Research into health care workers and stress

I was recently fortunate enough to be awarded an internal research grant by my School of Nursing to do a study into exposure to occupational stress & collective resilience amongst healthcare workers. It's currently going through the ethical process, and if approved to proceed could build upon the existing work I did with John Drury into mass emergencies & collective resilience. Further details are copied from my University's web-pages below, or the link can be accessed here.

 

Health promotion, policy and practice

Exposure to chronic stress in health responders: features of collective resilience, social identity and group support

Dr Chris Cocking was recently awarded an internal SNM research grant to explore the role of mutual social support in shielding people from work-related stress. More specifically he will focus on the experiences of healthcare workers who may be exposed to chronic stressors in their work when dealing with major trauma incidents. Existing work that Chris has done into exposure to traumatic incidents (such as mass emergencies, terrorist attacks, etc.) has found that people can often endure stressful events better than expected, and that collective resilience (rather than vulnerability) can often emerge from those affected, because they develop a sense of shared identity which encourages co-operation. However, less is known about those who may be exposed to chronic stress (as opposed to one-off incidents), and so Chris' research proposes to fill this gap in the knowledge.

Chris plans to conduct interviews with staff who work in the local Major Trauma Centre at Brighton and Sussex University Hospitals NHS Trust to explore their experiences of occupational stress, mutual social support and collective resilience to stress and trauma. He hopes that this study will create greater understanding about the impact of and processes involved in collective resilience and inspire further research into occupational stress and resilience in general.

 

References

Cocking, C (in press for June 2013) Collective resilience versus collective vulnerability after disasters- a Social Psychological perspective. In R. Arora (ed.) Disaster Management: A Medical Perspective.

Drury, J., Cocking, C., and Reicher, S. (2009) Everyone for themselves? Understanding how crowd solidarity can arise in an emergency: An interview study of disaster survivors. British Journal of Social Psychology 48.

Drury, J., Cocking, C., and Reicher, S. (2009) The nature of collective 'resilience': Survivor reactions to the July 7th (2005) London bombings. International Journal of Mass Emergencies and Disasters 27 (1) 66-95.

Differing views of legitimacy at March for England protest

Recriminations are playing out over the internet after the far-right group 'the March for England' (MfE) were escorted along Brighton sea front on St George's Day (21/4/13). It's the biggest single policing operation seen in the city for many years, with around 700 officers from at least 10 different forces present, and police quoted as saying the total bill will be "several hundreds of thousands of pounds". Estimates of those attending vary from 100-200 MfE protestors, and over 1000 counter-demonstrators who turned up to confront them. There were around 20 arrests reported, and there were sporadic clashes as MfE protestors sometimes broke free from the police cordons protecting them and were confronted by counter demonstrators. However, there were also clashes in the differing views of what was legitimate behaviour between the police and counter-demonstrators that illustrates the often deep divisions that exist in such situations & can promote distrust and/or conflict between the two sides.

Firstly, there is the issue of why such marches are even allowed to take place when they attract massive counter-protests and are incredibly disruptive to a community that does not share their views (it seems the vast majority of MfE marchers were not from Brighton, and came from elsewhere across the country). The march route along Brighton seafront was surrounded by a ring of steel, with either police, their vans, or metal barriers blocking all access to the route of the march (see photos below for examples). This meant that many sea front businesses had to close for the day and the streets of Brighton were full of disgruntled tourists (who may have had no prior knowledge of the protests) trying to find a way to get to the beach. The local paper the Sussex Argus reports on an emerging squabble between Labour Councillors and the Green council over whether there should have been an application to central government for the march to be banned. However, some of the more radical protest groups present felt that it was not for the authorities to approve (or disapprove) of political protests, and those who objected to what they deem as offensive views by others, should take to the streets and physically prevent such marches from happening.

All this presents a problem for the safe management of such events, and the police often claim that they have a duty to balance the priorities of 'lawful' protests, along with the needs of the local community. However, I think the police view such marches in a particular way which means that those who come to protest against them may find it difficult to trust them. For instance, there was a perception amongst some counter demonstrators that the police were not being even-handed with the two opposing sides, resulting in a common chant on the day of "Police protect the Nazis". This has been reinforced by some of the on-line Tweets I have seen since comparing the treatment of MfE marchers with the more negative treatment of counter-demonstrators, and the Argus has also reported that Sussex police paid for buses to escort MfE protestors to and from the march route. I have not come across any evidence that Sussex police are sympathetic to the aims or tactics of the MfE (I strongly suspect that they would much rather they didn't choose to march in Brighton!), but I think they are operating under a rather narrow definition of public order legislation and policing that results in them feeling that they are duty bound to facilitate such protests, even if they bring serious disruption to the community and consequent distrust from local protest groups.

