Dealing With Stress and Violence in the Workplace

Introduction

The Critical Incident Stress Debriefing (CIS) Management Tool is a supportive intervention process during a crisis. Critical Incident Stress Debriefing should not be equated to psychotherapy. Critical Incidents are traumatic events that outweigh the individual's coping ability. Responses to critical incidents can be physical, emotional, and behavioral. Critical Incident Stress Debriefing is a small unit of people who have encountered traumatic experiences to offer support in order to reduce stress. This aids in restoring cohesion and performance. Healthcare professionals encounter medical situations that are life-threatening and, sometimes, these events may overwhelm their ability to cope. This essay is a discussion of the critical Incident Stress Debriefing tool use and process.

Purpose of Critical Incident Stress Debriefing

Timely crisis intervention strategies positively impact recovery of individuals from traumatic stress. Debriefing is crucial as it enhances healthcare providers' coping ability, thus remarkably reducing the amount of incidences of post-traumatic stress disorder (Mitchell & Everly, 1997). When support policies are absent, delayed, or limited, there occurs development of post-traumatic stress disorder, which is a pathological effect of neglected critical incidents. This concept provides healthcare providers with coping skills to deal with subsequent traumatic events and they tend to acquire new job skills after exposure to such events.

Process of Critical Incident Stress Debriefing

During application of the debriefing strategy, appropriate and effective guidelines should be followed. Professionals who have faced traumatic situations use a model consisting of seven steps. Incorporation of vital points in the intervention is essential.

First, assessment of the traumatic event impact on the healthcare professional should be performed. This assessment will cover age, degree of incident involvement, development, and level of exposure to traumatic events. Second, there is identification of issues concerning the professionals' safety and security. These issues arise due to patients' tragedies and even death. Third, defusing is essential in exposing encounters, emotions, feelings, and thoughts relating to incidents. Validation of reactions is important at this stage.

Fourth, prediction of responses and events after the stressful event should occur. There should be assistance for healthcare providers through education and discussion of possible outcomes. Fifth, there should be a detailed analysis of the incidents' physical, emotional, and psychological impact. Review will aid in obtaining ideas on hurdles present during the management process. Sixth, closure is required to begin the recovery process. Assistance in dealing with future events is necessary for grounding the professionals. Finally, there is debriefing to get the professionals back to the healthcare service system so as to continue the service delivery (Mitchell, 1983). 

An expected outcome of the Critical Incident Stress Debriefing is provision of encouragement to traumatized workers in terms of sharing experiences, feelings, and thoughts about traumatic events with the aim of validating stress responses. The workers are also offered reassurance, support, resources, and knowledge about better skills for coping with critical incidents. They are also offered screening in order to point out individuals who should get more support or referral to expert care.

There are different professions that are at risk of traumatic events and that have utilized the CISD. Police officers are more prone to critical incidents and there is evidence of them utilizing the CISD. Firefighters also have CISD groups for support after traumatic events. Emergency medical personnel exposed to significant events who have undergone the CISD have remarkably lower rates of traumatic stress reactions.

Currently, there are individual testimonies of workers who have benefited from the Critical Incident Stress Debriefing tool. This tool has been useful for coping with the aftermath of traumatic events. However,  evaluation of the effectiveness of the CISD is important in order to ensure its continued use. Use of control groups and follow-ups are necessary for ensuring that the CISD is helpful. Focus should be on long-term recovery from stress (Mitchell & Everly, 1997). 

There are various reactions to stressful incidences. Physical reactions include insomnia, nausea, fatigue, headaches, physical problems, and under- or over-activity. Cognitive reactions may be confusion, flashbacks, lack of concentration, amnesia, poor problem-solving skills, abstract thinking, and change in alertness. There are behavioral reactions such as change in activity and communication, emotional outbursts, withdrawal, pacing, suspiciousness, and change in sexual behavior. Finally, emotional reactions such as anger, frustration, depression, irritability, anxiety, fear, oversensitivity, and guilt may occur as well (Deahl, 2000).

Conclusion

There has been tremendous recognition of workers' emotional needs that require a sophisticated response. Thus, respective initiatives have been implemented. Colleague-support and mentoring programs should be provided along with the debriefing tool. Inadequate support to a professional who is exposed to critical incidents may have a detrimental impact on his/her personal and professional life.