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Found 29 results
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    Related reading Find out more about Rob's Human Factors in healthcare workshops Emergency prompt cards (University Hospitals Sussex NHS Foundation Trust, 2019) Video: CCTV of Cardiac arrest with underlying AED rhythm and voice prompts (11 December 2022) Case study: Using e-rostering to improve staff wellbeing and retention (NHS England, October 2022) In Stitches: The Highs and Lows of Life as an A&E Doctor
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    The analysis identified six stages of the second victim journey. chaos and accident response intrusive reflections restoring personal integrity obtaining emotional first aid moving on. The authors defined the characteristics and typical questions second victims are desperate to have answered during these stages. Several reported that involvement in improvement work or patient safety advocacy helped them to once again enjoy their work. The authors conclude that institutional programmes could be developed to successfully screen at-risk professionals immediately after an event, and appropriate support could be deployed to expedite recovery and mitigate adverse career outcomes.
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    This web page is specific for manager and provides useful resources, advice and support.
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    In this film from the 2019 Boston Moth Grand Slam, Poorman tells her own story and argues that it's not perfection, but humanity and compassion that patients need.
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    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
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    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.
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    Following the posting of the recent anonymous blog by a brave nurse - a discussion was started on Twitter about the aspect of accountability, duty of candour mixed with a no blame culture. If there has been a drug error: The person who did the error needs to feel secure in the knowledge that there is a no blame culture, otherwise they may not report it in the first place. The patient needs to be told that they has been an error with their care The person who did the error needs to be held to account So, can these three points coexist or are we wanting the impossible?
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