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Eastman
Kodak is one of the most recognizable names
in the corporate world. The Eastman Kodak Company
located in Rochester, New York is headquarters
for Kodak's worldwide operations. It is a complex
involving miles of buildings and thousands of
employees. In fact, there are manufacturing
sites, chemical plants and office buildings
on hundreds of acres. There are approximately
25,000 employees in this location. Beyond Rochester,
throughout the United States, the workforce
exceeds 45,000 employees. The Critical Incident
Stress Management (CISM) team at Eastman Kodak
has a combined service experience with the company
of approximately 90 years. Dan McGuire became
involved with Emergency Medical Services in
1979. Dan has worked as an Emergency Medical
Technician for the last 20 years. He joined
the Monroe County Critical Incident Stress Management
(CISM) team and was promoted to the position
of Operations Team Leader in 1999. Evelyn Sklair
has been with Kodak for the past 19 years as
a Certified Occupational Health Nurse-Specialist.
In this capacity, she has held several different
positions within the medical department including
clinic staff nurse, clinic team leader, medical
resource partner, case manager and she has been
involved with Emergency Medical Services as
a nationally registered paramedic. Gary Roller
has been with the Eastman Kodak Company for
28 years as a Security Professional. He has
held several positions within the Kodak Security
Organization from Security Officer to his present
position as Manager. Charlann "Charley"
Tranella has been with Kodak's Employee Assistance
Program (EAP) for 13 years. As an EAP counselor,
she interacts with employees and family members
regularly and provides referrals for various
mental health and chemical dependency issues.
Dr. Wayne Lednar is a Physician. He serves as
Eastman Kodak's Medical Director and works closely
with the crisis response team. He is integrally
involved with medical services at the Eastman
Kodak Company.
JSV: As employees of Eastman Kodak, you have
developed a unique crisis response team. I know
that two of you are members of the Monroe County
Critical Incident Stress Management (CISM) team
that works with Emergency Medical Services (EMS)
personnel who are traumatized. Can you tell
me how the crisis response team evolved at Kodak?
ES: Typically, after a critical incident, a
nurse or physician for the affected area would
go over and chat with co-workers who were present.
When I came to Eastman Kodak in 1992, our EMS
responders knew that I was an EMS person and
that I had training in CISM. So, if they went
on a call for certain traumatic incidents such
as an entrapment or cardiac arrest, they would
call me. They would inform me that the group
was pretty upset and ask me to talk with them.
I would do some defusing or debriefing or whatever
was necessary to help. After doing that a few
times, it was recognized as valuable. It appeared
to truly help the people involved. I was asked
by my management to work with the Employee Assistance
Program (EAP) at Eastman Kodak and formalize
a crisis response team here and include EAP.
So I spoke with Charlann Tranella who pursued
further training and we began as a team.
CT: As with Evelyn, I have a nursing background.
As an EAP counselor, I was often dealing with
emotional crises. So this was a natural extension
for me to go out and help in this capacity.
Evelyn's EMS experience served an important
role. She could address a number of issues that
people would ask (e.g., "Why did the EMS
do...?"). The training that we obtained
in critical incident management gave us the
tools that we needed to go through the process.
We then decided that our team needed to be incorporated
into the workplace as a medical service and
we developed a business plan. Dan McGuire and
Gary Roller also had backgrounds in the area
of emergency response and we then had our team
of four.
WL: I just want to add one additional piece
to the evolution of the team. After an incident,
with individuals affected and a response team
working with them, the next question involved
the impact on supervision and management in
the work setting. Management wanted to know
that employees were getting adequate help. They
also wanted to know how the acute event would
be addressed in the aftermath. Would the employee
need time away? Would they need medical care?
How could management be more supportive to them?
How would supervisors and managers be impacted
as they try to continue with business operations
given that an event had occurred.
JSV: What process does the team use to be activated
when there is a need?
GR: Our small group is divided into two teams.
