Tom 💙 @EDPractitioner Twitter profile

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@davidirwin1988

Tom 💙

@EDPractitioner

3 years

One of our ED family has died in an RTC. Such a lovely person and an amazing nurse. RIP Beth ❤

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Tom 💙

@EDPractitioner

2 years

3 hrs+ from 999 to ambulance. 4 hrs+ waiting to offload into ED. 8 hrs+ wait for clinician. 18 hrs+ wait for a bed. Full resus (overflowing into majors). Waiting room overflowing. Every conceivable space filled with a chair. Everyone is trying. This is soul destroying.

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Tom 💙

@EDPractitioner

3 years

We cannot go back to corridor nursing. One patient on the corridor is one too many. It just isn't safe. Please.

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Tom 💙

@EDPractitioner

2 years

I think ACPs are becoming scapegoats for underpaid, overworked, over examined, government shafted doctors. We're not here to fight, we're not here to play doctors or to steal your jobs, we're here to help patients.

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Tom 💙

@EDPractitioner

4 months

I get the concerns around PA's, but please don't include ACP/ANP's in this. We generally have many years of relevant experience in the clinical environment, on top of a relevant degree, then go on to study MSc. I personally had ~12 years before I started my MSc.

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Tom 💙

@EDPractitioner

4 years

Ambulance crews: please dont tell patients they will "definitely go home today" or that they will be "seen by a doctor within the hour" or "they wont need a blood test". Really difficult to provide good care when patient expectations, informed by crews, are not achieved.

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Tom 💙

@EDPractitioner

2 years

I'm really surprised how many of my ED colleagues are unhappy about mandatory covid vaccinations and are going to leave the NHS. Have they been working in a parallel universe?

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Tom 💙

@EDPractitioner

8 months

Missed something on an xray yesterday. Thankfully no harm to the patient as it was picked up by someone else, but made me reflect on why it happened: 1) fatigue: I didn't sleep well the night before and woke up tired 2) workload: I had quite a few patients on the go, all 1/4

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Tom 💙

@EDPractitioner

3 years

@gnwren Amazing 😂😂😂😂😂

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Tom 💙

@EDPractitioner

4 years

Im sorry: "you've been waiting 6 hours to see a doctor" "there's no trolley for you to lay on" "there no cubicle" "you're waiting for a ward bed after 8 hours" "you're elderly mom is on a corridor" This isn't right or what any of the ED staff want. We are really trying our best.

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Tom 💙

@EDPractitioner

4 years

People keep referring to NHS workers as heroes. I'm not a hero, I'm just very fortunate to have a job I adore and be in a position to help save lives.

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Tom 💙

@EDPractitioner

2 years

@KatiePOwl @fessdoc This is a massively underrated tweet 😂😂😂

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Tom 💙

@EDPractitioner

1 year

My watch is probably cleaner than my uniform, it's washed multiple times on shift. My uniform isn't. Also, if you're going to tell me off, you need to tell everyone off for breaking uniform policy (false nails, shoes, jewellery, etc)! Show me the bare below elbow evidence too.

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Tom 💙

@EDPractitioner

4 years

I recently got asked what's the worst thing I'd ever seen. I knew they just wanted some juicy story, but wouldn't have any grasp on what these experiences / memories can do to people. So I simply replied with "Dead children, that's a bit shit." They didn't ask anything else.

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Tom 💙

@EDPractitioner

4 years

A new university journey starts next week for me as a Trainee ACP in ED. (I don't officially start the role for another few weeks, due to my notice period). I'm so excited, but absolutely BRICKING it!! Ps. I will iron my uniform 🤦‍♂️

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Tom 💙

@EDPractitioner

2 years

This feels pretty accurate right now.

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Tom 💙

@EDPractitioner

3 years

First year of my ACP MSc - Passed!!!

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Tom 💙

@EDPractitioner

3 years

"For ward based care. Not for ITU / HDU. For CPR" See similar on lots of RESPECT forms from the community. I think we need to be clearer with patients and families. If ITU / intubation is not appropriate. CPR is not either (Obvs there are a handful of caveats).

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Tom 💙

@EDPractitioner

4 years

PaO2 6 kpa on 15L via NRB and 15L O2 via nasal prongs. Alert and orientated. Mildly SOB. Hello again COVID.

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Tom 💙

@EDPractitioner

1 month

Strong smelling urine = UTI. I hate how much this is banded around!

