It was found that most “nurses love their work and hate their work” (Berliner and Ginzberg 2742). Given the current quality of the nursing environment, this is not surprising. The main factor hindering the quality of hospitals is the stress level of the workforce. While it is inevitable to eliminate stressors in all medical centers, how stress is perceived is a controllable factor. The idea of ​​stress management highlights the need for CISM programs in all healthcare facilities across America to address the critical incidents and stress that occur daily. CISM, as defined by Tracy, is a “comprehensive, multicomponent program based on counseling principles and peer support processes designed to assist emergency healthcare workers in effectively addressing the stressful components of their work” (28). The program is believed to be the most effective type of counseling in hospitals for critical incidents and stress, due to its extensive step-by-step guidelines. CISM is expected to increase nurse staffing, patient satisfaction, and overall create more efficient healthcare facilities by mitigating negative stress reactions in hospital workers. The program will provide a safer and healthier environment for both nurses and patients in medical centers. One study found that hospitals with more positive work environments for nurses had higher patient satisfaction (Greenslade and Jimmieson 1189). The increased patient satisfaction is most likely due to nurses' greater emotional preparedness to care for their patients in a thriving environment. CISM programs ensure a healthier environment and better working conditions in the hospital. CISM was initially created by Jeffrey Mitchell to reduce the… medium of paper… (2003). Crisis intervention and CISM: A research synthesis. Ellicott City, Maryland, International Critical Incident Stress Foundation. Retrieved from http://cism.cap.gov/files/articles/CISM%20Research%20Summary.pdf Parsley, Lee Ann, Conditions and Strategies Affecting Interagency Collaboration in Developing Critical Incident Stress Management Programs. Diss. U. of Ohio, 2003.UMI, 3093687. Print.Sieben, Laura. Staff debriefing after a critical incident in the emergency room. Diss.College of Scholastica, 2009, UMI, 14738626. Print.Tracy, Scott. How cumulative stress affected the lived experience of emergency medical service workers after a terrible natural disaster: Implications for professional counselors. Diss. Duquesne University, 2007. UMI, 3292249. Print.