December 14 2007
She has taught Indiana State University nursing students skills they will use throughout their careers. Along the way she has also helped hundreds of people deal with very stressful, traumatic events.
Burns, an assistant professor of nursing at ISU, has worked nearly 20 years as a crisis intervention consultant, responding to traumatic events, including Hurricane Andrew, the Oklahoma City bombing, TWA Flight 800, Sept. 11 and the Comair crash in Lexington, Ky. She has also provided assistance to schools, the military, law enforcement, and healthcare and currently serves as a crisis consultant to the Airline Pilot Association (ALPA).
A Chicago native who now lives in Rockville, she began her career in crisis intervention in 1988 as a hospital nurse in Joliet, Ill., working with nurses caring for critically ill patients.
Ã¢â‚¬Å“I noticed if it was someone they knew, a child or a patient who had been in the unit for a long time, they had a hard time dealing with those deaths. I would often walk into the lounge and find them crying. I recognized then that there needed to be something done for the caregivers,Ã¢â‚¬Â she said.
Talking to a peer or someone who can understand what youÃ¢â‚¬â„¢ve been through is an important step in coping with stress. Nurses understand nurses and the stress they feel when patients die, she added.
Ã¢â‚¬Å“Most of us in the medical field donÃ¢â‚¬â„¢t go home and discuss our day with our family. We donÃ¢â‚¬â„¢t want to hurt or scare them with the things we have seenÃ¢â‚¬Â, Burns commented. Ã¢â‚¬Å“We want to talk to someone who will understand.
Ã¢â‚¬Å“You donÃ¢â‚¬â„¢t have to suppress the aftermath of a traumatic event,Ã¢â‚¬Â she said. Ã¢â‚¬Å“Debriefing can make a difference.Ã¢â‚¬Â
There are seven steps in the debriefing process, which allows people to talk about and reflect on what they experienced, discuss unusual behaviors since the incident and get recommendations on how to cope. Like many things, timing is everything.
Ã¢â‚¬Å“I like to wait 24 hours after the critical incident to talk with them,Ã¢â‚¬Â Burns said, Ã¢â‚¬Å“ThatÃ¢â‚¬â„¢s when the stress symptoms start.Ã¢â‚¬Â
The most common stress symptom is difficulty sleeping, she said.
Ã¢â‚¬Å“I always ask how they slept last night,Ã¢â‚¬Â the board certified expert in traumatic stress said.
People can also experience memory problems, headaches, stomach upset, have trouble concentrating, withdraw from people and activities, feelings of guilt, or abuse alcohol or drugs.
Ã¢â‚¬Å“Stress affects the whole person,Ã¢â‚¬Â Burns said.
Throughout the entire process she avoids asking the obvious question - Ã¢â‚¬Å“How are you feeling'Ã¢â‚¬Â
Ã¢â‚¬Å“You donÃ¢â‚¬â„¢t ever want to use the word feeling because people will automatically say Ã¢â‚¬ËœIÃ¢â‚¬â„¢m fine. ThereÃ¢â‚¬â„¢s nothing wrong with meÃ¢â‚¬â„¢,Ã¢â‚¬Â she explained.
Instead she asks what she calls Ã¢â‚¬Å“the big money questionÃ¢â‚¬Â - What was the worst part of the event you experienced'
"It gets them thinking about whatÃ¢â‚¬â„¢s truly bothering them,Ã¢â‚¬Â Burns said. Ã¢â‚¬Å“Then you can figure out a coping plan to deal with the issue.Ã¢â‚¬Â
Ã¢â‚¬Å“According to Burns, anyone can be trained in this method, which is useful in everyday life.
Ã¢â‚¬Å“Practice this on your family,Ã¢â‚¬Â she said, adding it is a great way to get more information from teenagers.
Ã¢â‚¬Å“Ask Ã¢â‚¬ËœTell me a little about your day. What are your thoughts about what that teacher said'Ã¢â‚¬â„¢ Ã¢â‚¬ËœWhat was the best part of your day'Ã¢â‚¬â„¢ Ã¢â‚¬ËœWhat was the worst part of your day'Ã¢â‚¬â„¢ You wonÃ¢â‚¬â„¢t get just yes or no answers.Ã¢â‚¬Â
The process also helps get at the heart of lifeÃ¢â‚¬â„¢s difficult moments.
