‘Im just a nurse’
A nurse working in
#PedsICU
>19 years had nowhere to park for her shift on Tues morning
Leaves hospital at 8.15pm, 13 hrs after arriving, car has been towed by clampers
Phone charge runs out, walks 3km in pouring rain to Garda station
My lovely Granda brought me here for an interview to get into medical school in ‘89
He’d worked in the Post Office all his life and was mad with excitement and pride to walk into
@RCSI_Irl
I sent him up a thank you smile 😃 as i went in to give a lecture yesterday
#family
Although this isn’t over, and many remain vulnerable
I hope
@CMOIreland
Dr Tony Holohan and Dr Ronan Glynn get some peace and relaxation this weekend
They didn’t do everything right, wrong - they’re human - but it’s been a VERY long oncall shift for them
#COVID19
My colleague recounted this to me today, how she cried with cold and fatigue while waiting for phone to charge
But mostly she spoke about how small, insignificant and undervalued it made her feel
‘Just a nurse’
#ICU
#icunurse
My choice of role model to emerge from the pandemic
Can’t wait to see what he does next, fingers crossed it’s a prominent leadership position in Ireland ;-)
Dr Mike Ryan: ‘It’s very hard to bullsh*t me’
via
@IrishTimes
Hats off to the medical student who got a bus at 7.30am to shadow me on shift in
#PedsICU
- on soggy Saturday Dec 30th
Her company enhanced the day 🤩
🙄 we both forgot it was a Saturday when we made the arrangement a few weeks ago - but she decided to come anyway 😊
#MedEd
This sunny day our daughter Beatrice was born
Prematurely
I never imagined that neither she nor her father would be alive for her 13th birthday
So as a family we live and love today,
holding tight,
making meaning,
not knowing tomorrow⭐️
#carpediem
#LoveToday
#babyloss
In the hours following my return from the supermarket my teenagers attempt to eat the entire week’s food before nightfall
Am i safe in assuming this is in keeping with the species?
#family
#teenagers
Yes hospital porters are unsung heroes 😍
I have found them to possess a ready supply of jokes to relax nerves, experience that makes everyone feel calmer, solid opinions on football and are generally kind people who just want the patient to be ok
#healthcare
#teamwork
Our hospital porters bring our patients from the ward to theater on the night of a transplant. Even in these unsocial hours they make every effort to make these nervous patients feel at ease.
#MaterTransplant
Our nurses touch so many lives with their skill and kindness - i have seen many swap shifts to stay with a family in their worst hours
It should be possible to do better and look after the people who care for our sick loved ones
#healthcareworkers
#safeworkenvironment
My ancient volvo puncture tackled by crack carpark team of GI surgeon, eye surgeon, ENT surgeon, scrub nurse and anesthesiologist…
😂🙄seriously what could go wrong??😂🤣
#teamwork
#MedTwitter
Some days you notice certain things…
Children on today’s surgery list from Sligo, Limerick, Wexford…travelling thru the very early hours on icy roads to get here for 7am ❄️
hungry, waiting
Not ONE complaint
‘Im glad to get fixed’ - one brave kid
#hope
#brave
I asked about medications and a young mum gave me a lesson on keeping seizure and pain meds separate from where she has their food…and safely away from 2 small kids…in a hotel room w twin beds, a cot, rucksacks and a buggy
And a lesson in humility
#Homeless
#Children
ICU in 🇮🇪 couldn’t exist without Anaesthesia trainees
- most aren’t training to work in
#ICU
long term -
but they work long demanding shifts, make difficult decisions, break terrible news
We should be grateful to them, for their
#courage
in the
#COVID19
storm
#Anesthesiology
Small son sleeping beside me while on call…hears me on the phone during the night - next morning with a worried face:
‘Was that little girl ok Mummy?’
Our families absorb much of the hidden impact of being a doctor
#MedTwitter
#PedsICU
The pain of loss is worth the love this man gave us
Loved by everyone who knew him❤️
My Dad had much adversity in his 83 years,
but he carried it with grace & inspirational strength,
using his fine mind & big heart to be positive always 🥰
Rip Dad
Garda locate her car 5km away
She walks back to hospital, charges phone, pays release fee, walks to the car, soaked and freezing
Gets home to her worried family at 11pm
Dr Austin O’Carroll has inspired many a medical student to become a GP!
Tireless in his fight against health and social inequality,
and for disability rights, he is a genuine man for others
60 hours in house
AND 74 hours on call this wk
Yes i chose this life, am privileged & ❤️ my job
But if this work can only be done by clocking these hours, it’s a flawed unsustainable model
Intensity of demands on doctors in work & home have changed
Our system needs
#change
Extraordinary times when recruiters from abroad for healthcare staff are platformed on
@rte
Can we pull together as a nation to improve conditions and retain staff who have trained here?
