Debriefing in the Emergency Department

Emergency Department (ED) staff are repeatedly exposed to high stress situations and as a result suffer from compassion fatigue, secondary traumatic stress, symptoms of post-traumatic stress disorder, burnout and high turnover rates. Staff turnover is costly to the health system in the form of training new staff and potential poor patient outcomes due to under staffing or inexperience of staff. Based on a survey about debriefing, Level 1 Adult and Pediatric Emergency Department staff reported 81% felt there was inadequate support for critically stressful events that occur. Debriefing was identified by 75% of the staff as an option for support. This survey of the ED staff identified the need for an immediate and informal process for clinical care feedback and emotional processing after high stress events in the Emergency Department. An adaptation of the Debriefing in Situ Conversation after Emergent Resuscitation Now (DISCERN) tool was developed by an interdisciplinary team of ED nurses and physicians based upon the reported needs of the staff. Time was an overwhelmingly identified barrier to implementing a debriefing process, but nursing and physician leadership assurance in prioritizing a supportive work environment was provided. The benefits of debriefing expand beyond just improving work environment, it can also lead to improved teamwork, communication, patient satisfaction and even patient outcomes