Aim: The aim was to investigate the ambulance nurses experiences during a specific ambulance missions that led to usage of LUCAS ™.Method: Participating ambulance nurses were randomly assigned from a total sample group of 12 women and 39 men. Five women and five men participated. Qualitative interviews were conducted, where the Critical Incident Technique approach was used. Collected interviews were valued using qualitative content analysis.Result: Interview texts were divided into three domains, 10 subcategories could be identified which were sorted into three categories. A theme was finally formulated.The initial alarm data from SOS Alarm is important for the ambulance nurses preparation. There where cardiac arrest situations when the work went well, as well as situations where problems arose. The informants expressed that they should practice on LUCAS ™ to a greater extent than they now are doing. Staff in the emergency room, some time was perceived as stressful and they did not listen. The informants expressed frustration with the major administrative tasks after a LUCAS™ case, on the other hand, the "team spirit" where highlighted, they solve the task together.Conclusion: Developments during ambulance missions where LUCAS ™ will be used depends on, alarm data, resources, situation at the scene, planning, roles, supervision, handling of LUCAS ™ and Case Report Form, relatives and viewer reactions, the receipt at the emergency department and finally that ambulance staff cooperates after the LUCAS ™ mission. / Syfte: Syftet var att undersöka ambulanssjuksköterskors upplevelser under ett bestämt ambulansuppdrag som ledde fram till begagnande av LUCAS™. Metod: Deltagande ambulanssjuksköterskor lottades ur en total urvalsgrupp bestående av 12 kvinnor och 39 män. Fem kvinnor och fem män deltog. Kvalitativa intervjuer genomfördes, där Critical Incident Technique metoden användes. Insamlade intervjudata värderades med hjälp av kvalitativ innehållsanalys. Resultat: Intervjutexten kunde delas in i tre domäner, 10 underkategorier kunde identifieras som sorterades i tre kategorier. Slutligen formulerades ett tema. De initiala larmuppgifter från SOS Alarm är viktiga för ambulanssjuksköterskornas förberedelser. Det förekom hjärtstoppssituationer där arbetet gick bra, likväl situationer där problem uppstod. Informanterna uttryckte att de borde öva på LUCAS™ i större utsträckning än de gör i nu läget. Vid en del situationer upplevdes mottagande personal på akutmottagningen som stressade och att de inte lyssnade. Betecknande för informanternas upplevelser vad gäller de administrativa uppgifterna efter LUCAS™ uppdraget var inte positivt, dock betonades "team work". Slutsats: Utvecklingen under ambulansuppdrag där LUCAS™ kommer till användning är beroende av; larmfakta, resurser, situationen på plats, planering, roller, arbetsledning, hanterandet av LUCAS™ och Case Report Form, anhöriga och åskådares reaktioner, mottagandet på akutmottagningen och slutligen att ambulanspersonalen samarbetar efter LUCAS™ uppdraget.

