Reduce stress and increase the retention of your experienced, top-notch healthcare team throughout the Covid-19 pandemic.
Who Is This For? Physicians, nurses, respiratory therapists, technicians, every professional in your hospital who is working on the front lines throughout the Covid19 pandemic.
Why Is It Important?: There are four benefits of debriefing your experienced healthcare team. These include the following:
Case Review: Debriefing helps your team process their feelings and emotions from the interactions they had with patients, families, and colleagues and the stress they may have related to the pandemic.
Reduction of Stress, Burnout, and Compassion Fatigue: Reduction of Stress, Burnout, and Compassion Fatigue: Debriefing allows teams to communicate their feelings and emotions related to what happened during their shift. These interactions (debriefing) helps reduce physical and emotional stress after working several hours in fast-paced, high stress, critical situations.
Team Building and Modeling: Debriefings also provide a critical opportunity for new nurses (especially those new to your department or traveling) when working with preceptors or colleagues. By seeing the team debrief, they can see the supportive interactions provided by all team members.
Retention: Teams become more cohesive and collaborative. Debriefing helps them transition more effectively between patients and shifts.
“Yeah But….”– Sometimes the idea to debrief is met with “Oh no, not another meeting!” resistance; it’s not uncommon to hear:
“We don’t have time.”
“We have to get ready for the next shift.”
“I’m tired; I just want to go home.”
“I have to keep my ‘game face’ on.”
“My team handles everything so much better than I do; you should just talk to them.”
Here’s The Thing: It’s critical to retain your experienced healthcare team. Please make the time. Debrief so you and your team can leave work at work and go home and hug your families and the people you love the most. A “game face” (defined as the healthy defenses healthcare professionals use that protect them from the stress and trauma experienced daily in fast-paced healthcare environments) will not serve you well once you leave your hospital. And — there is no “I” in team. Protect your team; check in with each other before you go.
How Do You Debrief Your Team?: It takes only 5 Questions to facilitate an informal debriefing in your hospital. It’s an “end-of-shift” huddle to help you and your team leave work at work. Anyone on the team can take the lead, but make sure everyone checks in before leaving. Start by saying: “Hey team, let’s debrief before everyone leaves,” and then follow up by asking the following five questions:
“What was the most difficult part of your day today?” The goal of asking this question is to help the team review and discuss the most challenging part of their day.
“How did you feel?” The goal of asking this question is to help each team member identify their most stressful feeling.
Was there something a team member did or said that helped you during your shift?” The goal of asking this question is to help team members positively identify and support collaborative teamwork.
“What positive lesson did you learn about yourself (personally or professionally) based on the patients you cared for or an interaction you had during your shift?” The goal is to help your healthcare team transition from discussing their most difficult feelings to reviewing a positive lesson that helps “anchor” (i.e., leave work at work) your team on a more positive growth-focused foundation.
“Did anyone notice any opportunities to support each other more or provide better care for our patients and families based on your experiences today?” The goal of asking this last question is to put closure on the shift by looking at the team’s collaborative work in a manner that explores opportunities for growth. It also helps to ‘anchor’ the team as a group.
A debriefing for your team is NOT meant as therapy or a root-cause analysis for your shift. It’s a quick check-in for your team that can be done in 15–30 minutes to ensure your team is okay before everyone leaves to go home. This quick check-in will help anchor your team and the experience you had (lessons learned, interactions had with each other) to go home with less stress, tension, and residual angst.
Most importantly, thank you for the work that you and your team do in caring for the patients and families you have during this difficult time.
This article is for all of the frontline healthcare teams working at hospitals across the country — thank you!
I am blessed to have worked with top-notch leaders who frequently informed our team: “If you come to me with a problem, it would be helpful if you had an idea for a possible solution.” That’s how this article started.
As a healthcare professional, you know there’s stress, and then there’s traumatic stress. The kind of stress that stays with you and is not always easy to manage but makes you hunker down and keep going because that’s who you are; that’s what you do.
When the rest of us are asleep or celebrating holidays with our loved ones, healthcare professionals across the country are leaving their families to go and care for ours.
But when you add the dynamics and challenges of a global pandemic like the coronavirus to your career, which is already stressful, learning how to cope now needs to be significantly more comprehensive.
Here are seven strategies to consider when navigating traumatic stress in an acute, fast-paced, healthcare organization:
Your career in healthcare challenges you to have difficult conversations with the patients and families you serve. Because of this, physicians and nurses use the defenses necessary to manage their emotions during each interaction they have.
