PRESIDENT’S MESSAGE
CRITICAL INCIDENT STRESS MANAGEMENT: THE WHOLE TEAM
Matthew F. Powers, MS, BSN, RN, MICP, CEN , Pleasant Hill, CA
elcome to 2015. As we embark on ENA’s 45-year anniversary, let us take a moment to celebrate our organization, leaders, and JEN Editorial Staff who have brought us thus far. When I mention leaders, no one should be left out. ENA leaders include members who have committed to our organization, from our founders, Anita Dorr and Judith Kelleher, to our chapter, state, and national leaders in all leadership positions during the past 45 years. I offer congratulations and sincere gratitude for your work and involvement. Let me invite you to my passion. For much of my emergency nursing journey, I have challenged myself to break down the wall between the prehospital world and the emergency department. We are teams that work together to provide our patients and their families with the highest quality and most proficient emergency care available. When I speak of teams, this never discounts any member of the patient care team, from the 911 call taker or dispatcher, volunteer, law enforcement, first responder, EMT, and paramedic, to the registered nurse, licensed practical nurse/licensed vocational nurse, physician, ED staff, and inpatient caregiving staff. During my 25 years of experience as both a paramedic and a registered nurse, I have recognized one area in which
W
Matthew F. Powers is President of the Emergency Nurses Association. For correspondence, write: Matthew F. Powers, MS, BSN, RN, MICP, CEN, Emergency Nurses Association, 915 Lee St, Des Plaines, IL 60016; E-mail: [email protected]. J Emerg Nurs 2015;41:1-2. 0099-1767 Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jen.2014.11.010
January 2015
VOLUME 41 • ISSUE 1
we all must improve, and that is the coordination and inclusion of participants in critical incident stress debriefings. Mental health for our EMS colleagues—yes, including ED personnel—is essential for emotional healing after providing care to those who have suffered events that are incomprehensible to the majority of the community. The difficult situations we encounter daily are not limited to catastrophic death, pediatric emergencies with poor outcomes, or the unexpected death of a co-worker, whether accidental or by suicide. The larger question is, how do we cope with the experience of mental strain day by day or as a rather frequent occurrence? How can we remain mentally fit to experience even more of the unknown? Critical Incident Stress Management (CISM) was created for the purpose of bringing together people who have experienced similar events to provide a means to cope with them. As a team leader for our local critical incident stress team, I was most intrigued by the participation of not only prehospital staff but ED physicians, nurses, technicians, and involved staff who participated in a debriefing for a 3-year-old who was accidentally shot in the head. During a crisis our adrenalin pumps to help us provide the best care we can deliver, but then having to deliver the news of their child’s demise to a family is most certainly not an easy task for any of us. How many of us have encountered a devastating circumstance and gone home in tears, saddened by the day’s activities? How do we cope with tragedy and yet return to function emotionally and cognitively again the next day? Imagine carrying a piece of luggage that becomes heavier with every emergency event we have experienced and have been unable to talk about freely with colleagues. Over time, as we hold these events inside as luggage, we simply burn out and cannot carry any more. The burden has become too heavy. Do we then become less satisfied with our work and unintentionally deliver less quality of care than our patients deserve? We must always remember we serve those with their perceived emergency, not ours. How, then, do we remain mentally healthy? We need to talk it out, express feelings, or at least listen to the experiences of others. With CISM, the ideal goal is to understand that the reactions we have to a stressful event are normal and that by working through our own grieving process, we can achieve and maintain normal mental balance. If we are saddened or distraught by an event, we are experiencing a normal human reaction to witnessing an unfortunate event. Often we ask ourselves questions such as,
WWW.JENONLINE.ORG
1
PRESIDENT’S MESSAGE/Powers
"What did the 911 caller say?" “What was the home like?” “Where was the gun?” “Who was there, and why or how could this have happened?” We seek to have our questions answered by the story. In a CISM debriefing, all participants who had a part in the incident come together to talk about what each person witnessed and how he or she felt at the time and thereafter. Including both prehospital and hospital personnel in debriefings will assist in finding answers for all parties. The questions about what happened on scene and what happened in the hospital must be discussed. Knowing the answers to the
2
JOURNAL OF EMERGENCY NURSING
assumptions we naturally make may allow us to connect the dots to make more sense of an incident. I believe when those questions are answered, or at least acknowledged, we can start to move through the grieving period ourselves. When a terrible incident occurs in your emergency setting, insist on a critical incident debriefing, and not with just your own staff, but with all involved players. As emergency nurses, our passion is to take care of others in an emergent event, but who is taking care of us? For more information, visit www.icisf.org.