We have thousands of doctors in training!
They deserve a central HR division managing contracts, pay, tax, garda clearance…
Beginning with first employment and continuing through until permanent appointment with hospital/GP practice, with flexibility re. leave etc
#change
Not paid today by UHG a month after changeover. HR not responding to emails or answering calls to explain. This is not good enough for
#NCHDs
!
@HSE_HR
will have to do better if they want to entice me back after my fellowship next year.
#twofingerstodoctors
Real worries for our frontline staff:
1. Not enough of us
2. Not enough beds for sick people
3. Huge waiting lists
4. Staff getting sick
5. Staff resigning
6. Winter is coming
Taoiseach ‘concerned’ about welfare of frontline healthcare staff
✨Angel Trip Home from
#PedsICU
There is a v special transport team who take a dying child home, on their intensive care support…and gently discontinue icu support there
So that the family go home together ❤️
Siblings, grandparents, cousins, can share time at home with baby
Deep down in the doldrums last night about a small disappointment…which i raged about at some length 😂…when i got home this eve the much put-upon daughter had made me a cake ❤️
#family
when is the next General Election?
My mum used to keep her questions in a notebook by the front door, to grill canvassing local politicians
She logged their promises in writing, in front of them
We were mortified 😆
My fingers itch for that notebook
#politics
#healthcare
staff leave the job because they are NOT able to provide good safe care
They want to DO the work
If we don’t offer exit interviews we miss this issue - and assume that staff leave because they DON’T want to work
This disconnect is important, and real
New normal in PICU... communicating in full Personal Protective Equipment (PPE) using walkie-talkies! Walkie-talkies arrived thanks to Smyths toystore.
#COVID19
#StayAtHome
@WFPICCS
@pedsicu
Got referral of a very sick little one last wk - doctor sending them so worried, many anxious calls to set up
#PedsICU
admission
Called today to let them know baby now recovered, discharged to ward
Cue wobbly voice, relief and happiness
So much care ❤️ in healthcare
Perhaps some don’t know that it’s not the norm for doctors to leave a health service en masse
In France/Sweden/Canada/Australia doctors leave for training but they come back
Our doctors are not coming back
Parenting solo the phone call from the school to come pick up a virally child is heart sink :-((
The worry about your child and the sudden stress of covering a list of patients or a shift asap - when there is NO cover, NO spare capacity in the system
#family
#COVID19
Thank you for your vote!
It’s a huge honour to return with a strong mandate for change from our profession
Genuinely touched by support, including from my nursing and allied health professional colleagues who who got in touch to say they’d vote if they could 😊
Biggest worry beyond wretched
#COVID19
is the current culture in healthcare
We don’t have a culture of care for HCWs, and inevitably this erodes the culture of care for patients
I can’t understand why many don’t see the connection 🤷🏻♀️
This problem exists for healthcare staff throughout our major urban areas. Addressing it would help greatly with morale and retention, especially at present
*Patients will be looked after
*Everything will be slower
*Staff will absorb the anger of those waiting
Our health service has super people, working in chaos, pulling together no matter what
We’re asking for change
Solidarity with colleagues
#medicalscientists
🎉 Celebrate!🌤🎈
When a baby recovers and gets stronger…it’s time to get them off the ventilator…and take out the tube!
Sometimes even hearing a little cry for the first time 😍
One of the loveliest tasks on
#PedsICU
😊😍
Just a decade ago it would have been unthinkable that both presidents of
@RCSI_Irl
and
@MedCouncilIRL
would be women
- progress…but lots more to be done
@WomenMedIreland
A pleasure working w Prof Viani on a range of projects to improve patient care
All week carrying the burden of giving terrible information to families
Knowing that the words don’t always come out as i want them
Going back over these meetings in my mind
Knowing how much pain flows from these days
#PedsICU
So grateful for the privilege of re-election!
A vote for continuing the important changes taking place 👍
⭐️I’m delighted that
@MaryDavoren
is elected to Vice President,
her measure and values will bring a lot to the role
⭐️Two women doctors chairing Council for first time
We are delighted to announce that today the Medical Council has re-elected Dr Suzanne Crowe as President and has elected Dr Mary Davoren as Vice President. Read more here
We are talking about the tide of viral sick young children - we aren’t talking enough about the flood of anxiety and depression in teenagers
It’s everywhere in child and adolescent services right now
#mentalhealth
#PedsICU
#Children
In our cities there are often derelict sites relatively close by hospitals - these could be surfaced and given over to hospital parking until more sustainable solutions developed
It seems contradictory and disingenuous to run
#patientsafety
and
#OpenDisclosure
campaigns…then freeze recruitment of doctors in training,
which health service relies on for patient care
Not recruiting essential staff in winter is like leaving Keith Earls on the bench today
Many doctors in training finishing rotations today
Some will work the weekend before moving, which is challenging
These doctors will care for us, our children, grandchildren - how we look after them now is important
⭐️ All brilliant committed people, wishing them well!
