Perceived Effectiveness of Critical Incident Stress Debriefing by Australian Nurses

This paper examines the perceived effectiveness of stress debriefing by a sample of 129 Australian hospital nurses and the relationship of their perceptions to demographic variables such as qualifications and work area. The survey generally showed debriefing as helpful, but lack of helpfulness was also recognised because of time taken from personal lives and adverse group processes. Factor analysis identified five scales; three helpful (‘Understanding’, ‘Sharing’ , and ‘Cohesion’) and two, unhelpful (‘Procedure’ and ‘Dynamics’). Results suggested that helpfulness of debriefing was unrelated to demographic differences. Although further research is required to replicate these findings, they suggest that replacing the current ad hoc forms of debriefing available at the hospital with a standardised model would overcome shortcomings identified by respondents. INTRODUCTION T he earliest description of Critical Incident Stress Debriefing (CISD) in nursing literature appeared in 1988 when Jimmerson described a program modelled on Mitchell’s (1983) prototype. This was seen as a turning point for emergency nurses because they could acknowledge the psychological impact of their work. According to Jimmerson, (1988, p.44A) the experience of CISD had eroded the view of the emergency nurses being ‘unhurtable superbeings’ and ‘pillars of strength’. In the following decade, the value of CISD in mitigating critical incident stress (CIS) experienced by nurses was recognised by the nursing profession (Cudmore 1998; Jefferson and Northway 1996; Wright and Casier 1996; Laws and Hawkins 1995; Appleton 1994; Martin 1993). Martin (1993, p.39) considered that implementation of Critical Incident Stress Management (CISM) programs in hospitals provided caregivers with a way of countering the insidious, cumulative effects of emotional trauma because ‘medical/surgical nurses, oncology nurses, neonatal nurses all nurses involved in traumatic events’ could benefit from them. Following the categorisation of critical incidents experienced by the nurses in her study, Appleton (1994) suggested that debriefing could be useful in assisting nurses to cope with CIS and recommended the availability of peer support groups and counselling for all acute care agencies. Laws and Hawkins (1995) argued that debriefing was essential but lamented the lack of wide recognition of CIS in Australian hospitals and the sparsity of CISD facilities for nurses. Lam et al (1999) also identified the urgent Dr Jillian O’Connor is a clinical psychologist, Aged Psychiatry Service, Caulfield General Medical Centre, Caulfield, Victoria, Australia Dr Sue Jeavons is a lecturer, School of Psychological Science, La Trobe University, Bendigo, Victoria, Australia Accepted for publication October 2002 ACKNOWLEDGMENTS The authors wish to acknowledge the nurses who participated in the study, Dr Ramon Lewis, and Paul Aguis, La Trobe University, Bundoora, Victoria, for their assistance in preparation of the statistical analysis. PERCEIVED EFFECTIVENESS OF CRITICAL INCIDENT STRESS DEBRIEFING BY AUSTRALIAN NURSES