[Psychological crisis debriefing should cease].
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The staff of the Pentagon Family Assistance Center was closely exposed to the intense grief experienced by those who had suddenly lost their loved ones following the crash of American Airlines Flight 77 into the Pentagon on September 11, 2001. In addition, some Pentagon Family Assistance Center workers were in the Pentagon when it was attacked, and others lost friends or colleagues in the event. A "Brief Education and Support" group intervention, designed to avoid the detailed exploration of traumatic experiences, was used to help workers recognize and understand their reactions to the event, and, as appropriate, to normalize those reactions. A second aim was to support positive coping and warn against problematic coping. The groups were characterized by much sharing of emotional and behavioral reactions to the work and to the Pentagon crash, and they were useful in prompting reflection on ways of coping. They appeared to offer one acceptable and effective way of educating emergency workers about their traumatic stress reactions, normalizing those reactions, and promoting adaptive coping.
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It is clear that it is very difficult to treat trauma-related stress after the fact. EMS and fire personnel must develop personal stress management strategies and have a personal-support system in place. Most stresses in EMS are the day-to-day hassles of the job. Occasionally, some of us will be involved in a disaster operation. As with the day-to-day stressors, the best way to manage disasters is through planning and preparation. As Lauren Simon Ostrow wrote, "In the end, EMS may want to re-examine the all-American notion that we should always feel good, that stress is bad and that we have to take corrective action to resolve every negative reaction to stress, even if it is normal."
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In health care, stress and sadness come with the job. Hospitals now recognize that letting clinicians and nonclinicians decompress--through talking groups, counseling or a few minutes of quiet time-is good for the soul and for the quality of patient care.
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