Evelyn and Gary are one team and Dan and Charley
are another. Each team is responsible for a
given month throughout the year. The Eastman
Kodak Company has a staffed, 24-hour Emergency
Communications Center. Should there be a need
for a debriefing or defusing, the request is
forwarded to the Communications Center. They
in turn contact the team that is on call for
that given month. Our team is a truly 24/7 operation.
We all carry pagers.
CT: One of the critical parts of the response
involves speaking with a supervisor first. We
must let them know what we are doing with what
group and why. We "triage" on the
phone first.
JSV: What benefits have you observed from having
a crisis response team at Eastman Kodak?
ES: We are able to keep people at work. We are
able to keep them productive. We help them quickly
(i.e., defuse situations quickly) and help them
to understand that what they are going through
is normal and that the best support they have
can be the person who is working right next
to them. This helps people keep work which lowers
lost time costs.
WL: The things that I often hear from community-based
providers is that this type of support given
at Eastman Kodak is very positive and timely.
Moreover, it all helps the quality of care for
their patients, especially in helping people
to move on.
JSV: Critical Incident Stress Management (CISM)
was initially intended to be used for assisting
EMS providers after their response to a traumatic
event. Do you find that the layperson, such
as the corporate employee, is similarly affected
by a critical incident?
DM: Corporate workers have many workplace issues
that get drawn into the critical incident, such
as doing more with less, increasing responsibilities
with little or no increased remuneration, increased
deadlines and competition. They also don't have
the pre-education on management of critical
incidents that EMS, firefighters and police
workers are now getting in their training. With
that said, you need to adjust your information
and techniques to these additional stressors.
I know that when I come into work each day,
I have a certain pattern that I follow. I check
my mail, messages and get a cup of coffee and
begin my normal work day. Nothing in my workplace
training has prepared me for dealing with the
death of one of my co-workers or the serious
illness of one of my colleagues. This is a major
reason why there is a need for corporate-based
crisis response teams. These things that are
happening more and more and there is a need
to be better prepared for them.
ES: Co-workers can be traumatized watching an
incident unfold. However, there may be a greater
sense of helplessness. They don't understand
what is going on when EMS gets there which increases
confusion and frustration. Many workers have
never seen a deceased person outside of a funeral
home. It can dredge up old memories of losing
someone near to them. Their loss may be perceived
differently than EMS. Their loss is not a stranger
but a "work-family" member.
WL: EMS members may question themselves and
ask "Was I skilled enough to help that
person?" A layperson might ask, "Did
I fail to do something?" Of course, the
root causes of their anxiety may vary and the
answers may also be different between the layperson
and EMS worker.
JSV: How would you define a "crisis"
in the corporate sector? What types of traumatic
stressors would typically require intervention
and support? Please give me some examples.
GR: A crisis in the industrial/corporate sector
can be defined as an extraordinary event that
overwhelms the individual's normal coping capacity.
We have had employees accidentally inhale toxic
substances as well as become entrapped in machines.
Industrial accidents, cardiac arrests resulting
in death or emergency hospitalization, harassment,
seizures. These are a sampling of some of the
things that we have seen.
CT: Other types of incidents that may occur
could be a criminal act against a person, such
as an assault. Our team has been involved in
all of these situations.
JSV: In your work with employees, what are your
observations of the responses of these individuals
to such traumatic events such as a cardiac arrest
or a machine entrapment?
DM: Typically, you see heavy questioning from
employees as to what has happened to their "normal"
work site. They want to know how and why did
this happen? Is Kodak doing everything it can
to protect people? Is my workplace safe anymore?
You see fear, anger and frustration since they
are simply not prepared to come to work and
experience such an event, it's that simple.
They really are affected as to the loss of a
stable work place. Who wakes up and says to
themselves "I will experience a traumatic
event today at work!"
