Safewards Clear mutual expectations Refresher Explanationinformation Role modelling

Safewards Clear mutual expectations Refresher

Explanation/information, Role modelling, Patient education, Removal of means, Presence & presence+ Staff Modifiers Denial of request, Staff demand, Limit setting, Bad news, Ignoring Flashpoints Staff anxiety & frustration, Moral commitments, Psychological understanding, Teamwork & consistency, Technical mastery, Positive appreciation Staff Modifiers A, , IC Rules, Routine, Efficiency, Clean/tidy, Ideology, Custom & practice Internal Structure Staff Team ics s s, ne c ti blo rs g rou tive ifie ckin erna od e, Che dy, Alt ff M isitiv & Ti Sta & inqu, Clean spect t oin de, shp litu Exit Fla ecy, Soshock, r Sec ission ked m Ad CONTAINMENT ork Anxiety management, Mutual support, Moral commitments, Psychological understanding, Technical mastery rist hy , Male, g cte p ed un ara ogra. , Abusall. s, Yo Ch em nhib s, H nt & d y/disi lusion tie Pa ptomsritabiliitght, De , Ir ns Symtraits sion, I s rs , PD re oia s, Dep an Par /drug Alc Patient Modifiers al f E r Ap ame xter pe wo n Re als, Prork, Natal Stru gul io s ato ecutionnal polcture ic s, ry Fra Hospitya, Comp la lp me w olicy ints, & sis ifie od erapy al analyns ff M coth ction entio Sta. Pharmya & fun& interv rap ort the upp cho g s ts Psy ursin N or al E sic t U Re ce ilan enan ices, PIC vig t n, cho gly Main sio nts rin Ca cor, es eclu poi Dé tur ity, S ture Fea plex , Liga om ooms , C t lity ory r en ua s , Q sen nm ked rt/ iro loc omfo nv C Do y Ph Leg Flashpoints Assembly/crowding/activity Queuing/waiting/noise Staff/pt turnover/change Bullying/stealing/ prop. damage oin s; y shp tion ntit Fla rba ide e c ce/ ty Exa nden everi s e ep ity/ Ind Acu CONFLICT C Fla Ad omp shp uls m o Co mp ission ory d ints l a tre int , App eten atm de ti e en nied al ref on, D t, E , En usa Ho ue p S t x pe l a it r f f , roc efu orce , Leg Infor ess, J f M sed d m o u Co itima atio stice dif nsi cy, n g , R ier ste e i nt Comp ving, spec s po licy ensa Supp t for , Fl tor ort righ exi y a bili uto to ap ts, p ty, n Re omy eal, spe , ct ie ctiv mil in e p y th volv rs ati era em en en t su py t pp F o l r Ba a t d n sh Los ew po s o s, H in acc f rela ome ts om tio cri Arg mod nship sis, um atio or en n, t Ou ito tsid De rs, Re pe e. H nd lative en osp cy s & f Str & i am ita e s nst i l itu ly ten sors tio na sions lisa tio , Pros n, De pecti ma ve Sta nd –ve Ca s& rer ff M /re ho move lat od me i F ve if a A Vis Patient Community Patient – patient interaction Contagion & discord

Background aims Background Some flashpoints, and therefore conflict, are due in part to unclear expectations, lack of clarity or inconsistency on the unit. Aims • • • Create a more egalitarian social unit Mutual holding to account Set clear standards for both staff and patients Build consistency and predictability while allowing flexibility Ensure patients and staff understand their obligations to each other

Clear mutual expectations and the Safewards model Staff modifier: Sharing expectations, Staff modifiers finding mutual agreement Originating domains: Patient Community Staff Team Patient Originating Characteristics domains Physical environment Patient modifiers: Patient Sharing modifiers expectations, finding mutual agreement Flashpoints Conflict Containment

Task: Examples of clear expectations • What are the benefits of having clear expectations? • What expectations can be unclear?

Lack of consistency and clarity can cause problems Lack of consistency and clarity is annoying for almost everyone. It may particularly affect those who: • aren't thinking clearly • are distracted by distressing thoughts or emotions, or are preoccupied • have difficulty interpreting communication • experience changes in mood • have a distorted, or different, view of world and others • have a history of trauma

Mutual expectations for consideration • General expectations • Staff • Excluded items • Property • Places

Role of the clear mutual expectations lead • Ensure clear mutual expectations meetings occur • Communicate meeting results in a visible manner e. g. posters • Ensure the clear mutual expectations are discussed: – If you're the admitting nurse, show the information/poster and explain its contents – If you are on duty when a person is admitted, remind the admitting nurse to refer to the clear mutual expectations – At handover, ask whether the poster has been shown and explained to new patients

Clear mutual expectations fidelity Clear mutual expectations IS NOT = ≠ • Sharing expectations across the community for consistency and high standards of behaviour • Facilitating public conversation about how different groups sharing one space can respect one another • Codifying rules for patients so staff have an easier time telling patients what to do • A pretty poster or mission statement to point to when things get tricky

Clear mutual expectations adjustments CAMHS None Forensic None Older people None, usable by all