Ask the Nursing Expert about ... dealing with adverse events

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Amy Franklin, RN,  DNS-MT, QCP-MT
Amy Franklin, RN, DNS-MT, QCP-MT

It's 3 a.m. and the death last week of a resident who failed despite CPR is still keeping me up. The staff members acted appropriately, but they still appear upset. As the director of nursing services, what can I do to help them?

Unanticipated adverse events do occur in nursing facilities, but there are certain ways to assist staff to recover from unsettling events and improve future practices. Staff members involved in an adverse event often suffer emotionally and struggle to cope with the incident. 

Within a week of the adverse event, consider calling a huddle with the team members involved to allow them to discuss how they are coping, but also to share ideas about how to improve care systems. The huddle should have a structure that allows them to safely share their thoughts and feelings regarding the adverse event, while sharing lessons learned from the particular situation being discussed. 

Begin the huddle with a roundtable of questions and answers, such as: 

• Since the adverse event, how have you been feeling or coping? 

• Is there something you would have done differently? 

• What suggestions do you have for how to avoid this situation in the future? 

Your gathering also should have a ground rule of setting time limits, providing each staff member time to express his or her feelings. Open sharing during a huddle encourages staff members to support each other, enhancing the opportunity for closure of a difficult situation. 

An effective huddle helps your staff restore their confidence by providing them with a caring environment in which to emotionally recover from the psychological impact of medical errors. The goal is to support your staff emotionally while developing a more transparent and systems-thinking team.