Promotion of staff resiliency and interdisciplinary team cohesion through two small-group narrative exchange models designed to facilitate patient- and family-centered care

Abstract

Facilitated narrative exchange and reflective practice (narrative medicine) sessions were offered at a large community academic Magnet medical center to promote staff education in the cultural changes needed to successfully implement Patient- and Family-Centered Care philosophies and 24/7 Family Presence policies. Our models included a unit-based, 60 minutes, bi-weekly small-group session format and a hospital-based, quarterly, 4-hour small-group-divided workshop format. In collaboration with the hospital ethnographer, we developed a survey tool and determined these sessions were well received by physicians, nurses, and ancillary staff members alike, regardless of their professional position or their length of time working in health care. Participants also reported an enhanced sense of personal resiliency, an enhanced sense of professional team cohesion and affiliation, and an enhanced ability to deliver high-quality care for their patients and families.

Keywords:

• Narrative medicine
• Reflective practice
• Patient- and Family-Centered Care
• Compassion fatigue
• Burnout
• Team building
• Professionalism

Acknowledgements

The authors would like to acknowledge Narrative Pediatrics is supported by separate $1500 educational grants from both Ross Products, division of Abbott Laboratories, and MedImmune, Inc. (consultant fee support and lunches provided). Our thanks to Mr Joseph Zarola from Ross Products and Ms Barbara Clouden, RRT, from MedImmune, Inc., for their continuing support of this important initiative.

The Professional Caregivers' Plan for Resiliency (P-CPR^©) Narrative Medicine Workshops are supported by a $15 000 2-year grant from the Anne Anderson Trust, Leonard and Dorothy Poole Foundation.

The authors would also like to acknowledge Carol Sorrentino for her devotion to this initiative as a Key Facilitator for all the P-CPR^© Stress, Burnout, and Compassion Fatigue Workshops.

All authors had full access to all of the data in the study and take full responsibility for the integrity of the data and the accuracy of the data analysis. There are no potential conflicts of interest, financial interests, or relationships relevant to the subject of this research.

The authors also extend their gratitude of the writers of the exemplary narratives who gave their approval to publish their narratives in the expressive formats displayed in this article.

Additional information

Notes on contributors

Lorraine A Dickey

Lorraine A Dickey, MD, MBA, FAAP, is a senior clinical neonatologist and is currently the Chief, Division of Neonatology, and the Medical Director of the Nursery ICU at Lehigh Valley Health Network. She earned her MBA in Health Care Management in 2006 from Regis University, completed Narrative Medicine Facilitator training in 2007, and Advanced Narrative Medicine Facilitator training in 2008 with Dr Rita Charon and the Narrative Medicine Core Faculty at Columbia College of Physicians and Surgeons. Along with Jack Truten, in 2005 she co-founded of The Professional Caregivers' Plan for Resiliency, an interdisciplinary grassroots approach that addresses operational barriers to the successful implementation of Patient- and Family-Centered Care.

Jack Truten

Jack Truten, RN, PhD, has received formal training in clinical ethics (fellowship, Lehigh Valley Health Network), and in Narrative Medicine (foundational and advanced levels, Columbia University). Dr Truten is currently Director of Professionalism Education at the University of Pennsylvania School of Medicine where he trains faculty and leads seminars for house staff in ‘Narrative Professionalism’.

LaDene M Gross

LaDene M Gross, RN, MSed, Administrator, Patient Care Services, is a registered nurse with more than 35 years experience encompassing direct patient care, education, and leadership responsibilities in an acute care facility. Current responsibilities include administrative oversite for labor and delivery and mother baby clinical areas (more than 3900 deliveries per year). She is administratively responsible for pediatrics, pediatric intensive care, and neonatal intensive care patient care units. LaDene has experience with team building, facilitation, and project development and has completed Narrative Medicine education and participant in Patient Family-Centered Care, Narrative Pediatrics, and Professional Caregivers' Plan for Resiliency initiatives and programs.

Lynn M Deitrick

Lynn M Deitrick, RN, PhD, is a Medical Anthropologist/Ethnographer, Division of Community Health & Health Studies, LehighValley Health Network in Allentown, PA. She is a qualitative research expert and has numerous publications and presentations on the use of qualitative methods in nursing, health research, patient satisfaction, and quality of care. Her research interests include cultural awareness, health disparities, patient satisfaction, quality of care, and the application of qualitative methods for use in the clinical setting.