Podcast appearances and mentions of wellington icu

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  

Rob Mac Sweeney is an intensivist working at the Royal Victoria Hospital in Belfast, Northern Ireland. He founded and runs Critical Care Reviews, a free, not-for-profit critical care educational project spanning a website, journal watch facility, newsletter, international meeting, annual book and podcast. He also co-founded a platinium open access journal, Critical Care Horizons. Rob is a passionate believer that scientific advances, especially through publically funded research, should be available to all and works to promote open access to such work through Critical Care Reviews and Critical Care Horizons. Alex Psirides is an Intensive Care specialist working in Wellington, having trained in London, Melbourne and New Zealand. He has been involved in the design and implementation of Rapid Response Systems in several different hospitals. Because of this, he is clinical lead for the New Zealand Health Quality & Safety Commission’s national ‘Deteriorating Patient’ programme. In his spare time, when not walking his dog or his children, he builds websites & designs logos for Wellington ICU’s prodigious research department. He has nearly written a lot more research papers & as such needs to spend less time on Twitter. He also once ventilated a chimpanzee but it didn’t end well (for the chimp).

Alex is an Intensive Care specialist working in Wellington, having trained in London, Melbourne and New Zealand. He has been involved in the design and implementation of Rapid Response Systems in several different hospitals. Because of this, he is clinical lead for the New Zealand Health Quality & Safety Commission’s national ‘Deteriorating Patient’ programme. In his spare time, when not walking his dog or his children, he builds websites & designs logos for Wellington ICU’s prodigious research department. He has nearly written a lot more research papers & as such needs to spend less time on Twitter. He also once ventilated a chimpanzee but it didn’t end well (for the chimp).

Alex is an Intensive Care specialist working in Wellington, having trained in London, Melbourne and New Zealand. He has been involved in the design and implementation of Rapid Response Systems in several different hospitals. Because of this, he is clinical lead for the New Zealand Health Quality & Safety Commission’s national ‘Deteriorating Patient’ programme. In his spare time, when not walking his dog or his children, he builds websites & designs logos for Wellington ICU’s prodigious research department. He has nearly written a lot more research papers & as such needs to spend less time on Twitter. He also once ventilated a chimpanzee but it didn’t end well (for the chimp).

Are you receiving elderly intubated patients where someone else says they want “everything” done? Are the doctors who refer patients to intensive care finding out what their patients really want towards the end of life? Does this frustrate you on a daily basis?   This is a huge topic in intensive care. Finding out the wishes of our patients before they end up on a ventilator with no one to speak for them is vital if we wish to deliver optimal healthcare. Yet so often we intensivists are left to deal with this situation. And whilst in most cases we do this very well, many of us like Dr Alex Psirides, a UK, New Zealand and Australian-trained intensivist, feel the despair as we hold another lengthy meeting with a patient’s family. In this episode I spoke with Alex about this topic, which he had just delivered a brilliant TED-like talk on at the DasSMACC international conference in June. Alex has a great perspective to share as two of his specific clinical interests are managing dying patients and rapid response systems for deteriorating patients. This is the fourth in a series of DasSMACC special episodes, where I interviewed speakers from the recent DasSMACC conference held in Berlin. Alex is an Intensive Care specialist at Wellington Regional Hospital in Wellington, New Zealand. His work and research in the area of rapid response systems has led to an appointment as the clinical lead for the New Zealand Health Quality & Safety Commission’s 5-year national ‘Deteriorating Patient’ programme. He is also the clinical lead for Wellington’s aeromedical retrieval service, which covers the lower North and upper South Islands of New Zealand. In his spare time, when not walking his dog or children, he builds websites & designs logos for Wellington ICU’s prodigious research department, as well as sending a few tweets via Twitter handle @psirides. Given Alex has been an ICU consultant for less time than most of my other guests, I had to talk him into doing an interview, but I’m really glad he agreed. There is so much to like about this conversation. Alex is honest and humble enough to say he’s not so sure he’s that good at predicting patient outcomes, at least in neurosurgical patients, which is the precise reason he has something to teach us on the podcast. We also cover topics including: Why Alex loves intensive care (with a great answer) How his consultant team work so cohesively The need to respect co-worker’s opinions and to avoid tribalism How a team of intensivists meeting with a team of neurosurgeons away from the patients can make practice more consistent and evidence-based How his team uses simulation to reduce rudeness and lack of respect How efficiently his hospital ran when there was a 3 day doctors strike A good ward round requires asking for and addressing the nurse’s concerns but also finishes with a clear plan to move the patient forwards Bringing his best self to work requires feeling loved at home and having a great team to work with Some of the non-textbook medical books Alex has been enjoying reading Hobbies allow him to escape from work and to use his creativity How far away he feels right now from burnout What he can get better at over the next 5 years How palliative care physicians can be helpful in teaching us and our trainees about end of life discussions This podcast is my quest to improve patient care, in ICUs all round the world, by inspiring all of us to bring our best selves to work to more masterfully interact with our patients, their families, ourselves and our fellow healthcare professionals so that we can achieve the most satisfactory outcomes for all. Please help me to spread the word by simply emailing your colleagues or posting on social media. Feel free to leave a comment or a question. I hope we can build community through Mastering Intensive Care so colleagues can share their thoughts and tell us how they are mastering their own skills. Leave a comment on the LITFL episode page, on twitter using #masteringintensivecare, on the Facebook “mastering intensive care” page or by sending me an email at andrew@masteringintensivecare.com. Thanks for listening. Please do the very best you can for your patients. Andrew Davies     Show notes (people, organisations, resources or links mentioned in the episode): Wellington Intensive Care medical team: http://www.wellingtonicu.com/AboutUs/Staff/SMO/ DasSMACC: www.smacc.net.au Alex Psirides talk on “Doing everything at end of life”: http://wellingtonicu.com/Data/Doing%20Everything%20DasSMACC.pdf Book “Being Mortal” by Atul Gawande: http://atulgawande.com/book/being-mortal/ Book “Do No Harm” by Henry Marsh: https://henrymarshdonoharm.wordpress.com/reviews/ Alex Psirides on Twitter: @psirides