1

Running Heading: UTILIZATION OF DEBRIEFING AS COPING MECHANISM

The Utilization of Debriefing as a Coping Mechanism for ER Nurses after a Code

By
Angela Long
Coppin State University
A Non-Thesis Paper Submitted to the Faculty of the School of Graduate Studies of
Coppin State University in Partial Fulfillment of the Requirements for the
Degree of Master of Science in Nursing

Approvals
Advisor: __________________________________________

Date: ______________

Chairperson: _______________________________________

Date: ______________

Area Dean: ________________________________________

Date: ______________

Dean, Graduate Studies: ______________________________

Date: ______________

Format used: Publication Manual of the American Psychological Association, 6th edition

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

Table of Contents
Dedication3
Acknowledgment.4
Abstract5
Introduction..7
Problem ...8
Purpose of the Literature Review
Hypothesis

Theoretical Definitions:

Operational Definitions

10

The Review of Literature...10

History of debriefing..10
Principles of debriefing..10
Nurses experience with grief.....14
Coping Strategies...14
Conceptual framework...15
The Methodology...17
Anticipated Cost and Time....17
Limitations.17
Measures to protect human subjects..............17
Debriefing Survey..18
Results....21
Data Analysis.....23

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

Summary........23
References..24
PowerPoint presentation.appendix A
Turnitin Digital Receipt and Report .appendix B

Dedication

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

I would like to dedicate this work of mine to William M. Manico, who has been my strength
and my encouragement in this crazy journey of mine. Im thankful everyday that you were so
supportive and loving, always my voice of reason when times were hard and to my three
beautiful children, Samantha, Sarah, and Neal. I am grateful for your love and help with keeping
the house going so I could study.

Acknowledgment

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

I would like to express my sincere thanks and gratitude to Dr. Robin Warren-Dorsey, Chair,
Masters Nursing Education, for her continued support over the last three years, and her
dedication and valuable guidance. I would also like to thank Coppin State University for
providing me with the education and tools I need to be successful.

Abstract

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

This paper explores the coping mechanisms that nurses can use in order to deal with
stressful code situations where death of a patient occurs. The literature review searches many
articles that explain how different organizations use debriefings and explores the possibility of
debriefing to be used as a useful tool for not only learning purposes , but as a tool to help nurses
cope with loss and stress. After searching the literature their seems to be lack of articles
addressing debriefings us as coping mechanisms and according to the responses received from
the survey that was conducted nurses feel that debriefing are not conducted on a regular basis in
many of the hospitals. This paper suggests that more research is needed in the area of debriefing
as a coping mechanism.

The Utilization of Debriefing as a Coping Mechanism for ER Nurses after a Code

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

Introduction
Emergency room nurses face numerous unaddressed occupational health hazards after
dealing with critical codes, where loss of life happens. The emergency room nurse is often over
looked in these situations; the concern for the wellbeing of the family and the patient
overshadow what the nurse must face. Emergency room nurses commonly have to deal with
issues such as grief, uncertainty, panic, fear, guilt (Gerow et al., 2010, p. 122). Many of these
feelings cause headaches, loss of appetite, blaming, chest pain, withdrawal, nightmares, and
inability to rest just to name a few (Gerow et al., 2010, p. 122). All of this contributes to nursing
burnout, turnover, increases sick days, and job dissatisfaction (Gerow et al., 2010, p. 122).
Emergency room nurses must be able to control all of their emotions in order to finish
their shifts, in order to come back for their next shift, in order to continue to keep working in this
stressful environment. One tool that can help lessen some of these occupational health hazards is
debriefing immediately after a code situation where loss of life occurs.
Limited information exists about coping strategies that can be used for emergency room
nurses such as debriefing. No information could be found that states that debriefing can be used
as a tool to help nurse cope with loss of life and code situations.
Defining debriefing can be hard because debriefing is used by many hospitals in
different ways and for different reasons. Debriefings are not used at all hospitals. There are no
universal protocols for how or when to run a debriefing session. Debriefings are not used at all
hospitals When utilized it can be used to teach and to help staff handle stress reaction.

