Mastering Intensive Care

Climate change is a conversation we need to be having in Intensive Care circles. Right now. If the environmental catastrophe that is unfolding around us continues unabated there may no longer even be Intensive Care Units. The rising global temperatures, the melting ice, the extreme weather events, and their impact on agricultural crops and human habitation may well lead to such a fall in the economy that our healthcare system may not have the financial resources it does now. And given ICUs are the most expensive part of our hospitals, have a guess what might disappear first. So who is there better to listen to about the climate crisis than British intensivist, Professor Hugh Montgomery, a deeply passionate and highly intelligent man, who was a founding member of the UK Climate and Health Council, and who has helped raise awareness about climate change for over 2 decades. In this episode Hugh outlines some simple things you can do today to help fight climate change. Hugh is a Professor and the Director of the Institute for Human Health and Performance at University College London. He obtained a 1st class degree in cardiorespiratory physiology and neuropharmacology before graduating from the Middlesex Hospital Medical School in 1987. He has since obtained specialist accreditation in Cardiology, General Internal Medicine and Intensive Care medicine, and practices as a Consultant Intensivist in North London in the UK. Hugh obtained his MD(Res) in 1997, is known for his pioneering genetic research, and has published over 450 peer reviewed papers, three in Nature. Hugh is also an author of children's books, and most recently of the medical thriller 'Control'. Hugh has a such diverse array of interests and expertise that it's hard to understand how he fits it all in. He has presented on television shows, climbed tall Himalayan mountains, run ultra-marathons, jumped naked from a plane at 14,000 feet, holds the world record for underwater piano playing, and also consults as a medical expert on Artificial Intelligence. Despite all of this, he continues to work as a clinical intensivist, publishes in the medical literature about important critical care topics, and is working to raise patient awareness about their end of life wishes. To me this is one of the most important Mastering Intensive Care episodes so far, as in a wide-ranging conversation Hugh talks about: How he became interested in physiology and then intensive care The intensivists that shaped his career Climate change and why we all need to care What actions we can take today as Intensive Care professionals to help the environment His own views on diet, renewable energy and international flights Some perspectives on the ICU ward round The importance of relationships and building connection with patients in clinical medicine How his father's experience in hospital informed Hugh How "wisdom of the crowd" assists in making diagnoses Dealing with uncertainty at the bedside The importance of speaking to patients about end of life before they are admitted to the ICU How he speaks to families of the dying An end of life project he and his colleagues are working on Why he researches what he does Some tips for public speaking How the emergence of artificial intelligence might play out in healthcare Why we need to be engaged with Big Tech His own attitudes and practice of self-care and self development His non-medical writing, including his new medical thriller book "Control" I can not recommend more highly that you settle in and listen to this amazing man, Professor Hugh Montgomery. Andrew Davies -------------------- About the Mastering Intensive Care podcast: The podcast is aimed to inspire and empower you to bring your best self to the intensive care unit, through conversations with thought-provoking guests. The hope is you'll glean insights to move you closer towards being the best and most human healthcare professionals you can be, so you can make the most valuable contribution to your patient's lives. -------------------- Links related to Hugh Montgomery Hugh Montgomery at UCL Hugh Montgomery at Whittington Hospital Hugh Montgomery at ISEH Hugh Montgomery profile Hugh Montgomery on Twitter PubMed search for Hugh Montgomery Book "Control" (by Hugh Montgomery) Book "Control" (by Hugh Montgomery) Book "Control" (by Hugh Montgomery) Book "Cloudsailors" (by Hugh Montgomery) Book "Voyage of The Arctic Tern" (by Hugh Montgomery) Review of "Control" (by Hugh Montgomery) Article 1 about "Control" (by Hugh Montgomery) Article 2 about "Control" (by Hugh Montgomery) Interview of Hugh Montgomery on Desert Island Discs Interview of Hugh Montgomery on BBC Press article 1 featuring Hugh Montgomery Press article 2 featuring Hugh Montgomery Press article 3 featuring Hugh Montgomery Press article 4 featuring Hugh Montgomery Links to people, organisations and other resources as mentioned in order throughout podcast Physiologist Eric Neil Samson Wright's Applied Physiology 13th edition Hammersmith Hospital Article discussing Ron Bradley Gillian Hanson Information about Hugh Montgomery's 2019 talk at SMACC (video not released) Lancet Commissions 2009: "Managing the health effects of climate change: Lancet and University College London Institute for Global Health Commission" Lancet Commissions 2015: "Health and climate change: policy responses to protect public health" Lancet Countdown 2017: "The Lancet Countdown: tracking progress on health and climate change" Lancet Countdown 2018: "The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health" Lancet Countdown 2018: "The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come" Lancet Countdown: Tracking Progress on Health and Climate Change Lancet