Chris Hebbes

Bloomin’ tired. And realised I’d intended to book annual leave in my diary and never actually booked it. Oops, but explains why an evening with a book is needed!

Always a pleasure to teach! Thanks to the rest of the faculty and the candidates for making it fun! (Even if we do look like we are staring at a blank flip chart)

@JacquiDeevoy1 Just wondering what your qualifications are to mislead and misinform. Bacterial meningitis is contagious. To inform otherwise is harmful.

Meningitis is NOT contagious, so what’s with all the nonsense? As my friend Kat Watkins says on FB today: “Meningitis is an infection in the brain caused by toxins passing the blood brain barrier. You cannot 'catch' it, it's not contagious 🙄🙄 So all this closing of schools is just theatre. It's to scare you into making sure you jab yourselves and your kids up. How many of those who have presented with meningitis, had the covid vax? Since its a side effect? As well as a side effect of many other jabs 🤷🤷”

@ross_prager Mirroring. I’m fairly sure I watched a colleague at some point in the past agree that “it’s shit and I’m sorry”. Because sometimes life is shit and there aren’t other words that will do. (But be careful of this one)

@ross_prager They will have a rapport and will be able to help give courage for questions families don’t want to ask of “the doctor”

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!

Waggy retirement Cilla!

Not many colleagues retire at 13 but therapy dog Cilla is hanging up her lead 🐾 From ICU visits to school reading sessions, she’s spent 7 years bringing comfort, confidence and smiles to hundreds of people. Wishing Cilla a very happy and well-earned retirement. 💛

@TJCoats @davidcarr333 @DennisCho @ETtube @petrosoniak @EmICUcanada *but be careful of max doses and toxicity

@davidcarr333 @DennisCho @ETtube @petrosoniak @EmICUcanada Why chose? Mix the two in one syringe - early onset, late offset?

⁦@DennisCho⁩ stop thinking that bupivicaine takes longer than lidocaine to start working. Take advantage of the longer duration of action. ⁦@ETtube⁩ ⁦@petrosoniak⁩ ⁦@EmICUcanada⁩

@Pipes_n_pumps @ChatGPTapp Prism gives me fond memories of my time analysing fluorescence!

I’ve finally conceded to the @ChatGPTapp caricature craze! Play along by typing “Create a caricature of me and my job based on everything you know about me” #MedTwitter #MedX #ECLS #Trauma

Reflecting on an overwhelming sense of ‘not again’ for this. It’s the impossible problem. I’m not sure what can (reasonably) be done. Pulling residents out of work for a 50% turnout harms their training and wages, for limited if any gains. A farce from the militant bma. Again.

@Neuro_Matt Yup, although in theory when you change, the new starter form ‘this is now my only job’ should stop the nonsense of HMRC thinking that you are employed by 4 orgs simultaneously and earning 4x salary.

The absolute worst thing about rotational training and academic medicine is trying to stay on top of the absolute nonsense that constantly happens to your tax codes. Just got landed with thousands of pounds bill, due to having essentially 4 different employers in 24-25.

Electronic systems don’t reduce errors automatically, they simply change the nature of those errors. Safety should be designed in to avoid unintended consequences

@TheSnoozeDoctor @maffygirl Of course if they haven’t utilised their training capacity, it’s for the school of anaes / College tutor to take up with the service.

@TheSnoozeDoctor @maffygirl Wow! I presume that hospital has effectively utilised their training capacity - otherwise why on earth are they not using that list to train anaesthetists. That was exactly the sort of list I loved at ct1/2. (And now but I rarely get to do the more straightforward cases)

In Theatre 12 this morning @maffygirl, there is an Anaesthesia Associate (non physician) undertaking a quick fire day case list with 8 cases on it. The senior ladder pulling supervising consultant has yet to leave the coffee room! This is NOT safety first!

@thetimes Instead, the action reduces capacity at a time when gp slots are at a premium.

@thetimes Difficult to say without the full details. But this doesn’t feel proportionate or supportive of LTFT working and equality. A missed opportunity for her practice to adequately support her, maybe time shift to allow more flexible patient appointments at other times

GP faked appointments to avoid being late to pick up children #Echobox=1767129163-1" target="_blank" rel="nofollow noopener">thetimes.com/uk/healthcare/…