Consultant in Intensive Care | Council
@ICS_updates
| Author: Seven Signs of Life
@vintagebooks
| Section editor
@yourICM
| She/Her | Abortion is Healthcare
Let’s remember that at end April 2020 I was reprimanded by someone from THE POLICE because I stopped in a park, alone and not near other people, to LOOK at a swan, while on a walk to clear my head before work on ICU next day
Hope you enjoyed the garden party
@BorisJohnson
☀️ Today I went for a walk (alone) before going back to work tomorrow.
🧍🏻♀️I stopped (standing) to look at a swan sitting on her nest in the river.
👮🏼♂️And a policeman came and said I can’t stop and look
🦢 (I was >2 meters away from the swan. And other people)
The End
Spot the difference. There are two consultant intensivists here:
Female Consultant Intensivist gets called ‘Aoifie’ Abbey a ‘CCU doctor’
Male colleague is referred to as “Anaesthesia and Critical Care Consultant Dr Roger Townsend”
Really, I expect better of
@guardian
Listening to what this Emergency Department nurse, suffering from
#Covid19
, chose to say to
@BBCNews
is heartbreaking
Despite her pain.... despite everything:
For every one patient on ICU - there are likely ~ten(+) more on wards being diligently cared for by medical teams who are just as stretched & just as pressured
If not more so
Right now, you don’t often see those teams on the news.
They exist.
And they are mighty.
#together
Almost precisely 8 years since
@abiorzechowska
and I were band 5 nurse and ITU FY2 - now nurse in charge and consultant on call on that very same unit
Don’t you just love it when a team grows together 🙌🏻 ☺️
What’s the loneliest you’ve ever felt?
This moment: 04:33 on 6th April 2020 as lead Intensivist for the night is pretty close for me
I’d been appointed to consultant post exactly 2 wks prior
Won’t be tuning in to
#Breathtaking
-seeing fringe chat on socials is already enough
One month ago I posted this video from BBC news
I am so sad to hear that this nurse, Estrella Catalan, has now died
Friends have set up a gofundme here
I have no other other words
Listening to what this Emergency Department nurse, suffering from
#Covid19
, chose to say to
@BBCNews
is heartbreaking
Despite her pain.... despite everything:
Today I got appointed to a locum consutlant post in intensive care
@nhsuhcw
- I didn’t get to shake hands with anyone -and I didn’t expect to be starting this next part of my journey this week, in the midst of a pandemic but hey, I am pleased ☺️
#loveintensivecare
(even still)
This is literally why
#NHSfunding
for rehabilitation after any sort of critical illness cannot be an after thought. Organ support, drugs & acute care saves lives - access to rehab saves people.
Thanks for sharing your journey
#rehablegend
Source: TikTok @ tinabridge
Hands up if you’ve hugged a colleague in PPE because either they/you needed it-To get on with next tragedy
🙋🏻♀️
Hands up if you’ve worn PPE and put your arm around a person, who was dying, because it was the right thing to do
🙋🏻♀️
Complaints about staff hugging in PPE?! -grow up
It’s say a lot about our society today that a photograph of NHS staff working tirelessly & saving lives is reported to the health board, yet footballers can celebrate winning a game like this. We’re the ones that fight for you.
(Original image removed. ⚽️Getty images )
☀️ Today I went for a walk (alone) before going back to work tomorrow.
🧍🏻♀️I stopped (standing) to look at a swan sitting on her nest in the river.
👮🏼♂️And a policeman came and said I can’t stop and look
🦢 (I was >2 meters away from the swan. And other people)
The End
Me stood with nurse on unit. Male other specialty SpR (I’ve never met) walks past
Him - hello girls
Me - not sure who you’re calling girl?
Him - oh sorry; ladies?
Me - how about Doctor?
Him - *chuckles*
Nurse - I don’t know why your laughing, she really isn’t joking
Segun took home £2315 as new FY1 doctor in 2004.
