Comments on: CISD Opinion Paper

By: Chief Reason

Chief Reason — Tue, 10 Nov 2009 20:36:52 +0000

I have been involved in the fire service in different capacities for more than 29 years. I was instrumental in getting extrication out of the hands of our ambulance service and into the hands of our fire department.
In my 29 years, all of our fatalities have come from MVAs. We have not had a fire death since 1970.
I can’t speak for the ambulance, but the fire department will do their own debrief immediately after the incident. Whenever it’s a “bad call”, we need to insure that we had as much of a true picture as possible. It is there that if, someone is struggling, they will be pulled aside and offered assistance. If several are disturbed by it, then CISD will be called; attendance non-mandatory. However; those who don’t attend will be monitored.
I think that we expect too much from CISD, but many believe that CISD doesn’t go far enough. I also believe that if you can’t take SOMETHING from it, you were never open to it in the first place. It doesn’t help if the CISD team members are strangers, which is why I would encourage CISD teams to go to departments and introduce yourselves, hang out and let departments put a face to a name.
If CISD helps ONE person in the group, then it was worth it.

By: Kellen Teig

Kellen Teig — Tue, 10 Nov 2009 18:33:54 +0000

I have been in this field of ems for going on 15 years, have been to several CISD briefings and it does help to get your questions answered, having seen some horrific crashes, been on cpr calls with children involved, and especially going on calls when it someone you know, It is nice to vent! instead of turning inward and not say anything.

By: medicgts

medicgts — Tue, 10 Nov 2009 17:30:57 +0000

Being in the field a bit over 5 1/2 years now as an EMT-B and now as a medic I can really appreciate your view. I have never attended a CSID, not that the opportunity hasn’t come up, rather that I don’t do well in large groups when discussing my emotions. I maintain a small close knit group of friends in EMS and other areas of my life which allow me to work through things much more productively. Where I’m from CSID seems to be in the process of being phased out for just those reasons above. Great post.

By: Jennifer Jones EMT-P

Jennifer Jones EMT-P — Tue, 10 Nov 2009 17:12:43 +0000

Your post reflects most of the viewpoints I have heard from coworkers over the past 12 yrs of EMS service. I have been present for more than a half dozen CIS debriefing. These resulted from multiple shooting rampages, an explosion at a kindergarten, and the stabbing on the job of a coworker. While all attendance has been voluntary, I have attended in case my presence mattered to one of my coworkers, and to support the attendance of others who might otherwise pass it up. Your article remarks on social workers and some kind of councillors. Our system is very large, yet we utilize coworkers as facillitators, ensuring it was someone who had no close connection to the participants or the events.

I have mixed feeling about debriefing. I believe I found the most benefit from the down time given after the call in question. We were generally stood down until debriefing was complete. I also felt relief when I could comfort a coworker. My biggest concern about the structure of the debriefing was that their was no automatic classification of event that called for a debrief. Someone had to come forward and ask that one be held. Often, coworkers were embarassed to admit they were shaken, or didn’t want to seem like a ‘sissy’ in front of the bravado types. The stabbing was the most difficult to debrief, as it was the first serious violent on duty attack or department ever faced. Fortunately the paramedic survived, but the emotional impact was wide spread, and several individuals who were not involved in the attack, or well know to the victim were notably disturbed, but not included in the CISD invite. Two staff quit as they were unable to come to terms with their feelings of vulnerability. My last thought is in agreement with the basis of your paper. Our industry sees horror, and we need to do more to help. Counselling should be accessible privately, and free of charge. All services should have a priest or chaplain in the area familiar with EMS structure who can be called for consult directly by the worker if needed. And most importantly, the facilitator should not be a coworker or anyone the staff interact with regularily. The lack of confidentiality inhibits most participants from receiving optimum benefit from any type of debriefing. Just my thoughts…

By: EMS Chick

EMS Chick — Tue, 10 Nov 2009 13:59:24 +0000

Great post! I absolutely agree with what you’ve said.

A few years ago I read an article about a group of people who will bring dogs by departments after stressful events, I believe it was in a Jems magazine or the like. That’s something that would appeal to me more, personally, than the CISD meetings. I’ve only had one and it was horrible, I refuse to attend any of the others.

By: TB

TB — Mon, 09 Nov 2009 20:07:00 +0000

You’re not alone. Our local alternative paper that did a write-up on this in their current issue:

http://www.pitch.com/2009-11-05/news/stop-hugging-us/