Beyond “debrief”- Sharing our ICS Stories

Stories are such a powerful part of human interaction and society; as a way of teaching and knowledge sharing, and shaping cultural identity.

The stories we tell within critical care are just as powerful.

The word “debrief” is used frequently in the NHS. In our latest webinar, we explored the concept of debrief, with its pitfalls and mixed evidence base. When we talk of debrief, often people are thinking of a clinical or operational debrief, the kind of discussion that might fit well in an M&M meeting. However, its important to note that the evidence base for structured critical incident debriefing as a method for reducing distress or preventing PTSD is mixed, and there is some evidence it can cause harm (see https://ccforum.biomedcentral.com/articles/10.1186/cc1459 as an overview of some of the concerns). NICE guidance discourages it as a method for preventing PTSD.

Yet people continue to want to come together, they follow that urge to share stories.  So how can we do this in a safer way, making use of people’s naturalistic recovery?

Perhaps the phrase, “We need a debrief” is a safe way of saying, “We want to talk”. We often find natural spaces to do so, the coffee room, the corridor, the sluice. However, the pandemic has taken away some of those spaces to come together safely.

If we are to create ways to come together to talk and reflect, to share our stories and experiences without “debriefing”, how can we do so? When building these safe spaces, it helps to follow a few key points. Firstly, it should be a choice- offering space without expectation or mandate. Not everyone processes experience by talking, and not everyone is ready at the same time. Secondly, the lead needs to set the scene through boundaries of time & approach. People need to feel safe in the room. Thirdly, the ethos should be about checking in with each other & how people are doing, rather than focusing on deconstructing what happened in detail. Staff appreciate knowing they did the best they could, and its often an opportunity to seek that reassurance, however, if something did not go to plan the discussion needs to remain without blame and take a reflective stance - what went wrong not who went wrong.

If you are a team leader, sometimes just the very act of offering a space to talk as a team can be a powerful way of reminding your team you care, and that you acknowledge the emotional pitfalls of the work. It is important to acknowledge, however, that not all of us are equipped or confident to facilitate such discussions with ease. If you are lucky enough to have a Psychologist in your team they are there to guide and co-facilitate these reflective sessions with you.

The webinar is available to watch on our YouTube channel.

Our next webinar,  PTSD in the Workplace and the Traumatic Impact of Work, 15 October 2020, is available to book now.

If your unit does not have a psychologist, please visit www.ics.ac.uk and follow links to the Wellbeing Hub to learn how we can help you with team reflections, or to develop a post.

If you are an Intensive Care Society member and you would like to benefit from some 1:1 time with a trained psychologist, click here to send your request.