You’ve recognized that you or a physician colleague has a stress injury—that’s severe and persistent distress—or there’s been a loss of the ability to function because of the damage done from exposure to the overwhelming stressors burnout, trauma, loss or moral injury.

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Now it’s time to administer some stress first aid.

What is it? It’s a framework for peer support and self-care for health care professionals and it’s parallel to how a clinician or first responder approaches physical first aid: Intervening to preserve safety, when needed; preventing further harm and promoting recovery for those that the significant stress has strongly affected.

An AMA STEPS Forward™ toolkit, “Stress First Aid for Health Care Professionals,” outlines the stress first aid framework and helps physicians and others in health care recognize and respond early to stress injuries, and manage them as one would any other injury. It is a peer-support and self-care model that health systems can provide to improve self-care. Based on years of research, it is practical, flexible and tailored to specific styles and needs of those involved in recuperating from stress injury.

You can use the framework when supporting peers or even if you are aware of injuries to yourself. Organizations can also train a team of health care professionals to administer stress first aid to their colleagues.

Creating an environment that allows five essential needs to be met will help foster success in providing stress first aid for those in distress.

“We understand that stress injuries can impact many aspects of a person's life and there are many different strategies that may be helpful. We can use the five essential needs as a way of identifying and prioritizing what types of activities of resources would be most helpful to promote resilience and recovery,” said Richard Westphal, PhD, co-director of the Wisdom and Wellbeing Program at the University of Virginia School of Nursing in Charlottesville. He is a co-creator of the stress first aid toolkit.

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Meeting these five essential needs will help increase resilience and recovery during a variety of adverse circumstances:

  • A sense of safety.
  • Calming.
  • Social support.
  • Occupational and coping competence.
  • Confidence in oneself, others and the future.

“First, it is important to help create a sense of physical and psychological safety and for those who are feeling over-whelmed to help promote calming. Second, we can use the other three essential needs as a way to identify how co-workers and leaders can be helpful. We know that social support, having resources to address challenges, and confidence that things will work out sustains us during tough times,” Westphal said.

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The five essential needs, in turn, are the foundation for the seven core functions of stress first aid to improve self-care or support a person whose may be experiencing a stress injury:

  • Check and Coordinate, which are part of recognizing a stress injury.
  • Cover and Calm, which help provide the primary aid.
  • Connect Competence and Confidence, which help provide secondary aid.

Once a framework is in place, it’s important to have leaders in the workplace who are able to acknowledge that stress injuries are going to happen and the job, be willing to talk about problem solving and try to mitigate problems when they can, said Patricia Watson, PhD, a senior educational specialist at the National Center for PTSD and a co-creator of the AMA toolkit.

“We have to bring this forward. It can’t sit on the back burner,” she said. “Having a leader who will to do that is huge.”

Learn more from the AMA STEPS Forward™ webinar series, which focuses on physician well-being, practice redesign and implementing telehealth during COVID-19.

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