Sam Ghali, M.D.

@EM_RESUS

1 month

What’s a medical myth that you’ve seen perpetuated over the years? I’ll start: If your nose is bleeding, you should tilt your head backward.

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Tom 💙

@EDPractitioner

8 months

I pride myself on being thorough with my clinical exam and decision making, but lots of things meant it didn't go right this time. Thankfully, there was no harm, and I have definitely taken on board what happened and understood why, so it won't happen again. 4/4.

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Tom 💙

@EDPractitioner

3 years

Years ago, when I worked in theatres, I wanted to be a paramedic. I loved doing pre-hospital shifts. I wouldn't be a paramedic now - things are so bad for ambulance staff at the min.

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Tom 💙

@EDPractitioner

3 years

Some days I feel like I really get this, other days I genuinely feel completely stupid. This ACP journey is strange - but will all be worth it.

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Tom 💙

@EDPractitioner

2 years

Just FYI ED docs - you may be hating on ACPs right now, but we still love you all.

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Tom 💙

@EDPractitioner

3 years

Emergency Department Bake Off today... here's my submission: "Colon the Caterpillar". I got you Cuthbert! #freecuthbert @marksandspencer @AldiUK @Morrisons @asda @Tesco @sainsburys

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Tom 💙

@EDPractitioner

4 years

No one who works in the ED thinks this is acceptable. We are having these conversations on a daily basis and its emotionally draining for everyone From all Emergency departments across the UK, we are so sorry. We are trying to do the best we can but resources are so limited. #NHS

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Tom 💙

@EDPractitioner

4 years

Happy ODP day!! I'm proud to be an ODP and really fortunate to have extended my skills and knowledge so much - for the last decade (almost) I have worked as an ODP based solely in the ED! #ODPday @CollegeODP

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Tom 💙

@EDPractitioner

5 years

"I'd rather have got her checked, but I'm not waiting!" If you are worried enough to come to the ED with your child, you should be worried enough to wait to be seen. There are lots of alternative services available: 111, walk-in centres, GP, pharmacy...

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Tom 💙

@EDPractitioner

4 years

Whatever you do with the ED, you cant get people out if there are no beds for them to go to. You cant push a ball through a pipe when the end of the pipe is blocked. Irrespective of targets, numbers or anything else you can measure... just wont happen.

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Tom 💙

@EDPractitioner

4 years

Do we deserve a bonus for working during COVID-19? I'm not sure. Don't get me wrong - I won't say no to extra money, but I'm thankful I still have a job at the moment.

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Tom 💙

@EDPractitioner

2 years

@georgecxde Never ceases to amaze me: you're overpaid they want it back IMMEDIATELY - but you get underpaid and wait months!

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Tom 💙

@EDPractitioner

4 years

NEWS2 of 7... straight to resus! Yet I'm here with a NEWS2 of 7, smashing paracetamol and oral fluids, feeling like death.

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Tom 💙

@EDPractitioner

3 years

I'm actually going to audit the amount of time I waste at work with IT issues, printer issues, stock issues, etc. Time I should be using to see patients. Unproductive is an understatement!

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Tom 💙

@EDPractitioner

8 months

waiting for odd tests / investigations to come back ie. Bloods, xrays, bladder scan, urine dips, etc. so some patients blurred into each other. 3) finances: I was incorrectly charged £1200 EXTRA tax this month, which meant I haven't had enough money for bills, life, etc 2/4

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Tom 💙

@EDPractitioner

4 years

I think we should use Arterial lines more frequently, especially for those patients who need frequent ABGs in the ED. What do you think Twitter?

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Tom 💙

@EDPractitioner

2 years

If numerous people don't want to work with you because your attitude is terrible, you need to sort it out! I would be devastated if someone felt that way about me. And as a B7, you need to support your team not berate them! Rant over.

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Tom 💙

@EDPractitioner

4 months

@Dr_Done_ I'm glad someone has highlighted the concerns of PAs, but differentiated between PAs and ANP/ACPs. I feel like we're all being dragged into his when most ACPs have masses of relevant experience, before even starting their ACP journey.

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Tom 💙

@EDPractitioner

8 years

Modified Valsalva... you're my hero! #winning #SVT

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Tom 💙

@EDPractitioner

4 years

6 shifts left until I officially start my new role. I cannot wait. 15 years in the NHS (9 in the ED) and I have never felt so demoralised in my whole career.

