Navy
Medicine Provides Ballast and Balance - 7Cs
by Douglas Stutz, Naval Hospital
Bremerton February 12, 2019
As long as Sailors have sailed the Seven Seas, there has been
times of stress, struggle and strain.
Just as noticeable
wounds, visible injuries and obvious impairments can bring such
tension, so too can hidden concern, mounting pressure, and
overwhelming anxiety.
All that stress, struggle, and strain –
internally as well as externally - can upset the ballast and balance
of even the best.
To help right the ship(s), Navy Medicine
has long advocated Tactical Combat Casualty Care (TCCC) training to
help prepare Sailors and Marines – externally - for being deployed
in a combat environment from shore to the Seven Seas and beyond.
Sailors need to know the necessary techniques, abilities and
knowledge to conduct rapid emergency medical support and evacuation.
Navy Medicine is also using that same principle to provide
Caregiver Occupational Stress First Aid training specifically aimed
– internally - to prevent stress-related injury and illness for
approximately 63,000 Navy Medicine personnel and support their
ability to render safe, quality patient care.
“The concepts
of Caregiver Occupational Stress First Aid (COSFA) are derived from
the combat equivalent, with aspects falling within the categories of
continuous, primary and secondary aid,” explained Cmdr. William
Hlavin, Naval Hospital Bremerton Command Chaplain.
COSFA is a
key component of Caregiver Occupational Stress Control (CgOSC), a
Navy Medicine initiative established to address stress reactions and
injuries in health care providers. As a flexible multi-step process,
COSFA helps provide timely assessment and preclinical care of
psychological stress injuries in individuals as well as units with
the goal to preserve life, prevent further harm, and promote
recovery.
COSFA is a pre-clinical peer intervention strategy
based on the assumption that peers will likely seek out peers for
help, and is comprised of the 7Cs: check, coordinate, cover, calm,
connect, confidence and competence.
Caregiver Occupational Stress First Aid (COSFA) is a pre-clinical
peer intervention strategy based on the assumption that peers will
likely seek out peers for help, and is comprised of the 7Cs: check,
coordinate, cover, calm, connect, confidence and competence ...
COSFA is a key component of Caregiver Occupational Stress Control (CgOSC),
a Navy Medicine initiative that Naval Hospital Bremerton has added
to address stress reactions and injuries in health care providers.
As a flexible multi-step process, COSFA helps provide timely
assessment and preclinical care of psychological stress injuries in
individuals as well as units with the goal to preserve life, prevent
further harm, and promote recovery. (Naval Hospital Bremerton photo
by Douglas Stutz)
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“For example, COSFA is a tool that allows the peer responder to
help establish a sense of calm, connect those in need with helping
resources and enable their return to the work place competence,
confidence, and new connections,” Hlavin said.
For Hospital
Corpsman 1st Class (Fleet Marine Warfare) Omar Garcia-Argueta,
enrolling in CgOSC has given him the opportunity to improve his
stress management skills and leadership ability in caring for his
Sailors, as well as patients.
“The training was great. We
spent the day learning about stress management methods so that we
can use ourselves or help out those around us. The most important
aspect of the training was the lesson on resiliency. We might not be
able to avoid stress, but we can become more resilient in order to
change our perspective and thrive during stressful situations,” said
Garcia-Argueta, noting that in hindsight, the course would have
improved his listening skills in the past to help others who were
going through a tough time.
“What I mean by helping people
who were having a tough time is the times when Marines would come to
me when they were having personal problems,” continued Garcia-Argueta,
who served as senior line corpsman for India Company, 3rd Battalion,
3rd Marines out of Kaneohe Bay, Hawaii, 2013-2016. “If I would have
known then what I know now, I would’ve been a better listener and
would have been better at promoting stress management techniques. I
would definitely say that the skills learned in CgOSC resemble a
first-aid tool for stress in the work environment. These skills
equip peers with the knowledge to help out co-workers who need
help.”
“This is a movement that invites and equips people to
become agents of change in the places where they work for the sake
of wellness. It’s people with passion that transform organizations
and cultures. We owe it to each other to create a healthy community,
so we’re inviting people with heart and passion into this movement,”
exclaimed Hlavin.
In 2010, Navy Medicine patterned CgOSC
after a 2007 Department of Defense focus study to enhance the
psychological health of the U.S. military by providing command
climate(s) of support, continuum of care, appropriate, time
resources and visible, empowered leadership. Doctors, nurses,
corpsmen and support staff with stress-related injuries and illness
could lead to medical errors, mental and emotional difficulties and
poor judgement if not addressed.
According to Hlavin,
providing this training was prompted in part by a recent command
Defense Equal Opportunity Climate Survey that indicated a rise in
staff stress and increased incidents of staff burnouts.
“The
idea was to create a tool for prevention of stress related injuries
and illness and a mechanism for intervention when injury and illness
happen. Stress often comes from some adjustment in the work
environment,” said Hlavin.
Hlavin attests that whether it’s a
sea change or a surgical site alteration, any variation from the
norm can impact anyone.
“Change is the one constant in a
healthcare setting with such issues as patient access to care.
Change upsets a delicate balance and imbalance creates stress,”
Hlavin said.
NHB has 37 staff members – and 15 instructor
trainers - who have attended Peer First Responder training, a
one-day course that centers on understanding the role of
peer-helping relationships, dynamics and effects of caregiver
occupational stress, building the resilience needed, along with
promoting and practicing stress first aid. The course will be
conducted quarterly.
“We're a small team, but growing
exponentially. Staff members routinely express interest in joining
the team and a desire to help their peers deal with the effects of
stress. The most telling evidence of implementation is a new level
of conversation about stress and resiliency taking place
command-wide. I believe the CgOSC movement has had something to do
with that new level of conversation, and will have a great deal to
contribute to the solutions as the movement continues to grow and
evolve with wellness as the goal,” Hlavin said.
As part of
Navy Medicine, NHB continues to provide stress control ballast and
balance across the Seven Seas – Arabian Sea, Atlantic Ocean, Bay of
Bengal, Mediterranean Sean, Persian Gulf, Red Sea, South China Sea
–to help those in need, internally as well as externally.
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