Required Texts:
  EMS Street Strategies, Effective Patient Interaction, 2nd Ed.,
  Stephen Sorefi, M.D. and Robert Cadigan, PhD., EMT,
  F.A. Davis Company, 2003.

Course Description:
  Provides a theoretical background for understanding crisis intervention and offers an arena to experience a variety of crisis management styles. Assists the emergency service worker or health care provider to evaluate their own emotional reactions and methods of coping in order to stay healthy on the job.

Course Objectives:
  Upon successful completion of this course, the student should be able to:

1. Assess the student's own stress levels and coping skills associated with personal and job related factors.
2. Describe how intervention in crisis situations including mental illness, alcoholism, drug abuse, suicide and battering might affect the health care provider.
3. Compare and contrast the concepts of balance and resiliency and how they relate to self care, promoting healthy behaviors and responses germane to the burnout syndrome.
4. Discuss the impact of violence on community and the field of medicine.
5. Examine the concept of power and powerlessness of the health care provider and/or the patient or recipient(s) of EMS services.
6. Examine personal biases and prejudices in order to develop a more accepting, tolerant and respectful approach to human diversity.
7. Propose methods of interacting with persons related to a crisis incident and with victims of trauma, illness or injury.
8. Discuss behavior and interactions for working with a dying patient and their families in a variety of cultural settings.
9. Describe the most effective standard principles and procedures when interacting in crisis situations.

Teaching Methods:
  This class is based on real life scenarios and a variety of activities are designed to help each student practice responses and evaluate the effectiveness of various responses. It is understood that each individual brings their own background and skills. During the class the student will be challenged to try a variety of intervention approaches to crisis situations. To be an effective intervener one must be able to access a wide variety of techniques.

Course Content Outline:

• I. Theoretical Background of Crisis Intervention
  • A. Develop working definitions
  • B. Assessment techniques
  • C. Perceptions of effectiveness
  • D. Individualize style of communications
  • E. Concepts of power / hope / comfort
    1. Control
    2. Therapeutic boundaries
  • F. Issues of Fear / Anger / Powerlessness / Helplessness
    1. De-escalation
    2. Collaboration
  
  
• II. Self Care
  • A. Stress management / preventing burnout
  • B. Concepts of hardiness / resilience / balance
  • C. Personal stress & coping skills evaluation
  • D. Explore additional healthy coping skills
    1. Critical Incident Stress Debriefing
    2. Others
  
  
• III. Specific Crisis Situations
  • A. Minor / major illness and injury
  • B. Acute / chronic illness
  • C. Culturally & socially diverse situations
  • D. Death and dying
  • E. Mental illness
  • F. Depression and suicide
  • G. Homelessness
  • H. Potential violent patients & situations
  • I. Domestic violence
  • J. Children's issues
  • K. Alcohol and substance abuse

Course Requirements:

1. Participation in class discussion and group assignments. This will be evaluated by the student's involvement in the face-to-face class and the on-line component. It is expected that each week the student will post assignments on line as assigned and respond to at least two other student's posted assignments.
2. Complete critical analysis of four (4) articles relating to the class topics
3. Project One
4. Complete weekly assignments
5. Project Two

Grading process:

• Participation         30
• Article critiques / Discussions (4 minimum)     15
• Project One          15
• Worksheets           25
• Project Two          15
  •     Total     100 Percent

In accordance with the EMS program expectations:
  A = 94 - 100 %
  B = 88 - 93 %
  C = 80 - 87 %
  D = 70 - 79 %
  F = Below 70 %

NOTES TO STUDENT:
  The face-to-face classes, those on campus, are mandatory attendance. Much of the material covered will NOT be found in a textbook. The group work and application of assessment and management techniques can not be duplicated individually and your team will be less effective if you aren't there.

Assignments / Homework
  For full credit, assignments must be completed in a timely manner. It is extremely important for the student to keep in contact with the instructor either via Web Board or email. If there are complications use some other means to contact the instructor such as message phone. The student must be in contact with the instructor at least once a week.
  You can expect a response from the instructor each time an emailed assignment is received. It is the student's responsibility to see that the assignments have been received if they don't receive this confirmation.
  You will be using the Chemeketa Community College Web Board for this class. Do not get this confused with WebCT, which is not used for this class. After you have registered for the class, you can get to the web board from the link put into 'My Courses' section of pipeline, or by clicking HERE.
  If you are new to the Web Board site, you will need to log in and register there before your instructor can put you into the functional portion of the Web Board for the class. Please feel free to contact the instructor with any problems or questions, I have been through this process several times and can usually trouble shoot problems.

