Shinobi and Emotional Wellbeing


Things which improve emotional resilience:



•Acceptable workload boundaries

•Minimise overtime and on-­call

•Ergonomic work process design

•Inbuilt System Redundancy






Acceptable workload boundaries:


Allows staff to structure their day in a way that is less fatiguing and allows a wind-­‐down period at the end of the day.


Minimise demands for overtime/ on-­ call


Minimises summative fatigue, and if excessive, chronic fatigue.


Ergonomic work process design


Improved workflow reduces energy demands and stress.


Inbuilt System Redundancy


Breathing space built into the system takes the pressure off when things are going to plan, and becomes the safety valve for when emergencies occur.




Debriefing is a physical and highly structured event, and is the mainstay of emotional support strategies.


However, we have found that delivering debriefing to staff is problematic.


•It requires alignment of too many people including the facilitators

•It requires time, which means stopping work

Roster scrambling confounds attempts to organise debriefing, since it is difficult to get the same team together at the same time and in the same place in the days following a sentinel event, mainly due to rotating rosters and sustained workload.


Providing Time and Opportunity for Emotional Support:


Given these obstacles, how do we provide both the time and opportunity required for the commencement of emotional processing?


“Everything is seemly when done at the right time”


We need Time for processing,


And then, once processing is underway,


we need to provide the opportunity for support…


Shinobi and Peer Support:


Shinobi, it seems, allows the nurse to reconnect with self, and so has physical AND emotional contributions to well-­being.


Now we have to engineer opprtunities for Peer Support,


That is:


Engineer a system that Provides Opportunities to be heard so that staff may begin to re­‐respect the Emotional workplace Environment.


Our original idea was a Telephone Peer Support Strategy


We looked at developing a Pilot of a telephone peer support strategy,

which allows mentors to be available to field phone calls from staff members

who feel the need to ‘defuse’ confidentially

following exposure to significant or sentinel events,

given that clinicians often put their emotions ‘aside’

until after they have gone home,

and then find that they are feeling distressed.


The format of the call was to roughly follow these steps:


•Engage with the caller

•Focus the call on the here and now.

•Relieve distress

•Enable coping

•Decide next steps

•Terminate the call


The strategy was to explore the caller’s feelings with respect to the sentinel event.


The model then focused on solutions (if there were any, and there don’t have to be any), fostering resilience and deciding next steps.


In order to discuss feelings, we needed ‘feeling’ words.


You might find yourself amazed, astonished and dazzled at the end of the day,

and enchanted to engage with yourself and your family….




At the end of a long tiring day you might find yourself:

alienated from work,

bored with life,

detached from your family

and numb to your own feelings…


Following the call, the content of which was to remain confidential,

Any agreed outcomes that required Organisational action, Formal debriefing Or follow-­up

could be represented by agreement to the OSM for confidential attention.


In the end, we elected for a less robust though less consuming alternative:

Sniffa the dog, who is a great listener, and confidential to boot,


though she is probably not as good at reflecting on and reframing ideas, and maybe not quite as good at helping people arrive at 'next step' strategies.


But then again, there are always (hopefully) people for that.



In conclusion:


I would like to watch the sun go down

On our bloody-­minded determination


I would like to see it happen

Without the need for rebellion

In order to effect cultural change…


So that we can be

Sustainably empowered

To perform our desperately needed ballet…


Because, as always, we think

The show must go on…



Below Ten Thousand

An international collaboration

Empowering clinicians in safety culture