Purpose: The purpose of this project was to develop and implement a critical stress management program for nurses and other health care providers within a 600+-bed hospital. Crisis intervention is situational “first aid” and consults can be initiated for a variety of situations. An abnormal event can cause stress and/or distress in an average person, and the goal is to mitigate stress and prevent escalating distress. While this program has been functioning for approximately 3 years, requests for consults have increased over the past year during the COVID-19 pandemic.
Description: Nurses are on the front lines of managing patient care and frequently encounter unique challenges and stressors. Stress may be affecting staff members physically and emotionally and in their personal relationships, both within and external to the hospital. Health care providers can experience many acute and chronic often-unpredictable occupational stressors (e.g., sudden death, managing critical trauma cases, dealing with patients with great potential for violent behavior) as well as a sense of not being heard, lack of support, and/or powerlessness/helplessness. This may lead to compassion fatigue and burnout. To support staff members through these difficult situations, we developed and implemented a critical stress management program. We initially sought staff members who were willing and able to attend the combined 3-day assisting individuals in crisis and group crisis intervention courses offered by the International Critical Incident Stress Foundation, Inc. Following successful completion of the courses, the facilitators are able to respond to requests and initiate contacts in a compassionate and helpful way. When a consult is received, a call goes to the facilitators to determine availability as well as background and experience. Participation is voluntary, confidentiality is essential, and only staff members involved in the event should participate. The facilitator takes time to actively listen and encourage the participants to talk about their thoughts and reactions as well as review stress management/coping techniques. For some situations, it is appropriate to offer follow-up or encourage professional resources.
Outcomes/evaluation: In response to staff requests, our organization also provides “comfort carts” for units/departments following a stressful/distressful event and “respite rooms” for staff members to use 24/7. A peer support group gives health care providers the opportunity to both give and receive support with other nurses. This creates a sense of shared experience, reminding them that they are not in this alone.
MN, RN, CCRN-K, CCTN,
Transplant/Surgery Program Nurse Specialist,
UPMC Presbyterian, University of Pittsburgh Medical Center
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