Disrupted Sleep and Safety on Scene

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Psychologists would argue that firefighters require workshops that target well-being, specifically those that teach coping strategies that help enhance physical and mental resilience. (Photo by Jeff Zimmerman.)

Talking about the well-being of firefighters is important for a number of reasons. Indeed, a recent survey by the recruitment service CareerCast ranked firefighting as the number one most stressful job for 2015 in the United States. Operational demands of the job that lead to sleep deprivation and health risks push trauma-exposed firefighters to the limits of physical and psychological endurance-which can seriously affect their work performance.

For this reason, Rebecca Milner, a business psychology consultant at the London-based multinational professional services firm Arup, says it is time to focus on firefighters’ well-being. In a study she presented at the 2016 British Psychological Society’s Division of Occupational Psychology Conference, held in Nottingham, United Kingdom, Milner looked into the relationship between well-being and work performance. In particular, she investigated how shift work, the practice of dividing the 24-hour workday into shifts to provide round-the-clock service, affects the relationship between well-being and work performance.

With the growing and ever-changing demands for services, between 15 and 20 percent of workers in industrialized countries carry out shift work. The highest prevalence is among protective service jobs, such as firefighting. “Shift working is a clear challenge faced by the emergency service industry,” says Milner. “Significantly, it is associated with a number of negative connotations for employees, including disruption to the sleep-wake cycle, physical and psychological health, and social relationships.” Irregular or prolonged work schedules tend to disrupt a person’s circadian rhythm, often referred to as the internal “body clock” or the natural 24-hour cycle that regulates physical and physiological processes.

Studying Shift work in Firefighters

Milner’s study comprised an initial survey that identified the natural sleep-wake cycles of 190 shift working firefighters from two fire services (one in the United Kingdom and one in Saudi Arabia) followed by a secondary survey capturing the levels of burnout, engagement, sleep quality, and self-rated performance. The design of the study was adopted from research models suggesting that a lack of balance between job demands (elements that require physiological and psychological effort such as time pressure, workload, and shift working) and job resources (elements that contribute to the achievement of goals and well-being, such as self-esteem, relationships, positive feedback, and rest) leads to stress, disengagement, and burnout.

A wealth of implications for fire and rescue organizations was identified. According to Milner, sleep quality was found to significantly predict both burnout and work engagement. Sleep quality and engagement were each found to significantly and positively predict performance, while burnout negatively predicted it. In other words, high sleep quality and high engagement in work predicted better work performance. In contrast, low sleep quality predicted worse performance. Milner suggests that firefighters who get insufficient quality sleep are more likely to experience a reduction in work engagement, which could in turn lead to burnout, emotional exhaustion, cynicism, and reduced personal efficacy.

The findings of this study effectively revealed the importance of considering a person’s natural sleep-wake cycle. It was found that incorporating the participant’s natural circadian type (sleep-wake cycle preference) helped strengthen the relationship between sleep quality, burnout, and performance. Burnout more readily affected firefighters with a preferred sleep-wake cycle because they were less flexible in adjusting their sleeping and waking times, increasing problems with drowsiness. “These individuals can be seen as a ‘high risk’ group,” says Milner, suggesting that, “burnout symptoms may have a more substantial impact on their performance.” On the other hand, she explains, “For those who are more flexible in sleeping and waking times, and who experience ease in overcoming drowsiness, burnout is less likely to impact performance.” This low-risk group is equipped with personal resources that counteract the job demands of shift work.

The Role of Fire Services

It was important to Milner to highlight the implications of disrupted sleep patterns to firefighter work performance. “I was keen to empirically demonstrate to organizations the importance of recognizing such well-being implications,” she explains. This kind of evidence is critical to fire and rescue agencies in understanding how they can optimize the effectiveness and productivity of staff in the context of working shifts.

More importantly, the study showed the critical role of fire institutions. While there is plenty of research on coping, post-traumatic growth, and stress management that fire departments can incorporate into their training methods, Milner raises an important issue: “It is concerning that practitioners conclude that the majority of employers see health and well-being as a private concern and the responsibility of employees.”

