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 econo...

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 in...

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...

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...

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...

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 leve...

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 ca...

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 Ho...

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 s...

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 lo...

Happy New Year. Here's hoping 2019 is a great one for you. Mastering Intensive Care is aimed to inspire and empower you, as an intensive care clinician, to bring your best self to the ICU, through conversations with thought-provoking guests. I think there's a gap in education on the topics we cover on this show and hopefully you find my guests useful. During the Christmas/New Year period I listene...

How well do you know your colleagues? How much do you socialise with them? Do you have an annual retreat for your colleagues and their families?   After you listen to this episode you may reflect on these questions. To give your patients the very best care possible it seems obvious that your team needs to know each other, understand the strengths and weaknesses of each other, and combine and commu...

Our ICUs might be growing larger in size but there seem to be the same number of very sick patients to care for overall. All of which means we seem to be admitting a greater proportion of less unwell patients to our ICUs, especially in the larger tertiary ICUs. Given we also suffer from "bed block", where there are no available beds in the hospital to transfer patients to, when they are no longer...

What number of patients should an intensivist simultaneously care for to optimise outcomes? Is a system with different day and night intensivists best for all? These are two of the questions discussed during the latest episode of Mastering Intensive Care in which Hayley Gershengorn shares her research and personal thoughts about resourcing our Intensive Care Units. There is no easy answer to match...

How did your patient feel that time you took several attempts to place a CVC? What might happen after a dose of haloperidol for delirium?   In this compelling episode, Professor Paul Wischmeyer, shares some of his experiences as a patient in the ICU. Since he was 15 he has endured multiple hospitalizations and ICU stays for his inflammatory bowel disease. This has given him an excellent vantage po...

Do you have too many career interests outside of your basic clinical practice? Are your daily focus areas as few as three? Family, clinical and perhaps one other thing?   In this episode Australian intensivist, Marianne Chapman, speaks about how she keeps her life under control by focussing on her big three - family, clinical and research. This allows her to manage the stresses of an intensive car...

Do you spend time finding out what the "why" is for your patient? Have you considered it's not what is the matter with the patient but what matters to the patient? What the patient thinks their purpose is? Or at the very least, what they wish for during the next part of life, however short that may be? In this episode American intensivist, Dr Wes Ely, tells us how he deeply cares about the whole p...

What is it like to witness an intensivist struggle?   And what can we learn from the shocking death of an intensivist?   This special Mastering Intensive Care episode is on a difficult and important topic. Rather than focusing on bringing our best selves to work, the focus of this episode is the ultimate tragedy of our profession, doctor suicide. I warn you that this is a sad and confronting story...

Is your ward round stimulating and educational?   Do you help learning by creating debates on the ward round for and against the simple interventions we use?   In this week's episode, Belgian intensivist, Professor Jean-Louis Vincent describes what happens in his ICU, on a daily basis, and indeed on the ward rounds. He tells us how he enjoys going several times a day to see what is happening in hi...

In this week's episode you'll hear an invigorating conversation with Francesca Rubulotta. This power-packed, enthusiastic, passionate, water polo-playing, Italian doctor, now living and working in London, UK, is seriously ambitious to help patients other than those in her ICU, mostly by advancing education using technological innovation. Francesca is a Consultant and Honorary Senior Clinical Lectu...

This week is International Nurses Week culminating in International Nurses Day on Saturday May 12th, the date on which Florence Nightingale was born. To celebrate this, my special guest this week is an intensive care nurse, Claire Davies. Claire is my wife. To me, she is intelligent, caring, kind and compassionate, as both a nurse and a person. So after struggling for a while with the choice of wh...

Does each bedside decision you make actually help your patient to feel, function or survive? Have you considered how frightening and intimidating the Intensive Care Unit environment is to your patients and their families? Do you feel empowered by the people you work with and the culture in your ICU?   Simon Finfer loves telling a tale. In this episode you'll hear the story of the serendipitous and...

How well do you understand what happens to your patients after they leave the ICU? Do you find out how they go and feed this back to your ICU team?   Most of you give excellent care to your patients whilst they are in the intensive care unit. No doubt this will be compassionate, appropriate, diligent, information-driven, holistic, team-based and communicative care. But when they leave the ICU, do...

How do you balance the use of your clinical experience with the literature-based evidence? Are you a good enough listener? Is the clinical handover in your ICU the best it could be?   I've been reflecting on these questions since I talked to A/Prof Peter Kruger for this week's Mastering Intensive Care podcast. Peter is Deputy Director of Intensive Care at the Princess Alexandra Hospital in Brisban...

What are the biggest challenges when beginning as a fully-fledged intensive care clinician? How do you best use your senior colleagues when your experience bank is still small? What can you do to help achieve gender equity in intensive care medicine?   These are some of the questions you'll ponder as you listen to the latest Mastering Intensive Care podcast guest Dr Sarah Yong from Melbourne. Havi...