5. Preparation and Consent

Illustrative case

Preparing for video review and obtaining provider consent are essential. But how do you actually implement these principles on a day-to-day basis?

Dr. van der Velde entered the bustling ICU room, where a team was stabilizing a critically ill patient, Mr. Jansen. Intubation was imminent to support his failing lungs. She scanned the room: Nurse Jeroen at the medication cart, Resident Max preparing the intubation equipment, and Respiratory Therapist Eva monitoring the ventilator.

Before initiating recording, Dr. van der Velde paused. "Team," she began, "I'd like to record this procedure with the ICU cameras. It's great for review and teaching. Any concerns?" No one objected, but Nurse Jeroen looked hesitant.

"Nurse Jeroen," Dr. van der Velde acknowledged, "Is anything on your mind? We fully support individual choice."

"It's not that, Doctor," he replied. "I'm just new to this unit, and it's my first time being recorded."

"Understandable," Dr. van der Velde affirmed. "How about we record, then afterwards, you and I preview it together. If you're not comfortable, no worries – it won't be used for anything." Nurse Jeroen nodded, relieved.

The procedure went smoothly. Afterwards, Dr. van der Velde and Nurse Jeroen sat down with the video. He fast-forwarded through setup, pausing during intubation. "Excellent airway positioning there," Dr. van der Velde praised, then later, "I noticed a slight delay in medication administration here. Let's discuss why, it might be something to optimize next time."

Nurse Jeroen relaxed. "This is actually helpful! I was nervous about recording, but seeing it back is valuable."

A week later, Dr. van der Velde planned the ICU's bi-weekly video review session. Knowing Nurse Jeroen had found recording valuable, she approached him. "Nurse Jeroen, mind if we use the intubation video for review? You can share your insights too."

He smiled. "Actually, that would be great."

During the session, Nurse Jeroen's perspective was a highlight, providing a valuable learning opportunity for the entire team. Dr. van der Velde reflected – triple consent wasn't just about respecting choice; it was about creating a culture where everyone felt empowered to learn and improve, together.

Here are some key considerations:

• Proactive Consent: Before recording, Dr. van der Velde transparently states her intention and seeks the consent of the entire team. This sets a standard of respect and empowers individuals to voice concerns.

• Addressing Individual Hesitation: Sensitivity to Nurse Jeroen's discomfort highlights the importance of addressing underlying apprehensions. It's not just about agreement, but about ensuring true comfort.

• "Triple Consent": Dr. van der Velde demonstrates that consent is an ongoing process:

  1. Consent to record

  2. Consent after recording

  3. Consent to share for wider learning

• Private Review as Learning Tool: The one-on-one review with Nurse Jeroen transforms a potentially stressful experience into a positive one, building confidence and openness to feedback.

• Fostering a Learning Culture: Nurse Jeroen's willingness to share his experience during the group review emphasizes the value of creating a safe, non-judgemental environment where everyone's perspective is valued for overall improvement.

• The Power of Empowerment: The story showcases how empowering individuals to actively participate in the video review process enhances learning outcomes, team dynamics, and a shared commitment to patient care.