Lisa Zaoutis MD FAAP FHM Allison Ballantine MD FAAP FHM Anne Fallon MD Disclosure None Nada Nil Zippo Zilch Bupkis Overview Background Introduction Peer Support Session Safety amp Security ID: 752666
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Slide1
First Aid for our Hearts and Minds
Lisa Zaoutis, MD, FAAP, FHM
Allison Ballantine, MD, FAAP,
FHM
Anne Fallon, MDSlide2
DisclosureNone
Nada
Nil
Zippo
Zilch
BupkisSlide3
OverviewBackgroundIntroductionPeer Support Session
Safety & Security
Ventilated & Validate
Predict & Prepare
Mock Sessions
Model one, try some
Sharing from other institutions
Q & ASlide4
Why?Our staff does amazing work every dayOccasionally…
Event
QI and Safety
Risk
Mngmt
Emotional SupportSlide5
What?System to provide emotional support to staff after an especially difficult work-related event
Timely
Peers
TrainedSlide6
GoalHelp staff understand effects of traumaSupport natural resilience
Individual
Group
Reduce isolation, burnout, dissatisfaction
Demonstrate institution’s concern for staff well-beingSlide7
How?
ESE
Supervisor or Team Member
Notices Distress
Peer Support Rep
First
8
hours
First
48
hours
Peer Responders
Scheduled
Supervisor Sets Up Time and Place
Peer Support SessionSlide8
What it isn’tNot psychotherapy or group therapy
Not
a QI investigation
Not
a legal inquiry Slide9
The Peer Support SessionAct 1: S&S (Safety and Security)
Act 2: V&V (Ventilate and Validate)
Act 3: P&P (Predict and Prepare)Slide10
Safety and SecuritySlide11
Safety and SecuritySet the tone: Take a deep breath, pause, look around the group.
Thank everyone
for joining you.
Your voice is gentle and
warm
Your
body is
S.O.L.E.R.Slide12
Safety and SecurityS.O.L.E.R
S
=
Sit
squarely
O
=
Open posture L = Lean in
E = Eye contact R = Relax (Soften)Slide13
Safety and SecurityIntroductions Explain why you’re
there
Explanation
of session purpose
Ground
rules, confidentialitySlide14
Ventilate and ValidateSlide15
Ventilate and Validate
Allow/encourage discussion
Affirm thoughts, feelings,
questions
Gently
point out commonalities and themes
.
Plenty of
pauses
after asking a questionbefore respondingSlide16
Ventilate and ValidateBe an active listener (lots of nonverbals)
Ask for “thoughts”, but listen for feelings
Use clarifying questions and statements, but use them sparinglySlide17
Ventilate and ValidateTry not to judgeavoid expressions of approval or disapproval
Try not to talk too much
Resist the need to frame the responses too much
Step in when things go off track
Try not to interview
Try not to
rescue
your
empathetic understanding is more valuable than you realizeSlide18
Ventilate and ValidateExpressions of Extreme Guilt or
Shame
Play
back without
agreeing
Validate the feelings without validating the facts.
“Real but not True”:
The
feelings are real whether or not the facts are correct
Try not to talk someone out of the facts to make them feel better. Slide19
Ventilate and Validate Play back without agreeing:
Are you feeling
like
you should have
done
more?
So
you feel bad
about how you handled
this?
It sounds like
you expect a lot from yourself.Slide20
Ventilate and Validate Validate feelings not facts:
I can
only imagine
how difficult it would be to see it that way
.
Is it hard
to
walk around
with
those thoughts/feelings?
Oh
.
Is that how you’re feeling?”
That’s quite a heavy burden to
carry.Slide21
Ventilate and ValidateAVOID:
“You shouldn’t feel that way because
…”
”Don’t be so hard on yourself
…”
“It wasn’t your fault
.”
”At least
…”
“You’re such a good nurse/doc/RT/pharmacist…”Slide22
Ventilate and ValidateBlaming
Diffuse the blame
Name the “anger”
(…or fear) in
the blamingSlide23
Ventilate and Validate
It’s hard to imagine that anyone meant for this to happen.
We may not have all the facts yet.
Is
that frustrating?
It could make a person angry, couldn’t it?
Does it shake
your confidence in the system?Slide24
Predict and PrepareSlide25
Predict and PrepareDealing with a trauma is a process
Wide range
of reactions to an extraordinary
event
You’re not crazy
Variable
but predictable
Gets better with time and
support
Some folks are minimally impactedSome folks are significantly impactedSlide26
Predict and Prepare
Common Reactions
Self-blame, self-doubt
Sadness
Anger
Anxiety
Irritability
Emotional numbness
Perseverative thoughts (replaying the tape)
Difficulty concentratingChanges in sleep, eating, or activity levelSlide27
Predict and PrepareTiming
Immediate or delayed reaction
Comes and goes
Morphs over time
Expected/unexpected
triggers
General trend: improving over time
Duration…
weeks to monthsSlide28
Predict and PrepareExplain how
to help
oneself
Know that you are resilient
Be gentle and understanding,
Give yourself extra time, support
Make it easier on yourself
where you can
when you can
for the time beingSlide29
Predict and Prepare
Positive ways of
coping
Talking to others
Getting needed information
Getting adequate rest, nutrition, exercise…
Engaging in enjoyable activities
Normal or lightened schedule
Soothing activitiesSlide30
Predict and Prepare
Negative ways of
coping
Drugs, alcohol
Excessive isolation
Activity level too high/low
Over- or under-eating
Risky or dangerous behavior
Uncontrolled or misdirected angerSlide31
Predict and Prepare
Options for additional
support
Your colleagues, family, friends
Hospital support group
Clergy
EAP or mental health servicesSlide32
Predict and Prepare
Closing
comments
Take good care of yourself
Take good care of
each other
Surveillance
Check in: “how
ya
doin
’?”
Offer an ear or other
resources
Our compassion grows through this process
For ourselves
For othersSlide33
QUESTIONS
?
COMMENTS?