8! missed landline calls from small son during meeting in work…
Me: for sure house is on fire/burgled/dog ran away…😩😩???
Boy: hi mum
Me: ok love???
Boy: just sayin’ hi
#family
#whatsfordinner
‘Make more ICU beds’
Each ICU bed needs nursing and medical staff
- It takes years to plan and scale up
@NDTP_HSE
Safe patient:nurse and doctor ratios set out by
@HSELive
Model of Care and international ICU/PICU standards
#ICU
#PedsICU
I know nothing about HR…but this summer my teenager had 1st ever job in a noodle takeaway…with portal to see shifts, log hrs, pay - all there
She learnt to be on time, work - and got paid
Pay for work is basic value exchange in our society!
Why are doctors not being paid?
Mater is one of the finest hospitals in our country
Their medical staff say it as it is
ICU doctors speak out: ‘There’s no optimistic scenario. There’s only pessimism and carnage’
via
@IrishTimes
On the eve of
#IWD2022
how wonderful to read a fitting tribute to Dr Mandiwanza :-)
Women surgeons rock, and in Ireland we have many who are truly fantastic!
‘I have to remind myself on a daily basis that I am a neurosurgeon’
via
@IrishTimes
Speaking to GP colleagues today - huge sadness & concern about working conditions & viability of community based medical care, esp rural areas
Many healthcare issues right now but we - the public - urgently need a plan to address this GP crisis
It’s real
#change
#health
No matter how you slice and dice the numbers and strategies we just don’t have enough beds in our healthcare system
Our population is 5m, more 65+ than ever before,
w more medical problems, more medical interventions possible
We’ve less beds than 1995, population 3.5m
This is wonderful idea
But
Id really like to see a review of HPAT - 12 yrs after it started, where is the evidence it has been of benefit?
It created an extra financial barrier to medical education
And i remain unconvinced it has changed the people who become doctors
#MedEd
AccessMed are delighted to announce our HPAT scholarships for 2022/2023!
The deadline is December 8th and any student in secondary school or on an access course in college who is sitting the HPAT in February can apply.
We can't wait to see your applications!
@MedisecIreland
Some people believe visible tattoos in healthcare staff are a problem…and that should be covered up…?
I don’t
In my mind there is no conflict between body art and competence,
no conflict between body art and respect for everyone,
patients and staff
#healthcare
When a doctor or other HCW raises concerns about resources,
they may find,
- their practice is scrutinised
- their complications are emphasised
- their waiting list is examined
- they become ‘the problem’
This is a recurrent form of silencing & intimidation in
#whistleblowing
This red stuff is magic 🪄 at helping big people and teenytiny people survive surgery
#Blood
Not a day goes past that i don’t marvel at the difference it makes
But it’s in really short supply rn
So if you are well, please consider donating
#donateblood
#RetweeetPlease
Listen to
@INMO_IRL
Sylvia Chambers
Imagine this in your workplace…!?
We will have no one left working in health and social care if a hard line isn’t taken on abusive behaviour
Unanticipated effect of taking up role of President of IMC has been nasty anonymous letters, at work & home
Anti-vaccines, pandemic denial, anti-feminist, anti-medicine…
Get in touch no bother
#health
But please sign it and leave contact details 😊 or…
Our medical scientists go the extra mile for
#PedsICU
patients
From following through on infections and antibiotic sensitivity to ensuring there is blood for our sick babies
Never have i heard the word ‘no’ from them
#MedicalScientists
Seeing medical staff, paramedics and Gardai comforting each other outside the Resus room reminds me of the real solidarity between public services ❤️
#publicservice
I disagree
We have plenty of wonderful medical and nursing students entering college
It’s what happens after qualifying that causes the difficulties in service delivery
‘There aren’t enough good people out there’: Why can’t the HSE find more staff?
‘every member of the Oireachtas, every senior official in the HSE and the Department of Health should be forced to experience this.
By themselves.
In pain’
Seán Moncrieff: A car park of trolleys, people screaming ... just another Friday in A&E
How did ‘resources’ come to mean ‘people’?!?
We need more well-trained people in our health services
We need to keep the good people that we have
‘Resources’ depersonalises and it’s awful, it’s not office furniture we’re talking about
‘We need another WTE’ is even worse 😂
Quick scan of other media and
@IrishTimes
only article on this problem..?
Are the public aware of how big retention/recruitment issues are in healthcare?
