Critical Incident Stress Management CISM dissertation

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CISM Program Surry Nuclear Power Plant

What is CISM?

Why is a CISM program necessary for the agency?

Agency description, community, and social context

Prevention and Interventions





Chronic health and innovative approaches

Cultural Issues

Proposed Budget .17

Critical incident stress management plays an important role in assuring the psychological resilience necessary for those who are exposed to a traumatic incident. This proposal outlines a program to add mental Health Services to the existing emergency management plan for the Surry Power Plant. The current plan does not address mental health issues, and this is an important need that will need to be considered in the future. The current plan will modify the existing plan through the addition of mental health services for the community.

Proposal: CISM Program

What is CISM?

A critical incident is any event that produces stress or trauma to personnel that are directly or indirectly involved. Stress reactions and symptoms vary among individuals and among the circumstances surrounding their proximity to the critical incident. Stress reactions to dramatic events can be influenced by a person's coping skills, personality, and their ability to adapt to the situation. If a person does not react in a way that is emotionally healthy, they can develop long-term symptoms that can last the rest of their life. Minor stress that is long-term can be just as damaging or harmful as acute stress that is of shorter duration.

Critical incident stress management (CISM) is a protocol that is designed to reduce the short- and long-term symptoms of stress cause by a dramatic event. CISM includes education that is designed to help the person adapt to the traumatic event into resume normal life as quickly as possible. The program also includes access to resources that can help individuals address the needs, such as cultural issues, or professional counseling if needed. It must be understood that CISM is not psychotherapy and does not replace psychotherapy, but it is a first step to facilitating the process of obtaining resources for healing as quickly as possible. The goal of CISM is to prevent the long-term effects of stress for the individual and their family.

CISM recognizes that the effects of the event do not end when the victims have all been transported to the medical facility, and the cleanup is complete. In the past, psychological effects of stress were not addressed at all. First responders were expected to have some type of special ability to handle what most cannot. They were expected to have a certain role in to portray a certain image of strength and emotional stamina to the rest of the world. However, it is now recognize that they do not have special powers and that they too can succumb to the stress associated with the critical incident. This program is being developed to help first responders obtain the help that they need to heal and attain a storm will lives as possible in a world that can seem filled with chaos.

Why is a CISM program necessary for the agency?

Nuclear energy is an important part for culture in the modern world in which we live. It has the ability to provide an abundant supply of energy upon which our nation is dependent. Nuclear energy is generally considered safe and reliable. The Nuclear Regulatory Commission (NRC) requires plants to operate with multiple layers of safety standards in place. The standards are a result of the reality that nuclear energy also has the ability to cause great harm to life and property if something should go wrong. Any incident that involves the release of radiation is potentially life threatening for citizens hundreds of miles away from the site. This potential is the key reason for the need to develop a critical incident stress management program that encompasses many levels of victims.

A critical incident that occurs in a nuclear energy facility differs in many ways from other critical incidents. The mechanism that causes the incident is less important than the effects of the potential radiation leak and its potential effects on the human body. Stress from the critical incident involving a nuclear power plant is not over when the situation is under control in the short-term effects of the accident are over. People in and around the facility, or those who were directly involved in the accident can have stress for many years concerning the effects of radiation on their body. This is a valid concern and one that needs to be specifically singled out and addressed in a CISM program at a nuclear power facility.

A CISM program is necessary for every nuclear power facility. In addition, the program needs to extend beyond first responders, their families, and those directly associated with the nuclear power facility. A CISM program knees to extend to the community and offer services to those who live close to the plant. The physical and mental effects of the accident are more likely to be acute the closer to the source of the radiation one is located. The CISM program for nuclear power facility can provide excellent public relations and demonstrate to the public that a comprehensive plan is in place to take care of their needs, should something go wrong at the facility. In multifaceted approach is needed for a CISM program involving a nuclear power facility. This proposal describes a program designed to be implemented at a nuclear power facility located in the local vicinity.

The purpose of the proposed CISM program is to provide psychological services to first responders and those in the local community in the event of any emergency involving the local nuclear power facility. It will be implemented in addition to stand in emergency procedures already in place at the plant. The following proposal describes the elements of the program as they relate to the facility and the surrounding community.

Agency Description, Community, and Social Context

The Surry Power Plant began operation in 1972 and is situated in Surry county Virginia. It generates 1,598 MW of Electric Power from its two nuclear reactors (Dominion, 2011). The CISM is important for the station due to its situation in close proximity to major population centers. The reactors sit directly across the river from Jamestown. The emergency preparedness plan for the reactor includes plans for evacuation of the Surry area, as well as the North and South Ana areas. The evacuation areas and present action zones around the plants encompases a large area with dense population.

The plant has been proactive in the development of safety plans for persons with in the area. They have established evacuation routes and they have emergency centers to care for the physical needs of the persons within the affected area. They have an extensive emergency management system in place to provide for the physical and medical needs of persons within the community. However, there is no part of the plan that addresses the mental health needs of the same community. The potential for long-term mental health consequences in the community is significant. Regardless of the source of the emergency of the nuclear power plant, the potential for long-term effects from trauma are significant, yet there is no plan currently in place to address these needs. This proposal addresses these needs and will propose an addendum that can be added to the current emergency plan to address the mental health needs of the community in the event of a nuclear accident, regardless of the source of the accident. The following proposal addresses these needs.

Prevention and Interventions

Prevention and intervention strategies take place on several different levels depending on the person's proximity to the nuclear power plant. Personnel and needs will be divided into three separate areas. Primaries will be those who work of the facility and first responders who will be closest to the radiation source. They will be at greatest risk for exposure to radiation and will be likely to have the highest level of anxiety associated with the event.

Secondaries will include the immediate family of first responders and plant workers. Their concerns will stem from concern for their loved one and if they live close to the plant, for their own well being and for that of their family. Another category of secondary zinc lutes medical personnel who must read those who are injured or become ill. These workers can experience stress from the long hours of caring for others. Tertiaries will include members of the community that are not directly affected by the emergency, but who are affected by news of the emergency in their community and the associated anxiety.

The CISM will include strategies to address the needs of all three of these groups. The plan will include the following elements.

1. Preventative educational programs to prevent critical incident stress

2. Training personnel on how to recognize the symptoms of critical incident stress in themselves and others

3. Developing appropriate interventions for plant workers and first responders who display these symptoms

4. Developing…[continue]

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