Mediating conflict between health professionals, patients and families: It’s all about the human stuff.

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Sarah Barclay, Founder/Director, The Medical Mediation Foundation.

Conflict between patients, families and health professionals is upsetting for all and can affect decision-making about medical care and treatment. All too often the warning signs are missed.  This can lead to a breakdown of relationships that may end up in court. Although recourse to the courts will lead to a decision, there are inevitably perceived to be winners and losers. Complex, often agonising dilemmas for families, patients and health professionals are portrayed (and felt) as battles.

Continue reading “Mediating conflict between health professionals, patients and families: It’s all about the human stuff.”

Are negative studies bad? – “Not at all” says Jeremy Bewley, newly elected Council member

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by Jeremy Bewley, Consultant in Anaesthesia and Intensive Care

I’ve been a member of the ICS for over 20 years and was on the trainee committee at the turn of the century.  I have fond memories of the meetings that we ran at the Belfry, Troon, Durham and Cheltenham. It was an exciting time for the specialty with the development of the UK intensive care training programme. Continue reading “Are negative studies bad? – “Not at all” says Jeremy Bewley, newly elected Council member”

Jottings from JICS: CQUINS, delayed discharges & perverse incentives

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by Jeremy Groves, Consultant Anaesthetist in Intensive Care

Looking at JICS this month the article by Stephen Gilligan, “Critical care delayed discharges: Good or bad?”, caught my eye.(1)  He argues that the evidence from ICNARC suggests that delayed discharges, especially in sicker patients, may be no bad thing.  He goes on to articulate that NHS England’s proposed CQUIN on delayed discharges (currently in limbo) would act as a perverse incentive that may have a detrimental effect on some of our patients’ outcomes. Continue reading “Jottings from JICS: CQUINS, delayed discharges & perverse incentives”

Bereavement Care in UK ICUs: Time for a Change

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by Jeremy Groves, Consultant Anaesthetist in Intensive Care

I’ve just been looking at the last Annual Report for the North Trent Critical Care Network and, if you look at the Network Units as a whole, the mortality rate is about 16%.  This equates to over a thousand deaths.  Now a death is not just a statistic.  To the relatives left behind, and to carers, there can be significant trauma.  This is true even for those with significant co-morbidity where death is always in the shadows.  It makes bereavement care a real and important issue. Continue reading “Bereavement Care in UK ICUs: Time for a Change”

Informed Consent

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by Hugh Montgomery

You’re diving a deep wreck far from the European mainland with no access to a decompression chamber and before mobile telephones; what do you do if someone gets ‘the bends’ and is paralyzed? One option: ‘Put them over the side, and report a drowning accident.’  No-one (or so a bunch of young bloods thought) would want to live paralysed. Wind forward two years, and a spinal bend happens. The victim isn’t going over the side, and no-one is actually going to put him there. Continue reading “Informed Consent”

No Smoke Without Fire: The Badness of Burnout

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by Linda-Jayne Mottram, Consultant in Anaesthesia and Intensive Care

Burnout: exhaustion of physical or emotional strength or motivation usually as a result of prolonged stress or frustration.

 

Who is at risk from burnout?

You may have heard the expression – ‘the flame that burns twice as bright burns half as long’, or similarly the colloquialism ‘to experience burnout you had to be fired up in the first place’. It suggests that only the highest achievers in medicine and nursing get burned out. I’ve started to think that this is an oversimplification. Continue reading “No Smoke Without Fire: The Badness of Burnout”

The Future Intensivist: A response

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by John Gannon

I remember the ‘critical care’ silo mentality that Dr Gary Masterson refers to. However, the problems created by so called ‘single organ doctors’, at that time, where not caused by the ‘ologists’ referred to, but by the ‘anaesthesia based intensivists’ who created the ‘silo’ mentality by shrouding critical care in the complexities of organ support. They did this by jealously guarding the critical care patch and dismissing any attempt by the ‘meddling ologists’ to get involved! Continue reading “The Future Intensivist: A response”

Wellbeing in the ICU: Countering Burnout

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by Jeremy Groves, Consultant in Critical Care

I’ve just listened to the recording of Helgi Johannson’s and Peter Brindley’s talks from the 2016 State of the Art Conference.¹ They were talking about burn-out, or in more positive language, wellbeing. These recordings will be made available in the near future on the SOA website, and we will be highlighting our favourites over the coming year, so look out for them. Burnout was one of the most popular topics at this years’ meeting Continue reading “Wellbeing in the ICU: Countering Burnout”

Meet the President

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by Gary Masterson

President of the Intensive Care Society

As your new ICS President, I thought an introduction would be useful as I don’t see myself as one of the big national names .

I was brought up in Belfast in the 60s and 70s, and studied medicine at Trinity College, Cambridge. My first exposure to critical care was during my surgical house job (or F1 in modern parlance) in Great Yarmouth, when one of my surgical patients was admitted to the intensive care unit. It was a seminal moment. I was mesmerised by the available technology, the data and numbers, and mostly the medical staff. Continue reading “Meet the President”