Feeling meek? The only time you are allowed to CUSS #WILTW

This is the 124th #WILTW

The person in front of you pulls, instead of pushes, the door they are trying to get though. How long do you leave them trying to heave open something that just needs a gentle nudge forward? Probably not long and it wouldn’t bother many people (even if they are British) to intervene and witness their awkward embarrassment.

But what if you are at the resuscitation of a seriously unwell child? The mechanistics of hospital staffing with many different specialties mean you may not know all the people around the bed.

This can raise problems if someone does something out of keeping with normal practice or hasn’t noticed that the child’s condition has changed. This may mean what they are currently doing might be making things worse. Although it may be assumed any health care professional would intervene, sadly, time an again, hierachies in medicine conspire against this (please click here if video doesn’t play)

A mechanism I was reviewing this week is the ‘CUSS’ method. CUSS stands for Concern, Uncomfortable, unSafe, Stop (there are slightly different versions out there). The aim of CUSS is to give any individual an approach to becoming more assertive. The standardisation of this approach has two benefits.

i) It is empowering to the individual using it

ii) It might prompt the recipient to become an aware that the tool is being used on them. Ideally this may trigger them to reflect on their own practice.


So if you are ever in a high stakes situation and someone is going in the wrong direction maybe a chance for a good CUSS.

What have you learnt this week? #WILTW

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Details on CUSS and other situational awareness tools are available from the RCPCH Safe Programme.




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