Stressed nurse in a mask and gloves

Overview of Critical Incident Stress Management

The healthcare environment is overflowing with stress. From the stress our patients experience to the stress that frontline workers endure from shift to shift; stress is everywhere. This stress is not limited to the constraints of a 12-hour shift but is often carried on the shoulders and minds of healthcare providers well beyond their workday. Given the current state of healthcare amidst the pandemic and now ‘coming down' from the height of it, frontline workers may soon have to confront the stress and trauma they experienced in their work. Supportive services are essential in helping these practitioners cope with the additional stress that 2020 brought them within their respective healthcare environments.

There are several supportive services available to frontline workers. One such program is Critical Incident Stress Management (CISM). A critical incident is defined as an event that triggers one’s emotions in a strong manner, potentially prohibiting them from functioning at the highest caliber in his or her role (Davis, 2020). CSIM is an all-encompassing program used to support an individual or a group of individuals before, during, or after a traumatic event. It is used to help alleviate the post-effects of trauma, assist in the recovery from a traumatic event, restore a person's or person's ability to cope with everyday life, and identify those who would benefit from additional, perhaps psychological services (Mitchell, 2020). CISM, which can be referred to as a form of psychological first aid (PFA), is a group of interventions, known to have positive results when used in conjunction. According to Swab (2020), of 132 EMS practitioner’s surveyed, 58% of the ‘strongly agreed’ with the efficacy of CISM. Further research is needed in the area of critical incident management, especially with the stress endured by healthcare personnel, secondary to the events of 2020, lingering into 2021.

Developed by Dr. Everly at Johns Hopkins University, the RAPID model, is another PFA tool that can be utilized to help manage the stress of a critical incident. The RAPID model includes:

  • Reflective listening
  • Assessment of needs
  • Prioritization
  • Intervention
  • Disposition

(Everly, 2021)

This model can be used to work through the psychological effects people may endure after a traumatic event(s). The RAPID model has been found to benefit personal and community resilience in those who have experienced psychological trauma (2021).

The events of 2020 have and will continue to have lasting effects on our healthcare system. Equipping our organizations and the frontline workers with tools, such as those described above, to address any psychological concerns they may be enduring, is vital in tending to the mental well-being of our healthcare providers.

Davis, R. (2020, April 5). Critical incident stress debriefing for nurses in emergency and critical care departments.

Everly, G. (2021). Psychological first aid.

Mitchell, J. (2020). Critical incident stress management

Swab, J. (2020). Critical incident stress management: Perspectives on its history, frequency of use, efficacy, and success. Crisis, Stress, and Human Resilience: An International Journal, 1 (4), 215-226