Over the years I have noticed that the police are generally very keen on protest organisers contacting them in advance of planned protests to discuss proposed location, expected numbers etc. If people do not, then Section 11(1) of the 1986 Public Order Act, (POA) which  requires protest 'organisers' to notify police in advance of proposed marches, is sometimes invoked. However, I believe this section has often been misinterpreted by the police to conclude that if such notification is not forthcoming, then the whole protest becomes an 'illegal' event (a meaningless term if it has not been banned by the Home Secretary in advance) which then creates a climate where the police believe all people who attend are behaving 'unlawfully'. Such a conclusion was criticised in the HMIC report that was written after the death of Ian Tomlinson during the 2009 G20 protests in the City of London, which argued that police still have a duty to facilitate such protests even if the alleged 'organisers' may not have adhered to a rather minor subsection of the POA. I believe that the MfE organisers have approached the police each year for permission to march, but the counter demonstrators do not tend to do so as one coherent group, as they are composed of people from different political perspectives (and some may be unwilling to enter into a dialogue with the police because of mutual historical distrust). This may leave the police feeling pressure to facilitate such a march going ahead in the face of concerted opposition, as happened at last year's march. I believe that this is a problematic approach to take, not only because its legal basis is rather dubious, but also because those wishing to oppose such marches taking place in their locality will find it increasingly difficult to trust the police if they believe they are not being treated even-handedly. Such mutual distrust between police and protestors can only increase each side seeing the other's actions as illegitimate, which in turn could make conflict at any future events more likely.    

Some links to reports and pictures from the day follow below;

http://www.bbc.co.uk/news/uk-england-sussex-22244933

http://www.youtube.com/watch?v=pFwdFoCEMbA&feature=youtu.be

http://www.vice.com/en_uk/read/the-march-for-england-was-humiliated-in-brighton-this-weekend

http://stopmfe.wordpress.com/

http://jesshurd.com/clients/1304MarchforEngland/

http://www.theargus.co.uk/news/10370361.City_counting_cost_of_street_march/

http://www.schnews.org.uk/stories/MOBS-AND-COPPERS/

Examples of police cordons along the sea front 21/4/13

Different narratives in reporting of Boston marathon bombing

As news of the bomb attacks at the Boston marathon circulates around the globe, different narratives are emerging that illusrate the complex (and sometimes contradictory) ways that such horrific events can be portrayed. For instance, coverage by the BBC of the explosions talks of 'panic' but then in the very same sentence, mentions the almost instant co-operation in their aftermath;

'There was initial confusion and panic. Some runners fell to the floor while police and bystanders ran to help those caught in the blast'.

A video clip also shows people rushing in to help victims immediately after the blast, and bystanders joining with race officials, police, and military personnel to remove fencing and help the injured. There is also evidence of individual bystanders with no specialist role on the day putting themselves at risk to help others, and gawker focusses on the actions of a Costa Rican peace activist who was in the vicinity. This fits with studies of mass emergencies that have found that uninjured bystanders can often become 'zero-responders' by helping casualties before the emergency services arrive (Cocking, In Press; Cole et al, 2011)

Finally, coverage by the BBC on the day after the attacks explores the parallels drawn between this incident and 9/11, and alludes to a sense of solidarity amongst Bostonians, with a marathon runner saying; "terrible things do bring people together". There is also emphasis on the sense of defiance amongst joggers the following morning . I think that this shows how an initial narrative of vulnerability presented by the media can quickly shift into a narrative of resilience, despite the apparent inconsistency between the two perspectives.

John Drury looked in his blog post  at how differring narratives of the 7/7 London Bombings emerged in their aftermath, and of the possible implications that maintaining each narrative could have. We also developed this idea in an upcoming paper about the Hillsborough football  disaster (Cocking & Drury, in Press), where we argued that assuming vulnerable responses amongst crowds and communities affected by disasters could result in them being treated in ways that could stifle any potential resilience from emerging. I believe that the scenes of courage and altruism that happened in Boston yesterday illustrate the remarkable resilient potential that people have to cope with such horrific incidents and hope that such narratives will prevail rather than assuming that selfish 'panicked' behaviour is the dominant response.

Cocking, C. (In Press) Crowd resilience during the 7/7/2005 London Bombings: Implications for the Emergency Services. International Journal of the Emergency Services.

Cocking, C. & Drury, J. (in Press) Talking about a tragedy: ‘Panic’ as discourse in survivors’ accounts of the Hillsborough disaster. Journal of Community and Applied Social Psychology.

Cole, J., Walters, M. & Lynch, M (2011). Part of the solution, not the problem: the crowd's role in emergency response, Contemporary Social Science, 6 (3) 361-375.