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Tom 💙

@EDPractitioner

8 months

thankfully I have a credit card! But this stress meant my mind was often thinking about money this month 4) Complacency: I don't ever feel I'm complacent or cut corners, but I absolutely didn't follow my usual xray interpretation technique and missed something pretty obvious. 3/4

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Tom 💙

@EDPractitioner

4 years

@allisonpearson @BBCr4today My ED: 400+ attendances per day. Over 120 in the department. Patients waiting on ambulances as no free cubicles. Full waiting rooms. Patients waiting outside. If that's empty, I dread it when it's full!

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Tom 💙

@EDPractitioner

3 years

I may not see many patients per shift, but I guarantee they have care and compassion. They get time and everything is explained in a way they understand. Doesn't do much for the 'numbers' but does lots for the patient experience.

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Tom 💙

@EDPractitioner

1 year

Don't give naloxone in cardiac arrest. If they've OD they've arrested because of hypoxia 🤦‍♂️

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Tom 💙

@EDPractitioner

2 years

@moribunddr Technically most are retrospective. Ypu don't fill then in during an 'incident' and sometimes, something may not seem right and you need time to process it before you decide a DATIX is needed.

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Tom 💙

@EDPractitioner

8 months

To the handful of people saying "No excuses" or "you're trained and paid well enough, shouldn't happen", etc. You are the reason some people try to cover up their errors... those are the people you should worry about. Mistakes happen, we're all human.

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Tom 💙

@EDPractitioner

3 years

Happy #ODPday !! I've been fortunate to spend my career out of theatre and progress in a speciality I love! Emergency medicine was my calling and I worked my way up from a B5 ED Practitioner to B7 Lead ED Practitioner and now I'm on the journey to becoming an ACP in EM. 1/n

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Tom 💙

@EDPractitioner

4 years

I'm pretty skilled at vascular access and arterial sampling / A-Line insertions with ultrasound. If you're struggling and I offer my help, don't take it as an insult. I'm trying to make the patient journey better and save your time. We all have bad days.

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Tom 💙

@EDPractitioner

4 years

Our profession has seen big changes recently. Hopefully some of you have enjoyed this and have seen ODPs are not, and should not, be restricted to theatres. I will be putting jobs out soon for B5 Emergency Department Practitioners based in the ED at Heartlands Hospial in 1/3

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Tom 💙

@EDPractitioner

2 years

NHS Passwords:

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Tom 💙

@EDPractitioner

3 years

ED got battered today, everyone was working hard to provide good care - but its difficult: ambulances queueing, long waits for clinicians, multiple alerts, patients in corridors. I'm glad the @CQCProf were there to see the difficulties we face daily in the ED and how hard we try.

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Tom 💙

@EDPractitioner

4 years

Last night was my last shift as the Lead ED Practitioner in my department. Such a horrid shift: no beds, patients stuck in ED for hours and hours and also ambulances unable to offload for hours. Thankfully we have an amazing team. I can't thank them all enough for the past 1/2

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Tom 💙

@EDPractitioner

3 years

Dead mouse on the school run. Felt like they wanted to do a full ABCDE assessment on it 😂

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Tom 💙

@EDPractitioner

3 years

Every single incident (minor and major) that I've ever investigated was multifactorial. EVRY. SINGLE. ONE. Most had huge human factors elements too... Shouldn't we be doing more to educate staff about human factors? #HumanFactors

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Tom 💙

@EDPractitioner

3 years

The end of the first year of my ACP MSc is so close - this portfolio is a killer though! Spent more hours than I want to think about doing it. I would love an amazing mark, but I'll be happy to scrape through! As much as I hate the thought of the academia, I secretly enjoy it.

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Tom 💙

@EDPractitioner

1 year

This wasn't in the ALS manual...

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Tom 💙

@EDPractitioner

4 years

My week: don, doff, don, doff, "I'm really sorry xxx has died", don, doff, "Get out of there without PPE! NOW!" don, doff, don, doff, "That xray looks horrid!", don, doff, don, doff, don, doff, "Please identify early if your patients are suitable for ITU.", don, doff, don, doff

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Tom 💙

@EDPractitioner

1 year

Carlsberg don't make ACP teams... you know the rest. Last ACP meeting before Christmas... and the work night out tonight!

