Formaliser l’intervention collective pour soutenir la résilience individuelle : modèle d’une analyse post-événementielle dans l’accompagnement des décès d’enfants en milieu hospitalier

Résumé Fr En

L’analyse post-événementielle est un dispositif de soutien collectif des équipes soignantes mis en place après chaque décès d’enfant hospitalisé. Sa méthodologie comprenant une régulation pour la médiation interprofessionnelle en séance oriente les échanges sous la forme d’analyse de pratiques. Elle permet le développement de l’acte individuel et collectif du travail. C’est une nouvelle voie de soutien liée à la créativité et l’expertise collective de l’équipe, dont la permanence du dispositif accompagne la progression dans le temps. La participation de l’équipe à l’amélioration de ses pratiques et de ses conditions d’organisation offre une ressource supplémentaire pour faire face à la souffrance liée à la relation à l’enfant et la famille endeuillée. L’article questionne alors la responsabilité institutionnelle dans le choix de dispositifs préventifs de soutien face aux situations générant de la souffrance au travail. Il s’appuie sur une expérience de 15 ans et illustre la méthode par une situation concrète.

Post-event analysis (PEA) is a collective support for healthcare teams put in place after each death of a hospitalized child. PEA is made up of two distinct parts: first a chronological reconstitution of the event; in a second time, analysis of practices by the multidisciplinary team. Its systematic and recurrent metho­dology implies regulation by inter-professional mediation; it guides exchanges thanks to the analysis of practices. It increases the development of the individual and collective act of work. It is a new channel of support linked to the creativity and collective expertise of the team, and this device accompanies the team progress over time. The team’s participation in the improvement of its practices and organizational conditions provides an additional resource to deal with the extreme psychological distress associated to the relationship with the child and the bereaved family. The article presents the PEA from a socio-psychoanalytic approach. It explains the main characteristics of the humanization of the healthcare sector. We present the current aim of healthcare improvement with a systemic approach. The practice improvement brings benefices for the patients (child and family) as well as for the worker’s team. In this process, the team workers are involved as actors with a real impact on their practices and on work organization. This process takes into account collective field experience, with strong attention paid to ethics. The PEA efficiency is explained by the permanence of the process with the auto-evaluation of practices and a memory of the decisions and their effects. This collective work analysis increases the team cohesion and responsibility, it helps to gain control upon the situation. All these factors increase the individual and the collective team’s resilience, when workers face painful work situations which are part of their work. Finally, this article questions the institutional responsibility in the choice of preventive devices to support situations causing suffering at work. This article is based on a fifteen-year experience; the model is illustrated by a concrete situation of child’s death.