Code/Trauma Debriefing

  1. I was wondering if any of you had standards for staff debriefing after a code or trauma, particularly after a bad one or a pediatric one. Our ER does not debrief staff members at all and I was thinking about preparing a proposal for this, but I am not sure about what type of guidelines to suggest. We have had some very tragic cases (like all ERs) that have caused a lot of grief and anger to staff members with no outlet. Any suggestions?
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    About erdaynurse

    Joined: Oct '06; Posts: 25; Likes: 6
    ER RN
    Specialty: ER


  3. by   jayne109
    We don't debrief but if a person feels they need that then we have an Employee assistance program that lets us have 4 visits to a psychiatrist without charge. It can be used by immediate family if needed. The only bad thing about it is, My husband used up all of my visits and I am divorced now and when I needed one a few months ago I couldn't go. I think we get more every year, I am not sure. Hope this helps.
  4. by   erdaynurse
    We do have the Employee Assistance Program, but I was thinking more of a group debriefing. Thanks for the suggestion, though, and I am sorry about your ex-husband. I have one of those, so I know how it is!! But sometimes, it is better that they are GONE!!
  5. by   Altra
    Not sure what guidelines to suggest, but I'm glad you're trying to put this together.

    We very rarely do debriefings. If it were made to be the standard, then it would remove the "stigma" of asking for one.
  6. by   km5v6r
    The formal name for what you are looking for is Critical Incident Stress Debriefing. At least here the program is managed by the state and was expanded into hospitals. You might also check with the fire or police department; they have had these type programs for years. These programs are very valuable and have been proven to help prevent burnout.
  7. by   CoolhandHutch
    We have one that is really just a "giant round table" after a troubling event. Our sups are very good about finding coverage for those involved- and it is not a voluntary thing- you go. You do not have to stay, but this takes away from the stigma of the big bad toughies saying, "nah, I am okay" and ending up burned out. We do not talk about what coulda-shoulda-woulda happened; more of a "we've had a crappy day and need a time-out". One of our chaplins usually comes down, as does social work. Every discipline goes- if the security guards or unit secs or even the janitor was nearby or had interaction with the family- you go.

    I don't think this is something that should wait for EAP. Good for you for setting something up.
  8. by   BabyRN2Be
    Quote from CoolhandHutch

    I don't think this is something that should wait for EAP. Good for you for setting something up.
    Yeah, I agree. I don't think that this is for EAP either. Maybe I don't have the full grasp of EAP, but I thought it was for getting treatment for self or family for a long-term problem, such as alcoholism, things like that and not a one time debriefing for a critical incident.

    Good for you for taking the initiative for setting one up. I wish I could help but at the moment I don't have any good advice.
  9. by   JBudd
    I seem to remember a section on debriefing in the TNCC manuel. Do you have a hospital chaplain, or someone along those lines that could help you? I agree with the above post, try the EMS system. I know our police chaplain is great, he often comes to the ER if there is a bad MVA etc.
  10. by   sister--*
    We had a debriefing a couple of yrs. ago after a very tragic accident in the community involving a youth brought into E.R. There was a huge number of extended family that were right at our elbows as we worked through this one. Tragic incident/ tragic outcome.

    The team came from outside our facility and directed the debriefing. It wasn't as cathartic as I would have hoped for. It was extreemly generic. It did, however, allow me to see that I wasn't the only one stressing and grieveing over the incident.

    I'd like to see debriefings after especially tough shifts. Sometimes just getting input from others, sharing the experiences, and knowing you're not alone would be a great boost for pt. care and stress reduction. I could see it also encouraging a productive level of teamwork. It could be a lot like the post clinical conferences held when we were in training.

    I'd say check with your B.O.N. and see if there are organized debriefing teams already in place in your area. If so, take the lead from them but personalize it to meet your own facility's and employee's needs.

    What a great idea you have.
  11. by   traumaRUs
    I found some resources for Critical Incident Stress Debriefing. I worked in a level one trauma center for 10 years and had some just horrid events happen:

    Here is a website with more information:

    Here is a website from a fire dept about 9-11:
  12. by   EricJRN
    For the sake of good discussion, must play devil's advocate here and point out that CISM has been the subject of much debate for several years.

    While we can all recognize the need for mental health resources to be available to healthcare providers, the article below makes some interesting points about CISM.
  13. by   vamedic4
    Hi erdaynurse,
    At my facility we have many adverse outcomes in our patient population, and it hurts down to your soul when it happens. When these things do happen, social work, pastoral care, and other departments get involved to help us through our feelings. It's sort of an informal CISD, allowing us to express our feelings, and to share thoughts and memories.
    In my opinion, it should be a multidisciplinary approach to helping you overcome these terrible events we see every day.
    It may also be good to talk to your minister, I know they've been of great help to me in the past.
    Whatever the outcome, knowing you've done EVERYTHING you could is probably the single most reassuring thing I can do.

  14. by   jenzmom
    AHA just released an online program on debriefing- it's $ 25.00. I'm trying to see if our TC will purchase it.