Corridor conversion with ex-trainee, now heading to Australia to do A&E.
1/3rd of her year from Nottingham have gone already & none are coming back.
A literal brain drain from the NHS.
Our loss is Australia’s gain.
Cherish & pay our juniors properly
#payrestoration
@TheBMA
Be kind to Medical Students Day
UK FPO Allocations out today
First year these have been RANDOMLY allocated
A lot of young talent being sent places for their first job they’ve never been, worked or chosen
This is terribly unfair
#MedTwitter
Pop quiz for anyone treating hand injuries:
What causes this x-ray appearance?
Why should it never be seen?
What can you do to prevent it?
#MedTwitter
#MedEd
Plastic waste in theatres is shocking
All this “theoretically recyclable” plastic for an ankle #
Each screw packaged with 2 layers of hard plastic
Implant traceability is important in arthroplasty
but can we find a less environmentally damaging solution?
@BritOrthopaedic
@ldwijesinghe
@OrthopodReg
I think the potential for additional stress with a new job in a new location without the support of peers and friends is a recipe for disaster
“The urgent is the enemy of the important”
When you have a busy life there is “never” time to exercise.
When you’re sick you literally can’t do anything.
Look after yourself physicians:
make time to do some regular exercise
1/4
Why I am an Orthopaedic Surgeon
I asked for opinions from fellow surgeons in advance of a talk I’m giving to local trainees today
I found the responses uplifting, and hope you do too
#orthotwitter
@BritOrthopaedic
@BSSHand
@STASH_BSSH
The NHS is broken…
…but it is fantastic in an emergency.
Forever grateful to
@LeeBreakwell
, Ashley Cole
@SheffOrthoLtd
and the emergency spine team
@SheffieldHosp
Efficient, effective & kind despite huge pressures.
1000x Thankyou.
2/4
There is ‘never’ enough time to do exercise
We all have busy lives…
But when you’re sick you literally can’t do anything
Make time to look after your own fitness
Stay strong / get stronger.
Climb that hill.
Go on that bike ride.
Mucoid cysts / mucous cysts / myxoid cyst
Please do NOT pop them or attempt to drain them
They connect to the underlying DIP joint and if they get infected you could lose your finger
Seriously.
I’ve seen a few infected joints recently that have started off like this
#bssh
@BBCNews
So disappointing. Such abdication of leadership. Barnard castle was bad, this means everyone will now do whatever they want… which by extension means that things for the NHS are about to get a whole load worse. Demand answers to difficult questions Dan if you get a chance to ask
Please don’t climb with rings on!!
No matter how much of a struggle it is to get them off…
It’s much easier than putting your finger back on later
If you don’t believe me then google “ring avulsion injuries”
(squeamish image alert!)
@RoshanaMN
I’ve stopped calling it an “on call weekend” as it confuses people.
“On-call” is heard as “at home with a phone”
Reality is working 0800-1800 as a minimum Friday, Saturday and Sunday, fielding emergencies overnight and then carry on as normal on Monday…
The HAND-E tray
An attempt to minimise wastage in theatres and reduce the environmental cost of operations
Significantly reduced instrumentation for smaller hand operations (from 54 to 13)
Good for the environment, time & cost saving
Win-win
@RotherhamNHS_FT
@BSSHand
5 year recurrence rate after single level lumbar discectomy = 12.1%
(N=733)
Incidence of revision discectomy 7.5%
Smoking an independent risk factor
Useful paper from Norwich, BJJ March 2023; 105-B(3):315-322
@jamestoml1
@OrthopodReg
My main concern as an Educational (& clinical) supervisor of FY1s is the separation from peers and local support networks at an undoubtedly stressful time (starting work as a doctor)
And the impact on the morale of ambitious medical students
“In a service short on time & resource, there is no excuse for being short on kindness & politeness.
We are in control of how we treat each other.
Our behaviours determine the success of our working relationships, with both colleagues & patients”
Wise words from Clare Marx
The NHS is broken…
Real terms pay erosion and demoralised workforce are a genuine existential threat
…but it is still fantastic in an emergency
Forever grateful to
@LeeBreakwell
, Ashley Cole & the team
@SheffieldHosp
for timely & effective surgery
Teenage climbers are at risk of growth plate injuries from overtraining.
Painful PIPJs should prompt early appropriate investigation.
Latest overview in Current Sports Med Reports, Dec 22
@BSSHand
@STASH_BSSH
@BAHTHandtherapy
#surgery
#injury
“We live in a world of microwaves & emails”
@Gnomelover1970
Emergency surgery is physically & emotionally exhausting.
Getting better takes time.
I’ve “achieved” very little in 6 weeks other than getting better…
which is frustrating,
but I’m learning it’s ok.
3/4
Very grateful to whichever member of the public kindly nominated me for a Proud Award
Presumably someone I did “arm fracture surgery” on
Which is very kind… but doesn’t narrow it down very much!!
Many thanks!
#teamworkdreamwork
@SurgicalDivisi1
@RotherhamNHS_FT
Very grateful to the BSSH for taking a robust view on sterile packed implants in Hand Trauma
“…it is the clinical opinion of the BSSH that a move to sterile packed implants in Hand and Wrist trauma surgery will unavoidably compromise surgery and the clinical outcome.”
