Aug 16, 2017
What sort of things do you tell yourself when you are
resuscitating a patient?
Are you self-critical about your ability to deal with the
situation?
Is your inner voice so loud that you can’t concentrate on the
task?
This is a topic we don’t speak enough about in intensive care.
The inner dialogue, which can often be very negative, is commonly
going on in the background as we do our work. And as Associate
Professor Sara Gray, a dual-trained intensive care and emergency
physician from Canada points out, it can become louder and more
critical as we become more stressed with the situation in front of
us (eg. a difficult resuscitation). In this episode Sara talks
about how observing the inner voice and trying to make it kinder is
a form of self-compassion which can lead to improvements in our
performance, thereby helping us to bring the best outcomes to our
critically unwell patients. Such self-compassion can also provide
the additional benefits of making us happier, more mentally
healthy, and helping us to perform better in other areas of life.
But it’s not easy to change these voices in our heads. And we need
to slowly begin to develop the ability to simply observe them
before we can do the more difficult work of making the voices
kinder.
This is the first of a series of DasSMACC special episodes,
where I interview speakers from the recent DasSMACC conference held
in Berlin. This was the third SMACC conference I have attended, and
I enjoyed it for its international and multi-disciplinary flavour,
as well as the excellent speakers and the exceptional program
including topics from resuscitation and critical care interventions
to communication and our own health and well-being.
Dr Sara Gray is cross-trained in Emergency Medicine and Critical
Care. She works in both areas at St. Michael’s Hospital in Toronto,
Canada, and is an Associate Professor at the University of Toronto.
She is also the Medical Director for Emergency Preparedness at St
Mike’s. Her academic interests include knowledge translation and
optimizing performance; specifically how to improve the care of
critically ill patients in the Emergency Department. Her most
important achievements are her kids, who don’t care what she does
at work all day, and who remind her of what really matters in
life.
Sara spoke in the opening plenary session with a talk entitled
“Voices in my head”. In this podcast interview, we discuss the
premise of her talk, which is mainly about developing
self-compassion by noticing our inner voice. We speak about some
resources Sara has used to develop her own self-compassion,
including the use of mindfulness meditation, which she now
regularly practices. Sara is insightful, thoughtful, a true leader,
a caring doctor, and above all a woman blazing a path to helping us
to look after ourselves, our work colleagues, and indeed our
patients. She is really helping to modernize the thinking in
intensive care and emergency medicine circles. We covered several
other topics including:
- Sara’s own career combining emergency medicine and intensive
care - The potential benefits to the organisation of having doctors
trained in both specialties - How intensivists can develop better relationships with their
emergency department colleagues - The potential benefit of teaching our children to meditate so
that it becomes a normal part of an adult’s life - Sara’s attitude to sleep, how she is not a good napper, and how
she benefits from getting an even number of hours sleep - How getting away by herself to read a book for just 30 minutes
twice a week can revitalise her - How doctors need to listen more and talk less – and some
techniques to do that better - How the ICU ward round in the St Michael’s Hospital is
structured - Some of the phrases she uses when talking with colleagues and
patient’s families - How being a patient in her own hospital reminds her to approach
patients with what may seem minor complaints in a more engaged
manner - How burnout is not a binary outcome, and more something that
she swings closer to or further from depending on the
circumstances
With this podcast, and the previous episodes, please help me in
my quest to improve patient care, in ICUs all round the world, by
inspiring all of us to bring our best selves to work to more
masterfully interact with our patients, their families, ourselves
and our fellow healthcare professionals so that we can achieve the
most satisfactory outcomes for all. It would be much appreciated if
you could help to spread the word by simply emailing your
colleagues or posting on social media (using #DasSMACC, #SMACC or
#FOAMed)
If you want to send a comment or respond to something Sara said
on this episode, feel free to email me andrew@masteringintensivecare.com,
leave a comment on the Mastering Intensive Care podcast page on
LITFL or on Facebook, or post on twitter using
#masteringintensivecare. I’d love to hear what you think are your
major take-aways.
Thanks so much for listening. Please give your patients the very
best care you can, and take care of yourself too.
____________________________________________________________________________________________
Show notes (people, organisations resources or links mentioned
in the episode):
Dr Kristin Neff’s website: www.selfcompassion.org
MBSR course: Mindfulness-based stress reduction
Jon Kabat-Zinn: Founder of MBSR program
Headspace meditation: www.headspace.com
Sara Gray’s previous SMACC talk on “Optimising critical care in
the emergency department”:
https://itunes.apple.com/au/podcast/optimising-critical-care-in-emergency-department-by/id648203376?i=1000359000551&mt=2
Scott Weingart’s SMACC talk on “Kettlebells for the Brain”:
https://itunes.apple.com/au/podcast/kettlebells-for-the-brain/id648203376?i=1000375455720&mt=2
DasSMACC website: www.smacc.net.au
Dr Sara Gray: https://saragray.org/
