Very emotional as just opened my PhD certificate.
The thesis contains 272 pages and 28 published papers but really its all just about all applying common sense to improve patient safety ..
I started this journey when my father was still alive. He would have been so proud 😢
Wish this image was around when I was learning dermatomes..
Think of this position & they become sooooo logical and easy and to remember!!
We must put something like this in the next edition of Gray's Surgical Anatomy
The NHS is often criticised but it runs on goodwill and staff going above and beyond caring for patients. Not on call today but came to help a colleague. Seeing the sunlight at the end of the corridor made me smile! Wishing everyone who is working this BH weekend all the best.
Day 3 of my long on call stint..
Happy faces on the ward from both patients and staff..
Looked after well by senior management plus no shortage of PPE equipment with supplies in a special room..
Just have to remember the key code..!!
Keep safe & well on this Easter weekend
Working in a hospital every day, its so easy to forget just how intimidating, and scary it can be for patients and their relatives
Giving directions to someone who seems lost, holding the door, a simple smile..
Little things that can mean so much to worried patients
As a young doctor, was told I would never make it in surgery. Failed exams & often had poor support from bosses
Today I look at this priceless Silver Scalpel Award for Surgical Training - it still hasn’t sunk in
Giving trainees best experience possible is the greatest reward
After a 3 1/2 hour oral it seems I’ve passed the PhD..
A few minor changes needed (as is usual) but told the thesis will become a bible for safety in healthcare
Even managed to get a break halfway to emphasise the importance of HF
Thanks for all your support!! I’m blown away
Dr Sean Elliott, Consultant Anaesthetist & I have worked together for many years
He’s one of the safest & most caring doctors I know
Sean is leaving to do an arts degree & brought me this painting. What talent he has in art too!
I’ll miss him very much as will our patients 😢
Our team ID board
Can you spot the issue?
This morning a new member wrote everyone’s first name but mine was title & surname
This instantly creates a potentially steep hierarchy with new team members who might not feel able to speak up with concerns
We’ve changed it now 😀
A patient told me today they that in their eyes I’m an ‘expert’
They didn’t know about the many obstacles & failures along the way including having to resit surgery exams x3 (don’t tell anyone)
Success is usually not a straight path & experiencing failure can make us stronger
Today the British Medical Association announced junior doctor strike dates in March
Consultants & colleagues around the UK will stand in to support them & ensure the best possible care for patients
I’ve offered to do the night shifts & will be needing these essential items
Finally made it to Friday after working 2 weeks back to back
140+ hours on call for Easter and supporting our junior doctors this week
Feeling totally shattered but so proud how NHS staff come together to look after each other and keep our patients safe
I’m out of here 🥱💤
This little boy had no idea what he’d end up doing
Comprehensive school, bullied for being small & working hard
Belittled & bullied countless times as junior doctor, failed exams & almost gave up
Wish he’d known it would all be OK & that anything's possible despite the odds
18 hours awake = same cognitive function as being x2 over UK alcohol limit
Taking a short nap of just a few minutes is encouraged by many organisations as can make a big difference to performance - lots published on it
Needs to be actively promoted & embraced by healthcare
We don't go to work intending to make a mistake
When something doesn't go right, a good leader will not apportion blame but supports the whole team in resolving & rectifying problems
Learning from error is so important to minimise the chance of the same mistakes happening again
A very emotional day as found out our Surgical Specialty Council has awarded me the most prestigious accolade in UK Oral & Maxillofacial Surgery - the Down Prize
I love trying to make a difference, educate & support trainees and lead change & improvement
I’m blown away.. 🥲
For the last 6 weeks I’ve been a surgeon during the daytime and a student by night, writing my PhD on human factors and medical error..
And after finishing the clinic at lunchtime today I made the final push and have finished it!
Can’t wait for a large glass of wine tonight..
An emotional day
Just been awarded our specialty’s highest honour - Down Surgery Prize - for my work on human factors, safety, education & research
Throughout my career, all I’ve wanted to do is help & support others & change culture
This is icing on the cake
Thank you 🥲
Today & overnight - I'm the on call registrar
Tomorrow - I'm the on call consultant
As always, we're doing everything possible to support our junior doctors & deliver the highest standards of care for our patients
🩺
I use this image in many talks as it demonstrates the sacrifices, hard work & disappointments that we endure along the way
With my PhD viva tomorrow, stress-induced mouth ulcers need to be added to that iceberg!!
