Coda Change
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Mark Weedon takes us through the increasingly utilised concept of an optimal cerebral perfusion pressure (CPPopt) for each unique patient. This podcast was recorded at the Brain Symposium which took place in March 2023. For more talks and content like this, visit neuroresus.com.
Social Worker Victoria Whitfield and Bereavement councilor Louise Sayers discuss the power of words when health professionals are communicating topics around of death and serious injury with relatives and patients in critical care. They use role plays to bring theories to life. This podcast was recorded at the Brain Symposium which took place in March 2023. For more talks and content like this, visit neuroresus.com.
Ambulance Victoria has committed to become a more sustainable ambulance service. This includes achieving net zero emissions five years prior to the Victorian State Government commitment of 2050 with additional emissions reduction targets for 2025 and 2030. By fulfilling these targets, the carbon footprint for each patient cared for by Ambulance Victoria will be halved by 2030. It is apparent that to meet these emission reduction targets, Ambulance Victoria's current model of care needs perpetual refinement. Reducing emissions from electricity and fleet start to look easy in comparison to reducing low value care. Delivering better care to a patients according to their particular healthcare needs suggests that our pre-hospital service needs to be reimagined to start prior to any patient picking up the phone to dial Triple 000. Ambulance Victoria are discovering new ways to offer best care for particular patient cohorts via new technologies such as telehealth and the Virtual ED and by partnering across our communities primary and secondary healthcare networks, to offer timely support to those for whom an ambulance doesn't offer the greatest benefit. In 2021, Ambulance Victoria undertook a study to map the carbon pollution associated with its Triage Services and measure changes in carbon pollution resulting from the use of alternate patient care pathways. The analysis revealed interesting results that have implications for pre-hospital service design in the future. We hope that this study offers insight into new ways of thinking for decision makers and enables a triple bottom line approach to assessing the benefit of programs and keeping an awareness of how to serve the community in more environmentally sustainable ways. Using a multipronged approach to improving healthcare sustainability at Ambulance Victoria can reduce the environmental impact of pre-hospital healthcare services and thereby minimise the health impacts from the sector that are associated with dangerous climate change.
CODA Change and Sustainable Healthcare. Climate change is a pernicious environmental and health threat to humanity. Yet, healthcare itself pollutes, contributing to approximately 5% of total global anthropogenic emissions. What can be done to avoid this harm? Forbes McGain has spent 15 years undertaking research with colleagues to discover healthcare’s environmental footprint, with a particular emphasis upon practical efforts to reduce this environmental and economic burden. In this discussion we will hear of a series of micro, meso, and macro actions that each can contribute to reducing our carbon and other environmental footprints at work. Mico: all clinicians have agency to avoid, reduce, reuse, and if none of these are possible, recycle. Further, efforts to provide excellent primary care such as preventing obesity, diabetes, and drug harms, and delivering vaccinations are integral to ameliorating healthcare’s environmental footprint. From titrating oxygen on the hospital wards to deliver enough, but no more for patients, to undertaking antibiotic stewardship (and switching from i.v. to oral preparations) there are actually many daily activities in healthcare that could reduce our environmental footprint whilst delivering ongoing safe patient care. Meso: Collaboration is the key here! There are many low carbon healthcare activities that cannot be ameliorated without teamwork, for example at the GP clinic, hospital ward, or operating theatre level. A good example within hospitals are efforts to convert single use to reusable equipment. Although evidence is presented of the economic and environmental benefits of reusable anaesthesia equipment such information (and publications) has not lead to widespread adoption of such approaches. The importance of champions in each hospital and collaborating with clinical and non-clinical colleagues in hospitals is emphasized. Forming hospital environmental sustainability committees, and alliances with hospital executives and the board is vital. Macro: Advocacy at the medical and nursing societal and colleges level to incorporate environmentally sustainable healthcare into routine clinical education, examinations, and research agendas is the work of concerted groups of clinicians. Influencing the various state, territory and national governments to develop/extend sustainable healthcare units will likewise form part of macro efforts. Joining the Doctors for the Environment, Australia (DEA), activating the ANMF and AMA to get involved in environmentally sustainable healthcare will augment such efforts. Full Sails on Our Journey!
