Critical Incident Stress Debriefing

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.

Critical Incident Stress Debriefing

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:

Dr. Lenore Behar - Publications and Articles

American Academy of Experts in Stress:

Providing Critical Incident Stress Debriefing (CISD) to Individuals and Communities in Situational Crisis

1
Up Vote Up Vote ×
traumaRUs

About traumaRUs, MSN, APRN

Trauma Columnist
87 Articles   21,288 Posts

Share this post

Specializes in med-surg, hospice, wondering units,.

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.

Up Vote Up Vote ×
Specializes in Nephrology, Cardiology, ER, ICU.

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.

Up Vote Up Vote ×
Specializes in cardiac, psychiatric emergency, rehab.

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'. :)

Up Vote Up Vote ×

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?

Up Vote Up Vote ×
Specializes in Nephrology, Cardiology, ER, ICU.

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.

Up Vote Up Vote ×

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.

Up Vote Up Vote ×
Specializes in Operating Room.

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?

Up Vote Up Vote ×
Specializes in Nephrology, Cardiology, ER, ICU.

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?

Up Vote Up Vote ×
Specializes in Operating Room.

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?

Up Vote Up Vote ×
Specializes in Nephrology, Cardiology, ER, ICU.

mactheknife - sounds like a good idea. What about starting a thread in the ER forum or if you want to include everyone - the general nursing forum. Thanks for the suggestion.

Up Vote Up Vote ×
Specializes in Operating Room.

That is a great idea. I will do some research and make contact with Brian and co. At the minute I am just a tad tied up with the setting up of a new Operating room, including an imminent JCI accreditation.

Up Vote Up Vote ×