on "Health and Climate Change" Lancet Infographic on "Climate Change and Health" Philosophical Transactions of The Royal Society Book "Eat & Run" (by Scott Jurek) Nature paper on microbiome and elite athletes Carbon Footprint Calculator SMACC Oli Flower Roger Harris CODA change Trillion Trees Trillion Trees Australia Whittington Hospital ITU/Critical Care University College Hospital London Andy Webb Reading Hospital YouTube search for Hugh Montgomery Moore's law Deep Neural Networks Nature Medicine paper co-authored by Hugh Montgomery "Clinically applicable deep learning for diagnosis and referral in retinal disease." Nature paper co-authored by Hugh Montgomery "A clinically applicable approach to continuous prediction of future acute kidney injury." Google Health Particle physics New Normal Project podcast New Normal Project podcast - Episode 45 with Neal Barnard New Normal Project podcast - Episode 48 with Caldwell Esselstyn New Normal Project podcast - Episode 38 with Michael Klaper New Normal Project podcast - Episode 43 with Kim Williams New Normal Project podcast - Episode 49 with Scott Stoll New Normal Project podcast - Episode 51 with Alan Desmond "2040" Movie CODA 2020 Mastering Intensive Care podcast - Episode 48 with Laura Rock Links related to Mastering Intensive Care podcast Mastering Intensive Care podcast Mastering Intensive Care page on Facebook Mastering Intensive Care at Life In The Fast Lane Andrew Davies on Twitter: @andrewdavies66 Andrew Davies on Instagram: @andrewdavies66 Email Andrew Davies Audio Producer Chris Burke

Are you a good communicator? Can you identify the skills of optimal communication? Might you sometimes respond to emotion with facts? Communication is perhaps the most important thing we do in healthcare, let alone in life. And to support our patients in understanding their ill health and their healthcare needs requires a high level of human connection for communication to be optimal. So let me introduce you to Dr Laura Rock, an American intensivist, who reminds us on this podcast that (1) communication skills are learnable, (2) there are benefits in understanding our patients emotionally, (3) we can help patients greatly if we don't try to reassure with facts when we hear emotions in the words they use, and (4) a focus on transparency, respect and curiosity can help us all to understand each other better; all of which seem likely to help us in our roles in the Intensive Care Unit. Laura is a Pulmonologist, Intensivist and Director of Communication and Teamwork for Critical Care at Beth Israel Deaconess Medical Center in Boston, Massachusetts, an Assistant Professor at Harvard Medical School, Faculty for the Center for Medical Simulation and a VitalTalk instructor. Laura studies and teaches the role of emotion in critical conversations, debriefing, feedback, and interprofessional conflict negotiation. She thinks we can change the world one conversation at a time, when we truly listen, and when we allow for creative and collaborative possibilities. When not teaching or seeing patients in the ICU, Laura loves to spend time with her family and to hike, ski, mountain bike, surf and sing. In this episode you will hear Laura speaking about many aspects of communication, also including: How she got into critical care and then became focused on communication What good communicators do to make human connection How micro-encounters and casual interactions are all part of building trust The GIVE acronym she suggests for responding to people's emotions (Get there is emotion, Identify the emotion, Validate the feelings, Explore to understand) Some examples of how to respond to what sound like comments with emotions Some thoughts on what to do when the person is angry How we should guess at people's emotions, not tell them what they are feeling Her thoughts on touch including hugs How the universality of communication skills can help us with friends and family too Being specific when helping debrief a team The teaching she does on ward rounds How most poor communication interactions can be helped by saying sorry Her self care including her approach to exercise, nature, guitar-playing, sleep and balance The gratitude she feels for having recently spent a lot of time with her dying mother. Laura is kind, caring, astute, thoughtful and the sort of listener and communicator I would have liked to have been involved in the care of my father when he was dying, something we talk about towards the end of the episode. This one is really worth listening to, no matter how good you think your communication skills are. Please listen to and learn from Dr Laura Rock. Andrew Davies -------------------- About the Mastering Intensive Care podcast: The podcast is aimed to inspire and empower you to bring your best self to the intensive care unit, through conversations with thought-provoking guests. I hope you'll glean insights to help you improve as a healthcare professional and as a human being so you can make a truly valuable contribution to your patient's lives. -------------------- Links to people, organisations and other resources mentioned: Laura Rock on Twitter Laura Rock at Beth Israel Deaconess Medical Center Laura Rock at Harvard Catalyst Laura Rock on LinkedIn Center For Medical Simulation VitalTalk Published papers by Tony Back and Bob Arnold 2019 World Congress of Intensive Care Medicine SMACC Melbourne marathon Melbourne Cricket Ground Mastering Intensive Care podcast - Episode 47 with Matt Morgan New Normal Project podcast Mastering Intensive Care podcast Mastering Intensive Care page on Facebook Mastering Intensive Care at Life In The Fast Lane Andrew Davies on Twitter: @andrewdavies66 Andrew Davies on Instagram: @andrewdavies66 Email Andrew Davies

