Rank #1: Episode 3: night shift anxiety and patients with personality disorders
In a world before exam grade U-turns, shifting travel restrictions and evolving hot/cold pathways, the concerns of most staff working within the ED were much more 'precedented.' For the majority of us, these concerns could essentially be reduced to:
- Keeping patients safe
- Keeping the department happy
- Keeping your own sanity
Bonus points for keeping your own pen
However it always seems to be at exactly 2am, when there is a 3 hour wait to be seen, a full resus, someone belting out 'Hero' by Mariah Carey on repeat (with the occasional duet from the intoxicated patient next door) and an actively suicidal patient trying to abscond, that these three most basic of aims are at greatest threat. Its here that I often begin to re-evaluate my career & life choices.
This month, NETRAG+ discusses two major challenges in this all-too-familiar scenario: the impact of night shifts on healthcare workers, and the disruption that can sometimes arise when caring for patients with personality disorders. Whilst these are recognised and necessary features of our working lives in ED, this by no means renders us impervious or more innately resilient to them than our colleagues in other disciplines. We hope that this episode not only starts a conversation about such challenges, but also provides some practical pearls on how to better identify and navigate them, beyond a 2am yearning for emollient prescriptions, for the wellbeing of our patients, our teams and ourselves.
Read more at here: https://netragplus.wordpress.com/2020/09/17/episode-3-night-shift-anxiety-and-patients-with-personality-disorders/
Sep 17 2020
Rank #2: Episode 2: public health, moral injury & the ED
At the time of recording, the London Borough of Newham was reported to have the highest COVID-19 death rates in the UK with Brent, Hackney and Tower Hamlets not too far behind. It is no coincidence that Newham is also one of the poorest boroughs in the country as the pandemic lays bare our existing social, economic and political inequalities. These glaring disparities are likely to be exacerbated in the years to come given COVID-19's triple threat to health, education and income on both a national and global scale.
Hot on the heels of our first episode on "Racism & COVID-19", the NETRAG+ team had the opportunity to sit down with three health leaders working in distinct roles in Newham to listen to their personal and professional experiences of the pandemic thus far:
- Director of Public Health for Newham, Jason Strelitz - working tirelessly with other local authority partners to advise schools, businesses and care services, and to support those who are vulnerable through food distribution, prescription delivery and befriending via ‘Help Newham’ hubs.
- Emma Young, an EM consultant at Newham University Hospital, who describes the all-too-familiar transition from operational inconvenience to adrenaline-driven alarm reaction and, now, burnout and moral injury despite working in a specialty that is well-versed in problem-solving and dealing with uncertainty.
- Esther Murray, a health psychologist working in Barts and the London School of Medicine and Dentistry. Esther expands upon the concept of moral injury and its relationship with grief, guilt, minimisation and leadership. But is it possible to heal moral wounds - particularly at a time of social distancing when access to our usual support systems may be limited? Moral repair programmes for veteran soldiers suggests yes and, conveniently, its managed by conversations such as these - by sharing our stories and experiences with our peers. As Esther explains - we are each other’s most important resource.
What’s clear from episode 2 is that, amongst the very real tragedies of COVID-19, great compassion has emerged with a desire to look after each other and protect the wider community. There is, however, also outrage. Outrage for what has been long-apparent in Newham but which some of us had started to forget: inequality kills.
So as we move through this first wave - on to a second wave or recovery or whatever else befalls us - how do we use this outrage to rebuild better, respond better and, ultimately, do better so that all society moves forward and no one gets left behind?
There are a few other recommended resources on the accompanying blogpost here - listen, share and comment below to let us know what you think!
Jul 01 2020
Rank #3: Episode 1: racism & COVID-19
Both the COVID-19 pandemic & the treatment of humans like George Floyd have very publicly exposed the inequalities which lie at the heart of our societies and political structures the world over.
But what does that have to do with treating patients & working as an emergency physician, you might ask?
The answer: an awful lot - and much more than I've ever understood in the past.
Back in March, the guests for our very first NETRAG+ podcast, academic Darren Chetty & clinician Rageshri Dhairyawan (though they both have several other roles & hats) wrote a Discover Society article analysing these very issues: would the anticipated overwhelming of NHS resources by patients critically unwell with COVID-19 expose already deeply unequal outcomes between ethnic groups? And how do these relate to structural racism?
This challenging read linked well to a training day we were due to hold for our trainees around education & public health (you'll hear more content from this soon) and I was delighted when they agreed to a virtual chat around their motivations for writing the article.
We touch on many things: unconscious bias, The Marmot Review Ten Years On, the preoccupation with the biological over social explanations for health disparities, shameful racism & unethical research in the history of medicine, problems with physicians' interpretation of pain in females & BAME groups, and so much more.
Jun 06 2020
Rank #4: NETRAG+ episode 0
NETRAG = North East Thames Regional Academic Group - the name for educational days for higher trainees in emergency medicine in NC/NE London.
Our podcasts will give you learning in audio format on a wide range of topics for the emergency physician aspiring to be excellent.
Coming soon - episodes 1-5 with content including:
- managing the ED
- night shift anxiety
- calling a childrens' acute transport service
- patients with personality disorders
- the patient with cardiogenic shock
The NETRAG+ podcast team
May 09 2020