Managing Staff Following an Adverse Event Eliminate blame; provide support BY ROBERT KURTZ


o be a good provider, says Cori Prisco, RN, you must be able to confidently act on your instinct and experience. This can be difficult for staff members following an adverse event. “I know from personal experience that after such an event, there is a period where you question your actions and may hesitate to do what you know is right,” says Prisco, clinical director for Hudson Crossing Surgery Center in Fort Lee, New Jersey. “Such emotional distress can cause more mistakes that potentially harm patients and staff.” Following an adverse event, there is

a tendency to try to assign blame, says Mary Merrill, RN, administrator and director of nursing for the Endoscopy Center of Niagara in Niagara Falls, New York. “Staff want to excuse them- selves from any sense of responsibil- ity and involvement. Blaming some- one else is the easiest way to do so, but blame is unproductive and harmful. In addition, the causes of adverse events are often the result of system break- downs and not the act of individuals.” Managers, Merrill says, must strive to eliminate a culture of blame. “Treat the individual involved professionally. Reassure them that you know the act that caused the event was not inten- tional and you remain confident in their skills as a provider. By showing your support as a manager, you set the tone for how staff should act.” According to Prisco, managers have a critical period where they can really make a difference in the way a person involved in an adverse event is going to process the experience. “The sup- port you show—from words of kind- ness to approving time off away from work—can go a long way in helping the individual heal,” she adds.


It is a natural human instinct to look for connections following a traumatic experience. You want to find people who understand how you feel so you can share stories and have your feelings validated.”

—Cori Prisco, RN, Hudson Crossing Surgery Center

Prisco also advises managers to create a safe environment for the affected individual. “This environment encourages one to speak freely and start to form connections with others to help them process their emotions. It is a natural human instinct to look for connections following a traumatic experience. You want to find people who understand how you feel so you can share stories and have your feel- ings validated. There is nothing worse during these times than isolation.” For some team members, internal support is enough to help them recover from their experience. Others require external support. That outside sup- port, Merrill says, should be readily available. Her ASC has an employee assistance program that includes an anonymous phone line available for any staff member who feels a need to speak with someone outside the ASC. “If I do not believe we can provide someone enough emotional support, I

would highly recommend they speak to a professional,” Merrill says. She also advises managers to

involve the affected individual in efforts to improve processes that can help reduce the likelihood of a repeat event. “This collaboration can serve to refocus the individual on the reason why they likely chose to go into healthcare in the first place: helping patients.” Unfortunately, Prisco says, there is no checklist managers can follow that will ensure perfect staff man- agement following an adverse event. “Every event is different, and everyone responds differently, which is why you must treat each event individually.” Do the best you can, she says, and try to learn from every adverse event. “Work to improve how you manage staff and gain a better understanding of how to manage them correctly. This will help you be better prepared and confi- dent when the next event occurs.”

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