Wishing everyone also sitting exams this summer the best of luck
Many of us were bullied as trainees. One comment was so damaging: I was told I would never succeed in anything
In contrast, nurturing others is rewarding, improves morale & patient safety
So Silver Scalpel Lecture at
@ASiTofficial
in 2 wks will be on empowering trainees & team
Very emotional as just
been awarded special prize from Royal College of Surgeons of England for outstanding contribution to Surgery exams
It’s a privilege to lead initiatives to help candidates & examiners in surgery
To be recognised by peers in this way is deeply humbling
Awake for 18+ hours = same effect as being x2 over legal alcohol limit for driving
When staff transition from day to night shifts circadian rhythms also turned upside down
Employing organisations need to help & support staff to reduce risk of error & fatigue and improve morale
OMG...!!!!!
A sample copy of Gray’s Surgical Anatomy has just arrived..
I’m totally and utterly blown away by the quality and can’t quite believe I’m finally holding it..
As it should be our HF chapter on reducing error in theatre is right at the front..!
I’m speechless
Overwhelmed with emotion on winning 2022 Silver Scalpel Award
Always try & teach values of putting patients at centre of all we do, going the extra mile & valuing all team members
If my work helps to inspire others then I’ve truly succeeded
Thank you. I’m blown away 😢 😢
This little boy was blissfully unaware of failure
Experienced it many times including FRCS surgery exams x2
Today he’s in shock as been elected to
@RCSnews
College Council
Thank you so much for your support & confidence in me!!
I'm deeply humbled, honoured, daunted & excited
After a busy outpatient clinic I met my PhD supervisor this afternoon- it weighs a tonne as 271 pages long
The Uni has appointed 3 examiners - a great surgeon, an airline captain with an HF interest & a psychologist..
The oral exam is 10th June.
I’m bricking it already!!
Had upsetting call today from a GP who has decided to quit
Tipping point was attending one of my human factors talks where I explained how being awake for 18 hours = same analysis & decision making as being twice over UK alcohol limit
How sad. UK general practice is in crisis
My father died 9 years ago this evening. Always shed a tear or two & light a candle
He had no medical background but I just wanted to make him proud
Here’s to all who have lost love ones especially at this time of year
😢
Cancer stops for one one
Neither do we in trying to cure patients from the disease
Despite staff absences our cancer operating list is going ahead today as usual during the festive week to minimise delays for patients
An empowered & committed team as always
Happy New Year 🎉
Article in today's BMJ looking at 42,000 doctors...
Guess what...?
BURNOUT linked to sub-optimal patient care
We know this already but think we're invincible
LOOK AFTER YOURSELF FIRST and patient care will be so much better!!
Will tweet our resilience paper next week
So proud of Rob, one of our surgical trainees. After years of hard work, he’s just passed the final FRCS examination
Gives me so much pleasure to see trainees blossom & flourish and then leave the nest to establish their own independent careers
Don’t ever stop smiling 😀
The miracle on the Hudson happened 13 years ago today (15 Jan 2009).
No fatalities and the most amazing flying skills
We can never compare aviation to medicine but can learn & apply so many lessons from that day including minimising distractions & effective team working
Just done a team brief before full day operating list
What caught my eye was this great lanyard an anaesthetic colleague was wearing
Drug error is common.
Having colour labels for dangerous drugs makes a huge difference for communication and reducing error!
Can I have one?
A few weeks ago I was being wheeled around the hospital as a broken man after my accident. It was so frightening
Today I walked in for the first time, down the same corridors to start my job again
Going the extra mile for scared & anxious patients makes all the difference
Often get asked how I got in to human factors & patient safety
Simple: my father had many medical errors & a delayed diagnosis that likely cost him his life 11 years ago
Having an emotional moment as I prepare HF talk for a large surgical conference in Vancouver next Friday 🥲
In 2016 I had to persuade publishers of a major surgery textbook to include a human factors chapter.
