An Exploration of the Experience of Critical Incident Stress Debriefing on Firefighters Within a Region of the New Zealand Fire Service

<p>This study originates from my practice experience working for the New Zealand Fire Service back in the late 1980's and early 1990's as an Occupational Health Nurse where I piloted a Critical Incident Stress Peer Support programme in the No.4 Region. My interest in the area began after attending a seminar on Critical Incident Stress Debriefing based on Mitchell's model of debriefing (1983). I had begun to recognise in my practice what I believed to be work-related stress but was a little uncertain about where this stress originated. After attending the seminar I began to understand that some of this stress was related to Critical Incident Stress (CIS) from firefighters exposure to critical incidents. This study explores four firefighters experience of Critical Incident Stress Debriefing (CISD) within a Region of the New Zealand Fire Service. It explores the application of CISD as one component of Critical Incident Stress Management (CISM), and the Nurse Researcher's philosophy of Clinical Nurse practice in relation to the application of CISD. The knowledge gained from the analysis of the data has the potential to influence professionals understanding of their experience and affect future practice and that of others working in the field of CISM. The aim of the study was to gain a greater indepth understanding of firefighters experience specifically in relation to their participation in a Critical Incident Stress Debriefing (CISD) following their exposure to a critical incident. Much of the literature that supported CISD appeared to offer a rather superficial understanding of the firefighters experience in relation to CISD. I chose to use narratives as the methodology, utilising four individual case studies as a method of social inquiry in order to explore the experience of CISD. The narratives were able to creatively capture the complexity and the dynamic practice of CISD. An overall pattern of the formalised process was uncovered through the participants' narratives. Eight dominant themes were highlighted from the narratives which included safe environment; ventilating the stress reaction; similar feelings; getting the whole picture; peer support; bonding and resolution. While these themes were common to all the participants, each participant had a particular theme/s which was unique to their experience. As a Nurse Researcher with dual practice interests in the area of nursing education and Critical Incident Stress Management (CISM), I am in a position to inform practice and service development. It is my belief that the knowledge gained from this study has the potential to be transferred to others working in the field of CISM. The study results are timely, practical and informative at a time of major change in the New Zealand Fire Service.</p>

An Exploration of the Experience of Critical Incident Stress Debriefing on Firefighters Within a Region of the New Zealand Fire Service

<p>This study originates from my practice experience working for the New Zealand Fire Service back in the late 1980's and early 1990's as an Occupational Health Nurse where I piloted a Critical Incident Stress Peer Support programme in the No.4 Region. My interest in the area began after attending a seminar on Critical Incident Stress Debriefing based on Mitchell's model of debriefing (1983). I had begun to recognise in my practice what I believed to be work-related stress but was a little uncertain about where this stress originated. After attending the seminar I began to understand that some of this stress was related to Critical Incident Stress (CIS) from firefighters exposure to critical incidents. This study explores four firefighters experience of Critical Incident Stress Debriefing (CISD) within a Region of the New Zealand Fire Service. It explores the application of CISD as one component of Critical Incident Stress Management (CISM), and the Nurse Researcher's philosophy of Clinical Nurse practice in relation to the application of CISD. The knowledge gained from the analysis of the data has the potential to influence professionals understanding of their experience and affect future practice and that of others working in the field of CISM. The aim of the study was to gain a greater indepth understanding of firefighters experience specifically in relation to their participation in a Critical Incident Stress Debriefing (CISD) following their exposure to a critical incident. Much of the literature that supported CISD appeared to offer a rather superficial understanding of the firefighters experience in relation to CISD. I chose to use narratives as the methodology, utilising four individual case studies as a method of social inquiry in order to explore the experience of CISD. The narratives were able to creatively capture the complexity and the dynamic practice of CISD. An overall pattern of the formalised process was uncovered through the participants' narratives. Eight dominant themes were highlighted from the narratives which included safe environment; ventilating the stress reaction; similar feelings; getting the whole picture; peer support; bonding and resolution. While these themes were common to all the participants, each participant had a particular theme/s which was unique to their experience. As a Nurse Researcher with dual practice interests in the area of nursing education and Critical Incident Stress Management (CISM), I am in a position to inform practice and service development. It is my belief that the knowledge gained from this study has the potential to be transferred to others working in the field of CISM. The study results are timely, practical and informative at a time of major change in the New Zealand Fire Service.</p>

The HEROES Project

The chapter introduces the HEROES Project, an online training resource that develops mental resilience. The goal is to provide the reader with insight into a resource that can be used as an adjunct to employee assistance programs, critical incident stress debriefing, and counseling. The HEROES Project is the first virtual training course that combines the therapeutic tools of clinical and organizational psychology and provides first responders access to a self-driven wellness program. This respects many first responders' preference for anonymous and private self-care, while the autonomous nature of the training reinforces for all first responders that they are ultimately responsible for maintaining their own wellness.

Comprehending Crisis Intervention among Helpers

Crisis applies when an individual experiences a trauma or tense situation that causes imbalance, disorganization and disorientation. Failure to oversee the crisis brings a negative impression to the whole self. This study involved 25 crisis helpers as respondents and all of them are registered counselors in Malaysia. Data are collected through semi structured interviews. The open questions in semi structured interview were used to identify information on 1. the meaning of crisis, 2. the process used to handle crisis intervention; 3. the model of crisis intervention used among helpers. Results showed that respondents’ comprehending of crisis were quite accurate and varied depending on situations experienced. They also had some brief ideas on how the process should be implemented to handle crisis cases. However, only nine out of 25 helpers specifically mentioned that they used models such as Roberts’s seven stages, Gilliland six steps, Kubler Ross, Critical Incident Stress Debriefing to handle crisis intervention cases. Meanwhile, 19 helpers used counseling theories such as Cognitive Behavioral Therapy (CBT), Reality Therapy (RT), Psychological First Aid (PFA) and basic attending counseling skills. This study indicates that helpers need more knowledge and training on crisis intervention. They also need to comprehend process to handle crisis intervention cases in appropriate and structured ways. Development of a crisis intervention model that suits Malaysia’s culture would be most preferable and later utilized as a guide for helpers and counselors in dealing with event of crisis.

Best Practice in Responding to Critical Incidents and Potentially Traumatic Experience Within an Organisational Setting

This chapter addresses best practice for organisational support after critical incidents and traumatic events within social work. Critical incidents are situations and incidents within workplace settings or roles, which, whilst able to be anticipated and planned for, have the potential to create a sense of emergency, crisis, and extreme stress, or have a traumatic impact on those directly or indirectly affected. Alongside the notion of critical incidents are concepts of debriefing, psychological debriefing, critical incident stress debriefing (CISD), and critical incident stress management (CISM). Debate about debriefing models has concerned their effectiveness and safety; the terms being loaded with meaning and tensions between scientific and holistic paradigms and between academic and practitioner perspectives. The chapter suggests areas of research and exploration for agency managers and senior practitioners wishing to make sense of the debates and enables the reader to consider best practice for critical incident response within organisational settings.