Have you visited any of your past patients or their families in their homes? Would this be difficult? What might you learn? Medicine is mostly a series of stories of people's lives. This is a privilege we often overlook. In Intensive Care we usually only have a glimpse into each life, an almost unrecognisable flash of physical suffering, medical procedure, bedside vigil and hopefully recovery, but sadly we often miss the end of the story. What happened to that person? Did they recover? Did they regain their previous life? What do they remember? Dr Matt Morgan, a Welsh Intensivist, didn't enjoy missing the end of these stories, and he wasn't sure that laypeople really understood what we do in the ICU. So he took it upon himself to visit some of the patients or their families who he had helped care for in the Intensive Care Unit. And what he learned helped him write his recently published book "Critical - science and stories from the brink of life". Matt is a Consultant in Intensive Care Medicine at the University Hospital of Wales, and an Honorary Senior Research Fellow at Cardiff University in the UK. After completing medical school in Cardiff, where he still lives and works, Matt studied ethics at Bristol University, served as a junior doctor in the RAF, and subsequently chose the path of intensive care medicine, training in the UK and Australia, and completing a PhD. Matt is passionate about public engagement and has contributed to multiple scientific articles. The book "Critical" takes readers on a tour around the intensive care unit, meeting some of his most interesting and memorable cases. These stories include a pregnant woman who survived for weeks without a heart beat, the son of a police officer who was critically injured in a drug lab explosion, a judge who returns to the court room where he needed CPR, and an 18-year-old student who sadly died from sepsis after a trip to Africa. Throughout the book, Matt also highlights public health messages like the importance of bystander CPR, the harms of alcohol, the benefits of organ donation and how medicine is currently battling what should be done with what can be done. In this podcast conversation you'll hear Matt speak about his new book, and also about: How he has tried to mix science, history, emotions and humans together in his writing How hard it was to visit some of the patients and their families he wrote about in his book The value of doing this "deep follow up" The story of Vivi, who is understood to be the world's first ever Intensive Care patient How we can increase our use of narrative medicine including in medical note writing The changes he's made to the process of his ward round Some of his thoughts on burnout and how he deals with the demands of work The importance he places on sleep His views on mindfulness What he says and does in a family meeting The question he thinks is crucial in a family meeting How he involves trainees in these meetings Some advice for difficult conversations The value of reading outside of intensive care and outside of medicine His obsession with animal physiology His thoughts on changes we need to make in intensive care Matt is an excellent writer with a gift for describing disease and concepts very simply. He speaks articulately too. Please enjoy listening to Matt Morgan. Andrew Davies -------------------- About the Mastering Intensive Care podcast: The podcast is aimed to inspire and empower you to bring your best self to the intensive care unit, through conversations with thought-provoking guests. I hope you'll glean insights to help you improve as a healthcare professional and as a human being so you can make a truly valuable contribution to your patient's lives. -------------------- Links to people, organisations and other resources mentioned: Dr Matt Morgan website Matt Morgan on twitter Book "Critical" (by Matt Morgan) Blog piece "The ward round is broken" (by Matt Morgan) Blog piece "Burnout in healthcare workers - are we surprised" (by Peter Brindley and Matt Morgan) Other BMJ blog pieces by Matt Morgan Other blogs by Matt Morgan If this then that (IFTTT) Book "Why we Sleep" (by Matt Walker) Mastering Intensive Care podcast - Episode 40 with Ed Litton Mastering Intensive Care podcast - Episode 41 with Rana Awdish Mastering Intensive Care podcast - Episode 46 with Deborah Cook 2019 World Congress of Intensive Care Medicine New Normal Project podcast New Normal Project podcast - Episode 56 with Brad Dalrymple Mastering Intensive Care podcast Mastering Intensive Care page on Facebook Mastering Intensive Care at Life In The Fast Lane Andrew Davies on Twitter: @andrewdavies66 Andrew Davies on Instagram: @andrewdavies66 Email Andrew Davies

What do you do for your patients around their dying experience? Do you celebrate their lives and support those left behind in grief? Could you bring more humanity to your ICU? Whilst you and your ICU colleagues likely act with kindness much of the time, I suspect listening to this podcast will have you wondering whether you could do better, especially when your patients are receiving end of life care. This episode's guest, Professor Deborah Cook, from Hamilton in Canada, is striving to do this through the 3 Wishes Project she and her colleagues initiated several years ago. They encourage specific wishes unique to their dying patients, thereby dignifying the person, giving greater voice to the family and evoking clinician compassion. In this podcast you will hear all about this profound and important work, the sort of acts of kindness that have occurred in her ICU, the way you could approach this in your ICU, the benefits to clinical staff and institutional leaders, some of the logistical challenges