What happened?
Anika’s patient was receiving end-of-life care. The parents were struggling to accept their child was going to die.
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The consultant, Howard, wanted the child to come off the ventilator to die peacefully but the parents disagreed and wanted to keep their child on the ventilator.
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Anika was the bedside nurse and could understand both perspectives.
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Anika wanted to do the right thing for the patient but was caught in the middle.
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Anika agreed with Howard, but didn’t feel confident communicating this decision to the parents because discussing palliative care was new to her.
And then?
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On Anika’s break, she spoke to a consultant, Carole, about the position she found herself in.
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Carole had been on an advanced communication course for staff working in Paediatric Critical Care.
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Carole said the course helped her with how to support parents and what to say to them.
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Anika decided to find out more about the course.
How to improve
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Being aware of others experiencing moral distress in Paediatric Critical Care, and for the employer to recognise the significance of this kind of experience.
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Recognise this moral distress and encourage staff to share their experiences.
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Ensure staff know they can seek support – through peer support programmes, with their line manager, from a psychologist or wellbeing lead.
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Recognise the need for advanced communication skills to support family members sensitively.
How we created the SWell Avatars
All characters, scenarios and events have been developed from data gathered as part of the SWell Birmingham research project. The scenarios and events have been altered from the versions provided by research participants to protect their anonymity.
How to use the SWell Avatars
We know from our research and our own experiences that when we are under pressure at work, sometimes we behave out of character, interactions with colleagues or with patients or their parents can be challenging, and sometimes things happen that are beyond our control. For example, unexpected patient deaths, which might lead to unpredictable reactions. Working in paediatric critical care is a high-pressure environment and so we know it is important to become self-aware, to prepare ourselves with the skills to manage those challenges, and to be able to navigate the unexpected.
We have created a set of Swell Avatars in different scenarios to highlight some of these kinds of situations and to make suggestions about how they might be managed successfully. We’re keen for our SWell Avatars to respect equality, diversity and inclusion principles and for them to represent the workforce. To achieve this, when creating the SWell Avatars, we have been mindful of the intersectionality between staff members and their protected characteristics (e.g., age, disability, gender reassignment, marriage and civil partnership, race, religion or belief, sex, and sexual orientation).
We have created a number of scenarios, developed from real-life stories participants told us in our research. We have changed important details to protect their anonymity. We have identified potential solutions to the issues raised in the scenarios to help individuals find appropriate support and to help them reflect on and learn from the SWell Avatar scenarios. The SWell Avatars can be used to help facilitate a reflective conversation between colleagues, they might be used in mentoring, they could help teams identify new wellbeing initiatives or identify needs for staff training and development.
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