Tool: I'M SAFE Checklist
Being aware of, and honest about, your own physical, mental, and emotional health is a vital component of situation monitoring. “I’M SAFE” is a simple checklist that can be used to assess the ability of you or your team members to perform safely. While the checklist is simple, it is not designed to help you make rapid and overly simplistic assessments of whether it is safe for you or another team member to provide healthcare. Instead, it provides information that you should account for as you work together as a team.
Providers sometimes experience high levels of stress and burnout. Both patients and other team members live in a world full of stressors. Finances, workload, family responsibilities, and staff turnover affect everyone and affect how focused individuals are on their assigned tasks. Each element in I’M SAFE has a proven connection to impaired job performance and the ability to process and respond to messages from others.
Attempting to “fix” behaviors of others without an awareness of the factors that may be causing them can be ineffective or even counterproductive. I’M SAFE calls attention to underlying causes that may explain concerning behaviors or provide alerts to potential risks that need to be addressed.
How To Effectively Use the I'M SAFE Checklist
When assessing your own or other team members’ current ability to perform safely, consider the following:
- Illness: Am I feeling so bad that I cannot perform my duties?
- Medication: Are medications I am taking affecting my ability to maintain situation awareness and perform my duties?
- Stress: Is there anything, such as a life event or situation at work, that is detracting from my ability to focus and perform my duties?
- Alcohol/drugs: Is my use of alcohol or drugs affecting me such that I cannot focus on the performance of my duties?
- Fatigue: Am I tired? The effects of fatigue should not be ignored. Team members should alert the team regarding their state of fatigue—for example, saying, “Watch me a little closer today. I only had 3 hours of sleep last night.” Longer term issues of burnout are more difficult to assess but should be considered. The loss of energy can be gradual and harder to detect, but burnout has a direct relationship to one’s ability to respond appropriately in both emergencies and routine activities.
- Eating and elimination: Has it been considerably longer than normal since I have eaten or used the restroom? At times, when focusing on ensuring patients’ needs, providers forget to take care of their own. Not caring for eating and elimination needs affects our ability to concentrate and stresses us physiologically.
While reflecting on your current situation, ask yourself these questions:
- In your current situation, would you feel able to express that you are not as safe as normal? Would you feel comfortable raising this issue with a coworker? Frequently, these are not yes-no answers. Instead, it may require you to confront issues that make you or the coworker less safe in the moment.
- What factors inhibit you or others from saying you are not safe or contribute to an inability to do so?
- If you feel inhibited, what can you do to change the culture?
