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Carol Menashy

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Profile Information

  • First name
    Carol
  • Last name
    Menashy
  • Country
    United Kingdom

About me

  • About me
    I am a theatre nurse with a passion to support colleagues involved in safety incidents. I am the founder of SISOS safety Incident Supporting Our Staff a second victim support initiative .
  • Organisation
    All of our colleagues deserve confidential compassionate, empathetic support when things go wrong
  • Role
    I lead SISOS at Chase Farm Hospital where it was initiated and support staff throughout the Royal Free Trust where I work.

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  1. Content Article
    Bullying and scapegoating ride on the back of fear: When things go wrong or have an outcome that we were not anticipating different aspects of second victim phenomenon kick in, such as shame, guilt and fear. It is terrifying to fear for the loss of one’s professional registration or to be recognised as the care worker who damaged the reputation of your organisation. Quite apart from the pain and accompanying worry of knowing that you may have brought harm to your patient. Encouraging openness and honesty, permits emotional healing, supports staff retention and reduces the number of safety incidents. Emotional healing rides on the back of openness and honesty: In order to move on from a safety incident, it is essential to be truthful. Recognise that peoples’ perceptions of an incident are subjective and may differ from your own. Perceptions often germinate during a time of chaos. Refrain from judging, instead focus on your own personal recovery. Draw strength and comfort from your courage to speak the truth as you perceive it. No such thing as a Never Event: The use of the term ‘Never Event’, increases feelings of guilt and shame for those of us unfortunate enough to be associated with a safety incident. We are, at the end of the day, human beings working within a system of systems. There can never be such a thing as a Never Event. The term second victim is out dated: It degrades the trust that patients and families place in us as care givers. I suggest the term PIAE as an alternative. People In Adverse Events. Not all PIAEs will be involved in a review process. The majority won’t. Sometimes simply seeing something is sufficient to cause psychological trauma for a care worker. All PIAEs should have access to tiered emotional support. This is my challenge to the NHS. Finally the biggest challenge I faced on my amazing journey, was helping people to understand that PIAE support is not competing with other support initiatives. It is a specialised area, providing timely, empathetic, non-judgmental support by trained Listeners, for a specific group of people, namely PIAEs. Read the other blogs in my series Safety Incident Supporting Our Staff (SISOS): A second victim support initiative at Chase Farm Hospital Safety Incident Supporting Our Staff (SISOS) at Chase Farm Hospital: Part two Safety Incident Supporting Our Staff (SISOS) at Chase Farm Hospital. Part three: the SISOS calm space Safety Incident Supporting Our Staff (SISOS) at Chase Farm Hospital. Part four: Take up
  2. Content Article
    A flower does not think of competing with the flower next to it. It just blooms. (Zenkei Shibayama) My original presentation of SISOS to the department where I work (theatres) had a huge impact and colleagues recognised the need for it and wanted it. Strong leadership and commitment is essential. I have faced challenges along the way and so far have managed to keep going, but it hasn’t always been easy. I will talk about those challenges as I go. There have been times when I have questioned why I’ve kept going and every so often that question is answered. At a recent conference where I presented a poster, a beautiful human being, kind, intelligent, dedicated to saving lives, looked me in the eyes and said, "How do you support second victims?" and then proceeded to weep uncontrollably. Needless to say I took their willing hand and we shared tea together in a quiet spot. Their incident happened 4 years ago and no blame was attached. This beautiful human being was not an F1 but a consultant. Ironically two days later at work, a consultant suggested that consultants as a group don’t need support because "We have years of experience, we can manage". It’s fair to say that as a group, experienced consultants have challenged the need for this initiative more than other groups and some have been very cynical. However on the whole they have been supportive and welcoming of it. Following my original presentation and the positive feedback from my colleagues, the first thing I did was to form a working group of very senior staff. Nothing would have been possible without their belief and their buy-in. We examined our Trust policy and looked at existing resources; for example, we have an Employee Assistance Programme, which provides professional counselling free of charge to our staff. It was important to see what we as an organisation could provide without incurring additional cost. My experience has been that although support is there in theory, in reality staff were not necessarily accessing it and so one of our roles as Listeners is to improve accessibility. As a group we looked at safety, including the safety of our Listeners and how we support them. Guidelines were produced and training provided. We recognise that we are not experts and that this is still a relatively new initiative for us and one which is evolving. Read the other blogs in my series Safety Incident Supporting Our Staff (SISOS): A second victim support initiative at Chase Farm Hospital Safety Incident Supporting Our Staff (SISOS) at Chase Farm Hospital. Part three: the SISOS calm space Safety Incident Supporting Our Staff (SISOS) at Chase Farm Hospital. Part four: Take up Safety Incident Supporting Our Staff (SISOS): The journey part 5. A celebration For further information please contact me: carolmenashy@nhs.net