Climate change is now our lived experience. With no vaccine to reduce its impact on health, the only preventative strategy we have is to reduce emissions, including healthcare delivery. The greatest portion of healthcare’s emissions profile comes from the stuff we use, so we have to change what we do. But how? Decarbonisation on the clinical floor is a look at every day work activities. It is bridging the gap between abstract concept and service delivery. It comes with triple bottom line wins – people, planet, and profit. The future isn’t written yet. The things we do now are what make it. We have choices to make that matter. We need visionaries to show us the direction. We need practical examples that bridge the gap between ambition and action. We need to tell the climate story in a way that draws people in, that empowers them to take action and enables us to be part of the solutions.
Nick Watts In today’s podcast, Nick Watts - chief sustainability officer at the NHS speaks about why - when the NHS says there are three things they want to implement over the next decade - their response to climate change is number two. Watts explains that they understand the health implications of a rise in temperatures, they understand that it means a doubling of the number of high risk health facilities in flood zones, and a tripling of the average duration of fatal heatwaves and notes that they saw what that looks like for our healthcare system. He talks about how while the average across a summer the UK face 2200-2400 excess deaths from heatwaves; the recent six-day heatwave saw 12800 deaths – six times the usual amount. That’s why the NHS cares deeply about this. If the climate crisis is a healthcare crisis, Watts says that it’s important to face it head on. Principally, he says, acute care is responsible for the NHS’s emissions, while primary care also comes in strong due to its prescriptions and medicines. He discusses how in order to cultivate real change, you don’t just run at one small part – turning off the lights and turning the temperature down simply isn’t enough - you need look at every single emission you can possibly think of. For the NHS it means net zero by 2045. NHS reports publicly to both their board and 1.4million NHS professionals every single year. Watts says that it hit first year emissions target; he promises they’re going to hit their second. It will, however, start getting hard to hit their targets from year 5 onwards. Transparency is critical. Milestones and scope need to be clear. Watts explains that from 2027 onwards the NHS will no longer purchase from anyone that does not meet or exceed their commitments to net zero. He says that while the NHS will do absolutely everything in their power, they can’t run at this alone. The challenge is too big, medicine is too complex. Thankfully the NHS isn’t alone. 14 other countries followed suit in committing to reaching net zero. To end, Watts insists that it’s when other people take note, start taking this seriously, and when other healthcare systems start to engage that net zero stops becoming possible, and starts to become inevitable.
Sepsis in other words ‘life-threatening organ dysfunction’ in response to infection is a leading cause of death worldwide and a global health priority recognised by the World Health Organisation. In Australia, for adults with sepsis admitted to the intensive care unit, the in-hospital mortality is estimated as 18–27%. Early recognition of sepsis, prompt administration of antibiotics and resuscitation with intravenous fluids for those with features of hypoperfusion or shock are the mainstays of initial treatment. Emergency departments often being the first point of contact for patients presenting with sepsis, are required to prioritise sepsis as a medical emergency. The “Sepsis Kills” program implemented across the nation aims to reduce unwarranted clinical practice variation in management of sepsis. In a recent Australian based study conducted across four emergency departments in Western Sydney Local Health District, among 7533 patients with suspected infection, a reduction in risk of in-hospital mortality was observed for each 1000 mL increase in intravenous fluids administered in patients with septic shock or admitted to ICU. However, despite evidence showing mortality benefits, not all aspects of sepsis care have been given the needed attention. In the same setting, out of 4146 patients with sepsis, 45% of them did not receive intravenous fluids in the emergency departments within the first 24 hours. Younger patients with greater severity of illness and presented to smaller hospitals were more likely to receive fluids. The unanswered questions regarding the facilitators and barriers influencing intravenous fluid administration in sepsis are being explored using qualitative methods. Several emergency physicians and nurses have provided insight into aspects that influence their ability to provide appropriate fluid resuscitation such as constantly overcrowded emergency departments with chronic staff shortages of skilled health professional, failure to recognise sepsis early, the complexity of the presentations and lack of resources. Awareness of these challenges among stakeholders is the need of the hour. Leaving no one behind and not disregarding the critical aspects of sepsis care are crucial. Recognition of these factors and sustainable interventions are necessary to improve clinical outcomes for patients. For more head to our podcast page #CodaPodcast
