News Courtesy of: Mass Communication Specialist 2nd Class Stephanie Tigner and Mass Communication 1st Class Cindy Gill
SAN DIEGO (February 4, 2009) – Medical care professionals business is caring for others. Often overlooked is care for the caregivers themselves particularly those who serve in intense situations like disasters and battlefields. The Navy Medicine Caregiver Occupational Stress Control program training team recently provided stress management training to approximately 90 Navy medical caregivers from around the world at the Westin Hotel here.
Informally known as Care for the Caregiver, the training focused on understanding occupational and compassion fatigue, caregiver stress and burnout. Left unrecognized, accumulated stressors could lead to medical errors, job dissatisfaction and poor retention.
"The goal is that we have 80-90 people that have some new skills and some new training, and the training will provide them a new insight into work that they can do in their own command and support that they can provide to others," said Rear Adm. Karen Flaherty, Deputy Chief, Wounded, Ill and Injured. "Part of that is making sure that there is a self awareness of your own health, that there are things that you can do personally to improve your overall health and as a result the support we can provide to the wounded is better."
The Caregiver OSC program focuses on three fundamental principles: early recognition, peer intervention and connection with services as needed, according to Capt. Richard Westphal, mental health clinical specialist at the Navy’s Bureau of Medicine and Surgery in Washington D.C., and designer of the caregiver program.
Westphal said no matter what their role, Sailors need to recognize early warning signs of distress and intervene. The goal is to provide caregiver intervention and resources before pressure have impaired the individual’s ability to be effective.
Topics covered during the conference included buddy care assessment and intervention, self care, compassion fatigue skills and work environment assessment.
"This is tied to the Commandant of the Marine Corps, the Chief of Naval Operations and the Secretary of the Navy’s initiatives to do what is right for all of our Sailors and Marines, and part of what we’re doing is figuring out how to do right by our caregivers," said Westphal.
Several tools presented by Westphal include After Action Reviews, Combat and Operational Stress First Aid, self modulation skills, core leader functions, a stress injury decision matrix and OSCAR communication.
OSCAR communication consists of Observing behaviors, Stating the observations, Clarifying role and your concern about the behavior, Ask why to seek clarification of the behaviors and Respond with guided options.
After Action Review is a tool for small groups led at the unit level following a significant event. The reviews are for caregivers to understand what happened and why, anticipate and address problems particularly loss of confidence and excessive self-blame or over-confidence.
After Action Reviews provide an opportunity to assess the health and readiness of the unit and its members as well as support unit cohesion and reinforce shipmate and buddy dialog. After action reviews also create an opportunity for future healing if needed.
Combat and Operational Stress First Aid (COSFA) is similar to basic life support in that it combines assessment and getting help with effective actions. The seven C’s for helping a shipmate Check, Coordinate, Cover, Calm, Connect, Competence, and Confidence. Check – look, listen, assess. Coordinate – get help, refer as needed. Cover – quickly get to physical or emotional safety. Calm – slow deep breaths, slow heart rate, begin to relax. Connect – get support from others. Competence – restore effectiveness. Confidence – restore trust in self, others, and mission.
Self modulation or Subjective Units of Disturbance Scale (SUDS) is a zero to 10 scale for measuring the subjective intensity of distress.
Core Leader Functions are designed for leaders to strengthen the unit, identify stress loads and recognize reactions, injuries and illnesses; mitigate by ensuring adequate sleep and rest along with removing unnecessary stressors, treat through chaplains and medical services and finally, reintegrate a unit member who has been away.
The Operational Stress Control Decision Matrix is a flow chart with ‘yes’ and ‘no’ directions to help guide leaders and peers to assessing the potential severity of a Sailor’s stress levels. The four color chart begins with green for ready followed by a yellow zone as a flag for someone reacting. Upper zones are orange for injured followed by red to indicate medical intervention.
"We must interrupt the cycle of stress as early as possible," said Westphal. "If we do that for our shipmates then the need for high-end mental health services is reduced, we get a reduction in non-judicial punishments and a reduction in destructive behavior."
Westphal said he has had tremendous positive feedback from participants of the training.
"It’s very helpful and I really appreciate this training," said Chief Hospital Corpsman Straussi Mumford of Naval Hospital Camp Lejeune in North Carolina. "This is information that I can take back to my command to help out."
Westphal and the rest of the Caregiver OSC program team members intend to follow up with each of the commands’ represented at the conference within the next six to eight months to conduct training for all personnel.