National Ambulance Service – Critical Incident Stress Management System

The National Ambulance Service (NAS) Critical Incident Stress Management (CISM) Committee and Programme was established in 1997 as a partnership between the then regional health boards, ambulance service staff representative bodies (IARC/SIPTU) and the Department of Health & Children. The key aim of the CISM System within the NAS is to support the staff of the NAS, through partnership, by the provision of a CISM system.

Ambulance Personnel have a unique and pressurised role in society; they conduct pre-hospital emergency care under highly demanding circumstances and very often face the harsh realities of society. Over the last 10 – 15 years most emergency services internationally have implemented a psychosocial support system or Critical Incident Management System where Peer Support Workers (PSWs) provide peer support to colleagues to assist with trauma interventions including management of Critical Incidents. They form an important element of the Critical Incident Stress Management (CISM) system which also comprises stress awareness training programmes. The CISM system is co-ordinated by a Regional Coordinator in each of the three NAS regions and NEOC.

The peer support system provides a forum where staff can discuss stress related issues arising in their work with a view to learning from and providing support to each other. All peer support in the ambulance service is conducted on a voluntary and confidential basis. PSWs take part in a seven day training course which is followed up with regular ‘refresher’ courses. They commit to being available to their colleagues, both within and outside working hours, to support them in the aftermath of difficult or emotionally distressing ‘calls’. These are called critical incidents because of their psychological impact on those involved. When necessary, they are in a position to facilitate colleagues in accessing professional mental health support.

Since the implementation of the CISM programme, a group of trained Peer Supporters has been working on a voluntary basis to assist ambulance service staff affected by Critical Incident Stress and other work stress issues. Most consultations are informal and the PSW talks through the incident in question with their colleague. You can consult your local Peer Support Worker or any of the persons listed on the CISM website ( and we recommend that you contact them if you require any help and advice. There is a poster in each ambulance base with local numbers and contact names. In addition the HSE Employee Assistance staff support services are available at the following link:

The Joint Chairs, Macartan Hughes (NAS Leadership Team) and Hillery Collins (IARC/SIPTU), would like to take this opportunity to thank all the PSWs for their contribution, to date, and for their commitment to training and their enthusiasm and willingness to make themselves available to their colleagues. Dedication of this kind is at the heart of any successful Critical Incident Stress Management system.

The Committee would also like to pay particular thanks to the following regional Coordinators, deputy coordinators and assistants:
Regional PSW Coordinators:
Ms Mary O’Neill- Houlihan – NAS South
Mr Jim Leonard – NAS Dublin mid Leinster
Mr David Daly – NAS West
Ms Colleen Whelan – NEOC
Regional Deputy Coordinators:
Mr Gerry Tuohy – NAS South
Mr Paudge Gibson – NAS Dublin mid Leinster)
Ms Elaine Noone – (NEOC Ballyshannon)

Assistant Coordinators:
Olive Murphy (South Clonakilty)
Adrian Collins (South Cork City)
For more information please see the HSE NAS Website and the NAS CISM website –