Physiotherapists form a key part of the multi-disciplinary team in the Intensive Care, focusing on both respiratory care and optimisation of function. This talk will discuss the role of physiotherapy across the continuum specifically in the management of an acutely unwell septic patient. I will discuss the focus of a physiotherapy assessment, main treatment aims, some of the barriers for the implementation of physiotherapy in ICU, while identifying strategies to enable appropriate application of physiotherapy techniques. For more head to our podcast page #CodaPodcast
Sepsis is a common presentation in the prehospital and retrieval environment, with most cases having a respiratory, urinary or soft tissue origin. However the best practice for identifying and management sepsis in the prehospital environment remains unclear. Despite sepsis having been a priority for in hospital guidelines and protocols for decades now, relatively little attention has been paid to prehospital sepsis management. Traditional teaching is that early antibiotics in sepsis save lives, however trials examining this are observational and confounded by outdated ICU care. An appropriately sensitive and specific tool for the prehospital identification of sepsis remains elusive. NEWS2 is common and lactate-modified QSOFA emerging (although prehospital lactate measurement remains difficult). The role of prehospital antibiotics, and the most appropriate one are also unclear. Most ambulance services that carry antibiotics use ceftriaxone. The retrieval environment is similar, with sepsis probably being the single commonest reason to call a retrieval service. For more head to our podcast page #CodaPodcast
As part of the Sepsis Workshop, this presentation will briefly touch on the challenges that patients and their families face on discharge from hospital after an admission for sepsis. For more head to our podcast page #CodaPodcast
As an ICU registrar you meet septic patients at different points in time: as the first responder, asking ‘could this be sepsis?’; as the second responder, admitting the patient to the ICU; or the third responder, having to consider adjuncts in the deteriorating patient. Each of these presents different challenges and learning experiences, making the reality of managing sepsis more complex than one might first expect. For more head to our podcast page #CodaPodcast
As with everything else, ICU management of sepsis should ideally the evidence based. Evidence based practice combines the best scientific knowledge (evidence) with patient preferences and clinical assessment and judgement. While the pursuit of specific pharmaceutical agents to treat Sepsis has resulted in the expenditure of billions of dollars without producing a single effective agent, much of what we do in the treatment of patience with Sepsis can be evidence based. Clinicians make literally hundreds of decisions day on the management of an individual patient in the ICU, often these decisions are made routinely without a great deal of thought about the reasoning behind them. Every decision made about the treatment of a critically ill patient should be based on evidence or the belief that the action resulting from that decision will improve a patient centred outcome for that particular patient. A patient centred outcome is an outcome that affects how the patient feels, functions or survives meaning we should question every decision we make to ask whether it is going to improve one of those outcomes. The best evidence on which to base of such decisions comes from large robust randomised controlled trials conducted by unbiased investigators. The last 20 years has seen the emergence and maturing of regional and national clinical trials groups who conduct such studies and increasingly collaborate with each other. (2) Such collaboration is often essential to perform studies large enough to provide evidence to guide clinical practice such collaboration is often essential to perform studies large enough to provide evidence to guide clinical practice. As someone who designs and contacts clinical trials I am well aware that they provide evidence on a population basis. Each trial result is the net of harm and benefit resulting from the treatment being studied and even when a treatment is proven to have a net benefit there may