Leaders at Children’s Minnesota have long been committed to ensuring every employee has resources to support them when they are in need. On this episode of Talking Pediatrics, “Peer-to-Peer Support: Supporting Colleagues Through Challenging Events,” guest host Dr. Gabi Hester spoke with three kid experts about mental health triggers, trauma and the resources available for providers at Children’s Minnesota. Dr. Hester is a pediatric hospitalist and the medical director of quality improvement within the department of value and clinical excellence at Children’s Minnesota.
The impact of unanticipated medical events
In addition to the accumulating stress brought on by the pandemic, unanticipated events happen in health care settings that can trigger a mental health crisis for a provider. For example, these events can include unexpected patient outcomes, near-miss diagnostic or treatment events, partial or complete misdiagnoses and preventable patient or provider harm.
Unanticipated medical events are devastating for the families involved, and they can also have a dire impact on a health care provider. Still, the reality is they happen; in fact, medical error was the third leading cause of patient death in the United States, according to a 2013 study.
Health care providers as second victims
When a medical error happens involving a patient, the health care providers involved in the incident are described as “second victims” in the sense they may be traumatized by their role in the event and could be triggered into their own state of crisis. Second victims often feel personally responsible for the unanticipated event, leading them to suffer self-incrimination as though they have failed their patient or coworkers. They may also second-guess their clinical skills, question their education and/or the ability to continue doing their job.
Podcast guest Philip Johnson, RN on medical, surgical, intensive care and hematology/oncology units at Children’s Minnesota, recalled one of his stressful experiences: “The PICU [pediatric intensive care unit] was quite daunting because a lot of things happen all at once,” said Johnson. “You have to do everything in your power to make sure this child has it all under control… I left there completely torn apart…and it messed with my head.”
The Peer-to-Peer Support Program
The peer-to-peer program (P2P) at Children’s Minnesota has the goal of reducing the backdraft of harm experienced by health care providers after an unanticipated event by providing support and resources to anyone who needs them. P2P is a team of personnel that have been trained in crisis support and stress management. The program is designed to dispense “emotional first aid” through counseling, peer support and links to additional resources available through Children’s Minnesota. Information shared by those seeking help through the P2P program is strictly confidential.
“This framework gives us a productive way to talk and to support each other and to keep moving forward,” said podcast guest Natalie Lu, RN and quality and patient safety coach at Children’s Minnesota. “It helps us to acknowledge what’s happened, to give that space and then to keep moving on together.”
P2P also works to increase institutional awareness of reactions to stressful events and provide consistent and targeted system-wide guidance and support. “We’ve heard from so many participants that it is a very healing and cathartic experience to be together in a room full of health care workers who are identifying why it’s important to have a framework for conversations like this,” said Lu.
P2P helps patient families, too
P2P supporters learn tools and strategies that can also support patients and families, including how to facilitate difficult conversations and offer support in a health care setting.
“I’m met with a lot of strife and sickness [in my work], but I feel better prepared to help families and coworkers who may make medical errors or have a really bad day,” said Johnson, who has been trained as a P2P supporter. “I let them come to me. I have that peer-to-peer supporter [button] on my badge and I welcome [them] with open arms.”
Getting needed support helps everyone
It’s easy to see the link between individuals who feel supported and the overall benefit to clinical teams and the organization as a whole.
“Sometimes we think, ‘oh, I’m tough. I can do this on my own.’ But it sometimes just feels so much better when you have someone there besides you,” said podcast guest Abby Davis, a board-certified staff chaplain focused in the NICU and infant care units at Children’s Minnesota and P2P supporter. “I’ve been a chaplain at Children’s [Minnesota] for 25 years and one of the things I have discovered is how important empathy and compassion is here,” said Davis.
Participants in the P2P program frequently comment how helpful it is to connect with others who understand first-hand the challenges of the job. “Even though I have a really supportive network in my own family and friends, when the people who I work alongside can real-time approach me and have a conversation – a peer supported, emotional first aid dialogue – it makes a big difference,” said Lu.
Resources are available now
For more information about the peer-to-peer support program at Children’s’ Minnesota, please email [email protected]. Children’s Minnesota employees with access to Star Net will find information about the program here, including how to become a P2P supporter.
If you’re thinking about suicide, are worried about a friend, loved one or colleague, or would like emotional support, you can call the National Suicide and Crisis Lifeline by dialing 9-8-8. In addition, there are local resources available at Children’s Minnesota solutions to thrive at 866-542-3252.
Listen to the podcast or read the transcript: “Peer-to-Peer Support: Supporting Colleagues Through Challenging Events.”
Alexandra Rothstein