Samfattning   Bakgrund: I vår vardag världen över drabbas människor oavsett kön och ålder av olyckor, dödsfall och andra traumatiska händelser. Vissa yrken medför en större risk att utsättas för traumatiska händelser. Exempel på dessa är ambulans, räddningspersonal, polis och vårdpersonal inom främst akutsjukvård. Dessa händelser kan ibland bli personen övermäktigt. Ett sätt att motverka bl.a. utbrändhet och posttraumatiskt stressymptom (PTSD) hos vårdpersonalen är att genomföra debriefingsamtal. Detta genomförs med den vårdpersonal som varit delaktig i en traumatisk händelse.     Syfte: Syftet med denna studie var att beskriva erfarenheten av debriefing hos vårdpersonal inom akutsjukvården i samband med traumatiska händelser i sin yrkesutövning.   Metod: Litteraturstudie som totalt innehåller 10 vetenskapliga artiklar varav fem är kvalitativa och fem är kvantitativa.   Resultat: Studieresultatet påvisar att debriefing uppfattas som ett positiv redskap när det gäller avlastning efter en traumatisk händelse för vårdpersonalen inom akutsjukvården. De främsta faktorerna som lyfts i studien är tid och plats för debriefing, debriefingens inverkan på kommunikationen mellan vårdpersonalen, val av debriefingledare och behovet av väl utformade riktlinjer för debriefingen.   Slutsats: I föreliggande studie påvisas att debriefing bör betraktas som ett effektivt verktyg att motverka psykisk ohälsa hos vårdpersonalen och att debriefing även förstärker kommunikationen mellan de olika professionella yrkesgrupperna inom akutsjukvården. Studien visar även att det är viktigt med väl utformade riktlinjer för att debriefingens syfte skall uppnås. / Abstract Background: In our everyday lives worldwide, people are affected regardless of gender and age by accidents, deaths and other traumatic events. Some professions involve a greater risk of being exposed to traumatic events. Examples of these are ambulance, emergency personnel, police and health care personnel, primarily in emergency care. These events can sometimes become overpowering. One way to counteract burnout and post-traumatic stress symptom (PTSD) in healthcare professionals is to carry out debriefing talks. This is done with the healthcare staff who has participated in a traumatic event.   Aim: The purpose of this study was to describe the experience of debriefing in healthcare professionals in emergency care in connection with traumatic events in their professional practice.   Method: Literature study that contains a total of 10 scientific articles, five of which are qualitative and five are quantitative.   Results: The study results show that debriefing is perceived as a positive tool when it comes to unloading after a traumatic event for the healthcare staff in emergency care. The main factors raised in the study are time and place for debriefing, debriefing impact on the communication between the healthcare staff, the choice of debriefing leader and the need for well-designed guidelines for debriefing.   Conclusion: The present study demonstrates that debriefing should be regarded as an effective tool for counteracting mental illness in the healthcare staff and that debriefing also reinforces communication between the various professional occupational groups in emergency care. The study also shows that well-designed guidelines are important for achieving the purpose of the debriefing.

The Critical Incident Team (CIT) training program equips police officers with knowledge regarding mental illness and practical skills for effectively interacting with a mentally ill suspect. In addition to improving officer and suspect safety by decreasing the number of violent encounters between police and the mentally ill, CIT goals include reducing the number of mentally ill individuals who are arrested and providing them with assistance through community resources. However, there is a lack of empirical research on whether CIT training decreases arrest rates and increases diversion rates for mentally ill subjects. The purpose of this quantitative study was to measure the effects of CIT training on arrest and diversion rates of mentally ill subjects. The theoretical foundation for the study was evidence-based policing. Reports from a single police department in the southwestern United States were reviewed, and arrest and diversion incidents from 6-months pre and post CIT training for 30 police officers were collected. A paired-samples t test was used to analyze the data, which indicated that there was not a statistical difference in arrest rates or diversion rates between pre and post CIT training. Results corroborated the findings of other studies showing that arrest and diversion rates are not affected by CIT programs. Law enforcement agencies that currently have or are looking to implement a CIT program may find the study useful, as it reports an increase in resources being provided to mentally ill subjects following contact with a CIT officer. Recommendations include additional research into the effectiveness of the CIT program as well as the continuation of collaboration between community mental health organizations and police, both of which may lead to positive social change.

Abstract Working with child and youth welfare is one of the most difficult challenges a social worker might face in the field of social work. Those who work with child and youth welfare are more exposed to stress and burnout than other comparable human service occupations. Research links the prevalence of stress and burnout to several key variables, such as demographics, working conditions and personality factors. In contrast, even though social workers in this field face many negative work-related problems they report a high job satisfaction. The aim of this study is to examine how uplifting and straining experiences affect social workers, who work with child and youth welfare, through the use of The Critical Incident Technique and interviews. There were many factors that contributed to the social workers experiences of stress, but many ultimately reported a high satisfaction and engagement towards their work. Success with clients and positive client feedback generated engagement, even to the extent that it gave the social workers a sense of affirmation to their career choice. This means that the social workers sense of engagement is closely tied to their clients. They provide a large and important source of engagement, albeit an unstable one. Since positive client results and client feedback cannot be guaranteed nor manipulated, it is not a stable or usable source of engagement. It is therefore imperative to not rely on clients for engagement, but instead search for other alternative that might generate engagement in social workers.