they've faced, and some thoughts on spiritual care in the ICU. Deborah Cook is a Distinguished Professor at McMaster University in the Departments of Medicine, Clinical Epidemiology and Biostatistics. As a life long clinician-scientist, she holds the first Canada Research Chair in Intensive Care Medicine and is the Academic Chair in Critical Care Medicine at McMaster. She is a founding member and 2-term Chair of the Canadian Critical Care Trials Group. Deborah is an active practitioner in critical care medicine at St. Joseph's Hospital where she supervises junior and senior clinical trainees. She is devoted to mentoring Masters and PhD graduate students in McMaster's Health Research Methodology Program, and junior faculty around the world, resulting in the creation of the Deborah J Cook Mentorship Award by the Canadian Critical Care Trials Group. Deborah has published over 700 peer-review articles with an associated H index of 168. Her multi-method multi-disciplinary research interests include life support technology, prevention of ICU-acquired complications, end-of-life care, and research ethics. She has received numerous national and international awards for her practice, teaching, mentoring and research. She is a pre-eminent critical care scholar. Dr. Cook was inducted as a Fellow of the Royal Society of Canada (2009), a Fellow of the Canadian Academy of Health Sciences (2010), and received the inaugural Distinguished Lecturer Award in Critical Care Sciences from CIHR's Institute of Circulatory and Respiratory Health (2017). Her work on microbiome modification in critical illness using probiotics resulted in a prestigious Killam Fellowship in Health Sciences from the Canadian Council of the Arts (2017). Deborah received the Gold Leaf Award from CIHR for her enduring contributions to health care (2019). For life long scientific contributions to the improvement of global intensive care and her foundational leadership in the first national ICU research network in the world, Dr. Cook was appointed an Officer of the Order of Canada (2016). In this conversation Deborah also talks about: How she was drawn to intensive care from internal medicine How she discovered several gold mines to conduct research on Her belief that following your passion is the key to research success How humanity has fallen by the wayside as intensive care has developed How she was dissuaded from doing end of life research early in her career The growing interest in ethics and end of life care How she approaches ward rounds Dealing with our fixation on computer screens Being present and avoiding note-writing on ward rounds Her high expectations as a clinical mentor (including of herself) The importance of presence and engagement as the attending consultant The irrelevance of many of the words spoken on ward rounds The importance of keeping things fresh by releasing dying passions Her thoughts about how she cares for herself Which exercise and which books she prefers Her mindfulness practice Her love for family Some invaluable career tips Deborah is passionate about patients receiving the very best care, about clinicians delivering this in an organised and cohesive fashion, and about researchers providing the highest quality evidence to guide this. She has been a kind friend and advisor to me over many years and I can't think of anyone with a better mix of acumen, experience and personality as the ideal Mastering Intensive Care podcast guest. She is a personal favourite so please enjoy listening to the wonderful Deborah Cook. Andrew Davies -------------------- About the Mastering Intensive Care podcast: The podcast is aimed to inspire and empower you to bring your best self to the intensive care unit, through conversations with thought-provoking guests. I hope you'll glean insights to help you improve as a healthcare professional and as a human being so you can make a truly valuable contribution to your patient's lives. -------------------- Links to people, organisations and other resources mentioned: Deborah Cook (McMaster University) Article about Deborah Cook Article 2 about Deborah Cook Video of Deborah Cook Canadian Critical Care Trials Group PROTECT study comparing dalteparin and heparin The 3 Wishes Project Publication from 3 Wishes Project Other publications from 3 Wishes Project ANZICS Clinical Trials Group David Sackett Book "Essentialism – The Disciplined Pursuit of Less" (by Greg McKeown) Mastering Intensive Care podcast - Episode 45 with Scott Weingart EMCrit podcast 2019 World Congress of Intensive Care Medicine New Normal Project podcast Plantfit Summit Mastering Intensive Care podcast Mastering Intensive Care page on Facebook Mastering Intensive Care at Life In The Fast Lane Andrew Davies on Twitter: @andrewdavies66 Andrew Davies on Instagram: @andrewdavies66 Email Andrew Davies

Today's guest is Scott Weingart, the pioneer podcaster in the intensive care field through his EMCrit podcast. Scott is an ED Intensivist from New York, where he is Chief of the Division of Emergency Critical Care at Stony Brook Hospital and a Professor of Emergency Medicine at Stony Brook Medicine. Scott has devoted his career to bringing "Upstairs Care, Downstairs" (ie. bringing ICU care down to the ED - where it needs to be). He loves his job taking care of the sickest patients, innovating new ways to do it better, and then teaching these concepts to his residents. Of course, none of that is nearly as much fun as playing with his son, Mace. Scott is best known for talking to himself about Resuscitation and Critical Care on the EMCrit podcast, which has been downloaded over 20 million times. EMCrit is also a hugely valuable blog and educational resource. In this conversation Scott talks about: