Fixing what once was broken: Ross Fisher at DFTB18

Cite this article as:
Team DFTB. Fixing what once was broken: Ross Fisher at DFTB18, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.19345

Spoilers: There are some minor swears at the beginning of this talk so if you are easily offended or are listening with children around then fast-forward 10 seconds or so.

We have all made mistakes. Some are small – like forgetting to get the milk on the way home, some are huge – like forgetting your wedding anniversary. In this closing talk from DFTB18 Ross talks about the ancient Japanese art of Kintsugi. By fixing shards of broken pottery with molten gold artists created something even more beautiful than that which was broken.

 

What if you make a mistake at work? Can you be fixed?

This talk was recorded live at DFTB18 in Melbourne, Australia. With the theme of ‘Science and Story‘ we pushed our speakers to step out of their comfort zones and consider why we do what we do. Caring for children is not just about acquiring the scientific knowhow but also about taking a look beyond a diagnosis or clinical conundrum at the patient and their families.

DFTB19 has just a couple of main conference tickets left but there are still spots for some of the pre-conference workshops.

If you want our podcasts delivered straight to your listening device then subscribe to our iTunes feed or check out the RSS feed. If you are more a fan of the visual medium then subscribe to our YouTube channel. Please embrace the spirit of FOAMed and spread the word.

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Selected references

Callahan K, Christman G, Maltby L. Battling burnout: strategies for promoting physician wellness. Advances in pediatrics. 2018 May 7.

Shanafelt TD, Noseworthy JH. Executive leadership and physician well-being: nine organizational strategies to promote engagement and reduce burnout. InMayo Clinic Proceedings 2017 Jan 1 (Vol. 92, No. 1, pp. 129-146). Elsevier.

Vicarious Trauma : It’s ok to not be ok

Cite this article as:
Jasmine Antoine. Vicarious Trauma : It’s ok to not be ok, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.19256

One afternoon my team broke the news to three different families that their children had a non survivable condition. That same week I was involved with a patient transitioning to a palliative pathway focused on comfort. I returned home to utter the words, “She is so sweet, I hope she dies soon.

For many of us, days like these, occur commonly.

Being a doctor is a privilege, an honour, a calling. Our jobs are stressful, diagnostically challenging, involve managing team members, and effectively communicating and engaging with different families whom have different needs. We are reliant on our knowledge and skills. What sets our job apart from other high stress environments is that any given day can involve death and dying. We see distressing conditions. Our day includes the uncommon, the unlucky and the unfortunate events of life. To the public these events occur few and far between, but for us it may be a daily occurrence -a relentless barrage of traumatic events, poor outcomes and sad stories.

The intensive care environment is difficult to navigate. The rates of burnout, mental health issues and self medication are high amongst our peers. 70% of junior doctors feel burnt out following a neonatal rotation. Strikingly, their (our) rates of suicide are twice that of the general population. Most of us have heard the words compassion fatigue. Some of us may even be familiar with vicarious trauma – the negative experience of working directly with traumatised populations. Compassion fatigue and vicarious trauma are on a spectrum. We initially may feel overwhelmed by our interaction but this can develop into symptoms of post traumatic stress.

At DFTB18, I spoke about some of the things we can do to reduce this happening to us, and the events above reinforced that message;

  • Seek the support of those around you.
  • Reflect with your supervisor.
  • Get together with your team to debrief.
  • Seek professional psychological support.
  • Foster a culture in your workplace that is supportive and open, whilst also taking time for yourself.
  • Make a regular appointment to see you GP.

And remember, it’s ok not to be ok

For more on this topic of the difficulties of dealing with death and burn out hit up DFTB at:

Burning out by Mark Garcia

A short story about death by Andy Tagg

Selected References

Boss RD, Geller G, Donohue PK. Conflicts in Learning to Care for Critically Ill Newborns: “It makes me question my own morals”, Bioethical Inquiry. 2015;12:437-448

Hauser N, Natalucci G, Ulrich H, Sabine K, Fauchere JC. Work related burden on physicians and nurses working in neonatal intensive care units: a survey, Journal of Neonatology and Clinical Pediatrics. 2015;2:2:0013.

