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MCRA Connections

July 2022

In This Issue:

Welcome to the summer 2022 edition of Connections! We hope you are enjoying your summer.
In this issue, we are focusing on grief, self-care, resources, and team development.  Plus, it's almost MCRA Conference time!  The conference will be September 11-13, 2022 at the Ralph A. MacMullan Center in Roscommon, MI.

First, exciting news; MCRA's own Harvey Burnett has been appointed Chief of Police of Buchanan Police Department in Buchanan, MI. Congratulations Harvey!
MCRA Conference - Register Today
Registration is now open for the 33rd Annual MCRA Training Conference that is being held at the MacMullan Center in Roscommon, MI, September 11-13, 2022.   Click HERE to be taken to our website to view/download our conference brochure for all the details.
Click Here to Register Online for the MCRA Training Conference
Too Busy?

I've been trying to find time to write something about self-care in this busy world.  Webster defines busy as… (ha – I've been binge-watching The Office when I'm too worn out to do anything else, so I couldn't resist - those who 'suffer' from this Office' affliction' will understand.  For others:  Michael Scott always starts a speech with ‘Webster defines ______ as_______’).

I gave up my 'retirement job' earlier this year to watch my granddaughter’s full time.  Leaving the job was a good decision. My old job has not been posted, so others have absorbed those responsibilities. I have deeply regretted that. It seems to be a budget decision, and I feel guilty and sad that it has been made.  

However, I have moved on to another chapter in my life as a full-time nanny, and I love it even though I'm beyond tired at the end of many days.  I am on the 'downhill' side of 60, so all the bending and sitting on the floor comes with a price.  And it turns out that every time the babies get sick, I get some version of it.  

So, I need to take care of myself.  

Never has 'secure your oxygen mask first' been more accurate than when caring for people who can't take care of themselves.  One of the gifts of 'grandparenting/nannying' when you are almost retirement age is that you KNOW that things won't remain the same.  The kids will grow up, and if we have done our job well, they will hopefully be happy, independent people who don't NEED us (but will still want to share their lives with us).  So, I try to enjoy the moment(s) as they happen.  Mindfulness (living in the moment) was hard for me to do when I was much younger.  
One thing I am doing to take care of myself is maintaining a little of my pre-kid adult life – like the MCRA board.  I also have two other part-time jobs that have nothing to do with babies.  

Taking time to care for oneself is mandatory, not optional. Sometimes this comes in 5–10-minute snippets: I might read a few pages of a book, play a game on my phone, or take a walk (combining self-care and childcare using a stroller). Other times it can mean taking a few days off to GO somewhere.

As life returns to a somewhat normal pace and we are beyond the most active stages of the pandemic (hopefully), I'm going to try not to go entirely back to how my life was pre-pandemic.  We've all learned a few things about priorities, free time, and what constitutes work and play.  Maybe these lessons will stick going forward.
Anne Daws-Lazar, BSW
The Nurse Who Could Lift
BEFORE BECOMING a nurse, I worked as a paramedic and was known among colleagues as "the girl who could lift." Weighing barely 110 lbs. (50 kg) myself, I often lifted my share of patients weighing up to 400 lbs. (181 kg), plus the weight of the stretcher and equipment.  Whether extricating patients or returning them home from healthcare facilities, my partner and I faced situations that challenged our resourcefulness and our muscles.

I could have taken exception to the term girl and the assumption that "girls" can't lift, but I wore my nickname proudly, exercised to keep my legs and back strong, and assessed situations critically to avoid harm. I was never injured during my years on the road as a paramedic.

From paramedic to nurse
Eventually, I went back to school to become an RN. When people asked me where I wanted to work, I had one answer—the ED. My passion for helping people in harm's way made the transition from community paramedicine to hospital ED nursing a natural fit.

I loved my new position. Emergency nursing was fascinating, challenging, rewarding, and life-changing.  As I progressed from timid novice to expert nurse, protocols became automatic. I learned by observing and taking direction from the best nurses and physicians.

In time, I became "the nurse who could lift." Because I was older than many of my coworkers, keeping my symbolic superhero cape became my new goal. I thought I could do anything.

A strong dose of reality

As patient advocates, nurses are adept at doing without to give patients the best care possible. We've all gone without breaks, without meals, without visiting a bathroom for too many hours. We've become habituated to working without the appropriate help, and the supernurse cape emerges. We convince ourselves that we can do the work of at least five people and have the strength of a bodybuilder. I had to learn the hard way that this superhero attitude isn't realistic.

