Reflection on Difficult Facilitation

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I was involved in updating nursing staff after an incident involving controlled drugs (CDs) was highlighted to the ward manager. My aim was to facilitate staff to be more vigilant when performing safety checks involving CDs. In ICU we use a lot of CDs and there is perhaps a more relaxed culture/attitude towards them than I remember as a student nurse in the general ward environment. I believe this is may have contributed to the error.

As I had to update staff during the shifts, taking them away from their patients, I felt the best way to update them would be to use a short PowerPoint presentation followed by questions from the staff. I reread the NMC standards for admin of meds, the Trust’s policy and ICU’s policy relating to this and put my presentation together using these resources.

In ICU it is practice that only one nurse goes into the CD cupboard, verifies stock his or herself and then brings the CD book and drug to the bedside where the second nurse checks the drugs. My ward manager and I believed that the incident may have been less likely to happen if 2 nurses were present throughout the whole procedure (including checking stock at the cupboard). This was only part of my presentation but to the nursing staff on the floor, this posed the biggest change/problem. I encountered much resistance when I informed staff that this is what would be expected of them and even when I stated that the NMC consider this best practice, I was still met with resistance.

I remember one update in particular for all the wrong reasons. I had delivered the presentation but was aware of defensive/resistant body language throughout from one member of staff in particular (arms folded, poor eye contact etc). I knew that when I reached the end of my presentation, she was going to have a lot to say! No matter how much I reiterated my points and explained the reasons for the change, she had an answer and was making things very difficult for me. The other staff...
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