Ã¢â‚¬Å“You can do this with anyone - someone in a car accident, someone diagnosed with cancer, someone who has lost a loved one,Ã¢â‚¬Â Burns said.
Jeffery Mitchell, a firefighter/paramedic in Baltimore developed the debriefing process to keep people in the field almost 20 years ago.
Ã¢â‚¬Å“The goal is to get someone back to work as soon as possible, by having them talk about the incident and help them deal with their stress-related symptoms to prevent Post Traumatic Stress Disorder,Ã¢â‚¬Â Burns said.
When the debriefing movement started out, there were only a few people training in the technique. In fact, Burns was the 15th person in the country to be trained and certified to conduct Critical Incident Stress Debriefings.
Ã¢â‚¬Å“Now there are hundreds and probably thousands of people certified to conduct the training,Ã¢â‚¬Â she said.
Burns developed and coordinated one of the first hospital-based critical incident stress debriefing teams in the country. Since she could fill the role of either a nurse or a mental health worker she became part of larger team, Northern Illinois Critical Incident Stress Debriefing Team, which debriefed public safety workers.
In 1992, after just four years as a crisis intervention consultant, Burns found herself on a team that provided comfort to stressed and overwhelmed workers who had responded to a natural disaster.
Ã¢â‚¬Å“Hurricane Andrew was my first experience traveling to a debriefing,Ã¢â‚¬Â she recalled. Ã¢â‚¬Å“You couldnÃ¢â‚¬â„¢t believe the devastation. It was a horrible sight.
While trying to help storm victims, Red Cross workers were being attacked, thrown out of the trucks and the trucks were robbed,Ã¢â‚¬Â she recalled. Ã¢â‚¬Å“I was shocked as well as scared.Ã¢â‚¬Â
She returned to Illinois a little sad and depressed, realizing that debriefing is more than a one-time thing.
Ã¢â‚¬Å“I learned to follow up with people in these situations. We conduct a debriefing and go back home and our lives return to normal. TheyÃ¢â‚¬â„¢re left dealing with the consequences. Many times they are in shock and reality doesnÃ¢â‚¬â„¢t hit them until a few weeks later,Ã¢â‚¬Â she said.
Ã¢â‚¬Å“Burns, who earned her masterÃ¢â‚¬â„¢s degree in psychiatric nursing, was the first mental health person in the country called to work with the airline industry.
Ã¢â‚¬Å“The airline industry implemented their debriefing program in 1995 and two months later they had their first crash.Ã¢â‚¬Â
Her first call from the airline industry came on Halloween 1995, when American Eagle Flight 4184 crashed near Roselawn, Ind.
Burns was listed on a national registry for stress debriefers and was hired from among several candidates because of her nursing background and her empathic demeanor. Although she had never worked with pilots or accident investigators she felt she had what they needed, someone to listen to their story. Burns traveled to Roselawn for a week, where she worked the crash site and debriefed accident investigators.
After the American Eagle crash, the ALPA sent her through basic safety-school, accident investigation school, and advanced accident investigator school.
Ã¢â‚¬Å“This training helped me understand the stress a pilot can experience and learn how to understand and speak their language.Ã¢â‚¬Â
Burns, who recently traveled to New Zealand to start a crisis response team, finds pilots are much more open around her.
Ã¢â‚¬Å“Most people trust nurses,Ã¢â‚¬Â she said. Ã¢â‚¬Å“The listening skills, being attentive, caring and compassionate are traits associated with a nurse.Ã¢â‚¬Â
She would tap into that compassion, trust and knowledge in order to provide comfort for two high-profile airline disasters -- TWA 800 and Sept. 11.
For TWA Flight 800, Burns spent a week with airline families helping them through the grieving process.
Her arrival in New York came with a dose of irony and reality.