One day I noticed that a confused older patient had maneuvered herself to the bottom of the ED stretcher and was about to dive off the end. She wasn't my patient; I just happened to see her as I walked toward the nurses' station and glanced through a partially open curtain. I shouted for help while I twisted and leaped backward, determined to get to the patient before she fell.

The patient was much larger than I was and pulling her safely to the top of the stretcher by myself seemed challenging but possible.  Without waiting for assistance, I lowered the bed, tilted it back with the foot pedals, and inched the patient into the center of the stretcher. I was able to use the sheet to pull her back into a safe position. By then, her nurse had arrived and taken over her care.

I didn't realize until days later that the twist and lift had injured my back. The hospital said they couldn't consider the injury work-related because I didn't report it immediately. Lesson learned: Take the time to complete an injury form no matter how minor the damage seems.

Donning your supernurse cape and lifting without help can do more harm to your body than you may realize. That's where habituation, acceptance of working alone and turning a blind eye to the dangers of our actions can hurt. Sometimes we unexpectedly encounter our limits.

It takes only one situation, one lift, one inner certainty of infallibility, for life to change. The advice has always been to wait for help when lifting or moving more weight than one person can handle, but sometimes I chose not to wait, convincing myself that my patient's needs outweighed my own.

Know your limits

I still remember the surgeon walking me down the hallway and saying, "You need to think about doing something else. Your body can't take any more of this." This meant no more abusing my body, no more lifting, no more supernurse.

I now offer this advice to all nurses: Please remember to take care of yourself. We quickly dismiss our limitations and needs because we desire to deliver the best patient care possible. Providing care expertly and from the heart makes us good nurses, but those who make a habit of putting themselves last can cause irreparable and long-lasting harm to themselves.

Still lifting

I'm no longer a direct caregiver but still "a nurse who can lift." I can lift spirits by encouraging and guiding early career nurses. I can enlighten; as nurses transition into other aspects of their professions through embracing higher education choices, I can share what I've learned. I can lift colleagues by thanking them for the excellent care they provide.

Most importantly, I've become an advocate for nurses who, in their struggle to help others, somehow neglect to help themselves.

Take my advice if you've seen yourself in this story, whatever your duties or career phase. Being a good nurse doesn't mean sacrificing yourself or your health to take good care of your patients. You can still be "the nurse who can lift" while being smart and considering the long-term outcomes of your actions. Living with the consequences of an occupational injury doesn't have to be the cost of caring. Take care of yourself.

------- Jones, S. (2017, May). The nurse who could lift. Nursing2017, 47(5), 42-44. doi: 10.1097/01.NURSE.0000515505.18087.ab
Click here to review and article submitted and written by guest writer Keith Overby:
Critical Incident Management Response (CISM) Team:  Suggested Guidelines for Team Development
By: Dennis Potter, MSW, FAAETS
As people consider starting a CISM team, there are some guidelines you might review to assist you in moving forward. These were first developed by Jeff Mitchell and placed in the Second Edition of the Group Crisis Intervention Workbook. I have added some of my thoughts and experiences along the way for your consideration. These steps are outlined in sequence, but you can proceed in the fashion that works for your community. If all these guidelines are addressed, you should be able to function well as a CISM team. 
Step One: Identify the need for the CISM team. 
Why do you think your agency/community needs a CISM team? What kind of events have or are happening that are affecting the personnel you hope to serve? Based upon these identified needs, a rationale for the team's existence should both pragmatically and theoretically emerge.
Step Two: Write the team's Mission and Goals. 
Clearly state the purpose of the team and the constituency to be served by the team. Are you going to be a team that serves the general community, First Responders, or just your agency? Are you going to be an in-house peer team or external and independent? 

Clearly state that you are adopting the ICISF models of intervention for your team. (There are many models of crisis intervention; the ICISF model is recognized as the most widespread around the world and the best-established model).

Clearly state that all information shared during any intervention by team members will be held confidential.

Step Three: Determine how the team will be legally constituted. 
Are you within an existing organization? You will need to get approval from the leadership of the organization. You must get buy-in for the uses of the team and the confidentiality of information shared during interventions.

Are you going to be a group of volunteers? You will need to set standards for being able to join the team. This usually means that all members have had the ICISF training in Group and Individual Crisis Intervention as a minimum standard. It is helpful to have written expectations of team members, so they understand their responsibilities.

How are you going to operate? It is important to write procedures for the team's functioning.

How will you "market your team" to those you wish to serve?

Are you going to become a Limited License Corporation? Some teams chose to become a corporation (see legal advice below). This may help in obtaining grants or opening a bank account.

Are you going to apply to become a non-profit corporation? Some teams chose to become a non-profit, allowing them to accept charitable donations.