…and what it means for patient care
…and how each further breach of fair working conditions is taking us over the cliff
Unfortunately true for families attending hospital as well as staff
Parents leaving seriously children in hospital to find a cold sandwich in Spar
Many parents can’t leave
@AlanMarrinan
@HSELive
A situation repeated in many hospitals. Canteen and coffee shop closed after 3pm and at the weekends (nothing to do with covid). Vending machines empty. Simply no understanding on behalf of management that many hospital staff don’t keep office hours.
This weekend 20 yrs ago I realised with a shock that I’d have to shelve my ambitious fellowship plans…because this beautiful person was on the way
Life happens, plans change ❤️
#lifeisbeautiful
In children’s hospitals everywhere this week there’s a race to get small people home in time for the big man 🎅
There’s a lighthearted atmosphere 🎅
We never forget our families who won’t have their special child home for Christmas
especially those who never will
#PedsICU
When your
#holiday
bestie is gone, each new trip is bittersweet
Flooding with memories from hols in the past…
and at the same time, creating new fun 🤩 memories with the children 🥰
Parents working in
#healthcare
find it difficult to source childcare for 12+hr shifts
Without family support or solo parents especially
Childcare needs to form part of retention strategy
‘Childcare costs are the new glass ceiling’
Europe-wide post-pandemic we have a wave of early retirements, graduates not staying in healthcare, absenteeism & quietly quitting
This is not coincidental
‘Recognition justice’ means we must give space & time for people to tell their story - and for it to be heard
Why should the public care about the working conditions of doctors?
Patient safety!
Excess of 40 hours/wk impacts on focus, judgement, motivation, energy, mood…decades of research in many types of job has shown this
(via
@thejournal_ie
)
Several of our little patients got a special hairwash and nails painted pink for celebrating NYE this eve 🥳
Never too small for a bit of sparkle ✨
#PedsICU
#makingmemories
Systemic issues that impact on doctors caring for patients:
-not enough doctors
-too many hours
-insufficient training opportunities
-inadequate career progression
- failure to integrate International med grads
? Solution
Workforce plan from med student to retirement
#change
lil’ guy in
#PedsICU
said he’d sing a song for me cos i told him he was well enough to leave..
..intense whispering w his mammy as he picked the song…
Tiny serious face,
big eyes,
high voice
‘It’s a small world after all,
It’s a small small world…’🎵
Me:😭
#meaning
#hope
Recognition of a critically sick patient is a vital skill
A core competency which needs regular practice- along with symptoms and signs,
there is a ‘look’ that accompanies serious illness
Experienced staff know the ‘look’
I wish there was a more concrete way to describe it..?!
I told a colleague I don’t know well that their work today had made a huge difference to a particular child
Their eyes filled with tears
It is so easy to completely underestimate how much our work means to each other,
and how a tiny morsel of recognition helps ❤️
In my class in school,
2 students were offered a place in medicine on the
#CAO
Many years later….
there are 4 doctors graduated from same Leaving Cert class,
2 GPs, one palliative care doctor and one
#PedsICU
We all did it our own way
There’s many paths to what you want!
Seeing many women doctors exiting specialties or postponing having their families, left a lasting impression on me when in the early part of training
A compromise made under pressure of training
is not the same as a choice freely made imo
#WomeninMedicine
Entry to a career in medicine should be equitable
Entry via HPAT needs reform
Healthcare staff should be as diverse as the patients they care for!
‘Medical aptitude test fee is unfair’
#muchmorethanaventilator
The best intensive care, with good outcomes, is delivered by 5-6 intensive care nurses PER BED. Compassionate, knowledgeable and skilled, ICU nurses are valuable to society and should be paid well.
@traceywall001
@djcribbin
#Covid19
Every healthcare worker should meet the principle of providing a good death, no matter what their specialty or level of experience
A good death is a basic right!
Brendan Gleeson: ‘This concept of your parent’s death being a good death is monumental’
Had meltdown last night cos washing machine broke... came home this eve to find 12 yr old daughter cleaning up having got door open, emptied blocked filter and changed fuse in plug. ‘Machine’s back on’ she says.
#youtube
#wondergirl
With
#OmicronVariant
arrival comes the realisation for many healthcare workers that they won’t be visiting family abroad for a 2nd year
Crazy hours and heartbreaking experiences w limited annual leave during the pandemic - many had finally booked trips over the coming months
Last night in
#PedsICU
I saw parents expecting their babies w
#RSV
to be cared for, to live
So we suctioned, rested on ventilation, gave antibiotics & oxygen, fed milk into tired tummies
It’s the right thing to do 💕
How can babies in
#Gaza
be seen differently?
One of our doctors who worked 25* hours shift yesterday couldn’t be at home with her children for
#MothersDay2022
Lots of mums working yesterday obvs…but in 2022 a 24 hour shift is a problem
*9am-10am
#healthcare
#family