What happened?
Tom was caring for a patient and prepping him for surgery. The patient’s father was at the bedside.
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Grace, the band 7, in front of everyone said, “why is this patient not ready for surgery yet?”
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Tom did not know how to respond to Grace whilst appearing professional in front of the patient’s father.
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Grace shouted, “this should have been done hours ago!” and tutted at Tom. Tom was shaken. He was shocked and knew this was out of character for Grace.
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The patient's father was agitated too and asked if his son’s surgery was going to be delayed.
And then?
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An ANP, Sally, overheard this and asked Tom if he’d like to take 5 minutes while she prepped the patient for surgery.
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Tom was grateful for the break as his hands were shaking. Tom stepped away for 5 minutes before he returned to help Sally prepare his patient for surgery.
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Sally spoke with Tom afterwards and explained that Grace was going through a difficult time and not to take it personally. Sally explained clearly to Tom that Grace’s behaviour was inappropriate.
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Sally then spoke to Grace to help Grace recognise the incivility of her interaction with Tom.
How to improve
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Provide staff with key phrases to use in an uncivil situation like this one.
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Provide structured conversations with staff following up instances of uncivility.
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Encourage staff to have a supported “cup of civility conversation” with colleagues in instances of uncivility.
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Point staff toward Civility saves lives: civilitysaveslives.com
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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