This Emergency Life

Well it’s been a minute since our last episode, but we are delighted to be back with a very special episode in a format that we haven’t tried before. A few weeks ago, This Emergency Life packed up our recording equipment and headed up to the Australasian College of Paramedicine (ACP) inaugural 2023 Critical Care Summit on the Gold Coast to record a live episode of the podcast. The ACP is the peak professional body representing and supporting paramedics and student paramedics across Australia and Aotearoa New Zealand since 1973. The ACP 2023 Critical Care Summit was the first time this novel and inspiring meeting has taken place and boy have they set a high bar. The summit is the brainchild of Intensive Care Paramedic and Senior Lecturer at Monash University Department of Paramedicine, Tim Andrews and senior Intensive Care Flight Paramedic (MICA) with Ambulance Victoria and Adjunct Senior Lecturer Dr Ben Meadley. Tim and Ben brought together a broad program of interdisciplinary speakers and teams for two days of targeted education and engagement with the central theme Contemporary care through collaboration. TEL were invited to record a live-on-stage episode of the podcast with free range to pick the episode’s guests for a chat about… well whatever we wanted! As you can imagine it was no easy task narrowing down our guest list to three people from the overwhelming expertise and experience represented by the delegates and speakers at the summit. During the live podcast we spoke with flight paramedic and PhD candidate Hanna Latta, Director Australasian College of Paramedicine and Senior Paramedic Specialist, Marty Nichols and Ben Meadley. These are three people who have a lot to say about the past, present and future of emergency care in Australasia. During the hour we spoke to Hanna, Ben and Marty about everything from the nexus between pre-hospital care and the ED, the evolving roles of paramedics and primary health care, advanced and specialist practice in pre-hospital care and the emergency care community’s roles and responsibilities in society. Our sincerest thanks the Australasian College of Paramedicine, Tim and Ben and everybody at the summit for the invitation and making us feel so welcome. We hope you enjoy hearing from Hanna, Ben and Marty as much as we enjoyed talking to them live on stage.

This month on the podcast we speak with Dr Mya Cubitt. Mya is an Emergency Physician whose clinical emergency work extends across the public and private emergency care sector in Victoria, Australia. However, like with many of our guests, Mya has several roles that extend beyond the clinical floor. Mya is also the Victorian Faculty Chair of ACEM, contributes to the delivery of emergency care at a state level through Safer Care Victoria and has sat on many reference groups through ACEM including the National COVID-19 task force, Health System Reform Committee, Discrimination Bullying and Sexual Harassment Working Group, New Fellows Reference Group, as well as Trauma and Geriatric Special Interest Groups. During our chat (recorded an embarrassingly long time ago) Mya talks about her very fascinating "peripatetic" medical journey from a focus on paediatrics to adult emergency care and a genuine enthusiasm for improving the care of older people in the ED. We discuss the "boxes" we put various patient groups into and how we can bring together our healthcare teams to improve the care we provide. We also cover a lot of ground on matters that affect our workforce, patients and healthcare system more broadly. While my fellow podcaster John Thompson works regularly on the ED floor with Mya, I have not. My interactions with Mya have been limited to various emergency care groups, but I have a very strong sense that she is 'one of those' consultants that brightens your day when you know she's on shift. I think you will agree that Mya is just the type of thoughtful, kind and inspiring leader that emergency care needs, and we hope you enjoy or chat as much as we did.

After an extended summer hiatus, This Emergency Life returns for its third season. This year the podcast will be released monthly with the occasional bonus episodes when the need arises. We hope you will join us for what we hope will be a less demanding year than the last two have proved to be. What better way to kick off season three of the podcast than to sit down and chat with The College of Emergency Nursing Australasia’s National President, Associate Professor Julia Morphet. Julia is an Associate Professor at Monash Nursing and Midwifery, the National President of The College of Emergency Nursing Australasia (CENA), Monash Health Senior Research Fellow (Emergency) and is the 2021 recipient of the Julie Finucane OAM Medal for Leadership in Emergency Nursing - the highest honour awarded by CENA. Many of you will know Julia as a passionate voice for emergency care, author of more than 80 peer reviewed papers and book chapters, accomplished public speaker and a considerate and articulate emergency care thought leader. However, with all of this comes a very busy schedule which has taken us two years to penetrate and find the time to speak with her. Though we do suspect that her genuine humility and reluctance for self-promotion has also kept Julia from coming on the show to date. During the podcast, we hear about Julia’s ‘back story’, her research and her thoughts on emergency care workforce and practice preparation. Oh, and we also hear Julia’s response to the perennial TEL question… in an ideal world what would the state of emergency care look like? It was delightful to finally catch up with Julia and we hope you find her insights as engaging, insightful and enjoyable as we did. We look forward to bringing you more stories from the emergency care community in 2022 and thank you all for your support of the podcast.

