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HomeMy WebLinkAbout12002_02 CISM SOP 2022020112002.02 Critical Incident Stress Management Standard Operating Procedure Implemented: January 2022 Revised: N/A Next Review: January 2024 This procedure is for internal use only and does not enlarge an employee’s civil liability in any way. The procedure should not be construed as creating a higher duty of care, in an evidentiary sense, with respect to third party civil claims against employees. A violation of this procedure, if proven, can only form the basis of a complaint by this department for non-judicial administrative action in accordance with the laws governing employee discipline. Related Policies: Chief’s Memo No. 2016-046 Applicable HI Statutes: I. PURPOSE The purpose of this policy is to identify the application and utilization of the peer support and critical incident stress management (CISM) team. The objective of this policy is to provide guidance for HFD personnel on how to obtain peer support as well as to activate CISM intervention immediately after critical incidents to minimize adverse impacts to all fire department personnel. II. APPLICABILITY The CISM policy applies to all Hawai‘i Fire Department (HFD) employees. III. DEFINITIONS Peer Support – Provides a format in which personnel can discuss their experiences and reactions and reduce stress related to the overall aspect of the job of a first responder. This format allows for one on one discussion with a trained peer support team member. Critical Incident Stress Management (CISM) - Provides a format in which personnel can discuss their experiences and reactions and reduce the stress related to exposure to critical incidents. CISM interactions are not a critique of Fire Department operations. Peer Support and CISM Team - The Hawai‘i Fire Department (HFD) Peer Support and CISM Team consists of peers of all ranks and disciplines as well as HFD chaplains. These Peer Support and CISM Team members are trained in critical incident stress management to include group and individual crisis intervention. The team also has access to mental health professionals experienced in stress-related counseling. The Peer Support and CISM Team is led by a team coordinator. The team coordinator is appointed by, and operates under, the office of the Fire Chief or their designee. The team coordinator is supported by a steering committee, made up of at least two Peer Support and CISM Team members. Critical Incident - An incident that exposes personnel to unusually strong emotional involvement. While examples of critical incidents are listed below, we recognize that any incident may illicit a strong emotional response and therefore qualify for a CISM activation. Serious injuries or death of a Fire Department member or other emergency personnel. Mass casualty incidents. Suicide of a Fire Department member. 12002.02 Critical Incident Stress Management Standard Operating Procedure Implemented: January 2022 Revised: N/A Next Review: January 2024 Serious injuries or death of a civilian resulting from Fire Department operations. Death of a child or violence to a child. Loss of life of a patient following extraordinary and prolonged expenditure of physical and emotional energy during rescue efforts by Fire Department personnel. Incidents that attract extremely unusual or critical news media coverage. Any critical incident in which the first responder knows the victim or patient. Any incident that is charged with profound emotion. An incident in which the circumstances were so unusual, or the sights and sounds so distressing, as to produce a high level of immediate or delayed emotional reaction. Defusing - Group discussions that center on a chronological recounting of events, observations, experiences and responses to the incident. The goal is to conduct the defusing before those involved in the incident complete their shift. They typically occur within eight to twelve hours after the incident. If the defusing cannot occur the same day, every effort should be made to conduct the defusing the next shift. Debriefing - A confidential, non-judgmental discussion of involvement, thoughts, and reactions resulting from the incident. They typically occur within seventy-two hours and the process is a more interactive and in-depth discussion of the incident. Due to the time frame, a debriefing allows those involved with the incident to process the events and reflect on its impact. Supervisor – Deputy Chief (for Administrative staff), Assistant Chief, Fire Communications Supervisor (FCS), Water Safety Officer (WSO) IV. IV. CRITICAL INCIDENT STRESS MANAGEMENT INTERACTIONS The following five types of interactions are most commonly utilized: 1. On-Scene or Near-Scene: Conducted during ongoing operations and moderated by a Peer Support and CISM Team member, including chaplains or a mental health professional. Most commonly used on large-scale incidents with extended operational periods. Peer Support and CISM Team members will be present on scene to be in contact with crews and assess the need for further interactions. Relief from duty for these personnel may also be a consideration and should be provided in accordance with applicable policy. 2. Defusing: Conducted shortly after the incident and moderated by a trained Peer Support and CISM Team member and assisted by at least one other Peer Support and CISM Team member. A follow-up one on one meeting may be provided on an individual basis as requested by a crew member. Attendance is mandatory, but participation is voluntary. 3. Debriefing: Conducted within seventy-two hours of the incident and moderated by at least two Peer Support and CISM Team members which may include chaplain support personnel and a mental health professional. Attendance is mandatory, but participation is voluntary. 12002.02 Critical Incident Stress Management Standard Operating Procedure Implemented: January 2022 Revised: N/A Next Review: January 2024 4. Follow-Up Debriefing: Based on the impact of the incident, a follow-up debriefing may be conducted weeks or months after the incident by either a Peer Support or CISM Team member or chaplain support personnel. Discussion is related to concerns with delayed, ongoing, or prolonged stress symptoms. 