It was Chapter 104 - right at end of the book
In 2023, a new book & its now where it should be - right at the front to improve patient safety & team work
This is progress 😀
1kg loss of body water = up to 20% reduction in cognitive function
Even when we’re busy don’t forget to look after yourself and drink lots during the day..
Headache after work? Might also be a sign of dehydration.
The last few months have been hard writing a PhD & working as a busy NHS Surgeon. It feels surreal finally crossing the finishing post
I set out to improve patient safety. What I didn't expect was to inspire others on this journey
Anything is possible if you put your mind to it
Handing over the on call bleep to my consultant colleague and friend Neil
Look - he’s even got a special mug ready!!
As always, our consultant team is supporting our junior doctors & doing all we can to provide the highest standard of patient care
Our lives are being turned upside down by coronavirus & healthcare staff are working flat out for our patients
But let's never forget that there is always light at the end a long hospital corridor & we're gonna send this thing packing!
Have a safe weekend
LOWERING HIERARCHY:
Spending some time relaxing as a team after our ward round..
A surgical consultant in another specialty joined us for coffee.
Everyone knows he’s the boss but he always wears a yellow (student) cap to reduce authority gradients.
Happy teams perform better
This is for all those who have lost loved ones at this time of year..
My father died 6 years ago today..
It still hurts but will always try and do you proud
So here it is...!
Our free to download book for medical students, trainees, allied healthcare professions & anyone wanting to know more about our specialty
The publication is kindly funded by the British Association of Oral & Maxillofacial Surgeons
👇
Been an emotional day. Took my PhD on HF & medical error to the University printers as want a couple of hard bound copies
I dedicated the work to my late father who died a few years back
It's hit me hard he's not around to read it
Here's to all those also missing loved ones..
The bound copies of my PhD have arrived & feels absolutely wonderful to hold- Indescribable actually
For all those contemplating doing a higher degree my advice is don’t hesitate!!
The dark days of writing, chasing reference & formatting vanish when you see the final version
Spoke today with a senior colleague about bullying in surgery
Reminded me of how I lived in fear of going back to school after the holidays
Bullying takes many forms & can be hurtful, disrupts training, team working & safety
No one should have to endure that feeling. No one
My father died this time a few years ago but always taught me to go the extra mile to help others
it’s been an incredible year with the Gray’s & a PhD on improving patient safety
Hope these might make a difference but miss him so much & wish he was around to see it all.
😢
Two colleague at each end of the medicine training spectrum - a consultant surgeon and medical student keen on surgery
Valuing and respecting team members at all stages makes a huge difference to morale, inclusivity and patient safety
After sustaining several fractures & other injuries a few weeks ago in an accident, feel so lucky to be alive
Looking at the tree lights & decorations when death could have been so close brings the magic of Christmas to life more than ever🎄🎄
Human factors application
Motorway closed this morning due to roadworks so 30 min journey to work took 90 mins
Arrived at hospital frustrated & late
Remember HALT if Hungry, Angry, Late or Tired
So taking 10 mins out before team brief to regain focus & plan operating list
So touched to be met with a name sign at hospital front entrance today by many of our junior doctors & nurses
Being wheeled around completely changes perception
Now I truly know how scared, & vulnerable patients feel
Can’t wait to get back to work when injuries have healed
Would you drive for 8 hours non stop before taking a break?
My car displays 'rest recommended' after 2.5 hours! ☕️
Other safety critical industries know performance deteriorates over time, yet in healthcare we can sometimes forget
Even short breaks can make a huge difference
Thanks so much for all the kind messages after posting about my injuries this wk
Most terrifying 2 seconds of my life & thought I was going to die. Back to hospital on Mon to get the latest
Can’t wait to do the planned festive Santa & HF webinar on 22/12
Details to follow!!
On cloud 9:
Not on call having done the last 4 days!!
Stayed safe from coronavirus today
And totally overwhelmed and humbled at being elected to the Royal College of Surgeons of England Council
So have to celebrate
Wish I could bottle up this feeling and share..
Obligatory team coffee after our Sunday morning ward round
A chance to relax and catch up with trainees away from the clinical environment.