Adjusted for inflation-equivalent to £3724.81 in Aug 22 (source BOE)
Below is my take home (inc on-call) AS A FULL TIME CONSULTANT of 2.5 yrs in intensive care in Aug 2022
£148.83 more a week than *brand new* Dr Segun did
Ok. As asked. True payslip transparency.
The left is one of my first payslips 18 years ago.
The right is from a few months ago.
DOI: On the old contract
Anyone interested in doing an adjustment for inflation?
1. Being an ICU nurse is a highly skilled job
2. There was a shortage of nurses before all this happened
3. We don’t have a magic trained nurse tree
And importantly
4. Intensive care doesn’t just materialise whenever a ventilator is wheeled into a room
I am both nervous and incredibly excited that
@vintagebooks
will be publishing my first book.
SEVEN SIGNS OF LIFE: Stories from an intensive care doctor
....forthcoming Jan 2019 📚
Got back from work at 23:30 last last night and found myself vividly remembering how it felt to stare in disbelief + fear at live coverage of 251,684 people attending Cheltenham races between 10/3-13/3 2020.
I was already treating Covid patients
#CovidEnquiryUK
#CovidEnquiry
Dr Hashem Salim, a refugee from war in Gaza arrived >1yr ago. He passed his GMC exams, found a job in Devon
‘He has now started work, but is unable to open a bank account to get paid…he has a yellow homemade button badge that he wears to work that states ‘I miss my wife’’ (also…
@Angelinahkg
@guardian
I have. And I am sure and confident they’ll change it for any subsequent online stuff. But it’s a thing isn’t it that ‘we’ are fed up of dealing with and today I felt like not letting it go unnoticed
‘Kingston Hospital Trust…received applications from > 400 black candidates in 20-21…no black doctors was offered a position’
Barts, Georges & Homerton Trusts: white applications 13 to 15 times more likely to be offered job (than black applicants)
Todays
@bmj_latest
After almost 11 months of locum consultancy and Covid, I am really proud to have accepted a substantive consultant intensivist post
@nhsuhcw
Here’s to looking forward 😀
Today I got appointed to a locum consutlant post in intensive care
@nhsuhcw
- I didn’t get to shake hands with anyone -and I didn’t expect to be starting this next part of my journey this week, in the midst of a pandemic but hey, I am pleased ☺️
#loveintensivecare
(even still)
We will retain staff by
1. Dragging them back from retirement to work until they die
2.Making it easier to drag them back from retirement
3. Allow them to fill less forms
4. Oh crap,what’s the last one? something about occu health and training, yes they’ll defs think that’s…
“Studies have shown that current gowns provide inadequate protection to breast tissue as they leave the upper outer quadrant and axilla exposed”
Data complicated due to ‘relatively small’ numbers of women working in T&O cardiology and IR specialties
So tired of this rubbish!!…
Learning points from
@ESICM
webinar on
#COVID19
(based on experience in China)
- 10% of all cases had GI symptoms in the first week
-80% OF CASES WERE MILD
- 5% of all cases were 'critical' and needed ICU (respiratory failure on air, shock or other organ failure)
(thread)
So HEE will be referring to previously labelled ‘junior doctors’ as ‘postgraduate doctors’ or ‘postgraduate doctors in training’
…but you literally have to be postgraduate to be a doctor (right?!)
Are we just saying naan bread here?!
@iceman_ex
What you have is a facebook group and an organisation that has actual membership totalling <2% of NHS doctors.
You don’t currently work in the NHS or work anywhere remotely near the ‘front line
Seriously, this is not a circus.
Hello! I’ve only been on Twitter for 2 months. I run a network of 26,000 doctors, and I’m given info about what’s happening in the NHS, which I anonymise and share
Please could you help me grow my following? I’ll keep you up-to-date on everything on the frontline!
Pls re-tweet🤞
‘Draw a line under this ….if you don’t there will be consequences’
As Dr Jayaram says, children who could have been saved would be going to school now.
