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Critical Incident Stress Debriefing



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Category: Emergency Nursing

Dec 29, 2008 03:19 PM

Critical Incident Stress Debriefing

by traumaRUs Staff
Updated Dec 29, 2008 at 05:09 PM by Joe V

What is a Critical Incident Stress Debriefing? A Critical Incident Stress Debriefing is a meeting involving mental health providers, peers, perhaps a religious representative that try to make sense out of something senseless.

What is a critical incident? They are typically sudden, powerful events outside the range of ordinary human experiences. There is likely to be a powerful response within those individuals who work in an arena where critical incidents readily occur.

Who should attend? The debriefing should be available to all ER staff: from the housekeeper, tech, nurses and physicians as well as ancillary personnel. The debriefing should occur as soon after the traumatic incident as possible.

We as human beings are just as vulnerable to stress related problems as the civilian population. However, we (as super calm, efficient and nothing-can-get-to-me ER nurses) don’t like to acknowledge it!

If you’ve experienced an especially stressful event, contact your local CISD team, start one at your facility if one doesn’t exist. Here are some resources:



How to start a CISD team:
http://www.pcchap.org/PCMANUEL/Chp%204/chapter4.htm

From: traumatology, volume 9:
http://www.fsu.edu/~trauma/V9/v9i1_911Aftermath.pdf

Lenore Behar article about CISD:
http://www.lenorebehar.com/publications.htm

American Academy of Experts in Stress:
http://www.aaets.org/article54.htm


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13 Comments
No. 1
Old Jan 02, 2009, 08:47 PM

Default Re: Critical Incident Stress Debriefing
Also a non-company consultant would help. This gives a totally confident debriefing and closure to any stress related problem.
A consultant that specializes in Stress Managment, Relaxation Management, and Post Traumatic Stress Syndrome is the key.
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No. 2
from traumaRUs
Old Jan 03, 2009, 03:43 PM

Default Re: Critical Incident Stress Debriefing
Excellent suggestion. As we both know, it is sometimes difficult to express your feelings after a horrible event if you know your bosses might find out about it. Thank you.
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No. 3
Old Jan 15, 2009, 08:58 AM

Default Re: Critical Incident Stress Debriefing
Debriefing is very important. Funny, I worked in mental health for 20 plus years; it took a very serious choking event to make me leave my director's position. They debriefed us over a MONTH after the event. Fortunatey, as a non nursing personnel at the time, I resucitated the individual; however, this was not the first incident I experienced with this facility followed by no support. This was eleven years after I found a patient with a fatal bullet wound to his head.

The day I found a guy with a fatal bullet wound to his head in the parking lot of a local hospital we provided mental health services to should have warned me as to how this agency handled these type of events.

We are human first, health professionals second. Many people believe that their reaction is the ONLY reaction to stressful eventes. Many facilities need work in this area. This incident two years ago pushed me right over the edge; there is nothing worse than having an emergency in a non medical facility, assisting and resucitating the individual and being responsible for thirty other program participants and ten other staff.

I continue to giggle every time someone identifies me as a 'new nurse' and will not allow me to expand my horizons or work as a PRN nurse elsewhere. They are clueless as to the experiences I have encountered. Trauma happens to the patient and anyone who is involved! Make sure you have resources available to you. The long term effects can show up just when 'you do not expect it'.
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No. 4
from Nursesds
Old Jan 15, 2009, 12:56 PM

Default Re: Critical Incident Stress Debriefing
I hear Emergency Departments talk about stress debriefing often, I have yet to actually see one happen. I do all the sexual assault cases and I can tell you these take their toll. It seems wrong to use an EAP type program, do you think it is a cost factor?
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No. 5
from traumaRUs
Old Jan 16, 2009, 07:33 AM

Default Re: Critical Incident Stress Debriefing
peaceonearth - It sure sounds like you have worked in a war zone. You are so right: debriefing wwwaaayyy after an incident does little to no good.

nursesds - Could be a cost factor. I think perhaps some places may not call it critical incident stress debriefing. However, if EAP is confidential and equipped, this might be an avenue to gaining services.
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No. 6
from Nursesds
Old Jan 16, 2009, 04:54 PM

Default Re: Critical Incident Stress Debriefing
yes TraumaRUs the EAP might be one method, we just need a champion to take it on. We used it once when one of our staff members died unexpectedly.
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No. 7
Old Jan 23, 2009, 12:54 AM

Default Re: Critical Incident Stress Debriefing
As with every thing else if we want it done nurses must take the lead. Let us pool our thoughts and develop this much needed service ourselves. How about a forum on this site where we can pool our ideas?
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No. 8
from traumaRUs
Old Jan 27, 2009, 11:46 AM

Default Re: Critical Incident Stress Debriefing
nursesds - I'm so sorry for your loss. We lost a very valuable member of our team (one of our night charge nurses) in Jun 2007. I still miss her - she was so much fun. EAP/CISD is what this is all about.

mactheknife - I think we (like many other facilities) are facing decreasing reimbursement and increasing costs and doubt $$$ could be spent on this endeavor.

I think it goes back to us supporting one another and being there with a listening ear and shoulder to cry on when necessary. If we don't nurture each other, who will?
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No. 9
Old Jan 27, 2009, 11:17 PM

Default Re: Critical Incident Stress Debriefing
traumaRUs, We don't need to spend $$$ but we can share ideas for debriefing and coping with nuring related stress with each other. Most of us, if not all, have had a traumatic expierience and if we share how we coped, others could benefit. How about setting up a "Share your stress relief" thread or blog on allnurses?
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