The Healing Circle creates the opportunity for essential reflective practice, release, sharing of personal narratives and coping strategies that many providers struggle with implementing independently. Nurse-midwives and other providers are particularly vulnerable to secondary stress and trauma, which have lasting effects examined in the literature (Chan, et al., 2016). Midwives’ ability to manage and cope with the highly emotional nature of their work impacts the quality of future experiences for midwives and their physical and emotional well-being (Hunter, 2001; Burlison, et al., 2017). A supportive intervention that allows for release and processing could improve coping and ability to recover (Burlison, 2017). The Healing Circle is one such intervention.
Providing competent and compassionate care to clients with multiple social and health issues presents daily challenges for clinicians and other members of healthcare teams. This kind of chronic stress, coupled with the trauma that providers regularly face in challenging clinical settings, put providers at great risk for burnout, depression, poor sense of self, and decreased ability to effectively care for patients (Seys, et al., 2013; Rayment, 2015). The Healing Circle model provides a vehicle by which provider communities can begin to explore wounds and learn how to meaningfully process feelings of anger, guilt, sadness, hopelessness, and frustration. An outlet such as the Healing Circle allows clinicians to continue doing the complex work of caring for patients. It provides a forum within which providers can discuss challenges, acknowledge vulnerability, share best practices for building resilience, and reflect upon the value and meaning of the work they do with patients and with each other.
In implementing the Healing Circle within a number of provider communities, it has become evident that this model can serve as an acute intervention when a sentinel event occurs as well as a long-term strategy to help develop resilience and encourage adoption of healthy coping strategies and adaptations to stress. In acute care settings, a facilitated opportunity for processing of emotions following an adverse outcome provides a well-suited complement to the clinical debriefing, an established practice in many clinical care settings (Sheen, et al., 2014). During a clinical debriefing, the team directly involved reviews the events as they unfolded, including actions taken, missed opportunities for patient care and treatment, and division of roles and responsibilities. During the Healing Circle, a different type of processing take place. Participants can include individuals peripherally involved in the incident in question, and those in attendance have the opportunity to reflect on their own emotional responses, share their perspective on the experience, and contribute to the community’s process of integrating the sentinel event and beginning the work of healing. In setting the ground rules, the facilitator makes it clear that the Healing Circle is not the appropriate setting for dialogue or a detailed clinical review of the event in question, and also emphasizes that both listening and speaking are equally meaningful ways to engage. In this way, the facilitator creates a safe environment for authentic sharing to occur.
As implemented thus far, the Healing Circle has also yielded benefit for provider communities in helping to create a culture of resilience. Not only is the Healing Circle itself a practice that by its very nature creates community, but it is also an opportunity to focus participants on sharing narratives of positive coping with trauma and navigating chronic stress, finding meaning in their work, and strategies for connecting with challenging patients. Themes that often arise organically are work-life balance, maladaptive coping, healing divisions within the provider community, improving collaboration across disciplines, and ways for the community to become more resourceful in sustaining its own well-being. Regularly practiced, the Healing Circle holds promise as a means to reducing chronic stress in a work environment and helping members of a provider community more skillfully work through work-related trauma.