This week on the Podcast we bring you another clinical update – disaster management with Don Garlick. Don is an Emergency Manager and Critical Care Nurse at Ballarat Health Services in Victoria, Australia. Don is also a reservist nursing officer in the Australian Army and has worked for the Country Fire Authority for more than 32 years. More recently Don has worked at the Howard Springs Quarantine Facility with AUSMAT. He was also deployed with the AUSMAT Alpha Team to West & Far West NSW, and was seconded to a Site Manager role for the Ballarat Community (Mass) COVID-19 Vaccination Clinic is the COVID-19 Response Coordinator. Don gives us a comprehensive background into the history of state and federal governance around disaster management before moving onto the principals, planning and processes we follow when faced with external disasters in the ED. We had a few internet connection and audio problems during the recording, but we don't think it detracts too much from Don's insight and breadth of knowledge about disaster management. We hope you enjoy this week’s episode as much as we enjoyed catching up with Don.

With just over 3 days to go before the 18th International Conference for Emergency Nurses 2021 starts, we spoke with Sarah-Louise Laing about what’s in store for us at the conference this year. Sarah-Louise is the Nurse Unit Manager at Royal Perth Hospital ED, president of CENA WA branch committee, CENA Board member and conference co-convenor for ICEN 2021. This year the conference is being held online and is PPE free! The theme is The Power & the Passion: Leading for the Future aims to celebrate emergency clinicians and teams, innovative care and the shaping of care practices for the future. Featuring a wide range of exceptional speakers over two days, including a keynote from Dr Norman Swan, expert panel sessions, poster presentations, as well as presentations on our four key topics: • Leading Change and Creating New Ways of Working • Digital Frontiers, Technology and Informatics in Emergency Care • Building Resilience, Compassion and Well-Being • Innovation and Advancement of Clinical Practice Head over to the conference site and read more about our program and keynote speakers here.

This week we talk about all things DKA with Dr Kelli Innes. An experienced emergency nurse, Kelli has worked in a wide variety of emergency departments. She was clinical nurse educator at Monash Health for six years prior to commencing at Monash University in 2009. Though she has a broad range of research interests, Kelli’s doctoral research examined the role of the waiting room nurse in the emergency department. Kelli is enthusiastic about emergency nursing and is the education coordinator for the Victorian branch of the College of Emergency Nursing Australasia (CENA) and sits on the CENA national education committee. This week on the podcast, Kelli shares her expertise and enthusiasm about endocrine emergencies. We hope the episode is a good primer for those new to the ED community and a good refresher for those who have been providing ED care for a long time.

This week on the podcast we spoke with Adjunct Associate Professor Nicola Cunningham. Nicola holds dual specialist Fellowships in Clinical Forensic Medicine and Emergency Medicine. She maintains clinical positions as a Senior Forensic Physician at the Victorian Institute of Forensic Medicine, Emergency Physician at St Vincent’s Hospital Melbourne, Academy Member with the Patient Safety Review Team at Safer Care Victoria, and Practitioner Member with the Victorian Medical Board of Australia (Victoria). Nicola combines her clinical work with leadership, teaching, research and advocacy in the fields of clinical forensic medicine, emergency medicine, medical ethics, law, and patient safety. Her diverse academic writing includes international emergency medicine textbooks, law journals and her work as co-founder and editor of The Communiqués. These are free-to-access educational publications highlighting lessons learned from coroners’ investigations into preventable deaths in healthcare settings. The unique and highly innovative print and podcast editions of the three series of The Communiqués (Clinical, Residential Aged Care, and the Future Leaders) are used widely as teaching resources and have been shown to prompt readers to initiate change in their professional practice to improve patient safety. We cover a lot of ground with Nicola, from the nexus of forensic medicine and emergency care and the impact of access block on patient safety, a particularly timely discussion and the focus of the most recent edition of the Clinical Communiqué.

Dr Margaret Murphy is a clinical nurse consultant at Westmead Hospital, Sydney. Margaret has over 26 years of experience as a senior emergency nurse clinician, leader, and change agent. In addition to working in emergency, she has had experience and qualifications in Intensive Care, Mental Health, Change Management and Education. Margaret has worked as a principal project officer at the NSW Ministry of Health and has been a content expert for several Commissions of Inquiry (Special Commission of Inquiry into the Campbelltown and Camden Hospitals; Hughes Walters Inquiry into early pregnancy care in NSW Emergency Departments; Drug inquiry into amphetamine use in NSW). Margaret holds executive and advisory positions with NSW Health, Emergency Care Institute and Westmead Hospital Clinical Board. Dr Murphy has consulted nationally and internationally on emergency care and participated in teaching programs in Nepal, Malaysia, Sri Lanka and Bangkok. She has been recognised by peers with awards that include Westmead Hospital Nurse of the Year. Her research has focused on demonstrating an association between team training, improved health service delivery and patient outcomes in major trauma patients. This research has been translated into recommendations for training curriculum and implementation methods. On the podcast we discuss the role of an ED CNC, Margaret’s trauma teamwork research interests, some of Margaret's emergency care innovations, as well as HiRAID (an evidence-based assessment framework designed to structure the initial patient assessment of patients presenting to the Emergency Department (ED) after triage. We hope you enjoy our chat with Margaret as much as we did.

