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Home | Community | Chaplaincy Services | CISS Services

Critical Incident Stress Support Team (CISS)

The Critical Incident Stress Support Team (CISS) service is for staff of Presbyterian Healthcare Services who respond to, or are involved in, a crisis. The CISS Team may be requested by any Presbyterian employee (CDS and Regionals) who determines that he/she or the team has just "experienced an abnormal" experience that is creating high levels of stress and grief.

CISS is a comprehensive, systematic and multi-component approach for the reduction and control of the harmful aspects of stress. It is not therapy, and it is not fact finding. It is a process that facilitates the recovery of normal people experiencing normal reactions to abnormal events.

At its heart, CISS is an expression of "caring for the caregiver." It is built on crisis and educational intervention theories, and uses a confidential peer support setting to defuse the immediate stress, while also preventing long-lasting stress symptoms. Participants are able to debrief, as well receive practical tips on managing stress in positive ways.

Services Overview

CISS Mission, Vision & Services

How we guide our caregiving services for staff during times of crisis.

CISS Team Details

More information on the Critical Incident Staff Support (CISS) offered by Presbyterian's Chaplaincy Services, as well as information on identifying stress indicators, becoming a CISS team member volunteer, and team policies.

Critical Incident Stress Management Basic Course

Annual training for staff involved in responding to critical incidents.

Request Help from the CISS Team 24 Hours a Day, 7 Days a Week

Please call the PH Operator at 505-841-1234 and request to be connected to the on-call chaplain.

Questions?

CISS Mission, Vision & Services

Vision

To respond in a supportive and preventive manner to the stress incurred by individuals involved in a crisis situation.

Mission

  • To provide prompt support to the staff following their involvement in a crisis event such as Internal Disaster, External Disaster, Sentinel Events, or other crises
  • To educate staff members in advance of stressful crisis events, teaching them techniques to manage stress and reduce its after effects

Services/Response Options

  • Debriefings (initiated by leadership for staff; longer, more complete and inclusive intervention)
  • Defusings (initiated by leadership for staff; shorter, abbreviated intervention)
  • Safe-R-U (initiated by staff; individual, one on one)
  • Self-requested (initiated anonymously by staff directly to chaplain)
  • Clinician called to testify in court

CISS Team Details

Presbyterian's Chaplaincy Services provides services to the staff in times of crisis. As frontline responders, healthcare professionals may experience situations that are difficult to process, upsetting, and sometimes dangerous. The Critical Incident Stress Support (CISS) Team is available to provide assistance.

Managing the Stress of Crisis

Some of the activities that may help healthcare workers in stressful situations include:

Emotional

  • Express feelings and memories by writing in journals or letters or use creative expression such as drawing, painting, sculpting, quilting, singing, dancing, etc.
  • Remember to use your sense of humor; know it is okay to laugh.
  • Give someone a hug; touching is very important.
  • Accept support from loved ones, friends, and neighbors.

Physical

  • Ensure that you are eating well-balanced and nutritious meals.
  • Drink plenty of water.
  • Avoid caffeine, sugar, or nicotine.
  • Avoid alcohol and non-prescribed medications.
  • Get plenty of exercise such as yoga, stretching, and massage.
  • Maintain your daily routine as nearly as possible.
  • Get plenty of sleep/rest.
  • Do deep breathing exercises.

Spiritual

  • Continue your spiritual and religious practices (worship, prayer, meditation, silence, etc.)
  • Draw on your spiritual or religious resources.
  • Meditation can be done in various forms. Meditation gives you a chance to devote a specified amount of time exclusively to you and your own mind.
  • Emptying the mind of all thought and become insensible to one's surroundings.
  • Focusing gently on thoughts as they come and then letting them go again.
  • Guided meditation with a tape or CD.

Resources

  • Department of Chaplaincy Services: 505-841-1191
  • PHS Behavioral Health: 505-291-2555
  • EAP: 505-254-3555 or 866-254-3555
  • Human Resources: 505-923-8750 or 800-432-4600
  • American Institute of Stress: 923-8750 or 800-432-4600

Stress Indicators

CISS is a service that responds in a supportive and preventive manner to the stress incurred by healthcare team members involved crisis situation.

Some examples of crises that would be appropriate events to request CISS, and which can serve as "indicators," are:

  • Child abuse
  • Elder abuse
  • Massive numbers of victims
  • The duration of the crisis
  • The scope of the crisis
  • Exposure risk—bio-terrorism, nuclear
  • Traumatic code
  • Death of a colleague
  • Death of an infant or child
  • Inappropriate and distressing interaction with another healthcare team member, patient, or family

These indicators are crises in which the clinical staff is placed under tremendous professional and personal stress. In such instances, it is recommended that CISS be requested.

