The Debriefing: A Forced Pause After an Unexpected Clinical Loss

Illustration by Barbara Hranilovich for AJN

Illustration by Barbara Hranilovich for AJN

The Reflections essay in the July issue of AJN is about the brief required debriefing of a medical team after an all-consuming struggle to save a patient.

The Power of Paperwork” is written by Amanda Anderson, an experienced nurse who is new to a supervisory role. She remains closely attuned to the emotional experiences of nurses and physicians. Leading her former colleagues as they huddled to examine what might have been done differently with a particular patient, she tells us, she found that her “suit and heels provided no armor.”

Sometimes bad things happen for perfectly obvious reasons. If you don’t turn an incontinent patient, he will develop pressure ulcers. If you don’t always verify your patient’s medication against the order and identifiers, you will likely give the wrong drug to the wrong person at some point. The factors involved in such errors can be complex, of course, but remain fairly easy to trace.

Sometimes, though, people just die. We don’t know why, and if we find out, it’s usually not reassuring. The thoughts that follow these deaths—what if I… ?, should I have… ?, we might have…—can move in unforgiving cycles that take months to silence.

The author knows what it’s like to second-guess yourself if you’re a nurse or doctor, and knows the dangers of doing so as well. This short, powerful essay is perceptive and honest. Click the link above to read it in entirety. (It’s free.)

Senior editor/social media strategy, American Journal of Nursing, and editor of AJN Off the Charts.

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