be some patients who are harmed by the use of that treatment. A graphic example of this is someone who suffers a massive intracranial haemorrhage when treated with thrombolysis. Causing visible harm to a patient may shake a clinician's faith in an effective treatment making it important that we accept such tragic events without changing our practice to deny that effective treatment to future patients. Research, like clinical practice, has inherent imperfections. Researchers, like clinicians, need to recognise this and be prepared to put their hand up and admit when they have been wrong. Conducting robust studies of appropriate size in an effective collaborative research group is the best way to avoid being wrong too often! For more head to our podcast page #CodaPodcast
Sepsis causes organ and tissue dysfunction in response to severe infection, resulting in significant physical and cognitive morbidities. For patients diagnosed with severe sepsis, admission to an intensive care unit and use of an artificial airway are often required. The sequalae of severe sepsis necessitating critical care can result in significant changes to a patient’s swallowing and communication function. These negative changes and impacts to function can occur during and after a diagnosis of sepsis, and ultimately impact a patient’s health and functional status. The nature and long-term recovery of swallowing and communication function is still to be completely understood; however evidence affirms recovery continues well beyond hospital discharge. This presentation will focus on tasks we do daily – eating, drinking and speaking. Specifically, the nature of swallow impairments will be described, and the impact of this new disability will be explored from the perspective of the patient’s body structure, function and activities. Core components of swallowing safety and efficiency will be described, alongside the role of assessment and management within and beyond the ICU. Changes to communication including altered voice, speech and language function will be described. Outcomes of altered communication function over the continuum of care during, and after hospital will be explored. The evidence base and the lived experience of sepsis and patient stories will underpin the content delivered in this presentation. The final aim of the presentation will be to describe and highlight the role of speech pathology, an allied health profession, in the management of swallowing and communication function. Following the workshop attendees will be able to (1) describe the characteristics of swallowing and communication disorders; (2) have knowledge of the impact of these new disabilities; and (3) will be able to describe the role of speech pathology in the healthcare team for the patient with sepsis. For more head to our podcast page #CodaPodcast
Dr Greg Kelly – a paediatric intensivist at Westmead Children’s Hospital – is today’s guest, on the #Coda22 podcast, during which he discusses a little girl called Abbie, who has lived in ICU for almost two years, and how she represents a very important group of patients – who are a tiny fraction of admissions, but a huge proportion of the workload at Westmead Children’s Hospital. Such patients are complex in such a way that no-one knows exactly what to do with them; nor how to respond to them. He goes on to discuss the problems they see every day at Westmead Children’s Hospital, and what the practitioners can do about them.
This session presents a series of medical cases with important clinical caveats. Additionally, a contextual discussion follows, focussing on the social determinants of health and their integral importance in delivering high quality care. The practice of acute medicine requires many skills to ensure the delivery of the highest quality care. Clinical knowledge and skill are essential, but equally communication, empathy, social/cultural awareness and advocacy are also vital. Knowing our patients and understanding their circumstances provides a foundation on which clinical practice can then be contextually applied. Without context raw facts can be misleading and even result in misdirected treatment plans.
In this week’s episode of the #CodaPodcast, Gemma Figtree – a Cardiologist and Professor discusses the profound inequality of gender issues.
In this week’s episode of the #CodaPodcast, Dr Daniel Nour – who founded Street Side Medics a not-for-profit, GP-led mobile medical service for people experiencing homelessness - in August 2020 talks about his grave concern for the homeless who have gone untreated for years. He talks about how it was seeing the inequality in healthcare among the homeless that made him want to do something about it and how we often think about their need for shelter and food, but not for suitable healthcare. He also discusses the barriers that face homeless people and what it was that led him to launch Street Side Medics.