Nimmo A, Huggard, P. A systematic review of the measurement of compassion fatigue, vicarious trauma and secondary traumatic stress in physicians. Australian Journal of Disaster and Trauma Studies. 2013;1:37-44.

Stress, burnout and vicarious trauma: looking after yourself. RACGP Webinar Series.

You have brains in your head: Eric Levi at DFTB18

Cite this article as:
Team DFTB. You have brains in your head: Eric Levi at DFTB18, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.19241

In honour of CrazySocks4Docs Day it seems only fitting that today we release Eric’s talk on mental wellbeing.

Outside of his interest in ears, noses and throats Eric is passionate about our wellbeing. No doctor or healthcare provider is immune to the risk of depression. Andrew Tagg spoke about his own personal struggles at our first conference. Perhaps part of the same spectrum of work potentiated illness is burnout. Characterized by emotional exhaustion, low professional efficacy and high levels of cynicism it is rampant amongst our profession.

#CrazySocks4Docs day was started by a Melbourne cardiologist, Geoff Toogood, with a view to ending the stigma surrounding mental health ion physicians. For more details check out the website here.

This talk was recorded live at DFTB18 in Melbourne, Australia. With the theme of ‘Science and Story‘ we pushed our speakers to step out of their comfort zones and consider why we do what we do. Caring for children is not just about acquiring the scientific knowhow but also about taking a look beyond a diagnosis or clinical conundrum at the patient and their families.

DFTB19 has just a couple of main conference tickets left but there are still spots for some of the pre-conference workshops.

If you want our podcasts delivered straight to your listening device then subscribe to our iTunes feed or check out the RSS feed. If you are more a fan of the visual medium then subscribe to our YouTube channel. Please embrace the spirit of FOAMed and spread the word.

iTunes Button

Selected references

Callahan K, Christman G, Maltby L. Battling burnout: strategies for promoting physician wellness. Advances in pediatrics. 2018 May 7.

Shanafelt TD, Noseworthy JH. Executive leadership and physician well-being: nine organizational strategies to promote engagement and reduce burnout. InMayo Clinic Proceedings 2017 Jan 1 (Vol. 92, No. 1, pp. 129-146). Elsevier.

Psychological defences in education: Ben Symon at DFTB18

Cite this article as:
Team DFTB. Psychological defences in education: Ben Symon at DFTB18, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.19224

The  audience at DFTB18 were privileged to attend a series of sessions from team at Simulcast, the premier podcast for all things sim and debriefing. 

In this second talk of the session Ben Symon interviews Jannie Geertsema about why we become defensive at work and in the educational space education when we could be connecting.

This talk was recorded live at DFTB18 in Melbourne, Australia. With the theme of ‘Science and Story‘ we pushed our speakers to step out of their comfort zones and consider why we do what we do. Caring for children is not just about acquiring the scientific knowhow but also about taking a look beyond a diagnosis or clinical conundrum at the patient and their families.

DFTB19 has just a handful of main conference tickets left but there are still spots for some of the pre-conference workshops.

If you want our podcasts delivered straight to your listening device then subscribe to our iTunes feed or check out the RSS feed. If you are more a fan of the visual medium then subscribe to our YouTube channel. Please embrace the spirit of FOAMed and spread the word.

iTunes Button

There are people with games: Vic Brazil at DFTB18

Cite this article as:
Team DFTB. There are people with games: Vic Brazil at DFTB18, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.19086

The  audience at DFTB18 were privileged to attend a series of sessions from team at Simulcast, the premier podcast for all things sim and debriefing. 

In this first talk of the session Vic Brazil interviews Kara Allen about the place of simulation and asks ‘Is at really all that?‘ Kara Allen is a consultant anaesthetist at the Royal Melbourne Hospital and Clinical Lead at Monash Simulation. Whilst sim seems like an exciting way of doing ‘stuff’ and we all love the chance to get out of our respective departments and play let’s- pretend is it fit for purpose?

