Critical Incidents

Health-care providers do their best to ensure patients, clients and residents receive safe care. But unintended events can happen and cause unintended harm. These are called patient safety events. A serious patient safety event may be recognized as a critical incident.

What is a Critical Incident?

A critical incident is an unintended event that occurs when health services are provided to a person and result in an effect to them that:

• Is serious and undesired, such as death, disability, injury or harm, unplanned admission to hospital or unusual extension of a hospital stay; and
• Does not result from the person’s underlying health condition or from a risk inherent in providing the health services.

More information on critical incidents can be found in the Critical Incident and Disclosure Guide.

What is Critical Incident Stress?

Critical Incident Stress (CIS) refers to the reaction someone may experience after being part of, or seeing, a critical incident. The reaction may happen right away or appear hours, days, or even weeks later. CIS is the body’s normal response to an abnormal event. Everyone reacts differently to a critical incident and these reactions are normal. (Lifesaving Society, 2017).

What are Potentially Psychologically Traumatic Events?

Potentially Psychologically Traumatic Event (PPTE) refers to events that have the potential to cause post-traumatic stress injuries (PTSI) or other trauma-related mental health conditions. They can overwhelm an individual’s ability to cope and can lead to significant emotional and psychological distress. PPTEs are often unexpected, intense, and involve situations such as:

• serious workplace accidents or injuries,
• exposure to violence or threats of violence,
• witnessing the death or serious injury of others,
• experiencing natural disasters, such as floods, fires, or tornadoes,
• working during a health crises or pandemic.

Health-care providers are especially vulnerable to PPTE due to the nature of their roles, which may include dealing with critical patient outcomes, high-stakes environments, and emotionally charged situations. These events can affect people differently and may result in feeling helplessness, fear, or loss of control.

Understanding what PPTEs are and recognizing their potential impact is essential to early support and intervention.

Symptoms of CIS

Here are some common signs and symptoms you may display when experiencing CIS:

• Physical – Feeling tired, having a racing heart, changes in sleeping and eating habits, body aches, headaches, or crying more than usual.
• Emotional – Feeling guilty, anxious, lonely, angry, or sad. You may also feel irritable.
• Cognitive – Feeling confused, having trouble focusing, having flashbacks, or finding it difficult to make decisions.
• Behavioural – Isolating yourself, losing interest in daily activities, and getting startled easily.

Ways to Cope with CIS

• Stay connected with others – it’s normal to want to be alone, but staying connected with people is beneficial to your mental health and can help with healing.
• Keep a regular routine as much as you can – go to bed and wake up at your regular time, continue bathing regularly and practicing good dental hygiene habits daily, and continue attending activities scheduled in your calendar, such as family gatherings and weekly classes.
• Nourish your body with nutritious food.
• Move your body – physical activity helps with blood flow and releases feel-good hormones.
• Drink plenty of water – staying hydrated can help to flush out stress hormones like cortisol.
• Be kind to yourself – do not think that you are weak for having a reaction to a critical incident, or that you need to “toughen up” in order to continue working in this profession. Your reaction is normal and it is okay to feel how you feel.

When to Seek Support

Most reactions to critical incidents will go away within six to eight weeks after the incident. Time is often helpful in recovery. The memories may stay, but the intensity of the feelings usually gets better over time. If your reactions are lasting longer and are affecting your life at work or home, reach out for more support.

Reaching out for Support

If you are experiencing CIS or are affected by a PPTE, it is important to reach out for support. Your leader can help guide you through the process of accessing support services, including reaching out to the Wellbeing Team, the Manitoba Blue Cross Employee Assistance Program (EAP), or other professional resources. The Wellbeing Team is here to help – our Wellbeing Leaders can offer guidance, support, and resources tailored to your individual needs.

It’s okay to ask for support—your wellbeing matters, and you don’t have to face these challenges alone.

If you are a leader and would like to access support from the Wellbeing Team for a member of your team, please visit our Critical Incident Stress Response Support page.