The well-being of firefighters and the knowledge about work-related factors that affect it should be a top concern for fire organizations. Milner hopes that the quantifiable evidence in her study linking well-being with business outcomes will contribute toward the prioritization of firefighter well-being. In particular, the findings shed light on the importance of setting up interventions that consider natural circadian types and sleep quality methods to enhance the well-being of firefighters and subsequently improve work engagement and reduce risk of burnout. For Milner, interventions should be designed to cover three aspects: the identification of risks, job design evaluation, and the development of well-being.

Leadership’s Ability to Identify and Address Risks

Leadership needs to be trained to be able to identify key indicators of burnout or reduced engagement, indicators that can then be supplemented by behavioral observation. Leadership will also gain from learning how to identify the natural sleep-wake cycle preferences of staff. Not only does this guide them when allocating shift work schedules, but it also facilitates the selection process to ensure that all new recruits are easily able to adapt to night work and rotating work shifts. “For instance,” suggests Milner, “those identified as being naturally less likely to adjust to shift working based on their circadian type, people who are considered to be at a higher risk of performing suboptimally should they experience burnout, might be allocated to day shift working.”

Having knowledge of and competence in understanding their employees’ circadian types also guides leadership in designing interventions that aim to develop employees’ awareness of their individual sleep-wake cycle preferences and teach them how to actively modify such preferences. When that is done, employees will be better able to optimize their work performance in the context of shift working. Training managers to identify the risks equips them with the tools they need to effectively support employees with work concerns who may compromise their personal well-being.

Job Design Evaluation and Improvement

Milner proposes implementing interventions that evaluate and improve the current job design of many fire and emergency services. According to her proposal, fire agency leaders must ask whether the current organizational setup is producing firefighting skills and capabilities that fully match the demands of the job. This highlights the primary need to discuss with employees not only the concepts of “job demands” and “job resources” but also the significance of balancing the two. Milner suggests that fire organizations map out the job demands and staffing levels against working hours and responsibilities, conduct a skills gap analysis, and make the necessary improvements to the job design to match job demands with job resources.

Job design evaluation can also reveal whether department leaders are themselves suited to managing the demands of the organization. According to Milner, “There is a need to ensure that managers are equipped with the knowledge and correct attitudes around well-being.” This influences leadership’s decisions about whether to provide employees with access to counseling, coaching, and helpline opportunities.

Interventions that Target Well-Being

Psychologists would argue that firefighters require workshops that target well-being, specifically those that teach coping strategies that help enhance physical and mental resilience. Milner cites the example of a study in which a 30-minute presentation on sleep-hygiene behavior was found to improve sleep quality among students six weeks after its implementation. She also cites a study that found bright-light therapy between 2:00 a.m. and 9:00 a.m. (this therapy activates the circadian system) actually improves vigilance levels and, consequently, performance in shift workers. Interventions can also be designed to educate staff about the importance of humor, socialization, exercise, and effective work detachment, in addition to teaching them the process of disengaging themselves from work concerns after work hours and showing them how to build psychological resilience.

With the unavoidable need for round-the-clock emergency services, shift working is a necessity. However, shift work firefighters are exposed to trauma and stress and often experience detrimental impacts on their health and well-being. To provide support for emergency service personnel, both researchers and leadership must continually investigate how the negative impacts of the occupation can be minimized and the effectiveness of workers optimized.

Milner offers her study as a resource for others to convince decision makers to invest in developing the well-being of firefighters. “The findings speak for themselves in that workplace well-being and sleep quality significantly predicted performance,” she says. “I hope that these findings help to communicate the need to review the demands under which we are placing shift workers, in addition to prompting investment in equipping employees with coping strategies and support networks.”

Improving sleep quality is not only the personal responsibility of fire personnel, but it is also an institutional concern because of its impact on the safety of those requiring assistance from fire services. Fire services, therefore, need to implement interventions that help employees build resilience and flexibility with shift working in efforts to secure their performance. This is critical within any organization that involves saving lives.

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September 2016
Volume 11, Issue 9
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