This talk was recorded live at DFTB18 in Melbourne, Australia. With the theme of ‘Science and Story‘ we pushed our speakers to step out of their comfort zones and consider why we do what we do. Caring for children is not just about acquiring the scientific knowhow but also about taking a look beyond a diagnosis or clinical conundrum at the patient and their families.

DFTB19 has just a handful of main conference tickets left but there are still spots for some of the pre-conference workshops.

If you want our podcasts delivered straight to your listening device then subscribe to our iTunes feed or check out the RSS feed. If you are more a fan of the visual medium then subscribe to our YouTube channel. Please embrace the spirit of FOAMed and spread the word.

iTunes Button

The illusion of patient choice

Cite this article as:
Amit Bali. The illusion of patient choice, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.19010

“Pick a card…any card”, as the saying goes.

I remember being the recipient of this common trick when a medical student, at a friend’s for dinner where a magician was a fellow guest. The scientist in me wanted to know how it was done, so I prepared to follow my card studiously. I chose carefully and deliberately, feinting to pick one card from the fan offered to me, before choosing – in my eyes – a less obvious card. However, after returning the card to the deck, the magician threw his arms up with a flourish, the pack hitting th eceiling with a thud, causing cards to scatter across the room. Amazingly, my chosen card was stuck to the ceiling, fixed in place by a drawing pin.

I made peace with the fact I was always going to choose that card, and applauded in awe.

 

The ‘magician’s choice’

A few years ago, during a lecture, I was introduced to the concept of the‘magician’s choice’ by Daniel Sokol (a medical ethicist and magician). He used it as an innovative analogy to illustrate how, in obtaining consent, the presentation of the different options is nothing like the free choice it is intended to be. Rather, the possibilities are presented, much like a deck of cards, only this time the ‘trick’ is that the clinician– whether consciously or not – weights information, making a certain choice more likely. I was reminded of this concept recently, after reading about a new app due to be rolled out in the English National Health System. This new platform, it is claimed, will enable patients to see waiting times at different emergency departments, the implication being that they will choose to go to the one with the shortest wait. Unsurprisingly, this sparked Twitter debate about whether or not this actually was a useful tool to help patient flow, with strong opinions on either side.

To my surprise, however, the assumption from everyone seemed to be that this app would offer choice. To which my first thought was: ‘choice, what choice?’

 

Patient choice?

For many years, the NHS has offered explicit patient choice for specialist outpatient care, offering a range of different hospitals at the point of referral. In recent years, the system has evolved to display waiting times. Sounds good so far? To an extent, I agree. A transparent system that allows patients, in conjunction with their GP, to book in to an appointment – even obtaining a date and time – is a pretty simple but effective use of technology. My objection is that the offered choice is nothing but an illusion.

The patient is given little idea of the constraints through which their choice is being made. As an example, many of the children I see have a long-term condition (epilepsy). Effective, joined-up care is much more than a quick hospital consultation, achieved through a combination of having a point of contact via their specialist nurse, close liaison with school, tracking of development progress, and surveillance of mental health and wellbeing. This is best achieved through local, networked care, a system which has been carefully developed over many years.When I see a patient outside this framework, the care is not just difficult to deliver – in what is far from a delicious irony, it actually gets delayed. When I have to inform families that ‘I can’t access that information’, ‘they won’t accept that referral from me’, or ‘our nurse doesn’t cover that area’ (all recurring themes from my practice over the last year), I empathise with the fact that they took a decision that they thought would get quicker access to care for their child, only to now discover that delay was just shifted further down the road. There are potential ways around this – not least patient record systems that speak to each other. Yet that sort of change doesn’t happen overnight so, until it does, surely patients deserve better? Until then, this resembles the ‘three cup and ball’ trick. The patient believes they have options, when actually the system is too constrained to offer the truly free choice that is advertised. No matter how much you try to pick the cup with the ball under it, the pieces move and the magician ensures you never can.

Legal and Ethical Quandaries: Ian Summers at DFTB18

Cite this article as:
Team DFTB. Legal and Ethical Quandaries: Ian Summers at DFTB18, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18919

When most of us think of ethics and law our eyes roll and we picture Rumpole of the Bailey and quiet Sunday afternoons in front of the television. But his time Ian Summers came up with something unique. Pushing the boundaries of simulation as an educational medium he introduced us to a series of hypotheticals. Take your time to watch rather than just listen to your iDevice. You’ll learn about ethical practice in paediatrics but if you pause, take a step back, and press play again, you’ll see a masterclass of simulation in action.

