magnus nelson

There’s a risk benefit equation at the back of many doctors’ minds that we don’t talk about enough Increasingly so there exists a choice between defensive medicine & doing the right thing for patients which often means taking on more professional risk I think about this a lot

Come and work with us on the Northern Beaches of Sydney. Emergency Medicine Trainee jobs available from August & later in the year jobs.health.nsw.gov.au/internal/via/T… and jobs.health.nsw.gov.au/internal/via/T… Enquiries to ED Director Andy Ratchford (not me please) - Andy.Ratchford@healthscope.com.au

The Royal Sussex County Hospital is the major trauma centre for a wide area so this will really make a difference. Those who argue it is a waste of money should think what they would want for their own family if they needed trauma care.

Happy Threads Day!

📢 Research Opportunity: Share Your TBI Recovery Journey ✅ Aged 18 to 65 ✅ Had a traumatic brain injury (within last 20 years) ✅ Can communicate clearly online 💬 Share your experience and help improve understanding of TBI recovery. Contact: h.fletcher3@uni.brighton.ac.uk

Medicine in the UK is crazy… One minute you are optimizing outcomes with the best technology in angioplasty, the next your NHS employer suggests removing basic emergency procedure call outs from your acute hospital in a return to medicine in the pre 1980s era..🤯#PatientSafety

Mrs. T, 76, background of mild dementia. Admitted with COPD exacerbation. Doing well. Discharge planned for day 3. AM, night 2: bed manager moves her to a different ward. Bed pressures. Wheeled through dark corridors. New bay. Different nurses. Belongings in bags. By morning: frightened, disorientated, and calling out. Delirium diagnosed. Workup: all normal. No infection, no medication change, no pain. The cause: probably mostly the ward move itself. Sleep deprivation + loss of orientation cues + unfamiliar environment = iatrogenic delirium. We do this every night, in every hospital. Her avoidable delirium was very costly to her: reduced confidence, worse mobility, lasting traumatic memories. It also meant 4 extra days of hospital bed costs. ↳ How many cases of delirium in your hospital are caused by inadequate care? #acutecare #dementia

Hems ⁦@airambulancekss⁩ familiarising at Royal Sussex #brighton more a ⁦@brightonargus⁩ theargus.co.uk/news/25883955.…

Huge moment today. Hard work over many years by a good few people to get this done. Amazing to give patients in Sussex access to the MTC by air with @airambulancekss. @GreenhalghRob @dbootland @BarbaraRayner1

"Why does our top performer get the worst reviews?" the boss asked. I was reviewing their annual performance data. "Show me," I said. She pulled up the ratings. Diana: 2.8 out of 5. Below average on "collaboration." Low marks for "team player." "What's her actual performance?" I asked. "Exceeded every target. Landed our biggest client. Trained three new hires." "So why the low scores?" "Her peer reviews are dragging her down." I scanned the comments. "Too direct." "Challenges ideas too much." "Not supportive enough." "Let me talk to Diana," I said. "I used to give honest feedback," Diana told me. "Said our pricing model was broken. Got dinged for 'negativity.'" "What happened with the pricing?" "They finally fixed it six months later. After we lost two major accounts." "What else?" "I questioned why we needed eleven approvals for a simple contract change. Manager said I wasn't being collaborative." "Are you still giving feedback?" "No. I learned my lesson. Now I smile. Nod. Say everything's great. My reviews are improving." "But nothing's actually improving?" "We're making the same mistakes. Just with better vibes." She chuckled. I went back to the boss. "Your review system doesn't measure performance," I said. "It measures compliance." "That's not true." "When was the last time someone got promoted for challenging bad ideas?" Silence. "When did someone get rewarded for preventing a mistake?" More silence. "You've trained your best people to stay quiet. And your mediocre people to stay nice." A few months later, they redesigned the system. Added a category: "Constructive Challenge." Points for identifying problems early. Rewards for preventing costly mistakes. Diana got promoted. "What changed?" I asked the boss. "We stopped confusing agreement with alignment. Stopped mistaking silence for harmony." "And?" "Turns out our 'difficult' people were our most valuable. They actually cared enough to speak up." Here's the truth about performance reviews: Most companies don't reward performance. They reward performance theater. The person who says the meeting was great beats the person who says it wasted an hour. The person who agrees with bad ideas beats the person who prevents disasters. You think you're measuring contribution. You're measuring conformity. And your best people? They've already figured out the game. They're just deciding whether to play it or find somewhere that values truth over comfort.

It's that time of year where an outdoors job is never usually a dry or mud free job. My trusty Salomons have kept my feet dry but are going to need a proper clean.

Consultants: we don’t expect you to know how to intubate, run a code, reduce a fracture, deliver a baby, or actively manage 30 patients simultaneously. Please don’t expect us to know every nuance of your specialty, either. That’s why we call.

YEEEEEEEEEAH rat fans

@ThatEricAlper Saw Radiohead supporting Kingmaker at the University of Kent in 1992. Went out and bought a first pressing of creep on 12 inch as soon as it came out which is still pristine and tucked away somewhere.

Have you ever been to a concert where the support act went on to become famous?

I am reposting my post - just in case people missed it! Closing on Thursday! Different categories but my interest is in you recognising someone doing excellent work in research - it is fantastic to have this as a category. Prof Malcolm Woollard would be excited to see this

We recognise some members have questions about the recent survey on advanced practice roles. The survey is exploratory, and we’re monitoring developments to ensure advanced paramedic practice is understood and supported. Read the full statement ➡️ bit.ly/4ceFSpz

Just 10 days left to nominate for the Royal College of Paramedics Honours and Awards. Don't forget about the Professor Malcolm Woollard Award for Research Excellence. It's the first year for this award so make it count. You can get all the details here - lnkd.in/e6_ka9Es

@EastAngliAirAmb PHEM Senior Clinical Fellow recruitment: start dates Feb 2027 and Aug 2027. If you’re looking for high-acuity prehospital practice with a strong clinical governance, education, and research culture, do have a look - and pls share :) tinyurl.com/EAAASCF

New analysis by the Royal College of Emergency Medicine reveals that there were 4,757 deaths associated with long A&E waits before admission in England last summer (1 June to 30 September 2025). Watch @RCEMPresident with ITV’s @BeccaBarry here: itv.com/news/2026-01-2…

I graduated from medical school in 2023. The total amount I borrowed was £77,549. After working for nearly three years as a doctor, this is my latest balance.