The value of building strong team relationships & valuing everyone equally cannot be underestimated 😀
Christmas has come early!!!
Official email just in from Elsevier..
Gray’s Surgical Anatomy is published TODAY.. 2 days ahead of the scheduled date.
In total disbelief & shock that we’ve finally done it after 3 years of hard work..
Hope Henry Gray would have approved!
Just found out this one has passed her first year medical school exams
And I always thought she wanted to be an airline pilot..
One immensely proud & tearful father 😢
Recognising signs of burnout in ourselves or team members is important
Then we can do something about it.
Here's a few:
Exhaustion despite regular sleep
Irritable with others
Lack of concentration
Losing your voice in the team
Boredom/fed up
Feeling like you're always failing
Just had paper accepted on benefits & potential disadvantages of coffee/high energy drinks on technical performance, including surgeons & interventional teams
Learnt so much doing research for this & definitely won't stop drinking coffee!
Will share link to paper once published
Will never forget the countless exams taken during my medical & surgical training
Failed several along the way & almost gave up on a surgical career
So as supervising examiner for surgery exams today, doing all I can to put candidates at ease & help them perform at their best
Was given this amazing bottle of champagne in a box some years ago
It winks at me every time I pass but despite plenty of excuses, haven't been able to open it.
When this crisis is over, that's the best possible reason to toast all our great NHS & colleagues near & far..!
Just want to say thank you for all the support over the last 8 weeks
The fracture clinic has just discharged me so I can go back to clinical work. Feels really weird walking without the crutches & knee brace
And got the COVID jab too What an incredible January day!
Years ago I walked out of Royal College of Surgeons of England (on more than one occasion) having failed surgery exams & almost gave up
Now walking in to the amazing newly refurbished building for first face to face Council meeting
A surreal & very emotional moment
How about we try and set up an MSc course & programme in Clinical Human Factors?
Been speaking to University, interested colleagues, Royal College & HF experts
Some great courses already but definitely a need and would further raise HF profile & patient safety in healthcare
A new wellbeing lounge has just landed very close to our head & neck offices
So during our Saturday on call weekend ward round my trainees & I are taking a short break (complete with free ice lollies)
This is great human factors application: happy teams = best patient care!
The more I read & study coronavirus & the way this thing is spreading, the more scared I become.
Nowhere is safe anymore. Petrol pumps, supermarket trolleys, open food
THINK - you can catch this from anything..
Please please stay at home unless absolutely necessary.. PLEASE
Our last cancer operating list before Christmas
As always:
Team briefing done
All staff valued equally and empowered to speak up if any safety concerns
Discussed the various what if? scenarios to reduce any ‘startle’ reactions
🫎
If ever I needed a really good excuse to splash out on a nice bottle of bubbly this is it:
I’m toasting amazing osteoblasts & Mother Nature for healing my fractures & other injuries after a fall 11 weeks ago
No more about it & thanks for so much support in my darkest hours
After 3 years hard work, Portsmouth will have a graduate entry Medical School from September 2024!!
Overseen by King's College London, it's a exciting time bringing a wide range of healthcare & wellbeing benefits
We'll showcase human factors for sure
👇
Had to give bad news to several cancer patients & their families today - one of the hardest parts of the job
Being honest & showing empathy is always so important but breaking bad news never gets any easier
In Dublin today to speak about human factors & reducing medical error at the Royal College of Surgeons in Ireland
Never had anything quite like it. They sent a chauffeur to collect me from the airport.. what amazing service!
Hope the talk will be ok or may be walking back…😀
Special day for me as just reached the milestone of 800 publications
My key to success is to always try and bring teams together, supporting & valuing them every step of the way
Countless rejections & failures but have never given up.
Still lots more to do, but not tonight! 😀
Tiredness kills
Several cases of hospital staff falling asleep while driving home after night shifts with tragic consequences
Being awake for 18 hours = same cognitive function as 2x over UK alcohol limit!
Even short naps if possible during a shift can make a huge difference
Here's an article we have written on the importance of looking after yourself at work. Will be published in the BMJ next week
Seems obvious but how many times do we miss lunch, eat junk food or not drink enough at work? Not good for us or our patients
Still in disbelief to learn the election news..