How he trained to be where he is now as an ED intensivist What inspired his mission to improve critical care prior to ICU admission How he got into podcasting The benefit of putting his views out into the online community How podcasting and new media can allow the "small to be seen" The automatic peer review built in to his podcasting The value he's had from SMACC conferences and the FOAM movement His obsession to improve What a day in his life is like How his martial arts experience spurned his meditation practice What his minimal effective dose of meditation is His thoughts and use of negative visualisation and mental rehearsal The value of errors in improving ourselves The need to be care- rather than people-orientated in resuscitation How his communication is changing over time The use of dramatic pauses to spur knowledge translation and learning His advice on reading And some of his favourite books and podcasts Scott is a deep-thinking man, very focused on understanding and practicing well considered and patient-oriented care particularly at the resuscitation end of intensive or critical care medicine, and is very good with spoken language. Please enjoy listening to Scott Weingart. Andrew Davies -------------------- About the Mastering Intensive Care podcast: The podcast is aimed to inspire and empower you to bring your best self to the intensive care unit, through conversations with thought-provoking guests. I hope you'll glean insights to help you improve as a healthcare professional and as a human being so you can make a truly valuable contribution to your patient's lives. -------------------- Links to people, organisations and other resources mentioned: Scott Weingart Scott Weingart on Twitter: @emcrit EMCrit podcast & website Liz Crowe Essay: The Thousand True Fans (by Kevin Kelly) Seth Godin SMACC Talk by Scott Weingart "The Path to Insanity" Talk by Scott Weingart "Kettlebells for the Brain" Mastering Intensive Care podcast - Episode 21 with Martin Bromiley Book "House of God" (by Samuel Shem) Cliff Reid Chris Hicks Sara Gray Mastering Intensive Care podcast – Episode 13 with Sara Gray Book "A Confederacy of Dunces" (by John Kennedy Toole) Book "Catch 22" (by Joseph Heller) 99% Invisible podcast Radiolab podcast The Flop House podcast Mastering Intensive Care podcast – episode 44 with Geoff Toogood Crazy Socks 4 Docs New Normal Project podcast Mastering Intensive Care podcast Mastering Intensive Care page on Facebook Mastering Intensive Care at Life In The Fast Lane Andrew Davies on Twitter: @andrewdavies66 Andrew Davies on Instagram: @andrewdavies66 Email Andrew Davies

To help raise awareness about #CrazySocks4Docs this episode's guest is Dr Geoff Toogood. Geoff is a Cardiologist at Peninsula Health and in Private Practice in Melbourne, Australia. He is also a Board Member of South West Health Care, Ambassador for Beyond Blue and Ambassador for Masters Swimming Victoria. He is both a pool and open water swimmer, having competed at National and International level, using swimming for his mental wellbeing. Geoff has completed a relay across the English Channel, swum solo in the Rottnest Island swim and many other open water and pool swims. Despite having a cardiologist on the show, this is mostly a talk about mental health, rather than cardiology. Geoff has had his share of mental health struggles, having had a period of anxiety early in his career and then more recently severe depression leading to suicidal ideation. But most importantly, Geoff has used his story, told humbly and vulnerably, to create awareness about Doctors mental health and to break the stigma, through the CrazySocks4Docs movement, which you'll hear about today. All healthcare workers are at risk of mental health issues. They are more common than we realise. Mental health disorders can lead to burnout, divorce and suicide. We must talk more about this issue; so we can understand this, do things to help reduce the risk, and to help each other when we identify mental ill health in our colleagues. If we talk about this as an industry, we will hopefully all be better off. We, ourselves. Our colleagues. And more importantly, our patients. The conversation on this podcast covers: Why Geoff got into medicine and then into cardiology How cardiology has changed over his career His mental health journey starting with anxiety as a younger doctor How this progressed to depression and then suicidal ideation Some of the symptoms he felt, and the ways he supported himself His need to take leave from work and what that meant The problems of needing to see mental health professionals Dealing with telling his colleagues at work The contribution of a medical work schedule and other life stressors His current wellbeing strategies including sleep and swimming His impressive swimming career and how this acts as mindfulness How helpful it's been to him to tell his story Thoughts on resilience and the stigma of mental ill health How the Crazy Socks For Docs movement began About the 2019 #CrazySocks4Docs day on June 7th The #CrazySocks4Docs Panel Discussion being held on May 31st 2019 How his mental health is now The value of mindfulness and yoga as wellbeing tools Hearing about Geoff's struggles, how he has dealt with them, and his ongoing advocacy, is more than helpful. It's powerful. Please enjoy listening to Geoff Toogood. Andrew Davies -------------------- About the Mastering Intensive Care podcast: The podcast is aimed to inspire and empower you to bring your best self to the intensive care unit, through conversations with thought-provoking guests. I hope you'll glean insights to help you improve as a healthcare professional and as a human being so you can make a truly valuable contribution