The Art of Being Brilliant

Take home messages:

  • Make a TO BE list rather than a TO DO list
  • how would the best version of oneself go in to work? – energetic, creative, resilient, positive, confident, upbeat, happy
  • Zig Ziggler
  • Vipassana Vendatta
  • Can choose to be positive vs be a mood hoover
  • Do not moan. ‘get over it’ choose to be positive, be grateful
  • If you did know the answer what would it be? If we were the best team, how would we act?
  • ratio of good/praise to bad/negativity:
    • 1:1 high risk
    • 2:1 at risk
    • 3:1 – minimum for good relationship
    • 6:1 – high performing team
    • 8:1 – children
  • 1st FOUR MINUTES = be the best self.
  • Reframing positively e.g. ‘was it good, great or amazing?’
  • Appreciative enquiry – meeting and discussing what went WELL

Andrew Cope

The Art of Being Brilliant – mentoring update

@beingbrillaint

Personal reflection – Cognitive bias

Case of acute and evolving intrinsic cord lesion in pregnancy presenting as unusually bizarre, but evolving neurology, referred as ‘cauda equina?’

When faced with an unusual presentation, particularly if it does not fit with anything ever seen before, and even if on probability it is very unlikely to be pathalogical, need to exclude the relevant and not be biased towards preliminary diagnosis planted by others. Consider Bayesian modelling.

Have an open mind and think broader than the problem presented. Is this something that we have neither yet considered nor ever seen before? How to prove/disprove this? Consider safety nets and worst case scenario. Accept uncertainty in an uncommon, undeclared situation rather than over-confidence. Observe evolution over time with multiple snap shots and opinions.

14th Annual Critical Care Symposium

Ventilation

6ml/kg, <30 cm H20, PEEP, SpO2 94-98%, recruit

 

Trials to review:

Recruitment, FEAT, FACTT, ACBIOS

 

Successful ward round

Patient, Doc, nurse, MDT

My name is (first name) to team, Dr xx to patient. call them by surname

Family present at WR. Adv: gain new info, open/honesty. Pre-claimer. Teach & treat.  Will translate.

White board next to each patient with important info, plan details.

Start at same time everyday – good for MDT

Daily plan understood by all, nurse/junior repeats back. To do list. Check

Interactive, educational, professional, fun

 

Crit care practitioner

service need, fill rota gaps. crit care practitioner podcast

robust ciricullum, education, cpd + appraisal pathway/training. Some can prescribe. know your limits. consistency, permanent

P. paradoxus – downwards swing in pleth/BIP in SV patient on inspiration

Digital Meeting

Positive reporting in Datix

Education – twitter journal clubs

‘Rapid weaver’ – Mac based website development

Safety events/handoever every 12 hours

[c.f. neonates WR – learning point of the 24 hours/week]

ipad/screen next to ABG with learning message

Use raspberry Pi

Check out portsmouth crit care