Dr Sarah Marsden

And with that, after a spectacular @Anaes_Residents conference and year as Chair, it’s time to hand over the reins to @Jamesbrooks90. I am so proud of everything the committee have achieved and grateful for their support. Over and out from the chair who never planned to be! 🎤⬇️

✍️ Unknown. One thing about anaesthetists you should know: “Most of the time we’re usually ice-cold. Alarms blaring? Whatever. BP dropping? Fixable. Surgeon wants paralysis again? Sure. But if you see us stand up really fast… that’s when everyone in the room should worry!”

@emilyltownsend @wesstreeting No anaesthesia representation demonstrates a fundamental misunderstanding of maternity patient safety.

I’d like to propose two things. 1. We have to openly acknowledge that being a healthcare practitioner is hazardous to your health. 2. We have to actually want to reduce that hazard, and not wear it as a badge of honour.

@oli_m_sims I’m an obs-by-choice anaesthetist, but that is a low in terminology from the midwives!

@GaslingSarah Indeed. Being referred to as “the cannula person” was a particular low point 🙄

New fear unlocked: being the only anaesthetist at PROMPT.

Delivering bad news as an ICU doctor is one of the harder parts of the job. Here are some lessons I've learned along the way👇 1. Always sit down 2. Don't just jump into it. Spend the first couple of minutes with introductions to yourself, your team (if present), but more importantly who all is in the room (patient, family etc.) 3. If you will be needing consent for something (procedure, palliation etc.) as part of the discussion, ensure you know who the decision maker(s) are. 4. Preface the bad news "I have to share something that might be hard to hear" 5. Clearly in <30 seconds deliver the bad news then STOP TALKING. The biggest mistake I see is people give the news and keep going. It takes time to process what may be the worst news they've ever received. Silence is the solution here. They will talk or ask questions when they are ready... it could be 10 seconds, 1 minute, or 10minutes. Give them the time they need before you proceed. 6. Ask if they have any questions about what you have delivered. 7. Be prepared to answer 'what comes next' .. 8. Ask about spirtual / religious beliefs when appropriate and offer support if that is available. 9. Let them know you or someone from your team will be available to answer questions that might come to mind... often in the moment, questions slip people's mind but come to them minutes after you leave. Make sure they know how they can have them clarified. Just some thoughts here... any others? Bonus: Don't construe family members becoming angry as them being angry at you or the team. Anger when faced with this news is common, normalize it and realize it likely isn't directed at you!

8️⃣ ASA 1 or 4, a good anaesthetic alters physiology as little as possible 9️⃣ People go crazy around exams, choose who you listen to wisely 🔟 Ignore radiotherapy to the neck at your peril And last and most importantly 🚨Never be told to go home twice🚨

4️⃣ If you can’t explain why you’re doing it, it probably doesn’t need doing 5️⃣ 20mcg of adrenaline can get you out of a lot of pickles 6️⃣ All things being equal, the best post op fluid is a cup of tea 7️⃣ The best way of fixing a problem is by avoiding it in the first place

I’ve been an anaesthetist for 17 years These are the 10 most important things I’ve learnt! 1️⃣ Just because you can, it doesn’t mean you should 2️⃣ There is such a thing as a silly question, but it’s always better to just ask anyway 3️⃣ Safety fast, don’t faff

@oli_m_sims @Resuspiece Already is bud. I have many criticisms of RCoA and recruitment, but senior residents and SAS doctors already interview for core/ACCS.

@Resuspiece The sensible, meaningful approach by ANRO and the college would be looking at how to expand access to interview. Things that make sense like opening interviewing to non consultants. But common sense not ANRO’s vibe. They’ve chosen the cheap option of an unvalidated sham test.

Totally agree with this What advice can you give to somebody struggling to get into anaesthesia? Try harder at the MSRA next year? It’s not right, it’s the wrong tool for the job, clearly.

The UK is desperate for medically-trained anaesthetics. Without them, many services cannot run There has been an inexplicable & deliberate attempt by successive govts, quangos, health ‘leaders’, GMC with passive complicity by the AoMRC & RCoA to throttle specialty training

@oli_m_sims @dieracg Solid numbers Oli, well done! Obstetrics isn’t something to be feared. Good communication and keeping up to date and involved will serve you well. A lot of ‘surprises’ in obstetrics are predictable if you keep your eye on the ball.

@dieracg Definitely a perk of working in a Head & Neck centre. No shortage of cases needing FOI and a lot of consultants who are not only comfortable but keen to teach and supervise. There’s a long way to go, and I’m starting my IACOA tomorrow when obstetrics broadly terrifies me.

CT1 in numbers: 684 cases Of GA: 45% Volatile 55% TIVA. 22% Ortho, 18% General, 12% Urology, 11% Paeds, 8% Gynae, 6% Plastics, 5% Max-Fax/ENT. 41 Spinals, 37 LL blocks, 18 UL blocks. 254 intubations. 44 RSIs, 11 FOI (inc 3 awake), 37 A-Lines, 18 CVCs. Onwards and upwards.

@isitsleepytime I think the little tactile creak of a Tuohy just before the epidural space is very satisfying. I also enjoy a well-executed block and the difference it makes to the patient, especially if for rescue analgesia.

So often overlooked. 5-6 years lost earnings & accumulating debts (student & private)..... Choosing to become a Dr is really expensive & the salary should reflect that.

Doctors have had 60 days of strike action in the last 25 years On the other 9000 we routinely go above & beyond, staying late, stepping in & keeping an under resourced ship afloat despite worsening pay & conditions So I’ve got 3 words for you Kemi “Work to rule” We dare you!

@BBCNewsnight We had our F1 accommodation taken away in 2008, successive RT pay cuts, a good pension deal removed in 2015, an awful contract imposed in 2016, but expected us to put ourselves at risk in 2020, rewarded with pay cuts & bottlenecks We should have listened to our 1948 predecessors

This ⬇️ Being a doctor is work. Anyone who works is entitled to be paid properly, based on their skills, training, experience and performance. As medicine is a “career” it should have a structured, funded career path. Doctors don’t need to court public opinion.

@DrRJWebb Nope. Big fat nope.

Just gone to apply for a course. Two days. £100 for Nurses/ANNPs/Ultrasonographers. For doctors… £400. Absolutely not.

@Anisocyte @jfdwolff @ShaunLintern This also, cynically, means absolutely nothing to post-exam resident doctors who have already paid.

@jfdwolff @ShaunLintern I don’t agree, unless I’ve misunderstood, these things come with +++ caveats. Eg, often RC exam will only be covered if you have an NTN, but you need the exams to get an NTN now

The BMA agrees to put a new government offer to resident doctors through an online survey