to your patient's lives. -------------------- Links to people, organisations and other resources mentioned: Geoff Toogood on Twitter: @gdtoogood Crazy Socks For Docs website Crazy Socks For Docs on Twitter: @crazysocks4docs Crazy Socks For Docs on Instagram: @crazysocks4docs Crazy Socks For Docs on Facebook Geoff Toogood on LinkedIn Peninsula Health South West Health Care Masters Swimming Victoria Beyond Blue Lifeline English Channel Swim Pier to Pub Swim Portsea Swim Classic Rottnest Island Swim Dr Sally Cockburn Prof Michael Myers on Twitter: @downstatedoctor Dr Kate Harding on Twitter: @katejh1970 Dr Yumiko (Miko) Kadota on Twitter: @mindbodymiko Article 1 written by Geoff Toogood Article 2 written by Geoff Toogood Articles 3 & 4 written by Geoff Toogood Article 1 written about Geoff Toogood Article 2 written about Geoff Toogood Article 3 written about Geoff Toogood Article 4 written about Geoff Toogood Article 5 written about Geoff Toogood Article 6 written about Geoff Toogood Article 7 written about Geoff Toogood Article 8 written about Geoff Toogood Video of talk by Geoff Toogood Video of TV show featuring Geoff Toogood New Normal Project podcast New Normal Project podcast - Episode 53 with John Orchard Mastering Intensive Care podcast - Episode 32 with Kate Harding Mastering Intensive Care podcast - Episode 43 with Jo Stewart Mastering Intensive Care page on Facebook Mastering Intensive Care at Life In The Fast Lane Andrew Davies on Twitter: @andrewdavies66 Andrew Davies on Instagram: @andrewdavies66 Email Andrew Davies

On International Nurses Day, please listen to Jo Stewart, the Clinical Nurse Unit Manager at the ICU in which I work - Frankston Hospital. On May 12th, the date that commemorates the birthdate of Florence Nightingale, we celebrate every single one of the many nurses who support and care for us when we are sick. Pretty much everyone on earth comes in contact with a nurse and, for us in intensive care, nurses are so important to all that we do. Let me simply say thank you to the nurses of the world. You are the lifeblood of healthcare, and especially in hospitals. I have learnt from watching hundreds of you; about how to better care for a patient, about how to better communicate, and how to better support a critically unwell person and their loved ones. If you read the cards that are sent to the ICUs when the patients and their families want to say thank you, you'll see who they value the most. Our nurses are simply amazing. On this episode I speak with Jo Stewart. Her role as Clinical Nurse Unit Manager allows her to offer training and support to the nurses of Frankston ICU as well as to work on quality and operational requirements of the unit. Jo is passionate about education and supporting novice nurses and brings experience from a variety of specialty ICU nursing areas such as Cardiothoracics (including ECMO), Neurosurgery, and Critical Care Liaison Nursing. Jo completed her Masters in Intensive Care Nursing at The Alfred Hospital in 2007, worked in Vancouver, and then commenced working at Frankston Hospital as a Clinical Support and Development Nurse in ICU in 2011 whilst concurrently lecturing at Monash University for both Undergraduate and Post Graduate Nursing courses. In the episode Jo speaks about: How she got into ICU nursing and what she enjoys about it Attracting and retaining ICU nurses The various roles she has worked in throughout her career Educating nurses How Jo educates herself Leading as a nurse unit manager Creating the right culture as a leader How she allocates her own time to different tasks Interactions between doctors and nurses in the ICU Principles of good communication Her self-care practices Encouraging wellness for the nursing workforce Working better as a team Some tips for the ICU doctors Jo is extraordinarily passionate and enthusiastic about her role. She is very welcoming, always happy for a chat, and I thought she would make an excellent guest for the show. Please enjoy listening to Jo Stewart. Andrew Davies -------------------- About the Mastering Intensive Care podcast: The podcast is aimed to inspire and empower you to bring your best self to the intensive care unit, through conversations with thought-provoking guests. I hope you'll glean insights to help you improve as a healthcare professional and as a human being so you can make the most valuable contribution to your patient's lives. -------------------- Links to people, organisations and other resources mentioned: Jo Stewart on Twitter: @JoStu82 Frankston Hospital ICU website BASIC for nurses FOAM (free open-access medical education) Insight Timer Smiling Mind 1 Giant Mind Mastering Intensive Care podcast: Episode 42 with Paul Young Mastering Intensive Care page on Facebook Mastering Intensive Care at Life In The Fast Lane Andrew Davies on Twitter: @andrewdavies66 Andrew Davies on Instagram: @andrewdavies66 Email Andrew Davies