 

 

 

This talk was recorded live at DFTB18 in Melbourne, Australia. With the theme of ‘Science and Story‘ we pushed our speakers to step out of their comfort zones and consider why we do what we do. Caring for children is not just about acquiring the scientific knowhow but also about taking a look beyond a diagnosis or clinical conundrum at the patient and their families.

 

If you want our podcasts delivered straight to your listening device then subscribe to our iTunes feed or check out the RSS feed. If you are more a fan of the visual medium then subscribe to our YouTube channel. Please embrace the spirit of FOAMed and spread the word.

 

iTunes Button

 

Women and Children First?

Cite this article as:
Davis, T et al.. Women and Children First?, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18694

There is an unwritten rule amongst the team at DFTB – equity and equality for all. As conference organizers we have always been proud to have equal gender representation throughout our events – both in terms of keynote speakers and sessional speakers. We took a look at the data to see how common this was in the field of paediatrics. You can see that report here.

Don’t Forget The Twitter

Cite this article as:
Grace Leo. Don’t Forget The Twitter, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18310

Perhaps you’ve been introduced to FOAMed and have dipped a toe into the land of Twitter but until now have been hesitant about joining in… here are some top tips from the DFTB Team to help you on your Twitter journey at the upcoming conference and beyond!

Cutting edge burns management: Fiona Wood at DFTB18

Cite this article as:
Team DFTB. Cutting edge burns management: Fiona Wood at DFTB18, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18295

Professor Fiona Wood, AM, is one of the worlds leading burns surgeons.  Having qualified from St Thomas’ in London she decided to do what so many of us do and move down under. Since the early days of her career, she has recognized that to improve the outcomes of burns victims involves not just scarless skin but also healing in mind and spirit. Along with Marie Stoner, she pioneered the use of ‘spray-on skin’ and is well known for the care she provided to the victims of the Bali bombings back in October 2002.

In this talk, she talks about the past, the present and the future of burns care whilst championing the roles of women in medicine and surgery. As a mother of six children, she reminds us all that there is nothing that cannot be achieved if you ask for it.

 

This talk was recorded live at DFTB18 in Melbourne, Australia. With the theme of ‘Science and Story’ we pushed our speakers to step out of their comfort zones and consider why we do what we do. Caring for children is not just about acquiring the scientific knowhow but also about taking a look beyond a diagnosis or clinical conundrum at the patient and their families.

If you want our podcasts delivered straight to your listening device then subscribe to our iTunes feed or check out the RSS feed. If you are more a fan of the visual medium then subscribe to our YouTube channel. Please embrace the spirit of FOAMed and spread the word.

 

iTunes Button

 

 

A future towards zero: Warwick Teague at DFTB18

Cite this article as:
Team DFTB. A future towards zero: Warwick Teague at DFTB18, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18203

This talk was recorded live at DFTB18 in Melbourne, Australia. With the theme of ‘Science and Story’ we pushed our speakers to step out of their comfort zones and consider why we do what we do. Caring for children is not just about acquiring the scientific knowhow but also about taking a look beyond a diagnosis or clinical conundrum at the patient and their families. Tickets for DFTB19, which will be held in London, UK, are now on sale from www.dftb19.com.

Antenatal Counselling: Trish Woods at DFTB18

Cite this article as:
Team DFTB. Antenatal Counselling: Trish Woods at DFTB18, Don't Forget the Bubbles, 2019. Available at:
https://doi.org/10.31440/DFTB.18153

This talk was recorded live at DFTB18 in Melbourne, Australia. With the theme of ‘Science and Story’ we pushed our speakers to step out of their comfort zones and consider why we do what we do. Caring for children is not just about acquiring the scientific knowhow but also about taking a look beyond a diagnosis or clinical conundrum at the patient and their families. Tickets for DFTB19, which will be held in London, UK, are now on sale from www.dftb19.com.