“Debriefing” in nursing/clinical practice; A thread

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1. Simon 〽ark 🩺 RN NMP MSc 11 Feb • 18 tweets • simonmarkdaley/status/1359891685606625288 @simonmarkdaley “Debriefing” in nursing/clinical practice; Working in healthcare - particularly areas such as ED & critical care - HCPs are exposed to a variety of traumatic, stressful &/or challenging events. /1 Debriefing is essential as it; 📍 Enhances team members’ ability to deal with events. 📍 Offers opportunity to challenge what happened. 📍 Reduces the risk of psychological harm. 📍 Allows for information to be used to analyse an event & reduce future untoward events. /2 Debriefs should focus on learning, supporting & providing closure after an incident/event. The tone should be non-threatening & non- judgemental. /3 Debirefs should not be about criticising or blame-placing. If there are genuine concerns about team members involved, then these should be addressed separately & prior - these should not be raised during the debrief. /4 That said, if team members ask specifically about these issues during the debrief, it is important to be as open & honest as is possible, whilst remaining professional & open-minded. /5 Debriefs can be highly emotionally charged so the leader needs to balance the need/opportunity to decompress early vs maintaining professionalism & allowing team members time to process before revisiting the event (individual coping
2. strategies). /6 It may be necessary to schedule a debrief in the days following an incident, although it may then be difficult to ensure all team members are able to participate. Generally same-shift “hot debriefs” are optimal; whilst details are fresh in the minds of team members. /7 Choose an appropriate environment; ➡ Comfortable, familiar & accessible to all team members. ➡ Free from interruption & distraction or direct association w/ the incident if this has been particularly emotional/traumatic. /8 If there is someone available (ideally who was not involved w/ the incident) ask them to sit in & make notes, so that this can be typed up & circulated to any team members who have been unable to attend. /9 Start by reviewing what happened. The debrief “leader” should talk through the event from start to finish, being as detailed & specific as possible. Allow team members the opportunity to add anything & offer their perspectives if they differ or add something. /10 ▪ Discuss & emphasise what went well. ▪ Allow team members the opportunity to contribute & discuss. ▪ Provide comment & praise where appropriate. /11 Discuss what went less well (this may be minimal) & what may have contributed to this. Allow the opportunity once more for team members to contribute. 🔸 Do they agree? 🔸 What is their perspective? 🔸 LISTEN. 🔸 Be understanding. 🔸 Be honest. 🔸 Re-focus on the positive. /12
3. • • • As already stated, any concerns/issues should be address seperately where possible, but there are times when this may be unavoidable. Avoiding appropriate criticism MAY be perceived as disingenuous. /13 Explore what can be learnt from the event - as a team. Allow team members to present their own observations & suggestions/ideas. Individual learning points are best addressed elsewhere. /14 Explore what measures could be put in place to prevent/mitigate future events of this nature. Again, allow team members ownership of this process. /15 Allow team members to add remarks. Make yourself available to team members to approach you individually, if they wish to. Signpost to any resources such as well- being services, HR, occupational health or counselling, if relevant. /16 📍 Summarise what has been discussed - nothing new. 📍 Reiterate learning points. 📍 How you leave team members feeling at this sign-off may be all that they remember afterwards; finish by refocusing on the positives. 📍 Thank team members for their participation/contributions. /17 Unroll @threadreaderapp