Problem

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

A search of the literature about debriefing provided minimal information. Current
articles or literature stating how debriefing immediately after a critical event can help emergency
room nurses do not exist. Debriefing is a hot topic but the research addresses the topic of
educational uses and how to improve code outcomes, not as a tool to help improve outcomes for
the nurses, not as a coping mechanism for nursing. The benefit of using debriefing as a tool can
help emergency room nurses deal with the stress reaction after a code, but no literature mentions
that.
Debriefing is used in many different hospitals, but not used on a constant basis in all
emergency rooms. The Military has practiced debriefing as far back as World War II,
(Emergency Department Royal Childrens Medical Hospital and Murdoch Childrens Research
Institute, 2010, p. 499). Historically debriefing has been used by the military to recap events,
and strategize future events, (Zigmont, Kappus, & Sudikoff, 2011, p 52). In the 1980s, Jeffery
Mitchell used this information and developed a framework to help emergency service workers
manage critical incidents stress, (Emergency Department Royal Childrens Medical Hospital and
Murdoch Childrens Research Institute, 2010, p. 499). Many hospitals have adapted their own
forms of debriefing but not all emergency rooms debrief and not in the same matter. Some
medical areas use debriefing as a performance improvement tool to focus on how the event was
managed, what went well, and what could be improved, (Corbett, Hurko, & Vallee, 2012, p.
572). Some areas use debriefing to promote coping skills for staff, give psychological closure,
prevention of traumatic stress, and promotion of return to normalcy according to Dietz, (Dietz,
2009, p. 243).

Purpose of the Literature Review

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

To identify and search how the area Baltimore emergency rooms use debriefing. To
identify how debriefing as a tool helps emergency room nurses cope with stressful situations
such as codes and loss of life. . The overall goal is to see what the benefits of debriefing are, to
formulate some guidelines to how it is used, to come up with some best practices guidelines to
help emergency room nurse
Hypothesis
The use of debriefing following a critical event that includes the loss of life is a useful
tool that can help ER nurses. Emergency room nurses who experience this are more likely to be
able to complete their shifts, able to cope, have less signs and symptoms of stress reaction.
Debriefing should be used to help staff with their emotions and help with their practices.
Debriefing is a kind of first aid for nurses. A review of the literature gives some simple
guidelines to follow in order to debrief correctly. The American Heart association has listed a set
of recommendations.
Theoretical Definitions:
Debriefing: Describes both professional inquiries concerning the professional teams function
conducted during the event and psychological therapeutic interventions, usually single session
(Knobler, Nachshoni, Jaffe, Peretz, & Yehuda, 2007, p. 582).
Emergency Room Nurse: Any nurse that works in an emergency room setting.
Critical events: Any incident such as a medical emergency, an unusual condition, a difficult
situation, or even a death.
Grief: A reaction to a major loss, most often an unhappy and painful emotion.
Stress reaction: A psychological condition arising in response to a terrifying or traumatic event.
Operational Definitions

10

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

Debriefing: a onetime session where everyone that participated in the event goes over and talks
about the event or situation with different goals in mine.
Emergency Room Nurse: any nurse working in an emergency room
Critical events: are codes; resuscitations were loss of life occurs
Grief: feeling of sadness after a death
Stress Reaction: a coping mechanism used by people to deal with death.
The Review of Literature:
History of debriefing:
The military first used debriefing in WWII as a means to explore combat events in a
supportive group context. It was not intended as a psychological intervention, although many
soldiers found it beneficial in the sharing of their experiences in reestablishing of group unity. In
1980, Jeffrey Mitchell examined the militarys practice to develop a framework in order to help
emergency service workers manage critical incident stress. He made comparisons between the
stressors of combat and the stressors of emergency service in developing his model (Emergency
Department Royal Childrens Medical Hospital and Murdoch Childrens Research Institute,
2010, p. 499).
Principles of debriefing:
Debriefing has many benefits such as psychological closure, prevention, and migration of
traumatic stress and promotion of a return to normalcy that can benefit the individual, the
organization, and the community at large (Dietz, 2009, p. 245). Debriefings are not meant to
substitute for counseling for those that may require it (Dietz, 2009, p. 245).

