Citation

Laurent A. Ann. Med. Psychol. (Paris) 2014; 172(6): 457-462.

Copyright

(Copyright © 2014, Societe Medico-Psychologique, Publisher Elsevier Publishing)

DOI

10.1016/j.amp.2012.03.015

PMID

unavailable

Abstract

The doctors, nurses and ambulance drivers of the mobile emergency medical service ("SMUR" in French) are confronted with the death of their patients in their daily occupation (Laborie et al., 2002). In this context, the patients' death is often unforeseeable and brutal; the deaths result from forms of violence, accidents, suicides and aggressions. Thus, two dimensions emerge from the urgency department; on the one hand the unpredictability of the operations and on the other hand the confrontation with death. These two dimensions refer to the two principal psychopathological aspects concerned in the psychic traumatism: the brutality of the event and the meeting with death.

OBJECTIVE: The goal of our study is to describe potentially traumatic intervention by the SMUR staff and to find out about their personal experiences and also to measure the psychotraumatic repercussions. All along this research, we will rely on a qualitative and quantitative methodology, in order to confront the subjective richness of the clinical interviews with the data resulting from the questionnaire.

METHODology: The study is based on 69 members of the mobile emergency medical service: doctors, nurses and ambulance drivers. Everybody has answered a semi-structured clinical interview and a questionnaire measuring the psychotraumatic disorder: posttraumatic stress disorder interview of Watson et al. (1996). From the clinical interview, we carried out a thematic analysis in order to identify the various topics emerging from each person's personal experience. We observe that the most exceptional interventions, such as catastrophes for example, are not more upsetting for the members of the SMUR. In a way, these interventions are regarded as a springboard for any professional career, a feeling of valorization is associated with it. On the contrary, it is more during their "daily" interventions that professionals express their traumatic experience. In this case, the professional is suddenly confronted with the horror, and the lack of preparation makes him more vulnerable to the "traumatic break down".

CONCLUSIONS: The traumatic event is not to be understood in a psychopathological dimension, but more like an "initiatic ritual" allowing reorganization of the professional identity to cope with the following interventions. Thus, we witness the appearance of new faculties: the members of SMUR change their values, they get new competences: from now on, they can apprehend their work in a new way. Thus, the professionals seem to escape from the "traumatic curse". However, time only reveals the true nature of the event, which has been experienced, since trauma is also what we do with it afterwards. © 2012 Elsevier Masson SAS.

Language: fr

Keywords

human; professional practice; qualitative research; posttraumatic stress disorder; article; questionnaire; psychotrauma; emergency health service; health personnel attitude; physician attitude; nurse attitude; personal experience; semi structured interview; quantitative study; work experience; Psychological adjustment; Emergency mobile Units; mobile emergency health service; Posttraumatic stress disorders; rescue personnel attitude; Traumatic experiences