Beautifully broken: Implementing a peer support program to help healthcare providers heal

Elaine Webb, Denise Stage McNulty


Introduction: This evidence-based project aimed to determine the feasibility of implementing a peer support program to minimize trauma in healthcare professionals (HCP)s following unanticipated adverse events. Based on the forYOU Program designed by Sue Scott at the University of Missouri Health System, this program trained peers to offer real-time caring and support to other clinicians coping with such events. Most healthcare professionals are involved in at least one adverse event in their careers. Albert Wu, MD (2000) coined the term second victim to capture the essence of the trauma experienced by healthcare professionals when an unanticipated event negatively impacts a patient. When left unchecked, this trauma can result in moral distress, stress disorders, and burnout as the clinician ruminates over the event. Providing emotional support has improved second victims' emotional well-being and recovery. Therefore, healthcare leaders are encouraged to develop comprehensive programs to provide easy access to peer and social support when they experience an adverse event.

Methods: Designed for implementation in the Women's Service Department of a 350-bed southwestern hospital, this project employed a pre-/post-evaluation of subjective outcomes using an online survey for nurses. A core group of trainers attended a two-day peer support train-the-trainer event hosted by the forYOU Program at the University of Missouri Health Care System. This group trained 26 peer supporters representing the four departments in Women's Services and both shifts. Baseline data was collected (n = 44) to assess the frequency and impact of unanticipated adverse events, the perceived support, and the type of support received. Following the four-month implementation in the Summer/Fall of 2020, post-data was obtained, including a program awareness assessment (n = 17).

Results: Pre- and post-implementation of the Peer Support Program, nurses in Women's Services reported adverse events impacting their emotional well-being. Post-program, more nurses reported receiving support (86% post-program versus 43% pre-program). Before employment, 79% of nurses who received support received peer support, versus 86% receiving peer support post-implementation. The implementation occurred during the COVID pandemic, which may have resulted in a decreased post-assessment sample size. However, the peer supporters reported hesitancy in completing encounter forms feeling that providing support was “too personal”. The participants said that they found the peer support program worthwhile.

Conclusions: Nurses on the implementation units indicated receiving more support after the peer support program was implemented and felt the program was beneficial. Since unanticipated events are inevitable in health care, the steering committee recommended sustaining and spreading the program to all the nursing departments. More data is needed to determine the full impact of the program.

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Journal of Nursing Education and Practice

ISSN 1925-4040 (Print)   ISSN 1925-4059 (Online)

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