Syftet med denna studie är att studera samspelet mellan socialarbetaren och det sociala arbetet. Detta görs utifrån fem pensionerade socialarbetares egna berättelser från sitt yrkesliv. Kritiska händelser och situationer som socialarbetaren sett som betydelsefulla har stått i fokus, samt hur dessa händelser och situationer har påverkat yrkesidentiteten och synen på sig själv. Studien är kvalitativ med en induktiv ansats och utgår från en narrativ forskningsmetod med inslag av Critical Incident metoden. Studien vilar på en fenomenologisk tolkningstradition. Resultatet visar att socialarbetaren i olika utsträckning utvecklar strategier och förhållningssätt för att möta, hantera samt fungera i det sociala arbetet. Dessa strategier och förhållningssätt presenteras i studiens analysdel utifrån fyra idealtyper; Den Krigande, Trädgårdsmästaren, Den Distanserade samt Den Sörjande.

In the past, the discussions on the development of service innovation are based on the analyses of manufacturing technology innovation and introduce the concept of manufacturing innovation and the model of product innovation to explore the service innovation of service industry sectors. Also, the past discussions center on the externalities of the service providers, the peripheral factors and new services introduced or provided by the enterprises and fail to focus on the impact of the service innovation on the interaction between customer service representatives and customers. This study will explore the interaction between the service providers (customer service representatives) and service demand (customers) from a microscopic angle and also analyze what roles of service providers and service demand play in the process of service innovation development. The purpose of the study is to understand the interaction roles played by the service representatives and customers, and to analyze the development and the model of service innovation when the representatives provide service to customers. The study will also explore the process of service innovation cycle development and what the driving force is in the formation of service innovation cycle development. The research obtains the qualitative data by the analysis of case study and supplements it with Critical Incident Technique (CIT). With the half structured questionnaire, the interview was conducted with the internal staff of the service providers and customers on the spot. The study tries to find out the reason behind the Critical Incident which prompts the service providers to innovate its service and its content. By analyzing the case study and Critical Incident of the innovation, the study proposes the model of the service innovation cycle and illustrates that the formation of service innovation is enhanced by repetitive evolution of innovation. Through the process of repetition and updated innovation cycle, the service providers can seek the goal of Continuous Service Innovation and outstanding performance. The study also employs Analytic Hierarchy Process (AHP) to analyze the critical driving force of the service innovation during the service process and the meaning each represents.

Police officers on-site service eccounters are the service quality for the moments of truth . For face to face contact with the process of understanding and control, affect the public perception of service quality.In this research,according to the perspectives of police officers service encounters,through the public and their experience of interactive codes, enhance the public satisfaction with the police officers. Study aimed to survey the public and police officers interactive codes of service eccounters in their role of symbol,and probe into the different levels between the public and police officers interactive codes of service eccounters, furthermore comprehend the relationship between public satisfaction and police officers interactive codes of service eccounters. The first stage of critical incident techique , 70 police personnel from the recovery of the questionnaire were satisfied with 66 events, with 60 not satisfied with the events.Through the analysis classified includeing interactive codes of service eccounters of the body language, self-disclosure and behavior characteristics.Then by the second phase of validation study, using convenience sampling, issued 250 questionnaires and collected 248 questionnaires, 236 valid samples. By descriptive statistics, independent test, ANOVA, regression analysis and verified by two-way ANOVA analysis to explore the relationship between public satisfaction and police officers interactive codes of service eccounters. Research results, in the critical incident techique cases show that police officers feel the people are the most satisfied with the police¡¦s treatment response.It is obviously that people confirm the police officers treatment response ability of endangered public security.Police officers feel the people are the most unsatisfied with the congnitive differences of exchange messages,and account for the overwhelming majority.Therefore, to protect the legal and ban the illegal, police officers will apply law and unlawful message across service encounters people. People distrust the police because of the congnitive differences .Therefore, the public awareness and law-abiding is the concept of the underlying factors differ. Police service and sincere response to contact with the body language of the higher performance, care had more positive interactions, people will have better contact with the police service satisfaction;Service access to expose the higher self-disclosure in confidence, more positive relationship with the public,the more people have better satisfaction;Service contact to the better qualities of convenience services, expertise being more substantial, the public will be better satisfied.But it is also show that the level of police officers interactive codes of service eccounters did not affect satisfaction interactive source for significant differences in the change.

