Taking care of the team (even when the team is YOU)

TAKING CARE OF THE TEAM (EVEN WHEN THE TEAM IS YOU)

By: Anne Daws-Lazar

I was at my usual Thursday evening music rehearsal when I received a call from a sergeant at one of the local police departments.  Two of their officers had responded the night before to a car crash with significant injuries.  Once on scene these officers performed CPR on a 9-year-old child.  By the time they turned the child over to the paramedics she had a heartbeat.  All would be well!  The officers did what first responders do after traumatic events like this – finished the report and moved on to the next call.  The next day, feeling good about the previous nights’ work, one of the officers called the mom to get an update on the young patient.  She reported that the child was in ICU but was stable.  So the officers went up to visit.  Though their young patient was stable, she was hooked up to lots of machines and staring off into space – not unconscious but not responsive either.  Over the course of this visit it became clear that this scenario would likely result in the passing of this child. This changed how one of the officers felt about the work they had done.  Did they do CPR correctly?  Should they have done it at all?  

This officer was having an especially difficult time with this call and that was the point at which I was called.  At this time, I’d been the coordinator of the Washtenaw County CISM team for several years.  The Sergeant WAS requesting me specifically, but I knew that I could instead contact a team member to come out and do this one on one with the police officer.  However, one of the issues (for me anyway) with being the coordinator of this team is that it often feels just so much easier to DO it myself than call someone else.  I knew this response might strike chords – I have 3 children and several grandkids and besides – responses involving kids are just more difficult anyway.  I left what I was doing to do this response.  We went through the One-on-One model. Themes included: Should they have NOT done CPR?  Did they do more harm than good?  There wasn’t really a question (from anyone else) that CPR wasn’t done correctly.  But was it worth it?  One of the things that had been said to this officer by the mother while they were at the hospital was that having their child revived at the scene gave family a chance to say goodbye and that was worth a lot to them (although this is NEVER a position any parent wants to be in).  The officer seemed lighter after we’d talked for a while – seemed to be coming to terms with the reality of CPR and this situation and grateful that they could provide this family some closure they might not have otherwise had.

At this point you may say – well that sounds like it all went pretty well.  The problem, however, was with me!  As we were going thru the story of what had happened and what the child looked like in the hospital – when the officer spoke of the ‘blank stare’ from the patient even as the machines were showing ‘normal’ heart function and pulse I was mentally no longer in the room for a few seconds.  Several years before this my dad had had a sudden heart attack.  He was 66 at the time.  My mom found him slumped in the chair – assumed he was sleeping for at least a few minutes.  When she couldn’t wake him, she called 911.  They were able to restart his heart and transport him.  Thus began our family nightmare.  He lived for 13 months but was never out of an institution.  5 nursing homes and 3 hospitals, I think.  He was ‘conscious’ but the blank stare, no talking, feeding tube.  We were trying to hope there was a light at the end of the tunnel.  There was lots of judgement about our choices from those around us.  My mom was in the early stages of Alzheimer’s at the time AND she was the ultimate decision maker.  Her understanding of the situation was inconsistent and sporadic and the entire 13 months included more than one ‘intervention’ with social workers at various facilities.  

Back to this One on One.  I was not prepared for my reaction to the officers’ story of the little girl in the hospital.  At the time it happened, I pulled myself back together quickly and we continued.  

After this One-on-One response I did what we tend to do – went back to my regularly scheduled activities just pushing my reaction to this incident into the back of my mind.  But of course, it didn’t stay there, and the effects weren’t invisible.  I had trouble sleeping and this was on my mind all the next day.  Finally, I called Mike Murphy who was my mentor and friend (one of the founders of our team and a long-time clinical coordinator for us).  We met for coffee and did what I should have done right after this incident happened.  If I had arranged for someone else to do the response, I would have included having an appropriate team member scheduled to do a PASS with the team responder- ideally right after the crisis response but, in any case, I would have scheduled it before the One on One occurred.  

In the aftermath of this incident, I have tried to be diligent in scheduling PASS’s and after care for the team member or members after all responses.  It doesn’t have to be long or involved, but a check up to make sure team members are ok to go about their lives after a response.  This is particularly important with one on one’s I think because it’s too easy to walk away from the person you did the response for and think you’re just ‘fine.’  And there is no one to provide any feedback on that.  

And my conclusion after this experience – and all CISM related experiences:  It’s a good model – use it!

Anne Daws-Lazar, Washtenaw County CISM, Ann Arbor, MI

ICISF Member & Approved Instructor since 2013