International Critical Incident Stress Foundation, Inc.
International Critical Incident Stress Foundation, Inc.
By: Richard A. Clinchy, III, Ph.D., LP, CHT(ret), KTJ, KCStG
By way of personal background, my interest in CISM goes way back to when Jeff Mitchell was first introducing the concept to those of us involved in Emergency Medical Services. In the late 70s and early 80s, I was a Squad Chief in northeastern Pennsylvania. One evening while managing a multi-fatality accident involving youngsters from the area, I noticed one of my EMTs just walking up the road. He was done! That evening piqued my interest in Jeff’s work, and I called a friend who worked, in those days, for R Adams Cowley. I asked him about “CISD” and learned a bit about it and did some reading. Most folks who have not been First Responders for as many years as I have, don’t know that in the early years of what was to become EMS, the attitude relative to stress as it related to First Responders was, “Suck it up, buttercup!” We were just supposed to be constantly exposed to patient suffering and the concurrent psychological trauma that came with it and keep on doing what we were doing. So, I was interested and started to do some research. Many years later, while deployed to Ground Zero, I was walking across the lobby of the hotel where we were billeted and “for no reason” started to cry. That was not the only time during that deployment where the tears came. So, it was ample evidence that this guy with, at that time, over thirty-five years’ experience as a First Responder realized that not only do others suffer from psychological trauma but so did I.
Now in northwestern Florida, I am involved with FloridaOne, Inc. FloridaOne, Inc. is a non-profit that owns a building in Ft. Walton Beach, Florida, that serves as the home-base for FL1 DMAT (HHS-NDMS), FloridaOne Disaster Response Medical Team (a regional medical team), The Emerald Coast Health Care Coalition serving ten counties in northwest Florida, and The Emerald Coast Crisis Stress Team (ECCST).
Several years ago, under the leadership of Frank Goldstein, Ph.D., COL USAF (ret), the Emerald Coast Crisis Stress Team came into existence. We would be called upon on occasion for crisis situations with Fire Departments, EMS agencies, hospitals, and the like. Probably the event that made the news where we did the defusing for approximately 24 First Responders was the mass shooting at Naval Air Station Pensacola in December of 2019. Everything we do with ECSST is on a volunteer basis.
With COVID starting to wear down those providing critical care to COVID patients, we are now frequently called upon to counsel hospital and department of health personnel. Our sessions may be with a group of individuals or many counseling sessions are conducted one-on-one. We essentially employ the time-tested steps in the Defusing process. First, by introducing ourselves, our background, and why we are there. Little is recorded and participants know that what we learn from what they share with us will be discussed with their management is very general terms without naming names.
COVID has had a stunning impact on these health care providers and from my perspective, the impact of COVID is going to be long-lasting insofar as young people having an interest in pursuing health care as a career. Just one example will illustrate: We were at a hospital in our area in recently. In what they described as a normal month; they have one to two patients die each month. The month prior to our visit, they had 67 patients expire from COVID. Young nurses did not get into nursing to watch their patients die every day. A notable quote from a very experienced nurse was, “They all die!”
The following are among the “tools” we have utilized with these health care providers:
Whether it’s a group or individual counseling session, the tools in our CISM toolbox really do make a difference.
A lesson-learned for me is that almost everywhere we go where there’s a “Peer Support” team, employees are reticent to reach out to those individuals for help. It has become quite clear that employees of an organization are reluctant to really open-up when a fellow-employee is the individual attempting to intervene or assist. When employees encounter “Outsiders”, which we are at ECCST, there is less reluctance to share since should we identify someone with some significant issues, we will suggest that the employee reach out to their EAP, if there is one in place. In a well thought out Employee Assistance Program (EAP), employees in distress are less reluctant to admit they have issues since they will be referred to a professional outside their work environment for assistance.
Through CISM, we can provide a great deal of assistance to our colleagues in the health care professions. Check in your geographical area how you can assist. Our friends and colleagues in the critical care health care professions are having a very difficult time managing COVID patients and most of those patients, if they’re in the ICU and have been intubated and placed on a ventilator, are unlikely to be discharged in good health.
If you would like copies of the material that we share with our new Team members, feel free to email me ([email protected]) and I’ll send you our documents.
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International Critical Incident Stress Foundation, Inc is a 501(c)3 Non Profit