Managing psychosocial hazards at work - First responder

Persons conducting a business or undertaking or PCBU for short must ensure the health and safety of workers and others. This includes managing psychosocial hazards and risks at work as much as managing physical hazards and risks. PCBUs must manage psychosocial risks in accordance with Part 3.1 of the Work Health and Safety regulation. This includes eliminating psychosocial hazards so far as is reasonably practicable. Psychosocial hazards must be identified and their risks assessed, controlled, and continually reviewed to protect workers' health and safety. A psychosocial hazard arises from, or relates to, the design or management of work, a work environment, plant at a workplace, or workplace interactions and behaviours. It may cause psychological harm, whether or not it also causes physical harm. PCBUs must consult with their workers about psychosocial hazards relevant to their work. Workers often have valuable insights about the impact of psychosocial hazards and potential ways to control the risks.

In this video, we're exploring a first responder case study. We will review how this workplace identifies, assesses, controls, and reviews psychosocial hazards and risks. See if you can spot all of the hazards and risks before we give you the answers.

Work performed by paramedics in a busy regional area involves frequent exposure to trauma, violence, and death. Due to a recent surge in emergency cases and a shortage of trained workers, staff have been required to work longer hours than usual with less time between shifts to recuperate. Workers have reported emotional and physical fatigue. Workers are regularly exposed to physical and biological hazards within their work, with supply shortages impacting the availability of PPE. Workers are concerned about the impact of exposure to infectious diseases on themselves, their families, and other contacts outside of work. High workloads and new policies requiring increased documentation, frustrate and confuse workers, and increase their physical and cognitive demands. Bed shortages in emergency departments within the local hospitals add pressure to staff tasked with making critical decisions about patient care. These shortages have also increased the level of exposure to violence and aggression due to increased wait times and delays in processing patients.

Let's take a look at what psychosocial hazards and risks are present. Workers are experiencing increased work hours and high workloads due to the staff shortages, which is impacting their ability to take breaks, access leave, or seek support where required. They're exposed to emotionally demanding scenes and content and are reporting physical demands. Increased demands arising from new systems of work and associated controls compete with existing workloads. Facility shortages are impacting workers' ability to safely provide care to patients. Critical decisions may be impacted by these logistical issues, which competes with medical and triaging processes. They are experiencing ongoing exposure to trauma and death, which could have a cumulative effect on them. Workers responding to incidents are also at high risk of injury themselves. They're regularly exposed to both threats and actual violence from patients and the public. Due to the recent increases in service demands, there are not enough workers or facilities to cater for patients. Staff feel unable to decline shifts due to the lack of available backfill. Staff working with infectious diseases are concerned about the impact on themselves and others. They worry about transmitting infections they may have been exposed to. These concerns have been exacerbated by shortages of PPE. Appropriate support may not be occurring due to role overload, lack of educational training around new processes, and limited resources for professional supervision.

After consulting with staff, the organisation takes the following steps to control the risks. They increase the level of practical support available during peak work times, through increased recruitment and up-skilling personnel to allow appropriate coverage for patients' needs. They allocate time to review new processes and systems of work with staff to improve their competence and confidence in applying these changes to their work. For example, specialised infection control training. They introduce additional opportunities for consultation with staff regarding support, rostering training, and other practical requirements. They implement changes to rostering, ensuring adequate staff are scheduled across all shifts, taking into account new systems of work, their staff skills mix, and ensuring there are adequately trained workers on all shifts to respond effectively to violent and or traumatic incidents. They implement regular supervision and consultation opportunities for staff, including safety debriefs, early referral to support services, as well as a peer support programme for workers. They establish processes to monitor exposure to trauma and violence and to offer support and services to those exposed and or showing early warning signs of distress. They receive training in managing aggressive or violent behaviour and hazard or incident reporting. They implement an escalation process to assist staff to access support, make quick decisions to respond to early warning signs, and for when there are differing views regarding patient management. The organisation recognised the need for reviewing and improving, so a more comprehensive risk assessment process is introduced and updated annually or following any major organisational changes to ensure new hazards and risks are identified and addressed. Improvements were also made to consultation arrangements and monitoring of staff welfare, including psychological welfare and fatigue. With regular meetings held with supervisors, providing an opportunity to raise any concerns, challenges, or incidents. An employee assistance service is introduced and actively promoted. Staff rosters are closely monitored to ensure appropriate distribution of workload and access to leave is available when needed. They improve the incident reporting system and encourage reporting of all incidents and near misses. And in addition, the organisation ensures reported incidents are investigated and feedback on the investigation and subsequent response to the incident is provided to workers. They address supply chain issues and delays to ensure staff have access to appropriate resources.

In this example, we saw how to identify different psychosocial hazards in a first responder organisation. Often these hazards will interact, and if exposure is frequent, prolonged, or severe, it can lead to work-related stress and subsequently psychological or physical harm. The identified hazards in this example were high job demands, exposure to violence and aggression, exposure to traumatic events, low job control, poor environmental conditions, and poor support. Control measures were used at multiple levels to eliminate, as well as minimise the risk. This example shows that psychosocial hazards, the types of control measures implemented, and the monitoring and review strategies can differ widely for organisations in different industries and of different sizes. It is important to consider the unique context of your organisation, including your organisation-wide systems, work practices, work environment, workplace behaviours, and types of tasks and roles.

For more information, download the Managing the Risk of Psychosocial Hazards At Work Code of Practice 2022.

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