ES: The EMS person deals with cardiac arrest
and then goes onto the next call. This process
may change, however, when the incident involves
a child or an infant. "They are not supposed
to die." However, it is that same emotion
that we see in employees. People believe that
others are not supposed to die or become seriously
ill at work. When this does occur, there is
a tremendous sense of unreality about it, like
a nightmare. There is lots of concern around
not knowing what to do, agitation, frustration,
helplessness and even devastation. Workers may
be very critical of EMS, especially with how
long it took them to leave the scene. The symptoms
are the same whether the affected employee survives
or dies. The only difference seems to be the
length of time until they're feeling better.
To them they have lost a family member, not
just a co-worker.
WL: Eastman Kodak is a company with good resources
and strong programs in a community with good
hospitals and good healthcare. Yet, what emerges
in these traumatic situations is the realization
that our existing healthcare system does not
deal effectively with a response to these events.
The Eastman Kodak CISM team plays an important
piece and fills in a gray area in the healthcare
system. Immediate response and psychological
support will not happen in most places like
this unless we make it happen.
JSV: Although many people are exposed to traumatic
experiences in their lifetime, most do not develop
posttraumatic stress disorder (PTSD). What factors
do you believe "buffer" a person from
developing full-blown PTSD?
CT: I think that some people are more resilient
to developing trauma than others. They have
better coping skills to recover from adversity.
There is evidence that people who are resilient
are more accepting of change, more responsive
to their environment, have faith in themselves,
are able to take risks, have a basic belief
system and maintain a sense of purpose (see
Harvard Women's Health Watch, Feb 1998). Resilience
may be an innate characteristic, but also one
that can be instilled through effective role
modeling and setting of examples for children.
Mental health counseling can also be effective
to treat co-morbid problems such as depression,
which can interfere with one's ability to "bounce
back" from adversity.
WL: Social support also plays an important role
in resiliency as well. Increasingly, it is difficult
to have a balance between work and life. People
spend so many of their waking hours at work.
Thus, their work group becomes a very important
part of their life and their social support.
A workgroup that is supportive to one another,
can assist in buffering one from the effects
of trauma.
JSV: What benefits have you seen, if any, from
a post-intervention response and have there
been any surprises?
DM: I've observed a swift return for those involved
in the incident, to a more normal work environment.
After such an event, we see and hear from those
involved that their work environment is disrupted
and becomes almost foreign to them. As I had
indicated earlier, one doesn't expect to go
to work each day prepared for a critical incident!
With use of our intervention, it really speeds
and facilitates the return for an employee back
to the "normalcy" of their workplace
as they have come to know it. One other benefit
that stands out in my mind involves doing debriefings
with the same group of individuals. We had a
group that, within a six-month period, had two
employees who became gravely ill. Soon after
one employee became ill, so did another. It
was clearly a critical incident for them. I
recall that after this second incident, these
individuals were much better prepared for that
second incident and commented that they were
able to do a better job supporting other co-workers.
The education, debriefings and defusings that
were initially conducted had true advantages
later on.
ES: Affected work groups can become more cohesive
as a result of their unique experience encountered
all together. Some individuals have gone on
to learn CPR and First Aid. Others have made
lifestyle changes to become healthier.
CT: Oftentimes, employees who have witnessed
a traumatic event in the workplace re-experience
previous traumas, losses and grief. Our intervention
provides an opportunity to educate and normalize
the experience that people may have in the aftermath
of an event and encourages further assistance
for them (as necessary).
WL: Another observation involves the fact that
Eastman Kodak in Rochester is the world headquarters
of a worldwide corporation. We have many employees
who are not Americans and are assigned here
for a temporary period of time. We have had
critical events involving non-American employees
and the response to someone of a different culture
needs to be culturally-appropriate in response
to them and their families' needs. It is important
to be aware of the right things to say and how
we can act to be supportive of our co-worker
from a different part of the world. We want
to be seen as supportive and not produce a negative
effect.
JSV: What resources do you have available if
defusing and debriefing just aren't enough for
someone?
