Barriers to frontline manager support for high-trauma workers
| Pages | 1394-1409 |
| DOI | https://doi.org/10.1108/PR-10-2018-0397 |
| Date | 02 September 2019 |
| Published date | 02 September 2019 |
| Author | Ashlea Kate Kellner,Keith Townsend,Rebecca Loudoun,Adrian Wilkinson |
| Subject Matter | Hr & organizational behaviour,Global hrm |
Barriers to frontline manager
support for high-trauma workers
Ashlea Kate Kellner
Centre for Work, Organisation and Wellbeing,
Griffith University, Nathan, Australia
Keith Townsend and Rebecca Loudoun
Department of Employment Relations and Human Resources,
Griffith University, Nathan, Australia, and
Adrian Wilkinson
Centre for Work, Organisation and Wellbeing,
Griffith University, Nathan, Australia
Abstract
Purpose –Exposure to high-trauma work has been associated with negative outcomes for individuals and
organisations. Support for these employees can buffer and protect against mental health problems. Frontline
managers (FLMs) are well placed to provide for employee support needs but are often not effective in doing
so. The purpose of this paper is to identify and understand barriers to provision of four different types of
social support as identified by House (1981) by FLMs to employees in a high-trauma workplace.
Design/methodology/approach –This qualitative study investigates three Australian ambulance service
organisations, including 72 interviews.
Findings –Nine barriers to support are identified that can obstruct the provision of optimum employee
support. These relate to the FLM themselves, the workplace context and employee-centric factors.
Research limitations/implications –This paper is a single industry case study; further complexity may
exist in other high-trauma industries. Future research should consult policy makers to develop strategies to
address the barriers to FLM support.
Practical implications –FLMs are critical support persons as they are well placed to provide many
employee support needs. Emotional support is the foundation for facilitating all other types of support to
employees but results here indicate it is often lacking for workers in high-trauma workplaces for a range of
individual and organisational barriers that operate in isolation and combined.
Originality/value –This paperjuxtaposes House’s (1981) supportframework with study findings to provide
a model of the barriers to optimal employee support. This model contributes to a reconceptualisation of the
relationship between employee and direct manager that is particularly pertinentfor high-trauma contexts.
Keywords Qualitative, Healthcare, Trauma, HRM function, Frontline managers, Emergency service work
Paper type Research paper
Introduction
The nature of emergency services work exposes paramedics to extreme events as a regular
feature of the role (Bigham et al., 2014; McFarlane et al., 2009). Chronic exposure to trauma
increases the risk of mental health problems such as depression, anxiety, high-risk alcohol
and drug use, and post-traumatic stress disorder (PTSD) (Bennett et al., 2005; Grant et al.,
2008; Huizink et al., 2006; Izutsu et al., 2004). PTSD in particular has been noted as
particularly high among paramedics, even in comparison with other emergency services
personnel (Drewitz-Chesney, 2012). Therefore, in this work environment, management of
individuals exposed to trauma, and support provided by key persons, is critical.
Deterioration of mental health has a significant impact on organisational performance.
Mental health problems are associated with declining employee health and well-being
(Berger et al., 2007), increased burnout and long-term absences (Brattberg, 2006), and
ultimately, greater employee turnover (Patterson et al., 2010). It is well accepted that
organisational factors can influence the prevalence and severity of such problems and
promote improved outcomes. For example, evidence supports the positive influence on
Personnel Review
Vol. 48 No. 6, 2019
pp. 1394-1409
© Emerald PublishingLimited
0048-3486
DOI 10.1108/PR-10-2018-0397
Received 11 October 2018
Revised 5 February 2019
Accepted 4 April 2019
The current issue and full text archive of this journal is available on Emerald Insight at:
www.emeraldinsight.com/0048-3486.htm
1394
PR
48,6
health and well-being of formal support systems such as professional counselling and
resilience training (see for instance, Richmond et al., 2017) and programmes whereby peers
are trained to provide counselling and support to one another (Revicki et al., 1993; Scully,
2011). Relationships with colleagues and frontline managers (FLMs) can also be
instrumental in reducing the severity of symptoms and encouraging positive
post-traumatic growth (Oginska-Bulik, 2015; Prati and Pietrantoni, 2010; Somville et al.,
2016). FLMs, in particular, play a key role in support provision. This could be simply
engaging in emotionally supportive dialogue, advising formal support pathways, or moving
an affected employee to a different role.
This paper investigates the role of, and barriers to, support provided by FLMs to
employees exposed to frequent work-related trauma. Specifically, we seek to identify and
understand barriers that prevent FLMs from providing the type, quality and quantity of
support employees require. Support is conceptualised as a multifaceted construct comprised
of four key types (House, 1981), and the FLM is in a unique position to address all four
employee support needs. Drawing on data from a three-case Australian study conducted in
the emergency service sector, three categories of barriers to provision of optimal employee
support are identified, specific to the FLM themselves, the workplace and the employee.
Under each category we expand on the nine barriers to support and investigate how
these barriers can individually or in combination prevent one or all types of employee
support from being provided or received. First though, this paper brings together previous
research on high-trauma workplaces, social support and FLMs.
High-trauma workplaces
Fire fighters, military personnel, emergency nurses, police officers and ambulance workers
all work in environments characterised by high stress and frequent exposure to extreme and
traumatic events. Work in such fields can be complex, unpredictable, time pressured, high
risk and involve human suffering. As noted, exposure to work of this kind is inextricably
linked with increased prevalence of mental health conditions (Bennett et al., 2005; Grant
et al., 2008; Huizink et al., 2006; Izutsu et al., 2004).
For ambulance workers, research details other job-related factors that compound the
effects of an already challenging role. Aside from vicarious trauma associated with
exposure to, or involvement in extreme events, ambulance workers are at risk of physical
and psychological injury. At least half of ambulance workers have been physically
assaulted (Gabrovec, 2015), and 90 per cent have been exposed to some type of violence
(Pourshaikhian et al., 2016). One of every four have also been sexually harassed or assaulted
at work (Bigham et al., 2014; Pourshaikhian et al., 2016). On the whole, the risk of serious
injury for ambulance workers is seven times higher than the Australian national average,
and the fatality rate is six times higher (Maguire et al., 2014). In combination, such factors
contribute to a high-trauma work environment where support is necessary to reduce the
incidence and severity of employee mental health problems.
Deconstructing social support
It has been long established that lack of social support is a causal contributor to physical
and psychological well-being (Blau, 1981; Cohen and Wills, 1985; Halbesleben, 2006). The
term “social support”is often used broadly to capture “any process through which social
relationships might promote health”(Cohen et al., 2000, p. 4). Specifically, social support is
the provision of psychological and material resources by the social network to the
individual, intended to improve an individual’s ability to manage stress (Cohen, 2004).
This paper focuses on the social support provided by FLMs and its effects on employees in
high-trauma workplaces. Although we refer to more formalised support systems in the
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