Volunteer to be a CISS Team Member

When you apply to be a Volunteer CISS Team Member, you are committing yourself to be part of an on call team. You will be "off the clock" when you come in to the hospital.

Team members will self-schedule their availability to be on call in to either Presbyterian Hospital or Presbyterian Kaseman Hospital to provide support to individuals involved in a crisis. The goal is to have up to twenty volunteers to serve on the CISS team. These people will constitute the pool from which individuals will be called to respond to a crisis. It is understood that volunteers may be unavailable at any given time for a variety of reasons, but the pool should ensure the availability of volunteers to meet the need.

Some examples of instances when the CISS team could be activated:

  • A multiple victim airplane accident where injured persons are rushed to the hospital for emergency treatment
  • A multiple victim school bus accident where injured students are rushed to the hospital for emergency treatment
  • A fire on one of the hospital floors results in the evacuation of patients, during which some of the hospital staff are injured, and require prompt treatment
  • A shooter comes onto the hospital grounds and wounds staff and visitors, all of whom are rushed to the ED for treatment
  • A sentinel event occurs, which affects the individual and the team
  • Death of a colleague
  • Death of an infant or child
  • Inappropriate and distressing interaction with another healthcare team member, patient, or family
  • Clinician called to testify in court

It is also expected that you undergo CISS "Basic" training so that you will be prepared for your role on the CISS team. This training will be on your own time.

Monthly meetings will be held for communication and education purposes. These team meetings will be on your own time.

The determining factors for accepting an application will be:

  • References
  • Ability to empathize
  • Previous training
  • Previous experience
  • Interpersonal skills
CISS Team Application

If there are no vacancies on the CISS team at the time of a person's application, successful applicants will be placed on a holding list, and be invited to join the team as vacancies occur.

CISS Team Policy

Critical Incident Stress Support (CISS) is a system designed to support individuals who have experienced a crisis event (Internal/External disaster; Sentinel Event; and other crises) which subjects them to increased levels of stress. CISS is a comprehensive, systematic and multi-component approach for the prevention, reduction and control of the harmful aspects of stress.

Purpose

To describe the circumstances and the process where Critical Incident Stress Support is provided to prevent, reduce and manage the harmful aspects of stress.

Policy

Realizing the harmful aspects of the stress caused by crisis situations, PDS-A will provide Critical Incident Stress Support (CISS) to those staff members involved in situations of intense and elevated stress.

The purpose of CISS is:

  • To provide prompt support to the staff following their involvement in a crisis event such as Internal Disaster, External Disaster, Sentinel Events, or other crises.
  • To educate staff members in advance of stressful crisis events, teaching them techniques to manage stress and reduce its after effects.

It is critical to the well-being of the staff (team) and the individual members of the affected team(s) that CISS be offered in a timely manner. CISS interventions demonstrate care for the caregiver with its early intervention, opportunity for catharsis, a setting to verbalize the stress, peer support, group support, and opportunities for follow-up. In addition, CISS benefits the institution in that valued employees are not lost or impaired due to the after-effects of the crisis.

Procedures

At Presbyterian Hospital, Rust Medical Center, or Presbyterian Kaseman Hospital, when the Internal/External Disaster Plan is activated, the Chaplaincy Services staff will report to the Command Center. Chaplaincy Services will work with the Incident Commander and the Operations Section Chief to determine the need to activate the CISS team.

CISS may be requested in other ways as well. A manager or director may request CISS for an individual or members of the team who have experienced a crisis. Also, an individual may anonymously request CISS for a situation they experienced as a crisis.

The Department of Chaplaincy Services will work cooperatively and collegially in order to provide CISS services to affected individuals and teams.

Request Help from the CISS Team 24 Hours a Day, 7 Days a Week

Please call the PH Operator at 505-841-1234 and request to be connected to the on-call chaplain.

Questions?

Critical Incident Stress Management Basic Course

Presbyterian's Chaplaincy Services provides an annual training program for staff in critical incident stress management.

2013 Annual Training

  • Dates: 05/30/13 – 05/31/13
  • Registration Fee: $40 PHS employees/ $50 non-PHS employees
  • Trainer for these sessions is Dr. Carl Russell
  • Class size is limited to 60 participants.

Registration fee includes:

  • Training materials
  • Certificate
  • Snacks for two days

Continuing Education Units:

  • Social Workers: NASW-NM - 13.5 hrs CEUs
  • Counselors: NM Counseling & Therapy Practice Board - 13.5 hrs CEUs
  • Physicians: Accredited by the New Mexico Medical Society to provide continuing medical education for physicians. Presbyterian Healthcare Services designates this live activity for a maximum of 13.5 AMA PRA Category 1 Credit(s). Physicians claim the credit commensurate with the extent of participation.
  • Nursing: CMEs recognized by NM State Board of Nursing

Questions?