What it is like when a much loved and respected leader in your Intensive Care suddenly dies? And do you view the people you work with in your ICU as an extended family? Paul Young, an Intensivist from New Zealand, discusses his perspectives on these questions, amongst many other valuable insights, in this important and moving interview. Paul Young is an intensive care specialist at Wellington Hospital in New Zealand where he is the co-clinical leader at Wellington ICU. He is also medical director of Wakefield Hospital ICU, Deputy Director at the Medical Research Institute of New Zealand, and holds a Clinical Practitioner Research Fellowship from the Health Research Council of New Zealand. Paul's predominant non-clinical interest is in ICU research. Since starting work as an intensive care specialist in 2010 he has published more than 120 papers in peer-reviewed journals including five papers in the New England Journal of Medicine, two in JAMA, and one in the Lancet. His involvement in clinical research has been instrumental in the development of his belief that intensive care is fundamentally about keeping people alive for long enough for them to recover whilst meddling as little as possible. In his leadership roles he encourages people to find joy in their work and to be nice to each other yet he constantly battles with his own tendency towards sarcasm. In late 2018, Dr Peter Hicks, the Clinical Lead at Wellington Hospital died suddenly. Peter was an excellent intensivist, a wonderful leader, and a friend to many in the Australian and New Zealand ICU community. His death is sad for all who knew him and most notably his family and colleagues. Paul speaks in this interview about the legacy Peter left behind, how Peter particularly guided Paul in his career and how the Wellington ICU is moving on after Peter's untimely death. In this conversation, Paul also discusses: Why he became an intensivist The cultural differences between Australia and New Zealand Telling the truth about his thoughts on the patient's likely outcome Worrying - and when it's useful and not useful The specifics of his ward round What it's like to have consultants changing daily in his ICU The start to his research career Some insights on designing clinical trials to answer important questions Why "negative studies" are so important to advance clinical practice (using the TARGET study as an example) How he keeps up with the literature including with Twitter His efforts to be more kind and to get on with people The effects of running on his general wellbeing A challenge for other units to try a "day about" clinical roster Paul is clever, incisive, and is delightfully able to simplify many concepts about intensive care practice and research. Please enjoy listening to Dr Paul Young. Andrew Davies -------------------- About the Mastering Intensive Care podcast: The podcast is aimed to inspire and empower you to bring your best self to the intensive care unit, through conversations with thought-provoking guests. I hope you'll glean insights to help you improve as a healthcare professional and as a human being so you can make a truly valuable contribution to your patient's lives. -------------------- Links to people, organisations and other resources mentioned: Paul Young on Twitter: @dogICUma Wellington ICU website Tribute to Peter Hicks written by David Pilcher ANZICS CTG (Australian and New Zealand Intensive Care Society Clinical Trials Group) Rinaldo Bellomo Critical Care Reviews Rob MacSweeney Wellington ICU Journal Club on Twitter: @WellingtonICU TARGET study Tweetorial on the TARGET study by Paul Young Rana Awdish on Twitter: @RanaAwdish Book "In Shock" (by Rana Awdish) Mastering Intensive Care podcast: Episode 3 with Rinaldo Bellomo Mastering Intensive Care podcast: Episode 19 with Alex Psirides Mastering Intensive Care podcast: Episode 20 with Jack Iwashyna Mastering Intensive Care podcast: Episode 23 - The Best of 2017 (Part 1) Mastering Intensive Care podcast: Episode 24 - The Best of 2017 (Part 2) Mastering Intensive Care podcast: Episode 39 - The Best of 2018 Mastering Intensive Care podcast – episode 41 with Rana Awdish Mastering Intensive Care podcast Mastering Intensive Care page on Facebook Mastering Intensive Care at Life In The Fast Lane Andrew Davies on Twitter: @andrewdavies66 Andrew Davies on Instagram: @andrewdavies66 Email Andrew Davies: andrew@masteringintensivecare.com

If you work in healthcare and haven't read the book "In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope" I really hope you will. In the meantime listen to intensivist and best-selling author Dr Rana Awdish on this week's episode of Mastering Intensive Care and you'll understand why. In her book, Rana brilliantly tells the real-life story of her near-death experience and subsequent recovery into which she weaves insightful observations and reflections on both the good and the bad of the healthcare she witnessed. Whilst Rana would have died without the excellence of the team who managed her sudden medical crisis the seeming lack of humanity was stark and frequently counterproductive. At the time Rana was in the final days of her Critical Care Fellowship in Detroit. Now an intensivist and frequent public speaker she has ample experience and expertise to assist intensive care clinicians to improve, the aim of this show. Rana graduated from Wayne State University School of Medicine in Detroit, completed Internal Medicine residency in New York, and then Pulmonary and Critical Care Medicine Fellowships at Henry Ford Health System in Detroit where she now works. She is Assistant Professor at the Department of Internal Medicine, Director of the Pulmonary Hypertension program, Senior Staff Physician in the Department of Pulmonary and Critical Care Medicine and Medical Director, Care Experience. Amongst many accomplishments she is the Physician Facilitator for the CLEAR Conversations program, teaches on communication, bioethics and physician wellness, and has won the National Compassionate Caregiver of the Year Award at the Schwartz Center for Compassionate Healthcare. Apart from beautifully describing how it really felt to be a patient, Rana also talks about: The suboptimal communication encounters she remembers Her gratitude for the skill and grace she received The benefits of being more engaged and connected with our patients Why first impressions matter The value of curiosity Using mindfulness to enhance presence What being cut off from knowledge as a patient felt like Her experience of asking for working