CT: Defusing is something that we routinely
do within the first 24 to 48 hours after a critical
incident. We continually assess the individuals
we are working with. We follow up with them
within the week and we then can easily make
the connection to our normal EAP process of
assessment and referral. As EAP counselors,
we are aware of which therapists in the community
work with traumatic stress and respond to critical
incidents as well as CISM.
DM: Part of our initial process when we get
activated as teams involves contacting a requesting
supervisor. We than size up the incident in
terms of severity (i.e., triage) and need for
immediate response as opposed to a delayed response.
We may have to work around people's work schedules
and calendars and we have to be flexible at
times. So, we may first do a defusing and make
an initial assessment. In a day or two, we will
make another assessment and decide if there
is a need for a full-blown debriefing.
ES: One of the things that we need to keep in
mind is that we are all full-time employees
with full-time jobs and we incorporate critical
incident management into our life here.
JSV: How do you justify having an in-house team
when there is a county team readily available?
What are the advantages and/or disadvantages?
DM: By having an in-house team, we are better
prepared to deal with the issues that a corporate
critical incident may produce. We have complete
access to the many buildings at Eastman Kodak.
Also, workers identify with us as being "one
of their own." When the Kodak team goes
in to work with people, we are seen as "Kodak
family." This helps the comfort level go
up as opposed to bringing in an outside source
to the inside. I know that I wouldn't feel as
comfortable because I don't know these people.
Also, we do link closely with the Monroe County
CISM team (which I head up). We are able to
draw upon their resources including pastoral
help, mental health specialists, etc.. The Eastman
Kodak response team is invited to the Monroe
County Team's
bi-monthly training sessions. By doing all of
this, we build solid cross-functional links
and we are able to share resources that each
team possesses.
ES: With belt-tightening, we needed to do a
"business case" to justify our existence.
Since we were already trained, this was quite
cost-effective. Costs are related materials
such as printing our new brochure and, of course,
the time that we use for meetings and call-outs.
However, advantages would include that we know
Eastman Kodak and it's "culture."
Also, as Dan mentioned, we have easy access
to most areas within Kodak. We have experience
in dealing with critical incidents and we can
respond faster. Some disadvantages of being
a small team are that we don't have as many
resources to call upon. As it turns out, if
they decided to use the county team instead
of the Kodak team, some of the first people
to be called would be Dan and I, so why not
have an internal team?
WL: Another advantage to an internal crisis
response team for a company involves extending
the response for a number of different types
of traumatic events. In the business environment,
a different type of trauma may involve a "business
decision." Examples may include a failed
product launch that was the result of a tremendous
effort, downsizing and loss of jobs, the abrupt
halting of an important research and development
project. These events are very traumatic. These
things may be known before the event happens
and we may be able to pre-empt some of the traumatic
effects or prevent some of the aftermath of
such exposure by a crisis response team working
with management. You could never get this kind
of response if you were engaging a team or resource
from outside of the company.
JSV: How did executives and upper corporate
management at Eastman Kodak initially respond
to the idea of a crisis response team?
WL: They received it very well. It appeared
as a natural extension of the immediate response.
We have had an internal medical department in
the company for more than 90 years. So addressing
the needs of employees, managers, supervisors
have always been a priority. I think that they
appreciated the fact that, not only were the
emergency medical needs of employees being addressed
but also the psychological needs that came with
these traumatic incidents.
JSV: In the time you have been involved with
crisis response (and CISM), do any specific
events stand out in your memories that you believe
have influenced you both personally and professionally?
ES: Before I became involved with Eastman Kodak,
I took care of a 22-year old with anaphylaxis
who died. It was a traumatic experience for
me. Even though I had worked in the emergency
room, I never had anyone die in my arms like
that. I did not received any crisis response
or CISM training at that time. After I got my
training, I realized that I should have been
defused and debriefed after that particular
incident. I became a paramedic because of that
experience. Later on, as a paramedic, I took
a call for anaphylaxis and had flashbacks. I
sought assistance from one of our CISM-trained
psychologists. Consequently, I'm a big proponent
for CISM.