Step Four: Obtain legal counsel to operationally define issues such as malpractice, standards of care, confidentiality, "good Samaritan" practices, necessary liability insurance coverage, etc.
  • This will vary based on the team's mission and local laws (some states have teams' requirements).
  • Most teams do not get liability insurance or formal corporate status depending again on the mission of the team 
Step Five: Determine how the team will be funded.
  • Initial funding to get an adequate number of team members trained in both the Group Crisis Intervention and the Assisting Individuals in Crisis courses, or the combined course as taught by an ICISF Approved Instructor.
  • Ongoing expenses of operation
    • Cell phone or pager?
    • Access to copy machines or printers for handouts etc.
    • Meeting space for team members
    • Refresher training for team members periodically
    • Training to add team members over time
    • Plan for ongoing "in-service" training
Step Six: Delineate guidelines for team members and the specific roles to be performed.
  • Administrative structure (terms and responsibilities)
    • Clinical Director
    • Team Members
    • Committees, if any
  • Dispatching functions and procedures
  • Response functions, 
    • Listing of team member roles
    • Listing mental health providers' roles 
    • Use of paraprofessionals (as applicable)
  • Clinical mental health oversight/supervision
  • Team member selection criteria
  • Agreement of full confidentiality of team interventions within the organization and any limits to that (mandated reporters' situations).
Step Seven: Determine what criteria and mechanisms will be used to activate the team. 
  • Determine what systems will be used to activate the team
  • Determine what backup systems will be used in the case of a mass disaster or widespread communication failure.
Step Eight: Stipulate guidelines and procedures for follow-up for team members after a crisis response.
  • Use of the PASS model is suggested
Step Nine: Create a clear, practical operating manual containing policies and procedures that address all the aforementioned issues.
  • Best to make this an electronic version that is distributed and kept up to date for all team members
  • It allows consistency and direction for team interventions
You will no doubt run up against situations that the above article does not cover. Please contact the ICISF or the author for assistance when you hit the road bumps. We want to be helpful.
Click here for Tips for Survivors - Grief after Disaster or Trauma from SAMHSA
Frontline Strong Together
The Assisting Individuals in Crisis and Group Crisis Intervention (GRIN) training being provided through MCRA uses funds from this initiative to cover the cost of training's for first responders.  If you are registering to attend the GRIN Training at the Annual MCRA Conference, be sure to ask for Frontline Strong Together funding to cover the cost of the training (excludes lodging and meals). 

If you cannot attend the Annual MCRA Conference September 11-13, 2022 you can still get basic CISM training by attending a GRIN Course on the following dates.

Save the Date
October 31, 2022 - November 2, 2022 in San Antonio, Texas

Attend the International Crisis Responder Network (ICIRN) conference. This is an opportunity to re-engage in person with CISM team members and to meet new faces of other organizations which provide crisis response within the US and Internationally. The link for registration and hotel reservations will be coming soon!!!!  The conference will be held at the Drury Plaza Riverwalk at a highly discounted rate: The registration fee will be $150.00. There will be multiple speakers, discussion panels, and time for networking and small group discussion. This event is hosted by District 7 Fire Rescue CISM Team, San Antonio, TX. POC is Denise Thompson,

The ICIRN comprises CISM team leaders, coordinators, and team members interested in improving services, sharing experiences, and mutual support.  Originally called the CISM Coordinators Conference, it was established in 1994 by Dan Casey, Murray Firth, Lynn Ewing, and other leaders in the evolving CISM community who recognized the need for a forum where teams could discuss "team-level" issues, often operational and logistical, and identify solutions.  The ICISF World Congress provides training and advances in CISM; the ICIRN conference allows a way to address issues with which responders and teams were struggling.  

The CISM Coordinators Conference (now ICIRN) was held every two years, alternating with the ICISF World Congress.  Conferences have been held in several US and internationally, hosted by local teams who volunteer to organize the events.  In 2006 the CISM Coordinators Conference was renamed ICIRN to expand the network, emphasize it is not just for team coordinators or directors, and recognize the group is international in scope, response, and issues.  ICIRN provides opportunities for mutual aid and support, sharing knowledge, networking, and making the conferences more financially affordable for team members to participate.

The ICIRN complements the ICISF World Congress and CISM training it provides.  ICISF gives us the skills; ICIRN helps us operationalize them at the grass-root level. The focus of the 2022 conference is to also address mutual aid responses with non-CISM resources and organizations
If you have questions or comments about Connections or if you'd like to submit an article for a future edition, contact a Member of the Marketing Committee Members:

Do you have a training that you would like MCRA to post?  Email your training information/details to

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