By Paula McKenzie 
During my CPE training, a veteran chaplain introduced me to critical incident stress debriefing. He shared information about the process with me and invited me to participate. This was an excellent foundation for my future work as a staff chaplain and, later, as a director of pastoral care.
Very early in my time as a staff chaplain, a baby on one of my units died unexpectedly. The staff were in great distress. They felt shocked and questioned how this could happen on their unit. Some found themselves unable to let go of the images of the event in their memory and were struggling with concentration. One of the hospital psychiatric nurses was asked to lead a debriefing and she suggested that I join her. We invited all involved staff to come. This included doctors, nurses, housekeepers, and any other staff connected with the case. For hourly staff, the session was paid time.
We began by setting the stage for a safe and grounded discussion. Those attending were asked not to discuss it with anyone who did not attend. We also acknowledged that this was not an analysis of the event. That would take place at another time. It was solely a time to reflect and share what had happened and provide an opportunity for staff healing.
Then we invited participants to share what had happened (the facts), starting with the first person involved. This gradually led to what they were experiencing (the feelings). By sharing the timeline of what had actually happened, we hoped to reduce rumors and speculation about the incident. It also gave staff members a chance to express their feelings in a safe environment, to grieve, and realize that they were not alone in their grief.
At the end of the session, we gave each participant a sheet of information about feelings to expect from dealing with a critical incident. If the feelings and symptoms continued, staff members were invited to seek individual counseling.
Evaluations of this session revealed that many participants not only appreciated the opportunity but that they also found it comforting and healing.
Over the 18 years that I served at this hospital, the critical incident stress debriefing team had many calls for sessions like the one described above. I learned that it was beneficial for team members to work in pairs. If possible, it was helpful for one of the facilitators be a nurse who had debriefing experience. With two facilitators, one person was always able to focus on the group dynamics in general while the other could attend to individual needs. Also, once the session was over the two facilitators could debrief together.
Sometimes we had large numbers of participants and sometimes just a few. Each time, the experience was helpful to those who participated. This kind of support from the hospital administration reflected care for the employees. I believe that these sessions helped alleviate at least a portion of the moral distress that hospital employees experienced.
Paula McKenzie, BCC, is the retired regional director of mission, pastoral care and ethics at SSM Health, St. Mary’s in Madison, WI