“When you get married you think you are coming into a safe harbour
The reality of marriage is heading out into the unknown ocean on a boat together”
So grateful to Rachie for all the adventures we’ve shared over the last 22 years.
Looking forward to all that the future holds
@mrdanwalker
I’m not watching it, but the only view I have is that Matt Hancock should be disqualified from winning.
He can eat as many unmentionables as time permits, but being “crowned” for his dereliction of duty (both now and while Home Secretary) should not happen
The Fit Note - elearning for healthcare
As of yesterday Fit Notes (Med3) can be completed by nurses, physios, OTs and pharmacists as well as doctors. Yay!
This info may be of use to some with helpful pointers below…
“Those that fail to learn from history are doomed to repeat it.”
Not an easy follow (and “likes”seem like the wrong thing to do) but an important one…
Consider following
@AuschwitzMuseum
Same day discharge uni knees from Rotherham may be key in these times of restricted bed availability. Excellent talk by Matt Hampton
@SYorksOrthoRegs
@RotherhamNHS_FT
@drphilhammond
Is no one else bothered that the order of the words isn’t even right?!
“48 new hospitals” (however unlikely) would make more sense than “new 48 hospitals”
Climbers hand injuries
BMC/BMMS Mountain Medicine Weekend, Hathersage
Always fun to discuss climbers hand injuries & prevention with outdoor enthusiasts
@Team_BMC
@davemacleod09
Thought for the day (celebrating 20th wedding anniversary in the Azores)
“When you get married you think you’re coming into a safe harbour: in reality you’re heading out in a boat together on uncharted seas” So grateful to R for sharing the adventure with me.
Unexpected wildlife on the way home over Ringinglow
Love seeing these majestic creatures
(Why do I never have a proper camera with me when they turn up!)
In case you���re wondering what is so great about working
@RotherhamNHS_FT
apart from the excellent colleagues, this is the view from my post work bike ride…
Must be getting old…
Genuinely excited to have been given a variety of socks for my birthday!
Waterproof socks for riding
Comfy ones for skiing
Fancy ones for theatres
Happy birthday to me 🥳
Principles of soft tissue cover:
Graft: Dead tissue we hope will become alive
Flap: Alive tissue we hope will not die
Practical strategies for hand reconstruction: excellent talk & practical by Emily West
@aotraumana1
@AOUKEd
Christmas has come (slightly) early at work!
So grateful to have a management team who listen & care.
Saddle stools are much more comfortable for hand surgeons with dodgy backs!
Huge thanks Joanne
@RotherhamNHS_FT
@SurgicalDivisi1
Perfect Cuppa, Ward round perfection
@RotherhamNHS_FT
!
(Should have added yesterday: if you could all avoid falling over as well as staying away from sharp things and pets that would be even better!)
Thought-provoking and inspirational masterclass on the black holes in hand anatomy knowledge by Prof McGrowther
“The more I know the more I learn there is yet to know”
@BSSHand
#BSSHAutumn23
@bjemec
Presumably they’re called Physician Assistants rather than Associates?
We often need assistance
Associate implies a different sort of thing
And I think this is where some of the problem lies?
The NHS really is broken…
Huge pay erosion and a demoralised workforce are a genuine existential threat
…but it can still be fantastic in an emergency
Forever grateful to
@LeeBreakwell
, Ashley Cole & the team
@SheffieldHosp
for timely & effective surgery
@mrdanwalker
“Goodness and mercy all my life
shall surely follow me,
and in God’s house forevermore
my dwelling place shall be”
3 wonderful choices from HRH who was certainly a “good & faithful servant”
Junior doctors pay “demand” of a 33% “rise” is about pay restoration
They have had a real terms pay cut of 25%
If you had 4 apples, & one is taken away, that is a 25% reduction.
Now you have 3 apples, so need a 33% increase to get back to 4 apples.
#payrestoration
#BMA
Yorkshire 3 Peaks
Pen-y-Ghent (694m)
Whernside (736m)
Ingleborough (723m)
39.2km walk: 10.5hrs with an enthusiastic 16yr old!
Great fun… consider doing it clockwise on a weekday to avoid crowds!
@VertebratePub
@OutsideShop
@Welcome2Yorks
#outdoors
Dame Clare Marx remembered fondly & missed by all
@eoeortho
Compassionate leadership
Calm & confident, but measured
Patient safety focused
An example to us all
“May I suggest…”
AO Trauma Introductory course for Medical Students / Junior doctors.
Birmingham, Sunday November 13th.
Great feedback from previous attendees. Excellent faculty : student ratio
Spread the word!
Sustainability in the OR
ONE Carpal tunnel decompression using 3 disposable gowns
Is the carbon equivalent of driving 21 miles in an average car
@BSSHand
@stash
we must move to reusable gowns!
#BOAAC23
Wonderful times in the Dolomites amidst magnificent scenery
Hard to imagine such beautiful countryside was a vicious front during WW1: a glorious place to walk, climb & relax must have been a terrible place to fight
There is ‘never’ enough time to do exercise
We all have busy lives…
But when you’re sick you literally can’t do anything
Make time to look after your own fitness
Stay strong / get stronger
Climb that hill
Go on that bike ride
@CoticLtd
@cycletography