. CISM, a crisis intervention model developed for first responders, may be a useful model if your employees are first responders (e.g. firefighters, security personnel, emergency medical workers). CISM sessions may include:

• Pre-Incident Planning
• Policy and Procedure development
• Pre-Incident Training for employees and management
• Post-Incident Services (e.g. demobilization, debriefing)

For more comprehensive information, contact your EAP. If your EAP is unable to provide these services, contact EAS at 1-888-366-8213.

(3) Psycho-Social Emergency Response Team

The Employee Assistance Services Bureau at Health Canada has developed and trained a Psycho-Social Emergency Response Team. This team of trauma professionals from across Canada will, upon your request, assist federal departments or agencies to manage the psychological and social response and recovery activities when a major traumatic event occurs in the workplace. Team members will work in cooperation with your department's EAP in responding to the psycho-social needs of your employees. They will also provide consultative services to help you manage the many issues that might arise in the aftermath of a traumatic event. These services are available on a cost-recovery basis, or, in case of a major disaster, through disaster funding. If you require the assistance of the team, call EAS at 1-800-268-7708.

(4) Human Resources

Human Resources and Pay and Benefits can assist by explaining, to loved ones of employees who died or were injured, the various entitlements offered by the employer:

• Death benefits
• Pension benefits
• Medical benefits
• Sick leave
• Disability benefits

Human Resources can also assist managers in developing a transition work schedule and work plan for employees who are returning to the workplace. The employees' family physician and the Workplace Health and Public Safety Programme's Occupational Health Medical Officer are also involved in determining if the employee is fit to return to duty.

(5) Departmental Security Officer

In accordance with Treasury Board's Government Security Policy, the Departmental Security Officer (DSO) in each federal department or agency is the designated official who takes the lead in establishing security programs for:

• The protection of employees (building occupants)
• Sensitive information holdings
• Assets.

The DSO is responsible for the development and implementation of relevant policies, programs and working tools and for the provision of expert security advice, consultation and emergency response services.

8.7.2 External Resources

(1) Municipal Trauma Management Team

Many municipalities across Canada, as part of their emergency response plans, have a Trauma Management Team in place to assist citizens affected by a major traumatic event.

(2) Community Resources

Most communities across Canada have a wide range of agencies and organizations which can offer short- and long-term emotional support to people affected by a traumatic event. Here are some key agencies which can help:

• Child and Family Services
• Canadian Mental Health Association
• Distress Line
• Crisis Intervention Services
• Bereaved Family Services

(3) Union Representatives

Employees may also want to consult with their union representatives for various forms of assistance, for example, compensation, disability, return to work. Some unions have additional death benefits that families of employees may be able to claim.

9. Taking Care of Yourself ⁷

As a manager, you can play an important role in facilitating the physical and emotional recovery of employees. However, you can become a hidden victim of traumatic events. Sudden, unexpected traumatic events can be as devastating for managers as they are for employees. Getting the job done while at the same time providing reassurance and support under conditions of severe, long-lasting stress, can lead to physical wear and tear.

9.1 Stressors That Can Affect You

Common sources of stress that you may face include:

• Trying to live up to high expectations from self, employees, senior managers
• Caring for others at the expense of yourself
• Mental, emotional and physical demands
• Heavy workloads
• Long hours on the job
• Time pressures
• Limited resources
• Competing priorities
• Organizational pressures
• Preparing a multitude of ongoing reports about the traumatic event for numerous investigation groups
• Being interviewed by police or Occupational Health and Safety Committee
• Appearing at a coroner's inquest or court.

Although many of the underlying stresses cannot easily be prevented, you can increase your resistance by taking care of yourself and staying healthy. It is important that you pace yourself so you can continue to be available to your employees and your organization.

9.2 Stress-relieving Activities

Here are some stress-relieving activities that you can act on immediately to stay healthy:

• Go for a 15-minute walk during a lunch or coffee break. Take other opportunities to stay physically active.
• Contact your EAP for personal support or for ideas to help you support your staff.
• Eat sensibly. Drink plenty of water and juices. Avoid excessive use of caffeine and alcohol.
• Know and respect your limits. If you feel exhausted and need time off, take it. Respect commitment for regularly scheduled time off.
• Spend time with family and friends. Talk to them. Listen to them if they become concerned with your health and well-being.
• As much as possible, continue to participate in previous social and recreational activities.
• Be on the lookout for any changes in your habits, attitudes and moods.
• Share your own reactions and management issues with other managers. Do not hesitate to ask for advice.
• Include yourself on the list of people you are taking care of. Take some time to do something just for yourself each day. Taking care of yourself will put you in better shape to give care to others.
• For additional information, refer to Coping with Workplace Trauma: A Self-Help eGuide for Employees, coming to Employee Assistance Services (EAS) in the Spring of 2005.

At any time during the recovery process, you may feel overwhelmed and unable to cope. If this is the case after trying the above suggestions, it may be time to speak to an EAP counsellor, family doctor or other health professional.

