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Critical Incident Stress Management (CISM) is a method of helping first responders and others who have been involved in critical incidents that leave them emotionally affected, physically affected, or both by those incidents. 

CISM is a process that enables peers to help their peers understand problems that might occur after an event. This process also helps people prepare to continue to perform their services. Or, in some cases, return to a normal lifestyle.

It’s a form of psychological “first-aid” designed to mitigate PTSD and further panic or injury to people in a crisis. It’s also helpful stress management for healthcare workers. Critical Incident Stress Management (CISM) is arguably the most widely used integrated continuum of crisis and disaster-oriented care in the world.

Typically, CISM is designed to help before—through education—or after a stressful event. CISM can help departments establish a baseline of communications and organizations may need skilled people to help their teams debrief after an equally stressful incident, such as a mass casualty or shooting event. 

In these instances, CISM helps participants understand interventions, such as 1:1’s, defusings, debriefings and stress prevention. Such as dealing with COVID-19 stress management.

This year we’re seeing how a critical incident can extend for months. COVID-19 is putting pressure on the mental health of healthcare providers. We heard from Union Health in Terre Haute earlier this year. They shared how the spring wave pushed staff into long hours, witnessing a lot of stress, and preparing for the mental burden of deaths. 

The Centers for Disease Control and even casual observers have seen how COVID-19 has negatively impacted the health and wellbeing of nurses, doctors, and medical personnel. 

CISM courses are typically offered in-person and include:

  • Creating effective plans for crisis interventions
  • Managing a crisis in your workplace
  • How to be an effective member of a crisis response team
  • Ways to mitigate or lessen the occurrence of PTSD, depression, grief, and stress among yourself, your team, and the public.

For years VPC has trained people in crisis intervention and disaster management. Often to deal with the things we thought were likely and common like floods, fires, mass casualty events like vehicle crashes, and shootings. Often focused on the security professional who needs to stabilize a situation. We now see CISM is useful for months-long pandemics.

Health care workers treating COVID-19 patients are likely to experience

  • Physical strain from wearing PPE (dehydration, heat exhaustion, tiredness, etc.)
  • Physical isolation, both in the workplace and at home
  • Decision and caution fatigue
  • Pressure from additional pandemic-inspired procedures and policies
  • Inner conflict about competing needs and demands, personally and professionally
  • Possible concern and stress about their family members
  • Stigma from other people’s fear of being in close contact with healthcare workers
  • Difficulties in recognizing their own needs

During CISM certified trainings, we teach people how to be more resilient. Staff should also be aware of their own state of mind:

  • Monitor yourself and others for pacing
  • Check in regularly with family and friends, either by phone or safely in-person. Social media can be helpful, but shouldn’t be an ongoing support system.
  • Take rest breaks wherever possible
  • Schedule time for physical care, whether that’s exercise or yoga classes or just regular reminders to drink water

As winter sets in across much of the country and healthcare providers are seeing familiar signs of a third wave, time is needed for readjustment. That can only happen if providers and professionals commit to the evidence-based practices we teach in stress management:

  • Know how and when to seek out social support
  • Check in with others and ask about their experiences
  • Increase supervision
  • Have a plan for scheduling time away from work
  • Preparing yourself and others for significant changes in their worldview and relationships, even if those changes are not apparent yet
  • Avoid negative habits like drinking, sudden and significant life changes, keeping too busy, negative assessments, and not wanting to be in contact with others.

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