11

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

The Joint Commission Journal on quality and Patient Safety have provided evidence
based recommendations for the process of debriefing. The Joint Commission has 12 best
practice tips.
1. Debrief must be diagnostic ("Debriefing process can strengthen," 2008, p. 109).
2. Ensure the organization creates supportive learning environment ("Debriefing process
can strengthen," 2008, p. 109).
3. Encourage team leaders and members to be attentive of teamwork processes during
performance episodes ("Debriefing process can strengthen," 2008, p. 109).
4. Educate team members on the science of leading debriefs ("Debriefing process can
strengthen," 2008, p. 109).
5. Ensure team members feel comfortable during debriefs ("Debriefing process can
strengthen," 2008, p. 109).
6. Focus on a few critical performance issues during debriefing ("Debriefing process can
strengthen," 2008, p. 109).
7. Describe specific teamwork interactions and processes that were involved in teams
performance ("Debriefing process can strengthen," 2008, p. 110).
8. Support feedback ("Debriefing process can strengthen," 2008, p. 110).
9. Provide outcome feedback later and less frequently than process feedback ("Debriefing
process can strengthen," 2008, p. 110).
10. Provide individual and team feedback ("Debriefing process can strengthen," 2008, p.
110).
11. Shorten the delay between task performance and feedback as much as possible
("Debriefing process can strengthen," 2008, p. 110).

12

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

12. Record conclusions made and goals set during the debriefing to facilitate feedback during
future debriefings ("Debriefing process can strengthen," 2008, p. 110).
According to Salsas , using these twelve principles along with planning, situation assessment,
supporting behaviors , communication and leadership will set up good debriefs that will benefit
all who are involved (Salas et al., 2008, p. 524).
The review of the literature shows three techniques for debriefing. Jeffery Mitchell used
techniques called Critical Incident Stress Debriefing or CISD (Emergency Department Royal
Childrens Medical Hospital and Murdoch Childrens Research Institute, 2010, p. 501). The
American Heart Associations also gives a set of recommendation for Resuscitation team critique
and debriefing.
The CISD uses phases. The first phase of a critical incident stress debriefing is the
introduction phase which defines expectations and process of debriefing, talks about
confidentiality, and gives formal introductions (Emergency Department Royal Childrens
Medical Hospital and Murdoch Childrens Research Institute, 2010, p. 501). The second phase is
the fact where each participant describes his/her perception of the incident (Emergency
Department Royal Childrens Medical Hospital and Murdoch Childrens Research Institute,
2010, p. 501). The third is the thought phase where each participant describes his/her thoughts
and feelings re the incident (Emergency Department Royal Childrens Medical Hospital and
Murdoch Childrens Research Institute, 2010, p. 501). The reaction phase is where all the
participants describe their thoughts and feelings and what they would like to change about the
incident (Emergency Department Royal Childrens Medical Hospital and Murdoch Childrens
Research Institute, 2010, p. 501). Another important phase is the symptoms phase where each
participant describes how he/she has changed from the incident (Emergency Department Royal

13

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

Childrens Medical Hospital and Murdoch Childrens Research Institute, 2010, p. 501). Sixth is
the teaching phase where the debriefing team teaches concepts such as stress reactions, ways to
manage their reactions, and helpful hints to aid recovery (Emergency Department Royal
Childrens Medical Hospital and Murdoch Childrens Research Institute, 2010, p. 501). The last
part is the reentry phase where team members answer any questions, present an overview or
summary to achieve a sense of closure and discuss lessons learned from the event (Emergency
Department Royal Childrens Medical Hospital and Murdoch Childrens Research Institute,
2010, p. 501).
The American Heart Associations recommendations for resuscitation, team critiquing,
and debriefing are as follows: 1) assemble team members soon after the event with team
members present; 2) gather the group in a private place using the resuscitation room if available;
3) start with a review of events and conduct of the code; 4) state the algorithm or protocol that
should have been followed, discuss what was actually done, discuss why there were any
variations; 5) analyze the decisions and reactions that were done correctly and effectively and
discuss decisions that may have been incorrect or performed less then optimal; 6) all team
members should share their feelings; 7) ask for recommendations or suggestions for future
resuscitative events; 8) inform team members unable to obtain the debriefing of the process
followed and the recommendations that were made; 9) the team leader should encourage the
team members to contact him or her (Dietz, 2009, p. 245).
The 3D model is the third technique or model found in the literature. The 3D model is
designed to address the individual, the key experiences and the learning environment (Zigmont et
al., 2011, p. 54). Based on the 3D model of debriefing the individual feels safe, knows what to
expect, is prepare to complete the task (Zigmont et al., 2011, p. 54) . The experience creates a

