Training for Paediatricians and Paediatric Students

4.2 – Coping with Stress in an High Risk-situation: Problem Solving and Report Information, the Role of Teamwork Communication

Emergencies and work overload are common stressors in the daily work at the paediatric ward and can be a driver to mental health issues or burnout syndrome for health care professionals. Among the variables producing stress in paediatrics there are some depending on personal characters, such as perfectionism, excessive involvement, self-esteem, sense of mastery, unrealistic expectations among the most significant, and others depending on interpersonal relationship. Conflict with colleagues, poor communication among staff, lack of support and collaboration, law team morale, disagreement about the goal care, family’s dynamics, poor doctor-patient relationship or doctor-family relationship, are frequent sources for stress staff and require specific coping strategies to overcome conflicting situation and facilitate problem solving strategies. Others relevant variable generating stress depends directly on health care system and the organization of patient’s care I the ward. Paperwork, workload, understaffing, organizational stress, lack of communication with administration, role conflicts are stressful factors influencing the decision making processes with significant consequences about patient’s standard care (Barns, 2011). Soft-skills are essential tools for paediatricians to cope with such a complex scenario and work on patient’s interests. Patients’ and families’ satisfaction are assured in part through the treatment efficacy and in part through the involvement of other actors involved in care scenario such as nurses, technicians, and other health care professionals. Among the softs-skills required the plurality of communication approaches is very important to overcome the interpersonal conflicts and lead with the difficult created by the institutional organization characters. Soft-skills help to identify barriers and develop facilitators for problem solving through the implementation of coping strategies reducing distress and supporting to deal with the complexity of paediatric ward life. Professional attitudes, organizational strategies, simplified decision-making processes can be effective solutions to minimize stress and avoid burn out and harm professionals’ health. In this chapter we will present precise communication strategies and organizational approaches to face stress and recovery a quality standard in professional life. One of the most effective communication strategy to lead with high-risk situation is debriefing, a conversational session to share and examine information related to a specific event after the event happened in the scenario (Duncan, 2018). The technique facilitates reflexion through open-ended questions about the scenario actors and extracts lessons for the future. Debrief after a stressful situation in the ward can improve the communication in paediatric teamwork and facilitate change of attitudes of health professional to discuss about the team performance and learn from errors and success to improve the clinical outcomes and patient safety (Cho, 2014). We will provide a list of soft skills a team leader should have in order to have collaboration and a good teamwork:

• Time management: this person should be good at scheduling a timetable, trying to not to make his companions “waste” their time and working effectively
• Rapid decision making: someone who makes quick decisions when required, always considering the facts and alternatives available
• Emotional intelligence: a person able to create a pleasant human environment for work, showing humility, empathy, friendliness, unselfishness. We can also describe this person like someone polite, easy-going … It will inspire a strong desire to succeed among team members
• Resilience: respond effectively to disappointments and setbacks, receive criticism in a good manner
• Flexibility: be adaptable and receptive to new ideas, adjust to continuous changing work demands and circumstances
• Persuasion: gain agreement to proposals and ideas, stand ground in the face of opposition
• Initiative and creativity: someone proactive and self-starting, seize opportunities and act upon them
• Leadership: people who create the conditions that allow people to grow and do their best. It also includes training and mentoring new and young team members
• Cultural and diversity awareness: communicate well with diverse people, show respect for others opinions or values
• Conformity to social norms: someone who governs his dress, body language, tone of voice and vocabulary according to the particularity of each situation
• Building external working relationships: a person who maintains positive relationships with people beyond his own team, forges useful partnerships with people across other organizations
• Conflict resolution: that kind of people who promote harmony and consensus through diplomatic handling and disagreements
• Inspiring moral trust: this person shows loyalty within the team, share information, treat all fairly, keeping his word
• Inspiring competence-based trust: inspire confidence in his own capacities and skills, underlying his competences and value to others
• Strategic thinking: someone able to think at a big level, with a long-term view with a vision of the future
• Assertiveness: someone who defends his rights, express his opinion and make suggestions in a truthfully without using aggressiveness or passivity, showing respect for the others
• Courtesy: frequently using the words “please”, “thank you”, “excuse me” in dealing with colleagues and patients

Practical Applications

Online Resources

• Staff stress in the children’s hospice: causes, effects and coping strategiesA very comprehensive explanation about the stress phenomenon in paediatrics and the strategies to overcome stressful situation
• Family paediatrics. Report of the Task Force on the FamilyThe paper is an interesting overview about the parents distress and its impact on children behaviour. Is an interesting paper to understand the impact of stressful situation on family in paediatric health care
• Paediatric Liver Transplant Teams’ Coping with Patient DeathThe paper offers an interpretation about the impact of stress on paediatrics in high-risk circumstance for the patient and debriefing as the best related coping strategies to face the challenge.
• Debriefing in paediatricsThe paper explains the effect of debriefing in paediatrics and its impact in the improvement of clinical outcome and teamwork performances
• Problem solving The source is a book offering a group of case scenario in paediatrics where the problem solving strategy is applied following a rigorous methodological approach. A case scenario database with of multiple-choice questions is included in each case to test learners’ skills during the case analysis