This interview is worse than anything I have ever imagined. A watershed for what management brand as ‘patient safety’
EXCLUSIVE: The doctor who helped catch Britain’s worst baby killer.
Dr Ravi Jayaram spent two years pleading with hospital managers to investigate Lucy Letby.
Instead, they made him apologise and attend mediation with her.
Me: drives up to border control booth in Dublin Port
Officer: how are ye love?
Me: *tears rolling down my face* Ok
O: Are ye vaccinated?
Me: *sniffs* yeah
O: off ye go
Thank you vaccine scientists 👩🔬 ☺️
My big brother Aaron & his ‘nothing about us without us’ sign & next at72hr protest outside Dáil to protest against gov cuts to independent living.He showed me the sort of health care professional I was going to be before knew I was being taught.He died suddenly this weekend ❤️
So this has confirmed 2things for me
1 I am in the right place
2 Medicine has changed
And that is wonderful
So remember, when you’re struggling to fit an audit between night shift & a weekend on-call
Being human matters. Looking after colleagues and yourself matters
End
It takes a huge amount of character and potential to work an inner city hospital during the pandemic and be chosen as chief registrar.
Then Dr
#VaishKumar
moved to a hospital just a few miles away and her life changed utterly. It ended.
Horrific
Colin’s story on
#hospital
tonight demonstrates how ‘getting out’ of ITU is still just the beginning and there are so many unknowns - even for relatively young patients; recovery of lung capacity, physical rehabilitation, psychological strain…so much ahead of them to navigate.
Colin was admitted to
#hospital
with shortness of breath and tested positive for Covid-19. For the past four weeks he's been in critical care, being treated with high levels of oxygen.
A grown adult fan just took down their trousers and defecated on the train platform beside my sister. It wasn’t even 6pm.
Thinking of the emergency services tonight 😩
Happy speciality registration date to me - proud to be an intensivist 🧑🏻⚕️
(balloon etc are not from
@gmcuk
but I think adding a floating ballon feature a la twitter on your birthday is something we’d all be interested in if you’re looking for suggestions 😏)
I keep meeting medical student already worried about doing ‘extra stuff’ to get their specialty ....Surely I’m not only one who just did medical school in medical school...and the standard FY requirements in FY? ...makes me sad to see that stress before they’ve even graduated!
While we *once again* use up airtime having to discuss Boris' behaviour during lockdown, this is a reminder that while whatever he did was happening.... I - a frontline intensivist - was forbidden from stopping in a park to look at a swan on my day off
☀️ Today I went for a walk (alone) before going back to work tomorrow.
🧍🏻♀️I stopped (standing) to look at a swan sitting on her nest in the river.
👮🏼♂️And a policeman came and said I can’t stop and look
🦢 (I was >2 meters away from the swan. And other people)
The End
I have never been the athletic sort - but have been trying to run 5km in under 30min since May (in between trying to not crumble at work)
...and TODAY was finally the day 😀 (just about!) 🥳
I am a consultant intensivist. I was first vaccinated in Dec2020-to protect myself and those around me
Covid kills the vulnerable
It creates premature births
& chronic illness
& yes it can kill ‘healthy’ people too
more than I can forget
We all want this to end
Get vaccinated
I want to share something, particularly with medical students and trainees just starting out in their career
I interviewed for substantive consultant post recently
Yes my application was strong. Yes I did QI & had M’gt experience...I had exams & on paper qualifications
Have been looking through my photos and this made me laugh:
First: all set for interview for locum consultant position 23rd March 2020
Second: 24th March 2020
How it started. How it’s going
Corporate relocation agencies from
🇮🇪 Ireland delivering packages and letters DIRECT to consultant picket lines this morning….
(Don’t get me started on the term Southern Ireland)
What a marketing opportunity! (But those houses prices 💯% aren’t Dublin)
#ConsultantsStrike
For all those who have asked…the pair have four lovely healthy cygnets this year AND there isa second pair with three cygnets and even the one with the crocked beak is doing great 👍🏼
Publication day!
