What is a Medical Debriefing?March 31, 2015
Regardless of whether you are a med student, nurse, doctor or other medical professional, you may have to deal with patients in life-threatening situations. For some people, such as those working in the emergency room or intensive care unit, life and death situations occur on a regular basis. In some cases, things go well, but in others, mistakes occur. Either way, reviewing the event can help medical workers improve efficiency and provide the best care possible for their patients.
Why is a Debriefing Held?
Medical debriefings are sometimes held after a significant event, such as a particularly difficult resuscitation or a mass causality incident. The concept of debriefings was started by the military. Debriefings were held after a mission to develop better strategies and allow soldiers a chance to talk about what occurred and process the events.
A hospital is different from a war zone, but the purpose of a debriefing after a difficult resuscitation is similar. Some hospitals hold regular debriefings others only have a debriefing if something out of the ordinary comes up.
There are a few reasons why a debriefing is held. One of the main purposes is to review the event and discuss how the staff responded. It is an opportunity for medical workers to communicate without the stress and pressure of being in the actual code blue.
The review may include a description of what led up to the event and what team members did in response. Since every resuscitation involves a scribe recording all medications and interventions, information is usually readily available to analyze.
Responding to a crisis, such as a mass casualty incident or a code blue, is not the same as performing the day to day responsibilities of the job. Emotions run high, and a lot is at stake. Good communication and teamwork are not as easy to maintain.
The purpose of the review is to discuss what went well and identify areas, which need improving. If a debriefing is held, it does not necessarily mean a mistake was made during the event. But an honest review of what took place may still help improve the medical team’s performance. A debriefing allows staff to develop ways to enhance communication and facilitate teamwork in a crisis.
Another reason a medical debriefing is held is it provides a chance for healthcare workers to talk about their feelings and work through emotions. Medical workers may be accustomed to witnessing life-threatening situations, but they are still human. There are instances where a situation is particularly sad, tragic or disturbing and even seasoned medical professionals may be affected.
During a resuscitation, staff need to remain professional and focus on the task at hand. They do not have the time to think about the situation at an emotional level. But when the event is over, it may be normal to have some lingering emotions. A debriefing is a chance to get things off your chest and talk to others who may understand. A debriefing can provide support.
The Debriefing Process
Rules of a debriefing may be discussed so participants will understand what the process involves. For example, a debriefing should be a situation where workers can open up about how they feel. Although it can be helpful to determine what could be done better, a debriefing is not the time to point fingers and assign blame.
Hospitals handle a debriefing process differently. It may be facilitated by a nursing supervisor, clinical coordinator or physician. Anyone who participated in the event, whether it was a code blue or other significant event, should be invited to participate.
If you are a student and participated in the code blue, you may also be invited to the debriefing. Although attendance will likely be optional, it is a good idea to attend. As a student, your role may not be scrutinized, but a debriefing can still be a good learning experience.
Usually, after introductions, the facilitator will explain what occurred and what the response was by members of the healthcare team. All the facts of the situation will be discussed. Those who participated will have the chance to share information. During this phase of the debriefing, staff are encouraged to talk about their feelings and share thoughts.
Together with the facilitator, staff should examine if anything could have been done differently that would have improved the patient’s outcome. There is also usually a phase for participates to ask questions or ask for recommendations for improvement.
Depending on the situation, support staff, such as counselors, social workers and chaplains, may be present at a debriefing. Although they may not be there to discuss specific clinical aspects of the situation, they can still play a vital role in a debriefing. For example, social workers or counselors may have ideas or suggestions for staff to deal with emotional issues of witnessing tragic events and death. Part of a debriefing is to allow staff to have the time to process the event and work through any negative emotions.
Most jobs do not involve witnessing death on a regular basis. But if you work in bedside care for any length of time, you are likely to encounter more than one difficult situation. In fact, some staff, such as ER doctors and nurses, witness tragic situations frequently. If you allow negative emotions to build up, you may find yourself overwhelmed or burnt-out. Learning ways to cope with stress and deal with bad patient outcomes will help you throughout your career.
A medical debriefing is not an individual counseling session. But it can help staff talk about the personal impact of a traumatic event they participated in. It can also help supervisors and facilitators identify staff who may be having a difficult time dealing with things and refer them for additional help.
Sometimes talking about your feelings with other people who share the same experiences can be helpful. Ultimately, a debriefing should be one tool, which can be used to improve patient care, support staff and help create a better sense of teamwork and comradery.
Gap Medics provides year-round hospital work experience for people aged 16 and over. Our shadowing placements offer a unique insight into the work of doctors, nurses, midwives and dentists – helping students to focus their career aspirations before embarking upon medical training.