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Tom 💙

@EDPractitioner

3 years

I'm at that point in my life where a sunny weather forecast gets me really excited - not because of beer gardens, alcohol, getting out, motorbike rides... but washing. Yes, I'm absolutely ecstatic I can get washing out on the line to dry.

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Tom 💙

@EDPractitioner

4 years

Im glad we have intubation teams, it's helping with one of the big anxieties facing the ED nurses in my department. The team are pretty slick too! @aroradrn

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Tom 💙

@EDPractitioner

6 years

To be a good educator you need to be credible and able to teach. Lots of people can do one, not as many can can both.

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Tom 💙

@EDPractitioner

7 months

@Medic_Russell If the ED clinicians had space and flow to see ED patients a few mins after booking in, we'd have them sorted pronto. But that's not how ED works. I'm genuinely a bit shocked by the post that seems to implicate ED / ED clinicians as the issue for horrendous ED waits.

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Tom 💙

@EDPractitioner

4 years

Been sent home from work. Temp started at 37.9 about 5pm... now this 🤦‍♂️. Great! Head feels fuzzy, a bit of a dry cough and neck pain

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Tom 💙

@EDPractitioner

5 years

Speaking about my role in the ED to ODP's on their 'Nearly Qualified Day' tomorrow @ODPBCU There are big things out there for ODPs... you have to push the boundaries. Emergency Department ODP's: Its about more than just the airway.

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Tom 💙

@EDPractitioner

2 years

A sad farewell to the legend that is @robfenwick tonight - leaving our trust and that means he's not being my mentor anymore. If ever you need a role model - he's your man. Honestly, I cannot thank him for everything over the years 👍

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Tom 💙

@EDPractitioner

1 year

A member of nursing staff walked out on shift today because they're so stressed by staffing levels and patient safety. I get it. 100%.

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Tom 💙

@EDPractitioner

3 years

@J_bagpuss @emergprehosp "Hi, I'm Tom, I'm not paid enough." 😂😂

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Tom 💙

@EDPractitioner

7 years

One of our doctors just called patient gowns 'Patient Uniforms' 😂

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Tom 💙

@EDPractitioner

4 years

Much better 👍

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Tom 💙

@EDPractitioner

2 years

Doing primary surveys, on trauma patients, in an MTC as an ACP is pretty intimidating. But also a great experience.

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Tom 💙

@EDPractitioner

3 years

@WAAMBMEDIC That they sometime make really sick people much better, so by the time they arrive at hospital, it can look like they have pre-alerted for no reason.

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Tom 💙

@EDPractitioner

3 years

@susb60 @FABSITEUK Is there any need? A lovely tweet from a police officer, great dog handler and great dad. This is a beautiful picture. Absolutely no need to pick on incorrect grammar. Does it change the message? Does it change the amazing role he does? No. Ridiculous.

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Tom 💙

@EDPractitioner

3 years

@pepemac27 Reminds me of the time my grandfather died about 14 years ago - I got 1 days compassionate leave and had to take the rest of the week as annual leave. Strangely when the mangers dog had surgery, she had a week off for compassionate leave. Go figure!

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Tom 💙

@EDPractitioner

4 years

9 years. I have developed so much and have learnt so much from everyone. The time was right to move, for various reasons I won't share, and I cannot wait to start ad a trainee ACP in the ED on Monday 👍 2/2

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Tom 💙

@EDPractitioner

4 months

@Cwor1Cwor That's not the general finding. I think the opposite is true. Most don't have relevant clinical experience. I've only heard of a handful of PAs who comes from a nursing / AHP background, where ALL ACP/ANPs do.

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Tom 💙

@EDPractitioner

4 years

I actually cannot wait to get back to work. My new job as a trainee ACP is amazing! My ACP colleagues are fantastic and I've learnt so much!!

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Tom 💙

@EDPractitioner

2 years

I don't care who you are, or how long you've been doing the job. If you ask me to do something and I don't understand why, or think it may be wrong, I'll respectfully challenge it so I can learn and make sure my patients gets the best care. Don't be a dick about it.

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Tom 💙

@EDPractitioner

2 years

@nadenegchandler I find most people like this either lack knowledge or confidence and feel threatened / intimated by the student. It is rarely a reflection of you. There are many other amazing people to work with, as you find out.

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Tom 💙

@EDPractitioner

5 years

1/3 Pelvic binders are becoming the new cspine collar for me. So many put on inappropriately then bought to a TU instead of a MTC when the trauma tool implicitly states pelvic fractures should go to a MTC. If you're concerned enough to put a binder on, you should be confident...

