Knowledge is power: Redeployment lessons to build resilience

Feeling unprepared in an unfamiliar environment contributes significantly to the stress felt by trainees starting a new rotation. This feeling was magnified in 2020 for paediatric trainees redeployed to a new specialty, often at short notice, to respond to the rapidly changing demands of the SARS-CoV 2 pandemic. As a group of neonatal intensive care doctors we were redeployed, with limited preparation time, to a variety of adult departments. Despite the unfamiliarity of the pathologies, the diverse needs of particular patient cohorts and alarmingly high doses of lorazepam, our neonatal skills and knowledge were often transferrable to adult medicine (including the case of an encephalopathic patient who required regular stimulation to remember to breathe). However, whilst a clinically necessary move, we felt the communication and information provided could have been enhanced to improve our readiness for redeployment. Objectives To improve well-being and readiness for redeployment by creating a trainee led induction framework. Methods As a neonatal cohort, together with our College Tutor and following our experience of redeployment, we identified the following specific training needs and challenges faced by paediatric trainees in our trust: New environment – Building, wards, logistics Different IT systems Training eg. ALS Unfamiliar escalation processes Adult medicine: ceiling of treatment, guidelines, medications and conditions Different resilience requirements – breaking bad news, death rate, drugs and alcohol. HR processes eg leave, rotas. Results We produced an electronic package to address these areas which outlined information and signposted to resources and training. This was the first collection of all relevant information drawing on multiple trust sources, discussions with adult colleagues, independent research and our own experience. This was registered as a QI project and presented to hospital management for use in future inductions. We received excellent feedback and the areas we highlighted were used as a basis to frame induction requirements in subsequent redeployments. Conclusions Paediatric trainees have much to gain from the redeployment experience. As a trainee group we have sufficient medical training to revert to adult medicine and have the procedural, situational awareness and communication skills to thrive in unfamiliar settings. However, uncertainty can adversely impact well-being whilst preparedness allows trainees to both better cope and to excel in new environments. From our experience of redeployment we identified key areas of uncertainty and addressed them in a framework that can be translated to other trusts and for other specialities. We believe that providing structured information to trainees moving out of their comfort zone helps them to best support their adult colleagues, to take advantage of development opportunities and builds resilience.

Citation

Jefferson, L., Fenton-Jones, M., Wynn-Lawrence, L., Croft, H., Hambidge, J., Tsakmakis, M., & Mannix, P. (2021). 938 Knowledge is power: Redeployment lessons to build resilience. Archives of Disease in Childhood, 106, A170-A171. doi:https://doi.org/10.1136/archdischild-2021-rcpch.296

DOI

10.1136/archdischild-2021-rcpch.296

URI

https://hdl.handle.net/20.500.14709/890

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