When you consider that there are over thirty defenses you can use to manage your feelings and hundreds of words to express the feelings and emotions you have, this can be a challenging process — almost an art form. Because while you’re feeling these feelings, you need to maintain composure, professionalism, and tact while having some of the saddest conversations patients and families will hear. “I’m sorry; she’s not going to make it through the night.” “We have the results of your tests, why don’t we sit down and discuss them.” “Your son has been in an accident; we’ll bring you in to see him in a moment, but first, I need to explain his injuries…”
When I worked with an Emergency Department team preparing for a code, I never witnessed anything other than intense professionalism, compassion, and collaboration. Some nurses later described their mental preparation as “putting on my game face” to help them work as quickly as possible to save each patient’s life in their care.
When I think of what the term “game face” really means, my thinking is that this consists of the top defenses used to help our teams cope with the challenges faced daily.
While a “game face” may work for a problematic code or a high-volume period, it will not work for the length of a global pandemic.
Sir Isaac Newton’s third law states: “For every action, there is an equal and opposite reaction.” In this case, this means that for every “game face” period you (as an experienced healthcare professional) use, you should have an equal amount of time to focus on being present for your colleagues and the patients in your care.
Presence means drifting back a little (and yes, this is a relative term that depends on your ability to do so during your shift) and having more authentic, supportive conversations with your colleagues and patients.
The most important lesson is not to just hunker down and use your defenses to navigate through each shift. Take the time to validate the work being done by your team so that you all feel supported.
Analyze your shift when it is over, the experiences you had, and the lessons you learned. Ask yourself the following seven questions:
What was the most challenging situation I experienced during my day?
What was the most difficult conversation I had with a patient or colleague?
What was the most intense emotion I felt?
What was the best part of my day?
What did I see one of my colleagues do that inspired me or made me change the way I do something?
What was something a patient or colleague told me that was supportive or motivated me during my shift?
What is something positive I learned about myself today?
These debriefing type questions are essential to ask because their answers anchor the lessons and experiences you attained during your shift.
Across the country, there is an increased awareness that you have exceeded selflessness as a result of your presence every day at your hospitals and clinics without always having the equipment, support, or staffing you need.
Keep going, but don’t lose sight of these three key points:
Selflessness is an admirable quality, but please pay attention to your needs as much as you do for everyone else in your care.
Set your team up for success by modeling leadership and professionalism — even if it’s not in your job title.
Anticipating your team’s needs will help provide support and cohesion while also reducing unanticipated stress or complications.
In any healthcare environment, you will have conversations with patients, and families are some of the most difficult ones to hear. Your goal is to have the conversations you need to have as tactfully as possible, taking into consideration their feelings and emotions.
The more authentic you are, the more comfortable and engaging your conversations will be. The other important factor to consider is paying attention to micro-expressions.
Micro-expressions are the split-second non-verbal expressions you see on the faces of the people you’re speaking with. If they appear to be questioning what you’re saying or don’t understand the words or terminology you may be using, stop the conversation, and check-in with them. Ask: “Tell me what you heard me say,” or “Do you have any questions that I can answer before I continue?”
Remember that, like you, the patients and families you are communicating with are also using their defenses to help them manage their feelings and emotions related to their care (or the care of their loved ones). They may feel scared or anxious because they may not understand the terminology or acronyms used.
Some examples of the defenses we use include intellectualization, rationalization, humor, and sarcasm — just to name a few. While they help us cope with our emotions while we continue to work in our departments, they also serve to conceal emotions like sadness, anger, frustration, resentment, stress, and irritability, among others.
These defenses are appropriate, and healthcare professionals have a way of using them all in an immensely self-protective manner that supports you and your team throughout your shift.
The challenge is making sure you can talk about your feelings when the time is right. Strategies such as talking to colleagues, journaling or video blogging, exercise, and talking to family members or friends are all essential when discussing your feelings. Most importantly, make sure you take the time to get them out instead of “stuffing them” or completely detaching them.
Your intuition is critical. It’s that gut feeling you have that tells you “look a little closer at this lab result,” or “pay more attention to the nonverbal expressions of your patient,” or “listen closely to what your team is telling you about how stressed they feel.”
Your intuition is equally as crucial as your intellect and professional experience, especially when having critical conversations with patients and families. Whether it’s a pause in a conversation, a look on a patient’s face, or a sense that something’s not quite right, it’s essential to pay attention to your intuition and listen to it.
One of the biggest challenges in healthcare is not always knowing who will be coming through the door next, how acute their symptoms will be, and who they may or may not have with them for support.