Whatever the outcome, I’m glad I captured these first 7yrs of my career now- before I might have the opportunity to reframe it all with hindsight
Thank you to so many people for support, to Vintage and of course to
@rosiepalmers
for such beautiful cover art
Worked the late A&E SHO shift on NYE and came out to this. Hundreds of maskless, drunk people in huge groups shouting "Covid is a hoax", literally outside the building where hundreds are sick and dying. Why do people still not realise the seriousness of this pandemic?
Don’t you love it when a vision for something a tiny bit better finally comes to fruition?
Just a small selection of our beautiful new wallpaper from Elegant Clutter (insta @ elegantclutter_art )
Our unit wasn’t blessed with windows - I am so pleased with this 🙂
Today I spent the morning on interview panel for band 7 specialist physiotherapist in critical care and honestly I have to say the sheer breadth of skills (clinical, leadership, research, management etc) and passion demonstrated were incredibly impressive.
The future is bright!
That awkward moment you’re listening to a chest in resus....and think *dont forget to check the calves*
So proceed to put your stethoscope on the calves and listen to them
And look up to see the medical Consultant and SpR staring at you
#hometime
#weekenddone
Currently looking at job adverts for intensive care consultants (not for me) .... just come across a surprising criteria in one avert marked ESSENTIAL
"Smooth progression through training"
🤷♀️🤷♂️
... I mean seriously, what is that? Nobody with bumps on the journey need apply?!
Two sides of a debate “should the surviving sepsis guidelines be retired?”
The Pro
@Manu_Malbrain
and con (Mitchell Levy) speaker’s main points
#LIVES2018
Please note - this is how I HEARD debate at the time and may not be the views of
@ESICM
, speakers or surviving sepsis
AS IF I needed government ‘approval’ to prescribe a drug which I already prescribe really quite frequently and have never found unavailable to me, ever
Why not just say - it’s great this research happened 😒
Woah there with the spin!
Today, we've approved Dexamethasone for immediate use across our NHS.
This life-saving discovery was made in Britain and is a testament to the brilliant work of scientists & the national effort to save lives & protect our NHS.
As photos from Guardian show, I work bare below elbows. Gloves + apron over short sleeved gown for contact. Wash hands and forearms in between:
I am pleased with this approach.
Doesn’t seem to be one chosen by many based on photos I see in press from other units? Thoughts?
I didn’t get in to medicine.
So Repeated exams - got AAAAAB.
Still didn’t get in.
So did 4yr science degree-got a first.
Applied for grad entry
Still didn’t get in
Then somebody dropped out of their place.
Or something.
And here I am.
Graduated MBChB Hons
#ALevel
Maintaining the patience to listen to referrals starting
“Oh hello, this XX man has presented with a 10 day history or cough and Pyrexia and now presents with type 1 respiratory failure. His CXR shows bilateral infiltrates”
Over and over again
Without interrupting
Is hard
One day we’ll look back on these days and say, yes we did our best. Shout out to
@abiorzechowska
and all the nurses I know making massive sacrifices to be be here for this crisis 🧡
#teamnightshift
Dear
@SkyNews
Boris Johnson is in ITU
I hope he gets better
Speculation on what treatment he is or not receiving is unhelpful -to Boris & everyone else
Info re mortality&treatment options for C-19 is in public domain.
Just wish him the best-you’ll get news when there’s news
In an airport with parents and two young girls ahead of me (around 5 and 8 yrs old)
Mam says to the girls ‘we’re going to do lots of walking on this holiday’
Dad ‘yes, Mum’s going to be a size 8 when we get back’
Why????? 😫😫
I wonder if Educational Supervisors realise that them saying a trainee is ‘excellent’ can count for as much as ….a pHD (?!)
I also wonder if early training Ed supervision is reliable enough to make that fair… mine was certainly very hit & miss!
(Source - 2023 ICM SA Matrix)