2. CISM in NOVA SCOTIA

3. CRITICAL INCIDENT STRESS MANAGEMENT A PRESENTATION BY THE CRITICAL INCIDENT STRESS MANAGEMENT TEAM FIRE OFFICER’S ASSOCIATION OF NOVA SCOTIA

5. HISTORY n Trauma has been around forever n During WW I it was called shell shock n In WW II we called it “lack of moral fibre” n Twice as many Viet Nam vets have committed suicide as were killed in the war n Canada’s Gen Dallaire and other peacekeepers have been affected. n We’re learning how to manage traumatic stress n CISM is not psycho therapy n Sharing of thoughts

6. WHAT KINDS OF INCIDENTS CAN TRIGGER CIS? n A n A line of duty death n The n The death of a child n Incidents n Incidents involving single / multiple casualties or injuries n Significant n Significant injury/threat to firefighters n Incidents n Incidents attracting heavy media coverage

7. SOME EXAMPLES FROM OUR EXPERIENCE n Two toddlers drown in a pond n Family delivering presents involved in fatal Christmas eve MVA n Father and two children die in house fire. One of the firefighters was born in the house and, as a heavy equipment operator, had to demolish it the next day.

8. HOW WILL I KNOW IF I’M SUFFERING FROM CIS? There are a number of physical, emotional and cognitive symptoms of CIS. You may experience one or a combination of the following:

9. CIS Physical Reactions May Be n Sleep disturbance n Fatigue n Changes in eating habits n Menstrual cycle changes n Headaches n Nausea

10. CIS Emotional Reactions May Be n Anxiety n Irritability n Depression n Sense of loss n Change in need for intimacy n Feelings of isolation n Guilt n Flashbacks

11. CIS Cognitive (Thinking) Reactions May Be 4 Confusion 4 Difficulty making decisions 4 Impaired thinking 4 Difficulty problem-solving 4 Memory loss 4 Calculation difficulties 4 Anomia (difficulty remembering names of things)

12. REMEMBER CIS IS A NORMAL REACTION TO AN ABNORMAL EXPERIENCE

13. WHY WE’RE VULNERABLE TO CIS CHARACTERISTICS OF FIREFIGHTERS n ACTION ORIENTED n EXPECT SUCCESS n LIKE TO CONTROL SITUATIONS n NEED TO CONTROL OURSELVES CHARACTERISTICS OF EMERGENCIES n IMPEDIMENTS TO ACTION n UNSAVEABLE SITUATIONS n NATURALLY CHAOTIC n SITUATION PERSONALIZED

14. HOW DO WE MANAGE CIS? We do this through a program called Critical Incident Stress Management. The components of CISM are: n PRE-INCIDENT EDUCATION n ON SCENE INTERVENTIONS n DEFUSINGS n DEBRIEFINGS n FOLLOW UP

15. DEFUSING n Ideal time 1-2 hours after incident n 20-45 minutes in length n Done in a group, led by a team of Peer debriefer(s) n Not an operational critique but venting of emotions

16. DEFUSING PROCESS Three stages: n INTRODUCTION n EXPLORATION n INFORMATION

17. DEBRIEFINGS n A more in depth version of a Defusing n They are held 24-72 hours after an incident n Done in a group led by a team of at least one mental health professional, trained in the fire service, and one firefighter trained in CISM. n Not an operational critique but venting of emotions

18. THE DEBRIEFING PROCESS 1. INTRODUCTION AND GROUND RULES 2. DESCRIPTION OF THE FACTS 3. RESPONDERS THOUGHTS 4. RESPONDERS REACTIONS 5. EXPLANATION OF CIS SYMPTOMS 6. STRATEGIES FOR COPING WITH CIS 7. CONCLUSION

19. HOW DO WE KNOW IF WE NEED A DEFUSING OR DEBRIEFING ? n A call involving a fatality, especially a child, line of duty death, significant injury or serious incident outside your department’s normal duties can trigger CIS n If you or any of your fellow firefighters experience CIS symptoms. n If in doubt then have one – prevention is everything. n Remember, only members involved in the incident attend debriefings. n Members not experiencing CIS symptoms should attend as their input can often be very helpful.

20. HOW DO WE ARRANGE A DEBRIEFING? n IT’S EASY. Simply call the Fire Marshall’s office. They’ll collect details from you and call out the Critical Incident Stress Response Team n Like you, CISRT members are volunteers and provide the service for free. 1-800-559-3473 24 / 7

21. DOES CISM WORK? A STUDY, BY MARY HANNEMAN, OF N.S. FIREFIGHTERS WHO HAD EXPERIENCED A DEBRIEFING FOUND DEBRIEFINGS: n PROVIDED A COMPLETE PICTURE OF THE INCIDENT n ALLOWED FIREFIGHTERS TO VENT n FACILITATED THE EXPRESSION OF EMOTIONS n HELPED FIREFIGHTERS KNOW THEY WEREN’T ALONE IN THEIR REACTOINS n BOOSTED MORALE AMONG FIREFIGHTERS n HELPED FIREFIGHTERS UNDERSTAND THEMSELVES AND EACH OTHER BETTER n RESULTED IN DEEPER, MORE MEANINGFUL DISCUSSIONS THAN USUAL.

22. HOW TO GET MORE INFORMATION n Talk to a member of the CISM team n Visit our website: n Visit our website: www.nsfirecism.ca this site will give you additional information on CISM and some good links

23. CONCLUSION n You provide a valuable service – the job isn’t easy n The likelihood of you being exposed to a critical incident is increasing n Just as you take care of your equipment, you need to take care of yourselves n We are proud to provide you with CISM support and encourage you to call on us