14

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

change in the body of the individual, is realistic to evoke emotion for an individual, is practical
and relevant and useful, knows what to expect out of the situation (Zigmont et al., 2011, p. 54).
The environment is safe for learning individual, distresses for individual, analyzes behaviors, and
leaves with practical and useful information (Zigmont et al., 2011, p. 54). This model concluded
that individuals use their experienced and their environments to efficacy achieve lifelong
learning (Zigmont et al., 2011, p. 54).
Nurses Experience with Grief
The grief process for nurses appears to be very different than the grief process for family
members, nurses may find themselves in conflicting roles (Gerow et al., 2010, p. 123). Nurses
are the ones that must remain strong and give support. On the other hand they have to grieve for
someone they took care of. Many nurses adapt ineffective coping mechanisms such as avoidance,
and compartmentalizations sometimes resulting in burnout and other physical and emotional
problems (Gerow et al., 2010, p. 122).
Some medical departments deal with death and dying by having death rounds. Based on a
study conducted by Knots (2010), death rounds have helped the residents perception of
emotional support and teaching end of life care (Khot et al., 2010, p. 1395). According to Khots
(2010), medical professionals are often not prepared for dealing with death and dying (Khot et
al., 2010, p. 1395).
Coping Strategies
According to Dietz (2009), the following recommendations to stress from the
International Critical Incident Stress Foundation are as follows: within the first 24 to 48 hours
engage in periods of appropriate physical activity and periods of relations, talk to people,
maintain a normal schedule, and keep a journal (Dietz, 2009, p. 244). Get plenty of rest, reach

15

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

out to people that care. Help your coworker sharing feelings and thoughts, spend time with each
Based on a study performed by Moores (2007), common coping strategy=is included talking to
coworkers, spending time alone, exercise (Moores, Castle, Shaw, Stockton, & Bennett, 2007, p.
942) .
Some medical professional may have negative coping strategies such as avoiding talking
about the issue, turning to work, lack of interest in normal activities, loss of appetite, sleep,
anxiety, irrability, crying (Moores et al., 2007, p. 943). All of these things can affect the ER
nurses professional and personal life.
Debriefing should give nurses five psychological interventions according to Royal
Childrens Hospital (Emergency Department Royal Childrens Medical Hospital and Murdoch
Childrens Research Institute, 2010, p. 503). Debriefing can promote a sense of safety and of
calming, sense of self and community efficacy (Emergency Department Royal Childrens
Medical Hospital and Murdoch Childrens Research Institute, 2010, p. 503). /debriefing also
encourages active coping, increasing nursing beliefs about their own capabilities to manage a
critical incident (Emergency Department Royal Childrens Medical Hospital and Murdoch
Childrens Research Institute, 2010, p. 503).
Conceptual frame work
Sr. Callista Roy developed Roys adaption Model which is widely applied as a nursing
model used in nursing, nursing education and nursing research ("theorists," 2012, p. 1).
According to Roys model nursing is the science and practice that expands adaptive abilities and
enhances person and environment transformation ("theorists," 2012, p. 1). The goals of this
conceptual framework is to promote adaptation for individuals and group in four adaptive modes,
thus contributing to health, quality of life, and dying with dignity. Roys adaption model

16

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

assesses behavior and factors that influence adaptive abilities and intervene to expand these
abilities and enhance the environmental reactions ("theorists," 2012, p. 1).
The Roy Adaptation Model presents the person as a holistic adaptive system in a constant
interaction with the internal and the external environment. The main task of the human system is
to maintain integrity in the face of the environmental stimuli. The metaparadigm of nursing is a
person must be able to cope with adaptation successfully. Roy uses a four step or part process to
address adaptation using the nursing process.
Roys adaptation model works perfectly to guide the research question addressing the use
of debriefing as a coping mechanism to help nurses who experience a code situation with stress
reaction. Roys four part process uses input, control processes, effectors and output (Roy, 2015).
In the first phase or the input, the stimuli is addressed, this stimulus can be the focal, contextual
or residual stimuli (Alligood & Tomey, 2010, p. 345). Next the control phase addresses the
coping mechanisms that are established (Alligood & Tomey, 2010, p. 345). The effector phase
explains the physiological functions which identities basic needs such as oxygenation, nutrition,
elimination, activity and rest, protection, senses, fluid and electrolytes and acid base balance,
neurological function and endocrine function, self-concepts which addresses psychic and
spiritual integrity, role functions and interdependence is concerned with the relationship and
nurturing of others (Alligood & Tomey, 2010, p. 345). The last and final phase is the output
results as either the person can be adaptive or ineffective responses; this is the stage where
adaptation should be promoted (Alligood & Tomey, 2010, p. 345). These four modes or phases
explain how everything in life is centered on change and adaptation. More than 163 studies have
been published using this model as a basis for their research in 44 English speaking journals
(William F. Connell School of Nursing, 2013, p. 2)