Ã¢â‚¬Å“We flew in and pulled up next to a 747,Ã¢â‚¬Â Burn recalled, Ã¢â‚¬Å“You couldÃ¢â‚¬â„¢ve heard a pin drop on the plane because it looked nearly identical to the plane that crashed. It really put things in perspective.Ã¢â‚¬Â
The scene was totally different from her encounter in Roselawn, since TWA 800 exploded in mid-air over a body of water.
Ã¢â‚¬Å“There was wreckage to look at, but no bodies to recover,Ã¢â‚¬Â Burns said, which made the healing process gut-wrenching.
Ã¢â‚¬Å“ItÃ¢â‚¬â„¢s hard to hear their pain and know you canÃ¢â‚¬â„¢t bring their loved one back,Ã¢â‚¬Â she said.
When Sept. 11 occurred Burns traveled to New Jersey to help United Airlines personnel and their families.
Burns attended the funerals of the captain and first officer of the plane that crashed into the south tower of the World Trade Center. She spent time with the families and has kept in contact with them over the past six years.
Ã¢â‚¬Å“Healing takes a long time and each person grieves at their own pace. You canÃ¢â‚¬â„¢t just say Ã¢â‚¬ËœItÃ¢â‚¬â„¢s been a year, just get over it.Ã¢â‚¬â„¢ It is even more difficult when there is no body to view, as with the victims of Sept. 11.Ã¢â‚¬Â
She found herself dealing with a pilotÃ¢â‚¬â„¢s family again in August 2006, with the crash of Comair Flight 5191 in Lexington. She worked with the wife of the captain, who sought Burns out.
Ã¢â‚¬Å“Families are draining,Ã¢â‚¬Â Burns said. Ã¢â‚¬Å“I am emotionally drained after these types of events. When you deal with someone who has suffered a loss, thereÃ¢â‚¬â„¢s nothing you can do to make it better.
Ã¢â‚¬Å“I offer support and get them the resources they need during this difficult time. If I had a magic wand I would take away all of their pain but I canÃ¢â‚¬â„¢t,Ã¢â‚¬Â she said. Ã¢â‚¬Å“Working through grief is just that - work. There is no easy fix.Ã¢â‚¬Â
Over the years, she has developed some coping mechanisms to deal with tough situations.
No matter where she goes, she carries around a cup or bottle of water,
Ã¢â‚¬Å“If I heard something horrendous, I would drink water or sing a song in my head so I donÃ¢â‚¬â„¢t loose control of my emotions,Ã¢â‚¬Â she said.
The trademarked high-top Converse sneakers she wears are not just for comfortÃ¢â‚¬â„¢ they serve a practical purpose as well.
Ã¢â‚¬Å“IÃ¢â‚¬â„¢ll bend down and lace up my shoes to keep my composure,Ã¢â‚¬Â she explained.
For Burns, crying is not allowed.
Ã¢â‚¬Å“You never want to cry in front of someone you are trying to debrief because if you cry they will shut down because now they feel theyÃ¢â‚¬â„¢ve hurt you. I do my crying before I drive home or at home. I have been doing this for 20 years and you never get use to it.Ã¢â‚¬Â
There are times dealing with trauma is rough on her.
Ã¢â‚¬Å“I have to go talk to someone,Ã¢â‚¬Â she said. Ã¢â‚¬Å“I have a strong faith in God, who I believe put me here to do this work. I hug my son after a debriefing involving a death of a child. I love to fish, so that helps me relax.Ã¢â‚¬Â
After nearly 20 years of conducting critical incident stress debriefings, she believes she makes a difference in the lives of total strangers.
Ã¢â‚¬Å“People will not remember what you say, theyÃ¢â‚¬â„¢ll remember you were there and you lent a hand and offered your compassion. ThatÃ¢â‚¬â„¢s what itÃ¢â‚¬â„¢s all about,Ã¢â‚¬Â Burns said, Ã¢â‚¬Å“I want to know that I made a difference in someoneÃ¢â‚¬â„¢s life.Ã¢â‚¬Â
Contact: Carolyn Burns, assistant professor of nursing, Indiana State University, 812-237-3480
Writer: Paula Meyer, ISU Communications & Marketing, 812-237-3783 or firstname.lastname@example.org
An Indiana State nursing professor has helped hundreds of people deal with very stressful, traumatic events.