  3. Content Article
    The Journey In the changing rooms where I worked as a scrub nurse, I overheard a group of nurses discussing the distressed state of a young doctor. There had been a never event in their theatre that day and the young doctor was the operating surgeon. Moved to tears I wanted to go and put my arms around that doctor but I didn’t feel that I had ‘permission’. ‘It was none of my business, what if I made things worse?’ So I dumped my scrub suit into the laundry bin, put my theatre shoes away and went home. I’m a theatre nurse but more importantly I’m a mother, the mother of a young doctor and that night fearful for the surgeon’s safety I was unable to rest. If it was my daughter I would have wanted someone to be there for her. Galvanised by a mother’s strength, I vowed that nothing could or would hold me back and so the next morning I wasted no time in knocking on my matron’s door. "I was worried about that young doctor last night", I said. "So was I", said my matron. "I rang her and she’s coping’". I was relieved to hear this but as I turned away I realised that there was an urgent need for timely, accessible structured support for when things go wrong. I reflected on an incident that had happened to me and I asked myself this question: What would have helped me, at one o’clock in the morning, all those years ago, when I sat alone in a hospital tea room: devastated, anxious, ashamed, guilty, having flashbacks and feeling like the worst nurse on the planet? I had let my patient down. Two things came out of those reflections. Firstly, I had craved the companionship and compassion of my colleagues because I knew that they above all people would get it. They would understand how this situation could possibly have arisen without attaching blame. Secondly I recognised the need for a safe space, a place where my dignity could have been protected and I could have shared this experience in privacy. As far as I was concerned, my name was in neon lights, I was the failed nurse, there to be gawped at. These two experiences, the young doctor’s and my own were the catalyst for SISOS. Safety Incident Supporting Our Staff. Chase Farm Hospital now has 24-hour support for staff affected by adverse events. The model which I’ve developed is known as the 365 second victim support model and sets out a framework to provide support at various levels from trained peers through to professional help. The care which we can now give our second victims is compassionate, non- judgmental and happens in a dedicated safe space, where experiences are shared in confidence. Empathy, respect and compassion assist in emotional healing. Following a successful audit I’m delighted to say that this model is now being rolled out Trust wide. My passion is that all of our colleagues deserve access to this kind of care. I recognise that it won’t be easy but I will not be deterred, will you? Read the other blogs in my series Safety Incident Supporting Our Staff (SISOS) at Chase Farm Hospital: Part two Safety Incident Supporting Our Staff (SISOS) at Chase Farm Hospital. Part three: the SISOS calm space Safety Incident Supporting Our Staff (SISOS) at Chase Farm Hospital. Part four: Take up Safety Incident Supporting Our Staff (SISOS): The journey part 5. A celebration For further information please contact me: carolmenashy@nhs.net Further reading: Hirschinge, LE et al. Clinician Support: Five Years of Lessons Learned. Patient Safety & Quality Healthcare. March/April 2015. Willis D, et al. Lessons for leadership and culture when doctors become second victims: a systematic literature review. BMJ Leader 2019;1–11.
  4. Content Article
    This initiative was set up by theatre nurse, Carol Menashy, Chase Farm Hospital, the Royal Free NHS Foundation Trust. It is a fun game to get staff in the operating theatre to really think about cost and wastage within theatres. While playing the game – Twist and Shout, by the Beatles is played. Attached are some fun exercises with shopping lists for various procedures where teams vie to get the closest estimate to the actual cost. Worked out by senior staff. Nearest team wins a box of toffees. Also, we do a cost awareness exercise audit fun day. Monthly audit of the cost buster bin where out of date items or items opened in error is audited monthly to see how much we are wasting and aiming to improve. The bin is placed inside the stock room. Here are some template questions you could use or make up your own depending on what surgeries you undertake. I'd love to hear from anyone who tries it out or from anyone who has similar initiatives.
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