17

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

The Methodology
Review all current literature on debriefing in emergency rooms. Survey emergency room
nurses that attend the power point presentation for this topic at Franklin Square Hospital
Emergency Room in December of 2014.
Anticipates cost, time, money
Cost of paper and ink and time of disturbing surveys and obtaining all the results, time to
give and schedule PowerPoint presentation. Time to talk and be granted permission by managers
of the Pediatric and Adult Emergency rooms at Medstar Franklin Square Hospital in order to
present power point presentation and distribute survey. The time and revisions to this paper
span over two years and multiple submissions to the Helen Fuld School of nursing,
Limitations
Research will be limited to the number of surveys obtained at the presentations. Limited
to the number of the surveys that are filled out completely. Limited by no funding of a masters
degree level student. Number of participants will be limited by time and resources for a graduate
student. Limitations also include the areas that the masters degree level student has access to in
order to obtain a diverse sample of nurses to fill out the survey.
Measures to protect human subjects
No humans will be used or tested in this research. Names will not be used in the surveys.
All participates will be given a letter with the survey to inform them of the purpose of this survey
and voluntary nature of the study. Individual responses will remain confidential. A PowerPoint
presentation will be offered prior to the participants completing the survey.

18

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

Debriefing Survey
The Debriefing survey will be a descriptive structured questionnaire to survey local
emergency room nurses. The survey was adapted from a questionnaire used by a study in the UK
of failed pediatric resuscitations. The survey has been altered and changed (Ireland, Gilchrist, &
Maconochie, 2008, p. 330). There are 12 questions present and ten of them can be measured by
the percentage of the number for each choice. All free text comments will be presented and
analyzed as qualitative data framework.

Debriefing Survey
Demographics (Circle one)
Gender
Female

Male

Age
Below 25
25-35
Above 35
Years of Services in Nursing
<5 years
10-15 years
> 15 years
Years of Service in Emergency Department
<5 years

19

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

10-15 years
>15 years
Answer the following questions with regard to what you think happens in your own opinion
following a critical incident where loss of life has occurred:
Is there a formal policy for carrying out debriefing in your hospital?
Yes
No
Following a critical incident would a debriefing occur?
Most of the time
Sometimes
Rarely
Is the aim of these debriefs to resolve or review?
Medical issues
Emotional or psychological issues
Both medical and emotional or psychological issues
When would a debriefing occur?
Immediately
Soon
Never
Who would be invited to attend?
Doctors
Nurses
Others

20

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

Where would the debriefing take place?
In the department where event took place
Somewhere else in hospital
Other
Would the session be led by someone involved in the resuscitation attempt?
Yes
No
What hospital do you work at? _________________________________
Please circle any of the following that you have experience after a critical event or code.
Weakness

Headache

Uncertainty

Blaming

Grief

Panic

Loss of appetite

Chest pain
Fear
Withdrawal

Nightmares
Guilt
Inability to rest

Other_________________________

Please describe how the debriefing is conducted and what topics are
discussed._____________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_____________________________
After a critical event with loss of life are you able to return to work to complete your shift?
Yes
No
Based on UK pediatric resuscitation Survey with modifications (Ireland et al., 2008, p. 330).

21

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

Demographic Characteristics of Respondents (N =20)

Characteristic
Gender
Female
Male
Age
Below 25
25-35
More than 35
Years of Services in Nursing

Frequency

Percentage

20
0

100
0

5
10
5

25
50
5

<5 years

10

50

5-10 years
11-15 years

9
1

40
10

>15 years

< 5 years

15

75

5-10 years

25

11-15 years

>15 years

Years of service in emergency

room

22

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

Data Analysis
Based on the surveys that were completed and turned in, at least 75% of emergency room
nurse were age below 35 years old and 50 % had less than five years of service in the emergency
room of which 75 % of then had less than five years of service as an emergency room nurse. All
of the nurses 100% stated that their hospital had no formal policy for carrying out debriefing in
their hospital. 100% of nurses surveyed stated they experience grief after a critical event or code
and 100% of the nurses surveyed stated that they completed their shifts.
Summary

23

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

Debriefing is a hot topic in the medical area today and has been used by many
professions dating back to the First World War. The utilization of debriefing as a coping
mechanism can and will greatly helps emergency room nurses deal with codes and critical
incidents. More research needs to be done to investigate this theory; currently today there is not
enough literature to support this theory. Every hospital need a set of guidelines or protocol on
how to and when to run a debriefing and what are the goals of the debriefing.
Utilization of debriefing will help emergency room nurse cope with the feeling of grief
and help some of the other negative effects from working in codes situations. Lastly debriefing
should also give the nurses a list of resources to get help if they need it after dealing with critical
incidents. The Emergency room nurse needs to know that they might need some support or help
too.