From your interactions with them, you will learn that your patient is a father or mother, sister or brother, partner, or spouse. The more time you spend with them, the faster they will transcend from the “patient in room 4” to someone with a name, a family, a legacy. You may not have the time necessary to know all there is to know about them, but you will have enough time to engage with them in a manner that shows you their challenges, vulnerability, strength, and heart.
Keep an open mind about who they are, as their relationship with you may be the last interaction they have.
Navigate To Your True North
You chose your career in healthcare for a reason. However, a global pandemic may not have been on your radar, and now the challenge becomes how to navigate your emotions, conversations, interactions, and stress.
You: Develop a routine that will help you navigate these difficult days ahead. While you can’t always predict what’s going to happen, you can control how you respond to it. The more of a routine you can develop for yourself, the less stress you will have.
Your career: What’s your why? Why did you decide to have a career in healthcare; what was it that attracted you to working with patients and families? The more grounded you are in your reasoning and the foundation of your career, the easier it will be to cope with your stress.
Your team: Pay attention to how your team is doing. Are you all working collaboratively and cohesively? If you notice that a colleague has called out, check-in with them. While they may say they’re “handling everything,” they may not be. They may attempt to show you that they can keep up with the team and the demands of what’s going on when, in fact, they may not be able to, which is difficult to admit when you know your team is depending on you. Take the lead; you will stay stronger together.
Your family: How are you communicating with your family, and how are they managing the “perfect storm” of the stress of your career, being isolated at home, and not knowing how long this global pandemic will last?
Establish a routine time to check in with each other. The more you can build a set routine that works for you and your family, the easier it will be for all of you to navigate your stresses and challenges.
Your children: Pay attention to the way that you’re communicating with your family. They know you are under a lot of stress that they may not comprehend (especially if you have younger children). Tell your family a little bit about your day. Using age-appropriate feeling words like “happy,” “sad,” “good,” or “bad” will help them understand a little more about the care you are providing and help reduce their stress.
Here’s the thing:
Retaining an experienced top-notch healthcare professional is critical. Nothing good comes from losing a highly qualified professional on a top-notch team. And this is my “why” for coaching and training the healthcare professionals who care for all of us. My goal is to help healthcare teams nurture and navigate their careers while improving relationships with family and friends and colleagues at work and creating a better work-life balance.
“Be Blessed; And Be A Blessing For Others.” – Rev Lark
I started Coaching For Nurses as a result of having been blessed to work with several healthcare teams in hospitals along the east coast of the U.S throughout my career. It’s been nothing short of excellent to be part of many healthcare teams on a mission to help patients, families, and each other by providing top-notch care.
Healthcare has remained one of the foundations supporting the mission of our family for years. My mom was a nurse, my grandmother was a nurse, several friends are nurses and physicians. My mom used to frequently tell me “you are known by the company you keep”. – In this regard, I’m really grateful for the phenomenal friends and family members I have whose lives and careers have been dedicated to helping others.
Early in my career, I was working as a crisis clinician in the Emergency Department at Rutland Regional Medical Center in Rutland, VT. At the time, Rutland Regional (RRMC as it was called) was a fairly small hospital but had a phenomenal Emergency Department team. The interesting part of working with the RRMC team happened whenever I was on call. Our team needed to live within a 15-minute radius of the hospital and be able to respond when needed. While I didn’t mind this at all, I was fascinated by the way that the ER team never seemed to call me right away whenever a patient came in. Whenever they called, they’d say “well the patient has been here for over an hour and we’d like you to come and see them.”
“Over an hour? Why did you wait so long to call me?”
Later in my career, I’d learn that the delay in calling was better as this would give the team time to have labs drawn and would give me time to learn as much as possible about our patients before speaking with them.
But I couldn’t quite figure out the team at Rutland as they were a little intimidating and extremely professional. – When this delay happened for the fifth time, I finally asked them “the patient’s been here for over 90 minutes – why didn’t you call me sooner?”
It was the charge nurse who told me that, as a team, they wanted to try to figure out what was going on with the patient before I arrived so that after my assessment of the patient they would learn how close they were to “getting it right”. I loved their eagerness to learn and their willingness to help me when interacting with patients who were in crisis or struggling with an uncontained addiction. I also saw the way they navigated their emotions and the interactions they had with families after a difficult code that involved the death of a patient. They were a top-notch team and in the short amount of time I worked with them, I learned a lot.
Since that time, the subsequent lessons I have learned from healthcare teams have involved the communication, collaboration and compassion shown during some of life’s most difficult moments. I am beyond blessed with the lessons I’ve learned and the opportunities I’ve had to work with them.