There is a moment that regularly occurs in the life of a clinician working at a major trauma service - where a rotating registrar, a keen sponge - appears, and a discussion about learning goals for the rotation is had. Its always about trauma, I'm here to learn procedures, intercostal catheter insertion, thoracotomies etc etc and if there is a trauma call, I'd love to be involved. But when I point to an older woman in the corner who has fallen from standing height, suggesting that perhaps we start our trauma education there, there are looks of confusion, annoyance even. This patient doesn't fit their expectation of what trauma physician needs to learn. But a trauma physician's paradigm, must evolve.
Healthcare Saves! Healthcare Pollutes! Healthcare is responsible for 7% of Australia's carbon emissions, consumes 10% of Australia's GDP, and has numerous other adverse environmental effects. In this talk, Forbes McGain, an anaesthetist and intensive care physician, introduces healthcare's polluting ways, and how clinicians can mitigate their own carbon footprint. Action is the Antidote to Anxiety! For more head to our podcast page #CodaPodcast https://codachange.org/podcasts/
The chair, Kate Charlesworth opens by explaining that the healthcare system has a big problem – we are, in effect, producing our own patients. We use huge amounts of resources; produce vast amounts of waste and have a big carbon footprint. Globally, if the healthcare system was a country, it would be the fifth biggest polluter on the planet. The irony is then of course that we’re therefore contributing towards the climate crisis which is harming human health. We’ve seen that with storms, fires, floods, and all the associated impact they’re having on our health. We have a huge job ahead of us – to decarbonise or to get to a net zero health system. Nick Watts, doctor, and chief sustainability office for the National Health Service in England says that he wants to discuss three things: why the NHS cares about climate change, what we can do about it and exactly what that change needs to looks like. He then goes on to explain the steps that the NHS is taking to reach net zero by 2045, and the exact steps that we need to take in order to do the same. His three key messages are: The climate crisis is a health care crisis. The time for talking about stuff is over, the only thing that matters is what we are going to do about it. Don’t listen to anyone that tells you that it can’t be done. For more head to our podcast page #CodaPodcast
Beyond Zero Emissions is an independent think tank that shows through research and innovative solutions how Australia can prosper in a zero-emissions economy. Over the past 10 years we have published research on how to decarbonise sectors of the economy such as energy, transport, buildings and heavy industry. Healthcare is a significant energy consumer - around 7% of national emissions come from healthcare facilities and services. Within this important sector, energy use holds the most emissions reduction potential, while manufacturing has the strongest ‘multiplier effect’ - the ability to deliver widespread benefits from decarbonisation. We can power our healthcare sector on 100% renewable energy right now. Energy is used in health facilities for heating water, air, running medical equipment and keeping the lights on. It is also used in vehicles transporting supplies, patients and staff. With clean technologies available now, e.g. heat pumps and electric vehicles, there are readily-available means to run our healthcare system with renewable energy. We can power our manufacturing sector on 100% renewable energy right now. We know what happens when global supply chains are disrupted. A strong onshore manufacturing sector is not only important for a zero-emissions economy, but for all Australian industries - including healthcare. Today, imports meet approximately 80% of domestic demand for medical devices and diagnostics, while nearly all medical technology products manufactured in Australia are exported. When our healthcare system can source more of its construction materials, products and equipment from local suppliers, we shorten supply links, speed up transport time and provide more onshore jobs supporting this sector. Beyond Zero Emissions is working with partner organisations around Australia to revitalise our manufacturing sector with 100% renewable energy. We’re building alliances of industry, government and community to support the decarbonisation of local manufacturing and supply chains in regional hubs where it’s needed most. Resilience for healthcare depends on resilient energy and manufacturing supply chains - and achieving that means more renewable energy powering our economy. For more head to our podcast page #CodaPodcast https://codachange.org/podcasts/
* * * * * * Each speaker delivers a short high impact clinical case from practice ranging from conflict zones to 2 week boarding in the emergency department in India. These cases have been chosen because of the profound personal impact upon the clinician. Following the clinical cases, Ben will facilitate a debrief to explore how these clinicians prepared for, performed in, or recovered from the situations.
