Welcome - Reassurance

Have a question about Reassurance? Had some experience with using it that you could share and that might help others? Found a particularly effective way of adapting it to your hospital? Please post it here in this section of the forum.

Hi everyone
I have found that when a service user is admitted onto the ward that if a gentle handshake can be shared before entering the ward environment then a tactile demonstration of non judgemental reassurance has been established. A foundation can be laid in this way to eliminate the them and us culture.

Hi Jane,

First impressions are of course very important. As you have pointed out, managing those first few minutes on the ward can set the whole tone for a patient, and if it is good can have a much longer impact. It is probably worth us thinking much more about those first five minutes and the welcome people get to our wards.

Len

As a team over the weekend we have been discussing the reassurance intervention during handovers. There are often many situations that arise on the ward that can be difficult to manage; the team agreed that one of the most difficult is when one service user has made a deogratory remark to another service user or has physically assaulted them. At times the person who has displayed violence and aggression has done so in the context of being unwell and it is at times difficult to feed this back to the victim. They will often say things like 'I don't understand what i've done I was just sat there, why did they hit me'. At these times staff on the ward always ensure that they spend time with the person talking to them and offering support. And also time with other service users who may have witnessed the incident. It's about being flexible at times as well. for example, it may not be cigarette time but sometimes opening the garden earlier so that they can go out and get some fresh air and have a smoke works wonders.

Another example that one of our staff gave was when at times service users are being treated individually; for example, we have a structured day on the ward so that service users add meaningful structure and activity to their day and so staff can fully assess their mental state. Part of this structured day is asking them to vacate their bedspaces for a few hours in the morning so that they can attend activities/meetings with professionals etc. At times we understand that people may need some time in their bedspace, for example, if they are hearing voices and they need a quiet space where they can go. At times other service users see this and say 'well if they can go in their room so can I'. At these times it is important to maintain confidentiality whilst putting the situation in context for them.

A person admitted to the ward and not happy at admission. The ward had a difficult night as a consequence.
In the morning, while the person was asleep, it was decided that we require a review and MDT discussion. We also felt that all the patents’ peers had witnessed the difficulties and deserved some kind of explanation. We duly spoke to them all about how they experienced the night.
The patient community expressed feelings of being upset, annoyed, but also felt sorry for the person admitted. We suggested that all patients are different which they acknowledged.
We acknowledged that this must have been a very difficult night for the whole community and jointly agreed that the ward structure for the day for would be suspended so that peers could catch up on their sleep.
Support given to all peers, the person themselves upon waking, and all staff members.

This intervention was implemented 29th March. Reassurance was given to patients following the use of restraint and seclusion to prevent self harm. The noise generated by the incident impacted on other individuals on the ward resulting in heightened anxiety.

Patients who had been made aware of the incident were comforted/ reassured by staff who provided an explanation for the event, and how it was necessary for the patient’s own safety. Staff made sure that their presence on the ward was visible for all patients to provide them with a sense of security and the opportunity to relay any fears.

Staff are fully aware that this intervention is implemented after any event of this nature and information relating to the intervention is indicated in staff handovers in accordance with the handover checklist.

Julie Burden HCA
Taliesin Ward