Thank you so much for your confidence and trust in me and the other elected Council members and commiserations to the other candidates who were unsuccessful this time.
I'm humbled, honoured, slightly daunted & excited to serve
Your votes have been counted and the results are in. We're delighted to announce six newly elected Council members in addition to three successfully re-standing for a second term. Read more here:
@svig2
@MrAhmedAhmed6
@BrennanSurgeon
@IanLoftus2
Deeply saddened to hear tragic news that Professor Sir Roy Calne has died aged 93
Prof was a pioneer in organ transplant surgery. Privileged to work for him in Cambridge & when I left, he gave me this painting.
He’s had a profound impact throughout my career. Rest in peace 😢
Half way through a 2 team major cancer operation with about 3 hours to go..
So what could be better than taking a break on a comfy sofa with my consultant friend and colleague?
We’ve had a drink & some lunch and now optimised to once again perform at 100%..
Just published this on sleep and performance..
Take home message (obvious really): we all need adequate sleep and rest. Without it we are much more likely to make a mistake for patients...
Shift patterns can take their toll-more likely to have car accident after night shift
Article in
@bmj_latest
about surgical checklists
'So much depends on the environment in which checklists are used. In isolation they will never prevent never events'
YES SO TRUE
My advice- own the checklist as if your own life or limb depends on it
MRCS results came out today.
For all those who passed well done
And for those who weren’t successful this time please don’t give up
I failed the old FRCS twice before it was MRCS
We all have setbacks along the way and it’s hard
Don’t give up and please try again
Can’t believe it’s almost 11 years since my father died. I was at a meeting at the Royal College of Surgeons & didn’t get to see him in time
Had a tear at the RCS this evening while looking at this lovely Christmas Tree
A chance to stop, pause & remember all the happy times 😢
No clinical duties today so writing article on human factors & stress during this crisis.
Highlight of the day?
Using my NHS badge to beat the queue & do much needed shopping for elderly neighbours
‘Lost’ the receipt so they couldn’t pay me!
Kindness to others is priceless
Why do I spend so much time caring for the next generation of doctors and surgeons?
Simple: just remember our time is fleeting & one day we'll be gone & forgotten
So need to do everything now to help and support our trainees & provide them with the very best experience we can
Wow I absolutely love this London Underground schematic anatomy map of the essential structures in the complex head & neck region
Just like the underground some lines run deeper than others & can get closed causing major disruption including neurological or other symptoms!
Today I saw NHS working at its very best
We needed an unexpected scan before complex surgery
Despite being busy the radiology department arranged it quickly so surgery could go ahead with minimal delay
Great staff, great day, grateful patients
So proud to work for our NHS!
This makes very shocking reading
Why has the profession allowed this abhorrent behaviour to go on for so long?
There has to be zero tolerance from employing Trusts to high level organisations.
3 years ago while cleaning gutters, ladder feet slipped & I fell 18 feet, sustaining multiple fractures & other injuries. Will never forget feeling of utter terror
Ladder didn't come off well either!
Ever since I have never taken life for granted & always value every single day
Ever since medical student days I’ve always dreamed of having an article in the special Christmas edition of the BMJ
Today that dream came true when I opened the post!!
Great to spread the human factors message far & wide
Thanks so much
@bmj_latest
Day 4 of my long on call weekend..
72 hours done & 24 to go.
Working with 4 different junior doctors, countless nursing staff & others.
From security guys to chief executive, the message is simple:
Morale is good & we are doing everything to beat this virus
Happy Easter!
That little boy with the woolly hat I tweeted about y'day had hopes & dreams & loved Star Trek
Kept him going despite constant bullying fear at school
Never thought he would become a surgeon
And now? Never give up when the going gets tough & always believe in the power of hope
On call today to help out a colleague.
Came down to the emergency department to see a patient and found the emergency team doing a great briefing including speaking up, valuing everyone, thinking ahead and assessing risk
Really impressed - great atmosphere to set up the day!
Found out today that the 4 Royal Colleges of Surgeons have cancelled exams including MRCS until end of the summer due to coronavirus
When you're preparing for exams & goalposts change its both devastating & disappointing..
Please stay strong. The virus will go & you'll succeed