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Tom 💙

@EDPractitioner

3 years

Portfolio compete (just need to proof read it)!!! 400 pages, 44k words, hundreds of bookmarks and links, and a lot of blood, sweat and tears. Just hope it passes!

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Tom 💙

@EDPractitioner

1 year

@OGdukeneurosurg A mew medical rep once fainted onto the surgical instruments during a ortho procedure, throwing the trays onto the floor. It was specialist kit ordered in just for that specific procedure, so we didnt have spares. Had to get them reprocessed whilst the pt was stiil under GA. 🤦‍♂️

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Tom 💙

@EDPractitioner

2 years

Well, I guess that's one way to sort out the ED crisis!

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Tom 💙

@EDPractitioner

3 months

@GottaBeDrD @TheSalariedPA @Dr_Done_ @toast36742904 I don't expect PAs to do what paras do. PAs should be used as they were planned to be: as assistants to doctors. Doing the tasks that take time, to free up docs to see / manage patients. The issue is, they're not doing that, but doing the doctors jobs.

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Tom 💙

@EDPractitioner

3 years

Me: "have you got any medical problems?" Pt: "no" M: "Do you take any regular medicines?" Pt: "Atorvastatin, bisoprolol, apixaban, ferrous sulphate, sertraline, omeprazole, senna, Novomix......." I have started to ask "do you have any "medical conditions". Patients think 1/2

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Tom 💙

@EDPractitioner

4 years

Seriously questioning my choice of friends right now. Can't show all the messages because I didnt hold back!!

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Tom 💙

@EDPractitioner

1 year

Oh shiiiiit. Why didn't they say that in the first place! We'll free up some beds and all the issues will be resolved. Jesus wept. 🤦‍♂️

Dave Murray - All views are my own

@remt69

1 year

Oh why did we not think of this Silly us 🤷‍♂️

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Tom 💙

@EDPractitioner

3 years

Major incidents happen. Care is compromised. But usually normal service is resumed fairly quickly (24-48h). COVID means we have been working as though a major incident is happening 24 hours a day, every day, for months and months. Its relentless.

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Tom 💙

@EDPractitioner

4 years

Was a fairly 'Q' shift last night so took the opportunity to teach some of the nursing staff ABG interpretation. Never miss a teaching opportunity 👍

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Tom 💙

@EDPractitioner

8 years

Start them young @ResusCouncilUK

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Tom 💙

@EDPractitioner

4 years

I think I love the modified valsalva more than I love my kids. Never ceases to amaze me (or the cardiology reg who didn't think I'd be able to do it 😂).

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Tom 💙

@EDPractitioner

3 years

If you're a registered HCP who has completed a level 7 examinations and diagnostic module you should be able to access a prescribing module and be able to prescribe. Shouldn't even be a question. Really feeling held back by my profession at the min. @The_HCPC @SaferSurgeryUK

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Tom 💙

@EDPractitioner

2 years

Teaching in Malta this week... what a chore 😂

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Tom 💙

@EDPractitioner

3 years

Reducing a pulled elbow is almost on par with the modified valsalva for a SVT.

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Tom 💙

@EDPractitioner

4 years

Job applicants: Please don't just copy and paste a personal statement. Especially when it's obviously not for the role you're applying for. 🤦‍♂️

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Tom 💙

@EDPractitioner

4 years

So proud of my other half. Got promoted to B6!!

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Tom 💙

@EDPractitioner

3 years

Invested in this - please dont judge me. 😂. Sick of not being able to find one at work (one that is working).

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Tom 💙

@EDPractitioner

7 years

When the shit hits the fan (ie. a big big sick patient) and people's first response is "where's Tom?" Makes me proud to do what I do.

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Tom 💙

@EDPractitioner

2 years

"I would trust him with my life" Probably the best MSF feedback you could ever recieve! I'm truly grateful for all of the appreciation I have recieved from my colleagues. (The imposter syndrome is still there!).

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Tom 💙

@EDPractitioner

3 years

Looks like a bit of ST elevation in Frances covid figures...

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Tom 💙

@EDPractitioner

6 years

Last night was the first shift for a very long time that we had less than 10 patients in the ED. It was such a relief for the team to have a bit of a break from the relentless amount of pressure that has become the norm for ED's across the country.

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