Emotional first aid for when the unexpected happens

Many doctors and nurses are drawn to the field of medicine because they embrace a strong desire to care for others. They have a natural instinct to put the needs of others before themselves, as seen during the COVID-19 pandemic.
They serve our community by working long hours, sometimes sacrificing their own health and safety, and give up spending time with their own families so they can help their patients.
But health care is a high-stakes environment and medical teams aren’t invincible — they’re human. And when adverse events or unexpected outcomes occur, health care workers often struggle with the circumstances.

When things don’t go right
Challenging or unexpected medical events can have long-term psychological or physical implications. Sharp’s CAREforYou program is designed to lend a listening ear and helping hand to employees who are affected by these events.
An event can be a mistake that results in harm or complications to a patient; “first” experiences such as a first patient death; or a code blue. It can also be a workplace injury or violence that may cause uncertainty and distress to those involved.
Bernadette Carrasco, administrative assistant at Sharp Grossmont Hospital’s Women’s Health Center, has been a Peer Supporter for CAREforYou for two years. She’s now the program co-chair along with Nicole Padiernos, Quality and Patient Safety senior specialist.
“Most births at the Women’s Center are joyous occasions and go as planned. But sometimes it doesn’t happen as planned, and those are tough circumstances for everyone,” says Carrasco. “I remember the first code blue I witnessed and nothing could have prepared me.”
A code blue is a medical emergency when a patient is in immediate danger, such as cardiac arrest. Hospital doctors, nurses and other staff members are trained to respond quickly, as every minute and second counts.
“The situation involved a healthy, young mother who was experiencing seizures during labor, caused by a rare condition,” she says. “It was serious. Her parents were here and begging us not to let their daughter die because they had just lost their son.”
Carrasco continues, “It was very intense, it affected everyone. Faces changed, people were rushing around. I didn’t know what to do. So I bought a card from the coffee cart and the whole NICU staff signed it and we gave it to the parents.”
Fortunately, the young mother recovered, and after some time in the NICU, the baby was fine too.
“Following events like these, there’s a debrief. It’s very clinical. But there’s also an element of emotional first aid, and that’s where CAREforYou comes in,” she says.

‘Second Victim’ syndrome
When health care workers are involved in unanticipated adverse events, many become traumatized themselves. It’s referred to as “Second Victim” syndrome.
The intent is not meant to minimize the significant impact on a patient or loved ones, who are of primary importance, but rather it’s an acknowledgment that there’s also an impact on members of the health care team.
As a result, many health care workers struggle with symptoms such as:

• Doubting one’s own clinical skills

• Blaming themselves and feeling like they have failed their patient or peers

• Replaying the experience repeatedly

• Sleep or eating disturbances

• Difficulty concentrating

CAREforYou Peer Supporters
CAREforYou Peer Supporters are trained to provide confidential support and a “safe zone” for affected team members to receive the help and empathy they need. Evidence confirms that what matters most is to still be accepted by colleagues and seen as a valued member of the team.
“When bad outcomes happen to staff members, someone needs to be there to ask them, ‘Are you OK?’ That’s the most important question I ask,” says Carrasco.
She also rounds and checks in with her team members regularly.
At Sharp Grossmont, there are about two dozen Peer Supporters, including managers who play a key role to help identify staff in need. Any staff member can volunteer.
Carrasco’s supervisor, Kari Bernet, director of Women’s and Infant Services and a Peer Supporter, says, “Bernadette has an innate ability to bring out the best in people. Not only uplifting a peer in need, but she’s always genuinely happy to share in others’ celebrations as well.”
“There was an instance when someone was having doubts and second-guessing themselves, wondering if they could have done more based on their particular situation,” says Carrasco. “I listened and let them talk.”
She says just talking and helping them see the situation through a different lens and an empathetic eye helps immensely.
Peer Supporters were also asked to visit the COVID unit where, at the height of the surge, medical teams experienced multiple deaths per day.
“You could feel the stress and exhaustion. It’s a lot for anyone to handle,” she says. “They were very busy and we couldn’t do much. We were able to drop off goodie bags, and they were extremely grateful for even this small gesture.”

How to get help
Besides CAREforYou, Sharp’s Employee Assistance Program offers other free, confidential services to help all Sharp employees address professional or personal challenges they may be facing.
“Reach out,” Carrasco says. “When these things happen, no one should shoulder the burden alone. Don’t be afraid or reluctant. It’s OK not to be OK.”