5. Individual Consults: Any HFD employee is welcome to request one-on-one peer support counseling from any of our Peer Support and CISM Team members. Individual consults will be on a strictly voluntary basis. V. ACTIVATION OF PEER SUPPORT AND CISM TEAM The process and events that led up to identifying an incident as a critical incident can be different in every situation. As there is no textbook description of how the events will unfold, we must be flexible so as to realize our ultimate goal of ensuring the wellbeing of our HFD family. All personnel have the responsibility to identify/recognize significant incidents that may qualify for Peer Support and CISM Team intervention and can initiate an activation. Once identified, activation of the Peer Support and CISM Team shall be made as soon as practical. Activation of the Team is as simple as contacting the Peer Support and CISM Team Coordinator or notifying your Battalion Chief or supervisor. Refer to the latest CISM brochure to identify the CISM Team Steering Committee Coordinator. Battalion Chiefs and supervisors shall work with the Peer Support and CISM Team members to help facilitate a timely response. Any employee who feels a need for an individual and confidential defusing or debriefing may contact any Peer Support and CISM Team member directly. VI. ATTENDANCE Attendance at a defusing or debriefing is required for all personnel who were directly exposed to the traumatic aspects of an incident or otherwise identified as a person suffering stress related behaviors and/or symptoms. While attendance is required for employees who were part of the incident or exposed to the incident, participation is voluntary. It is the responsibility of Battalion Chiefs and supervisors to make sure all exposed personnel are at the defusing or debriefing. Invitations to other agencies to attend may be considered if deemed appropriate by the Peer Support and CISM Team Coordinator based on their level of involvement with the incident. While it is impossible to predict all defusing or debriefing staffing scenarios, below are examples of the most common scenarios: The affected personnel from the incident may be scheduled to attend while on their day off. Typically, but not always, this is done immediately post shift. Relief personnel may be asked to come in to provide coverage so that affected personnel may attend a defusing or debriefing. 12002.02 Critical Incident Stress Management Standard Operating Procedure Implemented: January 2022 Revised: N/A Next Review: January 2024 If Operations personnel are involved, the affected company or companies may be out of service so that they may attend a defusing or debriefing. This will require approval from the respective Operations BC. VII. LOCATION Peer Support and CISM Team interactions (defusing or debriefings) may be conducted in any location that provides ample space, privacy, and freedom from distractions. Fire stations, fire station conference rooms, churches, hospitals, city facilities, or other meeting facilities centrally located to the involved companies are worthy of consideration. VIII. POST PEER SUPPORT AND CISM TEAM INTERACTION RETURN TO DUTY CLAIM Circumstances of a critical incident may result in a recommendation by the Peer Support and CISM Team member that individuals or companies be taken out of service, or that employees should be offered temporary release from duty. It is also possible that employees who were exposed to a critical incident may indicate that they are unable to complete their shift or return to work. The Peer Support and CISM Team Coordinator may recommend one of the following: 1. Recommend that the employee or crew return to normal duty. 2. Recommend that employee return to their post in a temporary out-of-service status. 3. Recommend that an employee be provided the option of relief from duty for the remainder of the shift. If it is deemed necessary for the employee to be relieved of duty, the Peer Support and CISM team member shall request Administrative Leave for the employee via the appropriate chain of command IX. CRITICAL INCIDENT LOSS OF TIME/ WORKER’S COMPENSATION CLAIM Under no circumstance will any leave of absence following a critical incident be interpreted as being disciplinary in nature. Employees should be aware that when they miss work due to stress caused by a critical incident and a worker’s compensation claim is submitted, the claim will be subject to review and approval by the Workers’ Compensation division of the County of Hawai‘i Department of Human Resources. Employees may have to use their own sick, vacation, or compensatory time balances to cover the time, pending approval of the claim, or leave without pay (LWOP) if no personal leave balances are available. If the claim is approved, any balances used will be credited back to the employee. The employee is responsible for following proper policies to return to work. X. ALTERNATIVES TO RELIEVING PERSONNEL FROM DUTY In certain circumstances, it may be necessary to temporarily reassign an employee who has experienced significant critical incident stress. The Fire Chief will make this determination based on information and recommendations provided by the Peer Support and CISM team or the employee’s supervisor. In such instances, the Fire Chief in consultation with the Hawai‘i 12002.02 Critical Incident Stress Management Standard Operating Procedure Implemented: January 2022 Revised: N/A Next Review: January 2024 Fire Fighters Association, may place the employee in a position that will be conducive to assisting the employee in the recovery process. Additionally, it is possible that an employee who has experienced a critical incident may wish to be temporarily reassigned from their normal duties or assignment for a period of time. The employee may make this request through their supervisor, the office of the Fire Chief, or a Peer Support and CISM Team member. If the employee makes the request through the Peer Support and CISM Team member, that team member shall notify the Peer Support and CISM Team coordinator, who will notify the office of the Fire Chief. XI. CONFIDENTIALITY All interactions with the Peer Support and CISM Team shall remain confidential.