References
Clay, A., Que, L., Petrusa, E., Sebastian, M., & Govert, J. (2007). Debriefing in the intensive
care unit: A feedback tool to facilitate bedside teaching. Critical Care Medicine, 35, 738754. doi:10.1097/01.CCM.0000257329.22025.18
Conceptual framework. (2012). Retrieved from www.currentnursing.com

24

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

Corbett, N., Hurko, P., & Vallee, J. (2012). Debriefing as a strategic tool for performance
improvement. Journal of Obstetric Gynecologic and Neonatal Nursing, 41(4), 572-579.
doi:10.111/j.1552-6909.2012.01374.x
Debriefing process can strengthen process for critical incidents. (2008). Retrieved from
www.ahcmedia.com.online.html
Dieckmann, P. (2012, June). Debriefing Olympics--a workshop concept to stimulate the
adaptation of debriefing to learning contexts. Simulation in Healthcare, 7(), 176-182.
Retrieved from
Dietz, D. (2009, July/August). Debriefing to help perinatal nurses cope with a maternal loss.
Maternal Child Nursing, 34(4), 243-248.
Dreifuerst, K. T. (2009, March/April). The essential of debriefing in simulation learning: a
concept analysis. Nursing Education Perspectives, 30(2), 109-114. Retrieved from
Emergency Department Royal Childrens Medical Hospital and Murdoch Childrens Research
Institute. (2010,). Review article: debriefing critical incidents in the emergency
department. Emergency Medicine Australasia, 22(1), 499-506. doi:10.1111/j.17426723.2010.01345.x
Gerow, L., Conejo, P., Alonzo, A., Davis, N., Rodgers, S., & Domian, E. W. (2010, November
21). Creating a curtain of protection: nurses experiences of grief following a patient
death. Journal of Nursing Scholarship, 42(2), 122-129.
Ireland, S., Gilchrist, J., & Maconochie, I. (2008, November 3). Debriefing after failed pediatric
resuscitation: a survey of current UK practice. Emergency Medical Journal, 25(1), 328330. doi:10.1136/emj.2007.048942

25

UTILIZATION OF DEBRIEFING AS COPING MECHANISM

Khot, S., Billings, M., Owens, D., & Longstreth Jr., W. (2010, November). Coping with death
and dying on a neurology inpatient service. Arch Neurology, 68(11), 1395-1397.
Knobler, H., Nachshoni, T., Jaffe, E., Peretz, G., & Yehuda, Y. (2007, June). Psychological
guidelines for a medical team debriefing after a stressful event. Military Medicine,
172(6), 581-585.
Moores, T., Castle, K., Shaw, K., Stockton, M., & Bennett, M. (2007). Memorable patient deaths:
reactions of hospital doctors and their need for support. Medical Education, 942-946.
Salas, E., Klein, C., King, H., Salisbury, M., Augenstein, J., Birnbach, D.,...Upshaw, C. (2008,
September). Debriefing medical teams: 12 evidence-based best practices and tips. The
Joint Commission Journal on Quality and Patient Safety, 34(9), 518-527.
Schenarts, P. (2007, March). Debriefing is an effective method for providing feedback and
ensuring best clinical practice by residents in the intensive care unit. Critical Care
Medicine, 35, 957-958. doi:10.1097/01.CCM.0000257225.84444.CE
Strote, J., Schroeder, E., Lemos, J., Paganelli, R., Solberg, J., & Hutson, R. (2011, March).
Academic emergency physicians experiences with patient death. Academic Emergency
Medicine, 18(3), 255-260. doi:10.1111/j.1553-2712.2011.01004.x
1. Zigmont, J., Kappus, L., & Sudikoff, S. (2011,). The 3D model of debriefing: defusing,
discovering, and deepening. Seminars in Perinatology, (), 52-57.