suction in her own operation The value of community in unburdening ourselves as health practitioners How Schwartz rounds can be helpful The very first patient she met after recovering from her illness Her belief that showing compassion will make you more efficient The healing effect of family member presence The benefits of self-care (and what Rana does herself) The part spirituality might play in healthcare Better understanding the use of opiates and pain management Going home after a chronic critical illness How the whole experience has affected how she acts on ward rounds Our own healthcare experiences should not be the main driver towards the compassionate and caring practitioners our patients need. But as you'll hear in this episode, they can deliver the sort of truth and learning we may not otherwise find. Please enjoy listening to Dr Rana Awdish. Andrew Davies -------------------- About the Mastering Intensive Care podcast: The podcast is aimed to inspire and empower you to bring your best self to the intensive care unit, through conversations with thought-provoking guests. I hope you'll glean things to help you improve as a healthcare professional and as a human being so you can make a truly valuable contribution to your patient's lives. -------------------- Links to people, organisations and other resources mentioned: Rana Awdish on Twitter @RanaAwdish Rana Awdish website Book "In Shock" (by Rana Awdish) Mastering Intensive Care podcast – episode 35 with Paul Wischmeyer CLEAR conversations Schwartz Center for Compassionate Healthcare Kenneth Schwartz Schwartz rounds Mindful Practice with Ronald Epstein and Mick Krasner New York Times article "After Surgery in Germany, I Wanted Vicodin, Not Herbal Tea" (by Firoozeh Dumas) Mastering Intensive Care podcast – episode 40 with Ed Litton SMACC New Normal Project podcast Mastering Intensive Care podcast Mastering Intensive Care page on Facebook Mastering Intensive Care at Life In The Fast Lane Andrew Davies on Twitter: @andrewdavies66 Andrew Davies on Instagram: @andrewdavies66 Email Andrew Davies

This week's guest, Australian intensivist Dr Ed Litton, truly amazes and inspires me. Despite having a full-time clinical and research career, and a young family, Ed pursues his passion for adventure mostly through ultra-endurance exercise. Many intensivists run, swim, cycle or do other sorts of vigorous exercise in their spare time. Some even run marathons, swim regularly with a squad or cycle long distances to and from work. Some do all 3 by competing in triathlon events. Yet not too many intensivists take on ironman triathlons like Ed does. And how many cycle across Australia from Sydney to Perth as he did a couple of years ago? Ed uses adventure and exercise to keep refreshed for his busy medical career. So to me this podcast conversation is a real treat. Hearing about this massive cross-continent bike ride, the recent family cycling trip across the New Zealand Alps he and his wife did with their 2 young children, and his love for other physical pursuits like surfing and climbing, is both educational and inspiring. Ed Litton is a Staff Specialist in Intensive Care Medicine and Director of ICU Research at Fiona Stanley Hospital in Perth, Australia, and a Clinical Research Fellow in the ICU at St John of God Hospital in Subiaco. He is the recipient of a National Health and Medical Research Council Early Career Fellowship and is a Clinical Senior Lecturer at the University of Western Australia. Ed is a member of the executive committee of the Australia and New Zealand Intensive Care Society Centre for Outcomes Research Evaluation where he is clinical director of the Critical Care Resources Registry. He's received over $6M in research support and published over 60 manuscripts in the peer reviewed literature. I have admired Ed and his thoughtful approach to intensive care and to life for several years now. Apart from his approach to adventure and exercise he has many valuable perspectives on his bedside approach including: What fascinates him about Intensive Care Some of the things he learnt from his key mentors The importance of reassurance for patients Mixing patient-centred and digital information The 2 phase ward round at his ICU The internal pressure he felt as a new consultant to make fast decisions Creating the right atmosphere in communicating with colleagues His tendency to ruminate about his patients Fatigue during ward rounds His thoughts on sleep How he uses meditation The value of reading books The difficulty in trying to be a jack of all trades in our careers. Ed is caring, mature and very patient-focused. He's also a super fit athlete. Please enjoy listening to the podcast. Andrew Davies -------------------- About the Mastering Intensive Care podcast: The podcast is aimed to inspire and empower you to bring your best self to the intensive care unit through conversations with thought-provoking guests. I hope you'll hear perspectives to help you improve as a healthcare professional and as a human being with the aim of helping your patients receive the best possible care. -------------------- Links to people, organisations and other resources mentioned: Ed Litton on Twitter: @ed_litton Article about Ed Litton's bike ride across Australia Alex Psirides Simon Finfer Muse Rottnest Island swim New Normal Project podcast New Normal Project podcast - episode 48 with Caldwell Esselstyn New Normal Project podcast - episode 49 with Scott Stoll Book "In Shock" (by Rana Awdish) Mastering Intensive Care podcast Mastering Intensive Care page on Facebook Mastering Intensive Care at Life In The Fast Lane Andrew Davies on Twitter: @andrewdavies66 Andrew Davies on Instagram: @andrewdavies66 Email Andrew Davies