Simulcast Journal Club is a monthly series that aims to encourage simulation educators to explore and learn from publications on Healthcare Simulation Education. Inspired by the ALiEM MEdIC Series, each month we publish a case and link a paper with associated questions for discussion. We moderate and summarise the discussion at the end of the month in pdf and podcast format, including opinions of experts from the field.
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Title : “Relationship Strain”
It was a conversation that Nimali had been avoiding but coming home to a filthy kitchen and a frying pan full of cold, day old rice had pushed her conflict avoidance tendencies out the window. She strode resentfully down the hall to find Joe and her son cuddled up on the couch. Her husband cheerfully raised his glass in a casual welcoming gesture and turned back to his phone.
“I’d like to talk about what’s going on in the kitchen.” She said icily. “Is an ounce of cleaning too much to ask when you’ve had the whole day off with the kids?”
“Not now mate.” sighed Joe. “I’m tuckered out. This one had me up since 4am.” He patted their son as he lay half asleep in his lap.
“I think that’s a bit dismissive.” countered Nimali. “We’ve had this fight a number of times and it’s a real trigger for me. The dynamic seems to be that I ask you to step up and then nothing has changed. I’m working full time again now, I need you to pull your weight!”.
“It’s not my fault I got retrenched, Nimali.” Joe scowled. “And it’s not lazy of me to leave some housework till after he gets to bed.”.
Nimali sighed and sat down next to him on the couch. She reached over and took the wine glass from his hands. “I get it, hun. I do. I know it’s been hard finding new work, especially when you loved that team so much. And I’m sure it’s not uncommon for men to struggle with their identity a bit after losing work. But I’ve taken on more hours to support this family. If we’re really honest you’re being a great Dad but I’m still doing most of the housework on weekends, and when you don’t follow through, it makes me feel like you don’t respect how hard I’m working to keep us afloat.”
Joe didn’t answer at first, but Nimali let the silence hang. Calmly, without any anger, she held his gaze.
A few more seconds passed, and then he leaned impulsively forwards in the couch and kissed her on the cheek. “I hear you.” He said. “And I’m glad that we could have a discussion without any damn debriefing techniques for once.”.
The Article :
In the case study today, Nimali faced a reluctant, dismissive encounter at home. While she and many of us may feel we have mastered the basics of debriefing, most of us could name similar times in our lives when a conversation was uncomfortable or difficult. In this open access paper by Grant et al, the authors provide us with a list of common debriefing conundrums while simultaneously providing useful verbal and non verbal techniques to approach them.
For our bloggers this month, what did you think of the paper? Do you think it will help your practice? Are there any challenges you experience commonly?