Claire Stewart, MD, MEd
Asst Professor of Pediatrics, Division of Critical Care Medicine
Nationwide Children's Hospital At Ohio State University, United States
Disclosure information not submitted.
Markita Suttle, BS, MD
Assistant Professor of Pediatrics
Nationwide Childrens Hospital
Westerville, Ohio, United States
Disclosure information not submitted.
Title: Emotional Debriefing in the Pediatric Intensive Care Unit: Where Are We Now?
Introduction: At the Critical Care Societies Collaborative national summit on the prevention and management of burnout, there was a call to action to improve wellness in healthcare providers in critical care. Debriefing sessions were identified as an organizational strategy to mitigate burnout and promote provider wellness. Repeated exposure to traumatic or impactful experiences may lead to post traumatic stress and moral distress that culminate in burnout. Finding ways to mitigate these experiences could have a long-term effect of preventing burnout and improving mental health of critical care providers.
Methods: We developed a 14-item needs assessment which was distributed to the faculty and fellows in our pediatric critical care medicine division, in an effort to institute a debriefing program in the pediatric intensive care unit (PICU).
Results: Sixty nine percent (24/35) of physicians in our program completed the survey. Following a patient death, 75% (18/24) of respondents felt it was very important or extremely important to debrief. After caring for a morally distressing patient, 88% (21/24) of respondents felt debriefing was very important or extremely important. However, only 25% (6/24) of physicians have received training in facilitating a debrief. Concerns about facilitating debriefing sessions included a lack of skill with leading these conversations, competing patient care demands, and a need for change in culture that prioritizes debriefing. Benefits anticipated from attending or facilitating emotional debriefings included decreased stress, isolation, burnout and PTSD, help identifying and processing emotions, validation of feelings and an increased sense of teamwork and improved relationships.
Conclusions: Pediatric critical care providers are aware of the potential benefits of debriefing and feel that debriefs after death or moral distress are important, but lack the formal training to lead these sessions. We thus identified a knowledge gap for our faculty and fellows. The next step in this study is to develop a formal debriefing curriculum for faculty, fellows, and nursing leadership and begin regular staff debriefings in the PICU.