10. References

1. Hénault, Ray (Chief of the Canadian Defence staff), Canadian Armed Forces. (2002). Promoting a culture of support. Ottawa Citizen, December 17, pages A1-A2.
2. American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition. Arlington, Virginia.
3. Health Canada, Emergency Services Division. (1990). Personal Services: Psychosocial Planning for Disasters. Ottawa: Minister of Supply and Services.
   www.hc-sc.gc.ca/pphb-dgspsp/emergency-urgence/index_e.html
4. American Federation of State, County and Municipal Employees. (AFL-CIO). (2002). Are You Prepared? An AFSCME Guide to Emergency Planning in the Workplace.
   www.afscme.org/health/bio-chem.htm
5. APA Online, APA Task Force on Workplace Violence. (2002). Response to Workplace Violence Post 9/11- What Can Organizations Do? www.apa.org/pubinfo/post911workplace.html
6. Government of Western Australia, Consumer and Employment Protection. (2000). Code of Practice: Workplace Violence.
   www.safetyline.wa.gov.au/pagebin/pg000036.htm
7. Health Canada, Centre for Emergency Preparedness and Response, Office of Emergency Services. (2003). Self-Care for Caregivers - Responding to the Stress of Terrorism and Armed Conflicts.
   www.hc-sc.gc.ca/pphb-dgspsp/publicat/oes-bsu-02/caregvr_e.html
8. National Association for Loss and Grief. (1999). Grief Reactions Associated with the Workplace. www.grieflink.asn.au/workplace.html
9. Rick, J., Young, K., & Guppy, A. (1999). From Accidents to Assaults: How Organizational Responses to Traumatic Events Can Prevent Post-Traumatic Stress Disorder (PTSD) in the Workplace. HSE Contract Research Report 195/98. ISBN 0 7176 1631 2.
   www.employment-studies.co.uk/summary/summary.php?id=ptsd2
10. U.S. Office of Personnel Management, Human Resources Office of Employee Relations and Workplace Performance. (1996). A Manager's Handbook: Handling Traumatic Events. Washington, DC. www.opm.gov/ehs/pdf/trauma.pdf
11. Kazak, Don & Rothman, Jason with contribution from Jeff Israely. (1994). Earthquake: Quake recovery still not complete. Palo Alto Online, October 12.
    www.paloaltoonline.com/weekly/morgue/news/
    1994_Oct_12.QUAKE.html
12. Queensland Government, Division of Workplace Health & Safety, Department of Employment, Training and Industrial Relations. (1999). Violence at Work: A Workplace Health and Safety Guide. http://www.whs.qld.gov.au/guide/gde02v1.pdf
13. Bernstein Communications Inc. (2003). An ounce of prevention: The do's and don'ts of successful media interviews. Crisis Manager - The Internet Newsletter About Crisis Management, January 15. www.bernsteincrisismanagement.com/nl/crisismgr030115.html
14. Health Canada, Centre for Emergency Preparedness and Response, Office of Emergency Services. (2002). Registration and Inquiry Services. Ottawa: Minister of Public Works and Government Services Canada.
    www.hc-sc.gc.ca/pphb-dgspsp/emergency-urgence/index_e.html
15. U.S. Department of Justice, Office of Justice Program. (2000). Responding to Terrorism Victims: Oklahoma and Beyond.
    www.ojp.usdoj.gov/ovc/publications/infores/respterrorism/chap3.html
16. National Partnership for Workplace Mental Health. (2002). When Disaster Strikes: Managing Mental Health in the Workplace. Pamphlet. www.workplacementalhealth.org/resources/APA_brochure_Aug02.pdf
17. Ferguson, Carol R., & Towhey, G. Mark. (2001). The Day After: Trauma in the Workplace. www.towhey.com/WorkplaceTrauma.htm
18. Shalev, Arieh Y., & Ursano, Robert J. (2003). Mapping the multidimensional picture of acute response to traumatic stress. In Roderick Ørner & Ulrich Schnyder (eds.), Reconstructing Early Intervention After Trauma: Innovations in the Care of Survivors. Oxford: Oxford University Press, pp. 118-129.
19. Ballard, Tanya. (2001). Federal employees get help coping with tragedy. Government Executive Magazine, Daily Briefingwww.govexec.com/dailyfed/0901/091301t1.htm
20. Health Canada, Employee Assistance Services. (2002). "Tips for the Supervisors and Managers of Employees Involved in a Traumatic Event." Internal document.
21. National Association for Loss and Grief. (1999). Grief Reactions Associated with the Workplace. http://www.grieflink.asn.au/workplace.html
22. Rick, J., Perryman, S., Young, K., Guppy, A., & Hillage, J. (1998). Workplace Trauma and Its Management: Review of the Literature. Colgate, Norwich: Her Majesty's Stationery Office. www.hse.gov.uk/research/crr_pdf/1998/crr98170.pdf
23. U.S. Department of Labor, Office of Disability Employment Policy. (2001). Facilitating Return to Work for Ill or Injured Employees. www.dol.gov/odep/pubs/ek01/facilitate.htm

11. Emergency Phone Numbers

• 911
• Fire Department
• Police
• Departmental Security Officer
• Human Resources Advisor
• Employee Assistance Program
• Employee Assistance Services 1-800-268-7708
• Psycho-Social Emergency Response Team 1-800-268-7708
• Physical Emergency Preparedness and Response Team 1-800-268-7708
• Regional Workplace Health and Public Safety Programme