DM: As we had mentioned before, the people you
work with become like family members. You spend
more time sometimes with your co-workers than
you do with your families. In a former position,
one of our most admired and respected peers
had died very suddenly over a weekend. I remember
her saying to us on a Friday at 5:00 as she
left "Have a great weekend. I'll see you
on Monday." That following Monday morning,
she wasn't at work. I can still, to this day,
see the face of my supervisor when she had to
break the news to the rest of us. She had just
gotten a call from this co-worker's family.
She had gone home and died in front of her family.
It was a terrible event and you could have heard
a pin drop. We were all close to her. The news
so stunned us that we were speechless for several
minutes. Talk about an opportunity for our team
to respond! This experience only furthered my
interest and desire to work with the Eastman
Kodak CISM team and a deeper passion for this
work.
CT: It is critical for EAP professionals to
know how to process traumatic information with
people. It is important to know how to talk
with individuals who have been involved with
a motor-vehicle accident, violence at home or
in the community. To effectively work with traumatized
people, we need to understand trauma.
JSV: Describe the feedback that you have received
from your management about the crisis response
team and those that you have interfaced with.
ES: We have had very positive feedback from
the employees. About two to three weeks post-event,
we send out a feedback form. The returns are
very good. Many respondents indicate that they
are very thankful to have had the session. They
also describe how important it was for them
to hear that others in the group were experiencing
the same thoughts and emotions as they were.
CT: Feedback has been good. It also provides
an opportunity to encourage supervisors to utilize
our services. It is often difficult for employees
to come forward with emotional issues in front
of their workgroup. Through feedback they may
learn that the intervention process is helpful
and non-threatening.
WL: Part of my role for the corporation involves
becoming quickly familiar with a significant
event anywhere in the world that involves employees
at our work sites and making sure that the right
things are happening for those involved. I will
often hear back from executive level management
how much they appreciate the timeliness and
effectiveness of the response. They are very
appreciative of the team's intervention. Management
of critical incidents (i.e., CISM) is the natural
"next step" following the medical
response in assisting workers with "moving
on." One can take this response and expand
on it in a business environment. Traumatic stress
can ultimately interfere with a product launch,
research and development projects and other
business sensitive issues.
JSV: What methods have you utilized to facilitate
the spread of information and background about
the Eastman Kodak CISM team? What plans do you
have for future communications?
DM: We've had communications regarding the Eastman
Kodak CISM team through our internal supervisors
and managers informational e-mail forum. This
e-mail publication comes out monthly. In it,
we describe the crisis response team, what a
critical incident is and how to activate a crisis
response team.. We also printed our official
Kodak CISM team brochure for distribution. We
also work with and partner with our Human Resources
Department, Employee Assistance Program and
education divisions to give pre-education opportunities
for Kodak employees.
JSV: There are only four of you who are on this
team. Does that pose any problems for the future?
Where do you see the team headed in the future?
DM: With our current volumes of call-outs, our
team size is right on the mark. As we get the
"word" out about us, there may be
a time where we will need to add more team members.
As for our future goals, we will need to continue
to work on becoming the "center of excellence"
as other teams may be formed internal to Eastman
Kodak. We will need to keep up with the trends
and changes in the critical incident management
arena and become "subject-matter experts"
in corporate CISM.
WL: I think the demands will increase in terms
of the need to respond to various events. I
think the biggest need will be in pre-education.
The team may ultimately coach other teams in
other locations as they are responding to their
events. The team can become the "center
of excellence" in leadership and competency
for the company.
JSV: What guidelines and efforts can other Fortune
500 companies like Eastman Kodak Company use
to develop trauma management teams for their
employees?
DM: Firstly, recognize that there is a need
for an in-house crisis response (or CISM) team!