Diversity Statement:
  We are a college community enriched by the diversity of our students and staff. Each individual and group has the potential to contribute in our learning environment. Each has dignity. To diminish the dignity of one is to diminish the dignity of us all.

Schedule:
  Week - - Learning Activities - - Readings

1. - Introduction -definition of crisis - - Chapter 1
         On-campus class Sept 29th - 1-5pm
   
   
2. - Stress Management - - Chapters 16 & 17 - - Article #1 Discussion Due
   
   
3. - Keeping the Balance - - Chapters 2, 4 & 15
         Developing Hardiness - - Article #2 Due
         Critical Incident Stress Debriefing
         - Movie: "Patch Adams"
   
   
4. - The Elderly / The Trauma Patient - - Chapter 3 & 5
         Responding to all equally - - Chapter 13
         October 21, 2006 - Midnight - - - - - - - Project #1 Due
   
   
5. - Death and Dying - - Chapter 14
         Intuition / Hope / Comfort - - Article #3 Due
         Powerwlessness / Hopelessness
   
   
6. - Potentially Violent Patients - - Chapter 8
         Defusing / De-escalating techniques
   
   
7. - Mental Illness Crisis - - Chapter 9, 11 & 12
         Depression / Psychosis / Suicide
         Working Scenarios
         - Movie: "Back from Madness"
         On-campus class - Nov. 18th - 9am-2pm
   
   
8. - Assault Cycles / Personal Violence - - Chapters 6, 7 & 10
         Children - in the midst of abuse - - Article #4 Due
   
   
9. - Domestic Violence
   
   
10. - Final Scenarios - - Project #2 Due -- Saturday December 2nd -

Recommended Reading:

1. Anonymous. Joe. A paper from a previous student. 5 pgs
2. Benson, Katy. Violence, Trauma and EMS. Emergency. April 1994: 40 6 pgs
3. Carey, Kristen, MD. Caring for Victims of Domestic Violence and Sexual Assault. Emergency Medical Services. January 2003. pp77-86. 4 pgs
4. Dionne, Lisa. Interviewer. One Year Later. Journal of Emergency Medical Services. Sept.2002: p44-54. 7 pgs
5. Everly & Mitchell. A Primer on Critical Incident Stress Management. Internet: www.icisf.org/inew_era.htm. 8pgs
6. Goldberg, Gerry & Richard Boustead. Compassion. Journal of Emergency Medical Services. 1998: February, 34-40. 6 pgs
7. Gropper, Elise. Promoting Health by Promoting Comfort. Nursing Forum. April-June 1992: Vol 27, No. 2: 5-8. 4pgs
8. Guttenberg, Michael, DO, EMTP. Under The Influence. Journal of Emergency Medical Services. Aug 2002. p 51-59. 6 pgs
9. Miller, Judith. Inspiring Hope. American Journal of Nursing. January 1985: 22-25. 4 pgs
10. Olejnik, Loralee. Putting Autistic Patients at Ease. Journal of Emergency Medical Services. June 2004. 4 pgs
11. Ostrow, Lauren. Mommy (and Daddy) Medic. Journal of Emergency Medical Services Sept. 1997. 8 pgs
12. Pain Articles:
    • Rodenberg. Improving Pain Control in the Field. Journal of Emergency Medical Services. Spring 2004.
    • Lafleur. Taking the Fifth Vital Sign. RN July 2004. 6 pgs
13. Reichel, Doug, PHD. The Roots of Burn Out. Emergency. March 1996 p.30-33.
14. Reigel, Mary and Daniel Barnes. A Sensitive Solution. Emergency. February 1994: 44-47.
15. Tartasky, Donna. Hardiness: Conceptual and Methodological Issues. Image: Journal of Nursing Scholarship. Fall 1993: Vol. 25, No 3. 225-228.
16. Wooten, Patty. Portions of: Compassionate Humor. Commune A-Key Publishing, 1996.