Ankur Verma opens the podcast by telling his listeners that he’s going to share with them something that happened during the time that Delta was in its dreadful stages in both Australia and India. He goes on to talk about a case that took place during the Delta wave, when minutes matter. He recounts a patient - Mrs P - who had come in gasping and immediately went into cardiac arrest, and notes that – as is often the case – she immediately became part of the ward’s family. After testing positive for Covid, they then gave her a CT scan to see if she had pneumonia and subsequently put her on various experimental medications, including steroids. She got better over the next four or five days and was weaned off the ventilator and over the next couple of days we removed her TPI (trigger point injection) but then her sugars went up. Ankur explains that just when he thought she was becoming much better, she started becoming hypoxic again and he then found out her left lung had collapsed. She then went on to improve – and, understandably – her family were thrilled, especially her son. After a two-week rollercoaster ride, she was discharged, much to the joy of everyone involved. At a time of great distress, Ankur explains that Mrs P reminded him and his co-workers of the power of determination and motivation, and it was through a combination of compassion and great determination and motivation that she survived. He notes that Mrs P gave the hospital staff a ray of hope and a much-needed silver lining during what was an otherwise hellish Covid wave, and notes that he owed her more than she owed him for saving her life. But, continues Ankur, she had other plans. She had been a ray of hope during the dreadful delta in India and the world and sadly, she died. But Ankur says that he and his co-workers didn’t lose sight of the vision and the hope that she gave them and that they continued to support each other. He concludes the podcast with an important lesson learnt: take care of yourself and those around you because when the dark times come, those people will be the ones surrounding you. For more head to our podcast page #CodaPodcast
Bec Szabo – an obstetrician, gynaecologist, and medical educator – begins the podcast by asking the audience to go back to Melbourne with her on a journey through the looking glass. She notes that while taking her listeners to Wonderland might be a bit quirky, but that it’s essential for the point of the story. Bec also wants to preface the talk with a trigger warning; and acknowledges that the subject matter of her talk might be triggering – so please do bear in mind that this talk covers Covid, ICU and pregnancy before listening. As per the notion of taking her readers through the looking glass, Bec wants to take listeners back to spring 2021 – a time that Melbourne was looking down the barrel of a sixth lockdown. Known as having had one of the longest – and strictest – lockdowns in the world - people in Melbourne were tired and had done a lot. Many were already vaccinated. Bec then goes on to say that she wants to talk about Covid and pregnancy and, explains to listeners that she wants to paint a picture of inequality and sexism. She runs through a case of what happened shortly after the Delta strain had arrived in Melbourne – it was a time when things were changing rapidly during covid with delta things came thick and fast. A pregnant woman was admitted to hospital; it was her third child, and her two toddlers, partner and parents were all sick with Covid; and despite concerns over a post-partum haemorrhage, a healthy baby was delivered, and the woman went back to the ICU. Except, says Bec, this wasn’t what actually happened; what she described was a simulation, carried out in order to ensure they had everything prepared in the case that something similar happened. She goes on to say that teamwork and communication are everything, but so too is listening to the voice of the patient. And that while we’ve heard that belonging and community and connection are important, having those values and shared goals to keep us doing what we’re doing. Bec closes the podcast by that we need to remember we’re the captains of our soul. And that if we can be human and kind, we can deal with emotionally fraught situations. For more head to our podcast page #CodaPodcast https://codachange.org/podcasts/