VOLUME 41 • ISSUE 1
January 2015
CRITICAL INCIDENT STRESS MANAGEMENT: THE WHOLE TEAM
Matthew F. Powers, MS, BSN, RN, MICP, CEN , Pleasant Hill, CA
elcome to 2015. As we embark on ENA’s 45-year anniversary, let us take a moment to celebrate our organization, leaders, and JEN Editorial Staff who have brought us thus far. When I mention leaders, no one should be left out. ENA leaders include members who have committed to our organization, from our founders, Anita Dorr and Judith Kelleher, to our chapter, state, and national leaders in all leadership positions during the past 45 years. I offer congratulations and sincere gratitude for your work and involvement. Let me invite you to my passion. For much of my emergency nursing journey, I have challenged myself to break down the wall between the prehospital world and the emergency department. We are teams that work together to provide our patients and their families with the highest quality and most proficient emergency care available. When I speak of teams, this never discounts any member of the patient care team, from the 911 call taker or dispatcher, volunteer, law enforcement, first responder, EMT, and paramedic, to the registered nurse, licensed practical nurse/licensed vocational nurse, physician, ED staff, and inpatient caregiving staff. During my 25 years of experience as both a paramedic and a registered nurse, I have recognized one area in which
W
Matthew F. Powers is President of the Emergency Nurses Association. For correspondence, write: Matthew F. Powers, MS, BSN, RN, MICP, CEN, Emergency Nurses Association, 915 Lee St, Des Plaines, IL 60016; E-mail: [email protected]. J Emerg Nurs 2015;41:1-2. 0099-1767 Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jen.2014.11.010
January 2015
VOLUME 41 • ISSUE 1
we all must improve, and that is the coordination and inclusion of participants in critical incident stress debriefings. Mental health for our EMS colleagues—yes, including ED personnel—is essential for emotional healing after providing care to those who have suffered events that are incomprehensible to the majority of the community. The difficult situations we encounter daily are not limited to catastrophic death, pediatric emergencies with poor outcomes, or the unexpected death of a co-worker, whether accidental or by suicide. The larger question is, how do we cope with the experience of mental strain day by day or as a rather frequent occurrence? How can we remain mentally fit to experience even more of the unknown? Critical Incident Stress Management (CISM) was created for the purpose of bringing together people who have experienced similar events to provide a means to cope with them. As a team leader for our local critical incident stress team, I was most intrigued by the participation of not only prehospital staff but ED physicians, nurses, technicians, and involved staff who participated in a debriefing for a 3-year-old who was accidentally shot in the head. During a crisis our adrenalin pumps to help us provide the best care we can deliver, but then having to deliver the news of their child’s demise to a family is most certainly not an easy task for any of us. How many of us have encountered a devastating circumstance and gone home in tears, saddened by the day’s activities? How do we cope with tragedy and yet return to function emotionally and cognitively again the next day? Imagine carrying a piece of luggage that becomes heavier with every emergency event we have experienced and have been unable to talk about freely with colleagues. Over time, as we hold these events inside as luggage, we simply burn out and cannot carry any more. The burden has become too heavy. Do we then become less satisfied with our work and unintentionally deliver less quality of care than our patients deserve? We must always remember we serve those with their perceived emergency, not ours. How, then, do we remain mentally healthy? We need to talk it out, express feelings, or at least listen to the experiences of others. With CISM, the ideal goal is to understand that the reactions we have to a stressful event are normal and that by working through our own grieving process, we can achieve and maintain normal mental balance. If we are saddened or distraught by an event, we are experiencing a normal human reaction to witnessing an unfortunate event. Often we ask ourselves questions such as,
WWW.JENONLINE.ORG
1
PRESIDENT’S MESSAGE/Powers
"What did the 911 caller say?" “What was the home like?” “Where was the gun?” “Who was there, and why or how could this have happened?” We seek to have our questions answered by the story. In a CISM debriefing, all participants who had a part in the incident come together to talk about what each person witnessed and how he or she felt at the time and thereafter. Including both prehospital and hospital personnel in debriefings will assist in finding answers for all parties. The questions about what happened on scene and what happened in the hospital must be discussed. Knowing the answers to the
2
JOURNAL OF EMERGENCY NURSING
assumptions we naturally make may allow us to connect the dots to make more sense of an incident. I believe when those questions are answered, or at least acknowledged, we can start to move through the grieving period ourselves. When a terrible incident occurs in your emergency setting, insist on a critical incident debriefing, and not with just your own staff, but with all involved players. As emergency nurses, our passion is to take care of others in an emergent event, but who is taking care of us? For more information, visit www.icisf.org.
VOLUME 41 • ISSUE 1
January 2015