The present study investigated what helped and what hindered multicultural supervision. The participants consisted of 19 females, and 6 males, including Asian-Canadians, Indo- Canadians, First Nations, Latin-Canadian and Afro-Canadian. They were individually interviewed, following an expanded version of Flanagan's (1954) Critical Incident Technique. There were 340 relevant meaning units related to positive incidents and 386 meaning units related to negative incidents. Forty-two meaning units were associated with coping efforts, and 87 meaning units were on recommendations. Categories extracted from these meaning units were grouped as follows: (a) 20 positive categories, (b) 15 negative categories, (c) 15 coping categories, and (d) 33 recommendations. The reliability of classifying meaning units according to these categories was satisfactory, based on inter-judge agreement (80% and higher). The validity of content analysis was established by (a) confirmation by participants, (b) crossvalidation by other participants, (c) cross-validation by an independent judge, and (d) cross-validation by other researchers. The most frequently cited positive categories were subsumed under five key areas: (a) personal attributes of the supervisor, (b) supervision competencies, (c) mentoring, (d) relationship, and (e) multicultural supervision competencies. The most frequently reported negative categories were associated with the following five areas: (a) personal difficulties as a visible minority, (b) negative personal attributes of the supervisor, (c) lack of a safe and trusting relationship, (d) lack of multicultural supervision competencies, and (e) lack of supervision competencies. The coping efforts employed were grouped into four areas: (a) help seeking, (b) existential coping, (c) active coping, and (d) emotional coping. Finally, recommendations were also grouped into four broad areas: (a) needs to improve the quality of supervision, (b) needs to improve multicultural supervision competencies, (c) needs for educational institutions to make changes, and (d) needs for minority students to make changes. The study provided a comprehensive picture of what works and what does not work in multicultural supervision. The results support a mentoring model, which posits that supervision is effective to the extent that the supervisor takes on the role of a mentor. The practical implications of the study include the need for cross-cultural supervision competencies and mentoring graduate students.

This research examined leadership in difficult situations using phenomenological and critical incident analyses of 14 interviews with respected leaders. Leadership in difficult situations was examined as a personal experience consistent with the perspective of counselling psychology. The phenomenological analysis has produced four voices. The first voice captures the participants' description of leadership as a paradox of personal and situational dynamics. The second voice forms an uncommon elucidation of the lived experience of leadership in difficult situations. The participants are seen to be striving in a resilient manner characterized by a sense of acceptance and authenticity. The third and fourth voices describe the means by which the participants are effective in difficult situations. The third voice captures the intra-personal process of resonance, personal and social awareness, personal supports, mastery of the issues, and the capacity to generate remarkable outcomes. The fourth phenomenological voice captures the participant's active engagement in connecting with people, shaping the work context and leading collaboration to develop a successful process. Five categories have been produced by the Critical Incident Technique, which examined what helps and what hinders in the experience of leadership through difficult situations. The five categories are: being experienced, principled and self-aware; having personal supports and influences; being interested and skilled in connecting with people; being both energetic and able to withdraw appropriately; finally, actively cultivating their perspective or vision. These five categories indicate the capacity of the participants for diverse means of participation in difficult situations. Results are discussed in terms of implications for research and practice.

As ambulance staff, are there any risks that critical incidents may be experienced as traumatic and affect the individual negatively? What the outcome will be for those affected depends on how well prepared the ambulance staff is. Research shows that peer support is an important feature to reduce the risk of the caregiver to suffer from posttraumatic stress disorder and how the continued careing becomes. The first support, however, is the most important thing when a carer experiences a critical incident. The aim of this study was to identify how ambulance staff experiences peer support. The methodology of the study was a triangulation, which means that quantitative and qualitative methods are mixed. This methodology makes it possible to study the subject as deeply as possible and still maintain a high validity and reliability. A questionnaire was designd and sent out to the informants. There were 169 persons who were asked to participate. The survery was voluntary and anonymous. A total number of 100 carers with different job titles chose to participate. A majority of the ambulance staff said that they had experienced a critical incident that influenced them at work. The results show that peer support is important to most people and that a majority of those affected chose to talk to their colleague in connection with the incident. When peer support was not used this had to do with personal chemistry and/or that it was not considered necessary. The results show that it would be desirable if a professional kept regular monitoring or reflection with those affected by a critical incident. Not a colleague since personal chemistry may lead to unsatisfactory results.