In this week’s podcast Liz Crowe – an advanced clinician social worker who has worked in Brisbane’s major children’s hospitals in intensive care, emergency departments and cancer wards - begins the podcast with the question – is all this talk of burn out, actually making us burnt out? In this podcast, Liz goes on to address exactly what the term burn out actually means and discusses how the literature on burnout in healthcare workers is prolific. She discusses how healthcare presents as an occupation of high risk, distress, and despair, with an escalation of risk post pandemic. Yet, she says, burnout is not the whole story even though it is the only story being told. Liz speaks about the extensive research into burnout and what it reveals, and the risk factors for burnout, which include excessive workload, lack of control or recognition, mismatch of values, lack of meaning and emotional contagion. However, she notes that none of these are individual deficits and says that it is concerning that ‘wellbeing’ in healthcare is never discussed in terms of meaning making, purpose, contribution, community, stimulating work or growth and development. Yet, she goes on to say, for many critical care staff these positive factors for wellbeing are found in abundance. Liz also states that her research shows that people want to believe that the bad stuff happens on one side of life; the good on the other, and people want to know how they get to the other side. Whereas, she says, in reality, life is a crappy mess that sits somewhere in the middle. The podcast concludes with Liz stating that purpose and community are everything, that life is messy, but some days - despite how awful we feel - we soar because of the opportunities we have. She encourages listeners to savour life, and to remember that even on the worst day of their working life, their patients are doing it tougher. For more head to our podcast page #CodaPodcast https://codachange.org/podcasts/
"Death is not the enemy but occasionally needs help with timing." Peter Josef Safar (1924 – 2003) 'The Father of Modern CPR' In this week’s episode of the Coda podcast, former flight paramedic Gary Berkowitz – who previously worked in Afghanistan and now works for Queensland Ambulance Service - explores how when death is inevitable, the way of dying matters. To open the discussion, he addresses the fact that out of hospital emergency care practitioners are often faced with time critical decisions. He notes that fortunately, most of these situations often have clear guidelines because – generally speaking - they follow pathways with expected outcomes. When it comes to ETHICS IN HEALTHCARE, however, it can be a nuanced topic. For example, the decision to not commence resuscitation, or to withdraw life saving measures in a patient who appears to have no meaningful prospect of recovery, can be a difficult one. Gary goes on to note that in this environment, it’s impossible to design a guideline that could encompass all the elements of such a complex decision. In this talk Gary examines providing care to patients rather than always trying to fight death. By way of example, Gary tells listeners how he was working closely with the various western military forces, when one day they asked a favour – a young Afghani soldier had been badly burnt fighting against the Taliban, and while his treatment had begun in a military hospital, it was decided it shouldn’t be continued there. Gary was asked if he could assist transporting the soldier to a hospital in the city, and he goes on to talk about the fact that he had two options – to take the easy choice, which would have involved giving the soldier enough medication that he wouldn’t have to see him suffer; or the brave choice – which would have been to give him enough medication so he wouldn’t be suffering at all. He discusses the ethics around each alternative – and how he came to sit with his final choice. Gary notes that the decision he made that day has remained with him ever since, and continues to influence his decisions in his everyday practice. For more head to our podcast page #CodaPodcast http://codachange.org/podcasts
