Drug Topics - October 8, 2007 - (Page 42)

42 DRUG TOPICS OCTOBER 8, 2007 www.drugtopics.com CONTINUING EDUCATION intervene if their buddy is overwhelmed. Second, buddies need to be receptive to their own buddy’s appraisals of their functioning. If a buddy opines that his or her buddy has become overwhelmed, that person needs to heed that advice. It has been found that many first responders are quite poor at assessing their own levels of distress and fatigue. There are several signs that a first responder has become overwhelmed. The responder may refuse to leave the scene, he or she may decline to take breaks, or reinattention to essential needs (such as eating, hydrating, or taking bathroom breaks), and so on. One should also monitor for first responders who are not functioning in their assigned role. Some first responders, although unaware of their level of distress, will nonetheless avoid either the work area or clinical tasks. Finally, it is important to monitor how first responders are interacting with others. When overwhelmed and compromised, some first responders are prone to having inappropriate relationships with victims and/or other first responders. It is advisable for first-responder teams to either include or coordinate with mental health professionals. Mental health professionals can assist victims with psychological needs, yet they are also able to serve as a resource for the team itself. If a first responder has become compromised, the mental health professional is in a position to intervene effectively. Further, mental health professionals can help with “debriefing” team members after their deployment has ended, thus facilitating reentry. The SAMHSA guidelines recommend that first responders be assessed by mental health professionals routinely. SAMHSA also offers recommendations for managing one’s stress while performing first-responder duties. Vary the difficulty/stress level of the tasks one performs throughout a shift; alternate among easy, medium difficulty, and difficult activities. First responders should avoid the temptation to focus exclusively on difficult tasks throughout their shifts. Shifts are recommended to be 12 hours at most in duration, with at least 12 hours off. It can be difficult for first responders to leave their post (even after 12 hours) during a disaster, yet they must be mindful that they need to pace and protect themselves in order to be the greatest help to others. They should take frequent breaks throughout their shifts, and make these “true” breaks—taking a short walk away from the site, finding a quiet place to relax, etc. First responders should also make efforts to talk with other first responders about their experiences, including emotional reactions. And, perhaps most important, they should set realistic expectations for themselves. They may start many tasks as pharmacists-first responders, but they may not be able to see them through to completion. Others who relieve them will pick up the work, and not everything can be “fixed” immediately in the aftermath of a disaster. By setting realistic goals, they are ensuring a sense of satisfaction and accomplishment while avoiding the upset or guilt that may come from feeling as though they “didn’t do enough.” Between shifts, first responders should make extra efforts to attend to their own well-being. Physical activity off-shift is important, even if it is simply deep breathing or walking to burn off stress. They should make sure On-line resources Federal Emergency Management Agency (FEMA) www.fema.gov National Stockpile—Centers for Disease Control & Prevention (CDC) www.bt.cdc.gov/stockpile American Red Cross (ARC) www.redcross.org Bioterrorism—Food & Drug Administration (FDA) www.fda.gov/oc/opacom/hottopics/bioterrorism.html Disaster Mental Health—Substance Abuse & Mental Health Services Administration (SAMHSA) http://mentalhealth.samhsa.gov/topics/explore/disaster Psychological First Aid—National Child Traumatic Stress Network (NCTSN) www.nctsn.org/nctsn_assets/pdfs/pfa/2/psyfirstaid.pdf All URLs current as of Sept.12, 2007 fuse direct orders. The responder may over-identify with the suffering of victims and lose the professional distance that is sometimes necessary to function as a first responder. “Gallows humor” is sometimes a sign that a first responder needs to rest and recuperate. Irritability, impulsivity, angry overreactions, and hypersensitivity to perceived criticism are also signs of “burnout.” Some first responders become overwhelmed and seek to compensate by focusing exclusively upon a single, unimportant task (e.g., “I can’t help you with that patient because I have to finish sweeping the floor”). Another sign is counter-phobic behaviors, such as when a first responder responds paradoxically to intense anxiety. Instead of retreating or avoiding an anxiety-provoking (and potentially dangerous) situation, the first responder may rush toward the situation, or seek such situations out unnecessarily. More obvious, gross signs of impairment include dissociation, panic, shock, hallucinations, aggressive behavior, or substance abuse. More subtle signs include concentration and attention problems (e.g., “going blank,” forgetting what one was doing, or difficulty with simple arithmetic), becoming withdrawn and isolated, fine motor tremors, flu-like symptoms, http://www.drugtopics.com http://www.fema.gov http://www.bt.cdc.gov/stockpile http://www.redcross.org http://www.fda.gov/oc/opacom/hottopics/bioterrorism.html http://mentalhealth.samhsa.gov/topics/explore/disaster http://www.nctsn.org/nctsn_assets/pdfs/pfa/2/psyfirstaid.pdf

Table of Contents Feed for the Digital Edition of Drug Topics - October 8, 2007

Drug Topics - October 8, 2007 Latebreakers Latebreakers in Depth Letters Rx Care Community Practice JP at Large 150 Years of American Pharmacy Hospital Practice Are You Getting Pharmacy's Message Across? Self-Care Government and Law Legal Q&A The Pharmacist as First Responder in Disaster Relief Technology Update New Products Advertisers Index Statement of Ownership Classified Viewpoint

Drug Topics - October 8, 2007

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