Children's Hospitals Today - Summer 2022 - 9

FROM EXPERIENCE / ROUNDS
IN BRIEF
programs begin with one
floor or unit, usually the
Emergency Department or
an intensive care unit, and
grow from there. " At CHLA,
we understand that no one
has a more stressful job
than anyone else. We have
different roles, but everyone
deserves support in the exact
same way. So from the beginning,
we said, 'We're going to
launch this program everywhere,
all together.' "
STRESS INJURIES AND
SECOND VICTIMS
A stress injury is a persistent
psychological difficulty
caused by a traumatic experience
or prolonged periods of
high stress or fatigue. Doctors,
nurses, social workers and
others in health care encounter
this type of injury in their
daily work. Stress injuries can
dramatically alter their ability
to cope and can affect the
quality of their work.
A similar injury can occur
when providers experience
what is known as the second
victim phenomenon. A second
victim can be anyone involved
in a stressful event whose
emotional and psychological
well-being is negatively
affected by the experience.
Second victims may feel
personally responsible for
a stressful event, secondguess
their clinical skills
or feel as though they have
failed their patients. " We
know through experience
and literature that there is
a wide range of events that
can create a second victim, "
says Rybarczyk. " It could be
the doctor performing CPR,
the environmental services
worker cleaning up after a
code blue event, or the team
member receiving a call about
a critical patient transferring
to the hospital. "
EVERYDAY RISKS
The HeaRT training curriculum
is largely based on
the Stress First Aid model
of care, which originated in
the United States military
and was translated for the
health care setting by the
National Center for PostTraumatic
Stress Disorder
and the Schwartz Center for
Compassionate Healthcare.
" The literature on Stress
First Aid identifies the top 10
events for which you should
always check on the people
involved, " says Rybarczyk.
" One of them is 'anything
involving children.' At CHLA,
that's all we do! Our team
members experience traumas
involving children every day. "
At CHLA, certain events
are considered " automatic
triggers " to which a peer
supporter is immediately
dispatched: patient deaths,
code blue events (emergency/
CPR), traumatic injuries, and
child abuse cases, among
others. But any team member
who experiences a stressful
situation can request peer
support. " We recognize that
every trigger situation and
every individual involved is
worthy of a check-in by a peer
supporter, " says Rybarczyk.
" Because we just don't know
when or how something's
going to affect us. "
BECOMING A HEART
SUPPORTER
HeaRT peer supporters
attend a four-hour workshop
that focuses on elements of
Stress First Aid, teachings
from a peer support program
at Nationwide Children's
Hospital, and what Rybarczyk
calls CHLA's " home-grown "
trainings. A brief check-in is
usually enough to alleviate
a team member's emotional
response to an event. Peer
supporters aren't there to
fix everything, but to make
space for emotions-to sit,
listen, and process.
" We know that our team
members are already giving
support to one another, " says
Rybarczyk. " It's innate to
being a caretaker, especially
in a children's hospital. But
we have found that they don't
always know what to say,
how to say it, and maybe most
importantly, when to hand it
off for additional support. "
In those cases, HeaRT can
call on one of the other peer
support services at CHLA:
the chaplains who lead " Tea
for the Soul, " the Employee
Assistance Program, social
workers and psychologists.
All of these specialists have
skills that are complementary
to HeaRT and help
ensure team members get the
support they need.
Sara Jones is senior writer,
marketing communications,
at Children's Hospital
Los Angeles.
Tell your hospital's story. Email
magazine@childrenshospitals.org.
ADMINISTRATOR NEWS
Spence and Becky Wilson
Baptist Children's Hospital
named Allison Bosse
administrator and CEO.
Holtz Children's Hospital
Jackson Memorial Hospital
named Joanne Ruggiero
senior vice president and CEO.
Children's Memorial Hermann
Hospital named Emily Weber
vice president and chief nursing
officer.
RESEARCH NEWS
Improving Pediatric Sepsis
Outcomes (IPSO), a national
collaborative that aims to
reduce sepsis-attributable
mortality, published an article
in the Annals of Emergency
Medicine on fluid resuscitation
in treating sepsis. The
researchers examined 1,204
children from 57 U.S. hospitals
with hypotensive septic shock
who all received timely, firsthour
fluid resuscitation in the
emergency department. The
researchers did not find an
association between mortality
and receiving >= 30 mL/kg of
bolus fluid or <30 mL/kg in the
first hour. The study suggests
against setting a specific fluid
volume target as a measure
of quality of care. This was
a retrospective study, and
future prospective studies
might illuminate questions
of early fluid resuscitation
volume further, the authors
said. For more information,
visit childrenshospitals.org/
IPSOstudy.
Share your hospital's news. Email
magazine@childrenshospitals.org.
CHILDREN'S HOSPITALS TODAY Summer 2022
9
http://childrenshospitals.org/IPSOstudy http://childrenshospitals.org/IPSOstudy
Children's Hospitals Today - Summer 2022

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