Working in medicine presents truly testing challenges for anyone. Adding the uncertainty that comes with autism can take these challenges to new heights. So how do those with autism break down the barriers of their diagnoses to become effective members of the healthcare community? And are there benefits to having such a unique mental approach to tasks? HEALTH & WELLBEING SPECIALIST LIZ CROWE SITS DOWN WITH CANDICE CARLISLE – A NURSE IN THE ACUTE PAIN SPECIALTY TEAM WHO ALSO HAS AUTISM. CANDICE ADDRESSES THE ASSUMPTIONS, CHALLENGES & UNEXPECTED BENEFITS OF BEING AN AUTISTIC MEMBER OF THE HEALTHCARE WORKFORCE. Candice begins by recognising the key role that autism plays in her shaping identity, and the importance of not shying away from her diagnosis. In saying this, she also affirms that having autism does not define who she is. Having two children with autism, Candice also ensures that they embrace the condition and see it as a good thing. CANDICE GOES ON TO EXPLAIN HOW THOSE WITHOUT AUTISM CAN “DO THE RIGHT THING” WHEN ADDRESSING THOSE WITH THE CONDITION. “For me, just knowing that people have the knowledge,” “…that’s fantastic.” Candice states that recognising autism within conversations and acknowledging the differences in a positive, open-minded light is helpful. LIZ DIRECTS THE CONVERSATION TO CANDICE’S CAREER AS A NURSE AND HOW HER AUTISM AFFECTS HER WORK. Candice concedes that the changes brought about by Covid were very difficult to deal with due to her reliance on routine. Different autism-specific anxieties make accepting change very difficult. Despite this, Candice explains that there are unexpected benefits to having autism in her line of work – the standout ones being attention-to-detail and situational awareness. She also explains how mechanisms like mimicry & masking can help autistic people cope in many areas of work and life. THE PAIR CONCLUDE BY DISCUSSING THE IMPORTANCE OF SUPPORT FROM THOSE WHO DON’T HAVE AUTISM, PARTICULARLY IN THE WORKFORCE. Tune in to this unique, insightful take on autism with Liz Crowe & Candice Carlisle. Breaking Barriers: Working in Healthcare with Autism For more like this, head to our podcast page https://codachange.org/podcasts/. #CodaPodcast
Health care constitutes 7% of Australians domestic carbon footprint with hospitals and pharmaceuticals being responsible for almost 2/3rd of these emissions. We can reduce this carbon burden by addressing our practice habits, taking emissions into account, while achieving best practice care. Three areas where we can really make a difference are in pathology ordering, asthma management and anaesthetic gases. In each of these, low carbon practice also constitutes good clinical practice, making climate action a win for emissions and a win for our patients. In this recorded After Hours Webinar presented by Kate Wylie, Dr Roger Harris presents the excellent work that Coda Change is doing to address these three climate actions. Dr Harris is a co-founder of Coda and a senior staff specialist in the intensive care unit at the Royal North Shore hospital and the Sydney Adventist hospital (SAN). He is dual qualified in Emergency Medicine and Intensive Care and is passionate about education and climate change. This is a recorded version of an After Hours webinar. For more like this, head to our podcast page. #CodaPodcast
“5 THINGS YOU CAN DO TO SAVE THE PLANET” with Hugh Montgomery (w. Liz Crowe) SCIENTIST & CLIMATE EXPERT HUGH MONTGOMERY DISCUSSES THE CONCERNING STATE OF THE PLANET & OUTLINES WHY WE NEED TO BEGIN TAKING REAL, IMMEDIATE ACTION TO SAVE IT. In this chat with wellbeing specialist Liz Crowe, Hugh begins by addressing the satirical Netflix film “Don’t Look Up” and pointing out that it may not be as far from reality as people think. We’ve been sitting on our hands & ignoring warnings in terms of greenhouse gases for too long, and Hugh warns that the “asteroid is about to strike”. HUGH CITES REPORTS WHICH CLAIM WE HAVE JUST A FEW YEARS TO TURN AROUND THE CLIMATE CRISIS. HE DETAILS WHAT COULD HAPPEN IF THINGS DON’T CHANGE. Extreme weather will be one of the most notable signs. Global sea levels will also rise noticeably and temperatures across the world will reach record highs. These will be “colossal changes” according to Hugh. This will lead to up to 2/3 of the world’s population needing to move to try and escape these extreme changes. There is a “rapidly closing window to secure a liveable future”. BUT WHAT CAN WE DO? HUGH SAYS WE NEED TO BEGIN TAKING RADICAL ACTION. For those wanting to take greater steps toward saving the planet, Hugh recommends starting with the following ways: __ __ To finish on a lighter note, Hugh states that “we are the only generation that has ever had the chance to save humanity” and reminds us that yes, we CAN do it. Tune in to this eye-opening assessment of our ever-changing climate with Hugh Montgomery & Liz Crowe. For more like this, head to our podcast page https://codachange.org/podcasts/ #CodaPodcast
