As a trainee I often felt isolated after patient deaths
• I had unanswered questions
• I ruminated over them
• I felt unsupported
Over 3 years, we implemented our own plan for staff for each death
There have been mistakes on the way
Here’s what this journey taught me:🧵👇
Lesson #1: Keep the hot debrief short
Success here comes down to keeping it brief + focused:
• Arrange it immediately
• Emotions are high: keep the chat focused
• Allow people to voice pressing concerns
• Let them disperse quickly after
This step has been very positive.
Lesson #2: Consider the aim of the cold debrief
The best cold debriefs know what they are trying to achieve
Systems change or psychological support?
Inevitably I've found that they will crossover
The difference between the two is you might not be qualified for psych support
Lesson #3: If psychological support is needed, sort it
The best way to do this is:
• try to identify particularly challenging cases
• engage your psychology team if able
• offer staff support
This is the biggest danger zone for debriefs
We mustn't cause more harm than good
Lesson #4: Get the key people there
The best ones ensured the important people were there
The debrief will be limited without certain people present.
• Arrange the debrief around them first
• Open it to all team members once the date is decided
Timing is the biggest barrier
Lesson #5: Workload time needs to be allocated
Many people with good intentions struggle to implement the plan.
• Shift work makes it tricky
• Admin load is high
• It takes lots of work to run + share learning
I wish I'd considered sustainability more at the beginning.
Lesson #6: Share the learning
Getting people at a debrief is one thing, but we also need to look after those who couldn't join.
• Use a template to format learning
• Circulate within the team for comments
• Once agreed, anonymise + share widely
We need to include everyone
Lesson #7: Show you care
100% the best part of our process is the email contact
We send a personal email to each team member
• We recognise it was difficult
• We offer them a chat
• We ask if they are ok
Some of us have never received an email like this before.
TL;DR - 7 lessons I learned when implementing a programme for staff around patient death
#1: Keep the hot debrief short
#2: Consider the aim of the cold debrief
#3: Use psych support if needed
#4: Get key people there
#5: Allocate time
#6: Share the learning
#7: Show you care
If you found this thread valuable:
1. Follow for more threads on surviving medicine → @TessaRDavis
Organisational psychologist @adammgrant is best known for helping us find meaning in our work.
This month he delivered a TED talk on languishing: a sense of stagnation.
The cure for languishing is finding our flow.
These 4 ideas from Grant allow us to get out of our rut: 🧵👇
Languishing isn't depression. It's not burnout.
It's:
• muddling through your days with no real purpose
• the sense of 'Meh'
• the void between depression + flourishing
• the absence of the dreaded 'wellbeing'
Is that what so many of us have felt over the last 18 months?
At the start of the pandemic we all felt fear. But after a while that changed to apathy.
Our days felt repetitive. A sense that we were stagnating.
We didn't feel excited at the prospect of socialising again.
We spent hours doom scrolling and 'revenge bedtime procrastinating'
Gertrude B Elion was a biochemist best known for discovering groundbreaking drugs (6-MP, azathioprine, aciclovir)
She is one of only 12 women to win the Nobel Prize for Medicine.
As medics we have much to learn from her.
Here are 5 lessons on life + careers from Elion: 🧵👇
1: Don't be discouraged by being the first.
Most of us are disheartened when nobody's done it before, or we're told we can't do something.
Elion kept going after 15 rejections of financial assistance from Grad schools.
She was the only female graduate in her Chemistry class.
"Nothing worthwhile comes easily. Don't let others discourage you or tell you that you can't do it. In my day I was told women didn't go into chemistry. I saw no reason why we couldn't"