supporting whole heartedness in clinical supervision
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Supporting ‘whole-heartedness’ in clinical supervision. 2013 CSSP Masterclass Series Conversations that change. Whole-heartedness. “ a willingness to be vulnerable and to feel a sense of self-worth in the face of uncertainty and risk ”

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supporting whole heartedness in clinical supervision

Supporting ‘whole-heartedness’ in clinical supervision

2013 CSSP Masterclass Series

Conversations that change

whole heartedness
Whole-heartedness

“a willingness to be vulnerable and to feel a sense of self-worth in the face of uncertainty and risk”

“We need courage, compassion and connection to be whole-hearted”

slide4

“I hated the way they handled Mum so roughly”

“They were just plain mean”

“A bunch of them came around this morning – I think they were doctors. They didn’t speak to me or let me know what was going on.”

let s take a closer look
Let’s take a closer look
  • Young woman dealing with the violent death of another young woman
  • Unable to save her – did I do everything possible?
  • Literally holding her life in my hands
  • Late at night, physically tiring
  • Required to keep working after
  • Follow-up regarding the technical side, no follow up about how the team felt
how do we cope
How do we cope?
  • Hide our feelings, numb our emotions
  • Stop asking patients how they feel so we don’t have to deal with our emotional reactions
  • Inappropriate humour and other unprofessional behaviour
  • Become exhausted and burn out
consequences
Consequences…..
  • Personally
  • Distress/sadness
  • Recurring memories
  • Reduced confidence
  • Isolation
  • Increasing difficulty speaking up as no-one else is
consequences1
Consequences….
  • Patient safety
  • Tired staff
  • Impaired thinking
  • Poor decision-making
  • Reduced technical proficiency
  • Poor team work
acknowledging the challenges
Acknowledging the challenges
  • ANZCA Welfare of Anaesthetists Special Interest Group
  • Examinable resource documents
  • Part 0 course
understanding when to speak up
Understanding when to speak up

When we think we could harm a patient or client

Hungry

Angry

Late

Tired

Sick

understanding when to speak up1
Understanding when to speak up

When we think someone else could harm a patient or client

understanding the barriers to speaking up
Understanding the barriers to speaking up

Professor Dan Raemer – Harvard Medical School/Massachusetts General Hospital

“Responding to (very) challenging cases”

barriers to speaking up
Barriers to speaking up

Relational

Content

Self

Climate

relational hurdles
Relational hurdles

Perceived hierarchy

Respect for territory

Respect for experience

Value of the relationship

Familiarity with the individual

content hurdles
Content hurdles

Uncertainty about the issue

Uncertainty about the consequences

Confidence about being able to deal with the consequences

slide18
Self

Perception of limited responsibility

Avoidance of potentially embarrassing situations

Fear of being wrong

Personal reputation

Protection of physician autonomy

Natural obedience

climate
Climate

Not an environmental norm

Waste of time

Fear of repercussions

Absence of a rubric/tool

the 2 challenge rule
The 2-challenge rule
  • Question with curiosity
  • Question with concern
  • Bring in a third party

CHALLENGE TWICE THEN CALL FOR ASSISTANCE

me too
“Me too”
  • Sharing our experiences including our mistakes
  • Showing we have felt the same way
  • Not just asking “What happened?” but also “How did you feel?”
  • Normalising ‘whole-heartedness’
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