1. Crisis Management &
Crisis Resource
Management
Unit 5 – Complex Health
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2. Session Objectives
 Understand the concepts of Crisis
Resource Management (CRM)
 Understand how the concepts of
CRM could be applied to health
situations
 Determine the effects of crises
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3. Crisis - definitions
 A period of disequilibrium and
decreased functioning as a result
of an event or situation that creates
a significant problem which cannot
be resolved by using familiar
coping strategies (Roberts, 2000)
 Time of extreme trouble or danger
(Collins English Dictionary)
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4. An Emergency is not a
Crisis...
 Except on rare occasions.
 An emergency is a situation in
which immediate action is
essential for the survival of the
system.
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5. Types of Crisis
 Product: Bad press, recalls
 Personnel: Labour conflict, racial/sexual
suits
 Financial: Sales failure, theft
 Natural Disasters: Floods, earthquakes
 Legal: Litigation, regulatory action
 Violence: Terrorism, sabotage,
kidnapping, workplace
 Accidents: Employee, customer,
executives
(Alf Nucifora - http://www.nucifora.com/art_187.html
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6. Recognise the Differences in
Crisis Management & Crisis
Resource Management
Crisis Management. Crisis Resource
 Teaches medical Management
management of the crisis  Teaches administration
e.g. Asthma, allergy, and team skills such as
shock/bleeding. leadership,
communication, calling for
 Knowledge is used and help, being a good
taught based on specific follower, using all
needs of the crisis. resources.
 Knowledge taught is
independent of actual
 Each speciality uses a crisis
different simulated crisis  Multiple disciplines work
and learns different together in a team
aspects of management. structure. All members
Roles are specific learn same skills
irrespective of the
underlying crisis
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7. Crisis Resource
Management – A National
Crisis
 How is National Crisis managed?
 CIMS Management
• Ministry of Health Emergency
Management Plan
• Case Study of the Jody F Millennium
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8. National Health
Emergency Management
 Nurses need to become more aware of
risks and plans
 Ministry of Health - National Health
Emergency Plan
 4 Guiding Principles
1. Activating and co-ordinating a response
2. Managing service delivery
3. Setting up a safe and appropriate
environment
4. Organisational management and
structure
( National Health Emergency Plan 2005 pg
4-5)
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9. After listening to the case
study consider answers to
the following questions
 Identify the public health issues associated with a
national emergency:
 Jody F Millennium
 Northland Floods 2007
 Describe how people react in a crisis situation
 How would a crisis affect you personally.
 What are the direct and indirect effects to
people
 What do you need to know as a nurse to function
effectively in a national emergency and manage
the crisis situation effectively?
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10. Case Study of the Jody
F Millennium
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11. What are the crucial
requirements to
managing a crisis?
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12. Effects of a Crisis
 Threat to fundamental instinctual
needs or a sense of integrity; link
to earlier threats & often
reactivation of old, unresolved
conflicts
 Anxiety & tension increase,
effective cognition functioning
decrease, behavioural
disorganisation follows
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13. Remember .....Stress
 Is tension
 Tension is not necessarily
disorganising to human systems
 A degree of stress appears to be a
prerequisite to growth and change
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14. Personal Knowledge
and Skills needed
 Understand own strengths,
weaknesses and triggers
 Resources – personal &
institutionally – reflection on
practice days, EAP, clinical
supervision, debriefing formal,
informal, interdisciplinary support
and skill dev. – SW, MHO, senior
staff
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15. Personal Knowledge
and skills needed (cont)
 Recognise ‘burnout’
 Vicarious traumatization
 Compassion fatigue
 Secondary traumatization in the
individual who works with people in
crisis
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16. In Conclusion....Become
More Aware
 Nurses need to be aware of the
real risks not just day to day crisis
but life changing crises.
 Evaluation
 Has the client/family/community
returned to emotional equilibrium
 Direct and indirect strategies
 Identify unresolved conflicts
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17. References
 Bosseau Murray, MD., Henry,J.,Jackson L., Murray C., Lamoreaux R.B., (2002)
Leadership training: A New Application of Crisis Resource Management
and Distance Education in a Large Group Format at a medical Simulation.
JEPM, 4(II).
 Mariano, C. (2002). Crisis theory and intervention: a critical component of nursing
intervention. Journal of the New York State Nurses Association. 33(1), 19
– 24.
 Parad, H. (1971). Crisis intervention. In Morris R. (ed) Encyclopedia of Social
Work, 16th edition. New York: National Association of Social Workers, pp
196-202.
 Roberts, A. (2000). An overview of crisis theory and crisis intervention. In: Roberts,
A. (ed.). Crisis Intervention handbook: Assessment, Treatment, Research.
New York: Oxford university Press.
 MOH website – Disaster management and National Health Emergency Plan
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