Things like workplace violence is increasing.
But, realize that it is not only violence but
also other traumatic events affecting employees
including accidents, illnesses, explosions,
fire and the like. Also, get early buy-in from
the supervisors of the team members. They need
to understand that the initial work of setting
up a team will take the employee away from their
core work duties from time to time. As well,
be sure to look internally for crisis management-based
resources that you may already have. Check with
your medical department, Human Resources and
Employee Assistance Program staff members. You
may be surprised that you have some well-trained
individuals at hand. Be sure to create solid
links to any existing external CISM teams. Lastly,
prepare a clear and concise business plan showing
the "return of investment" in the
team. The bottom line in the corporate world
is that you will need to justify your existence
and be able to demonstrate the cost-savings
of a corporate-based team. You must prove that
such intervention can save the company money,
make a stronger and healthier company and make
the company even more competitive. Team members
must be subject matter experts. In the beginning,
especially, you need strong people familiar
with techniques like defusing and debriefing.
WL: Companies are run on the basis of information
and facts. Many companies like ours are using
"fact-based" management. Get the idea
of crisis response teams in front of executives
and leadership teams. Talk about the "health
of the company." These are "people"
issues that effect individual's health and the
workforce. There is a need to make the connection
to business and the impact of trauma. This can
drive the follow-on actions. Have a "global
performance expectation" for the corporation
on health, safety and environment issues as
the company runs its business. Make what you
expect from supervisors and managers very clear
in terms of adhering to these expectations.
These kinds of events may make it clearer for
companies to identify the issues and respond
to employees needs accordingly.
JSV: We are learning more and more about the
effects of secondary traumatic stress such that
caregivers themselves become traumatized and/or
overwhelmed through their efforts to assist
others. What kind of counseling is available
for crisis response team members?
DM: It is our internal protocol that after each
call-out is done, we do a "debriefing of
the debriefers." In fact, we have even
used an article on the Academy's website (www.aaets.org).
and handed it out to further educate our team..
We take each other's "psychological temperature."
We ask thing like "How did it go for you?"
"What didn't go well?", "What
could we have done differently?", "Was
there anyone in the room that you think will
need more support?." We also attempt to
ensure that none of us is heavily carrying the
event around. If needed, we have a great group
of EAP staff that we can go to for counseling
resources including outside providers, clergy,
etc. We also have resources from the Monroe
County CISM team.
JSV: As you are aware, The American Academy
of Experts in Traumatic Stress recognizes that
traumatic events are an unfortunate part of
the human experience that professionals and
workers from many fields work with on a regular
basis. What do you see as the major advantage
of an organization such as the Academy that
is dedicated to increasing awareness and, ultimately,
improving the quality of intervention with survivors
of such events across such an eclectic group?
DM: The AAETS is an exceptional group of professionals
committed to the advancement and training of
crisis/trauma response, management and CISM
techniques, procedures and educational opportunities.
It gives anyone the chance to network with a
wide and diverse group of professionals and
resources that are truly worldwide. With the
new discussion forum on the website (www.aaets.org),
one can interface with many area specialists
and be able to exchange information and questions.
The AAETS gives one a broad-based affirmation
that training in trauma response and CISM does
indeed work. It gives a consistent stream of
information that is so necessary and is key
in the teaching of survival techniques and procedures
in crisis management, not just in the emergency
services arena, but also now in the corporate
workplace. Whether it is someone on an assembly
line or a senior management level person, training
and education in crisis response and management
can help people get better, healthier and stronger.
The Academy is an incredible resource. I have
been able to talk with individuals from other
corporate-based companies on the Academy's internet
forum that read my posting who do not have crisis
response teams and want to develop them. I know
that I speak for the entire Eastman Kodak CISM
team by saying that it has been an honor and
privilege to work with you (and Dr. Lerner).
We only hope our trail-blazing at Eastman Kodak
will start things equally as great elsewhere.
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