This week on TEL we spoke to Andrew Cashin. Andrew is Professor of Autism and Intellectual Disability at Southern Cross University. Andrew also conducts a Nurse Practitioner clinic for people with autism, their families and those that work with people with autism at the Southern Cross University Health Centre. In this week’s podcast Andrew talks about the Every Nurse’s Business learning site he has developed with Associate Professor Nathan Wilson from Western Sydney University. Every Nurse’s Business is is a free site aimed at Australian Registered Nurses to help build nursing capacity to address the healthcare needs of people with intellectual disability (ID) and/or autism (ASD) in mainstream health settings. We discuss the benefits of undertaking the course and how it can impact care for people with intellectual disability and/or autism presenting to the emergency department setting. We would encourage you to take advantage of the site, earn some CPD hours, and potentially get credit towards your postgraduate course while improving how you provide emergency care to people with an ID or ASD. Oh, and did we mention it's free!

This week on the podcast we talk with Greg ‘Fletch’ Fletcher. Fletch has been one of the ICU Clinical Nurse Educators at Dandenong Hospital, Monash Health in Victoria Australia for more than 20 years. He is also regularly delivers lectures to critical care postgraduate nurses at Monash Nursing and Midwifery. In his own no-nonsense style, Fletch talks about approaches to teaching and learning critical care concepts and the fundamentals of mechanical ventilation. Fletch’s superpowers relate to his mentoring, hands on bedside teaching as well as his ability to explain complex critical care concepts in plain language and in several different ways. We hope you enjoy the first of our chats with Fletch and keep a look out for his insights into ventilating the more complex and challenging patients.

This week we spoke with Dr Carolyn Hullick. Former former director of emergency medicine at John Hunter Hospital (JHH) and Greater Newcastle Acute Care Hospitals. Carolyn is an Emergency Physician and newly appointed clinical director for the Australian Commission on Safety and Quality in Health Care. With a long career in improving emergency care for people living in residential aged care facilities, Carolyn was ideally placed to talk to us about caring for older adults in the ED. Currently practicing emergency medicine in Belmont Hospital in NSW (one of the Hunter New England health district’s 36 emergency departments), Carolyn gives us her unique insights into how we can improve the equity of care provision for our older patients, as well as some great options and strategies for supporting older people’s transition from the ED back to their own homes / care facilities. In this episode we also hear about the complexity of providing care for this population, the NSW nurse led Aged Care Emergency (ACE) Model of Care, redesigning EDs for older patients and the interface between the ED and older people in the community. We hope you enjoys this week’s episode and join us in wishing Carolyn all the very best in her new role in the commission.

This week we are bringing you a Clinical Update on ECG interpretation delivered by Dr Tamsin Jones. Tamsin is currently an academic at Monash Nursing and Midwifery, Monash University teaching into the Undergraduate and Graduate Nursing degrees, and a mother to three young children. A Fellow of the College of Emergency Nursing Australasia, Tamsin has an extensive background in emergency nursing and is passionate about emergency nursing. She continues to work clinically when time permits. Having taught emergency nurses and nursing students for many years, Tamsin shares her insights into the main barriers we have when it comes to interpreting ECGs to dispel any myths and misconceptions (including the purpose of the aVR lead!). Tamsin provides a structured approach to ECG interpretation and handy tips regarding ECGs for common presentations to the ED. One of Tamsin’s areas of interest includes emergency nursing education. She has recently completed her PhD examining the minimum practice standards for graduate emergency nursing programs and, as of today, is officially Dr Tamsin Jones! We hope you enjoy the Clinical Update and find some useful hints and tips to incorporate into your practice. Some examples and further explanations of the ECGs we discuss in this episode can be found at the wonderful Life in the Fast Lane ECG library: The Normal ECG - the basics Atrial fibrillation Hypokalaemia & Hyperkalaemia Supraventricular tachycardia (SVT) Atrioventricular blocks (heart blocks) 1st degree 2nd degree, Mobitz I (Wenckebach) 2nd degree, Mobitz II 3rd degree (complete heart block)

This week on This Emergency Life, we obtain some clinical updates regarding mental health presentations in the Emergency Department from Associate Professor Tim Wand. Tim is a researcher and educator at the University of Sydney, and a Nurse Practitioner, Mental Health Liaison in the Emergency Department Royal Prince Alfred Hospital. Tim provides valuable insights into how we approach patients presenting with mental health complaints to improve their experience, mental health triage, and what emergency nurses and doctors can do to help our emergency mental health clinicians get better outcomes for our patients. Tim has numerous publications exploring mental health emergency presentations and published and has coauthored the textbook ‘Clinical helper for mental health nursing: The vital guide for students and new graduates’, a quick and reliable guide for students and new nurses starting in mental health to reduce stress and boost confidence. We hope you enjoy Tim’s insights. And as always, let us know what you think and what you want us to cover in future episodes.

Since 2005, Jo Niell has been Nurse at the Royal Adelaide Hospital Emergency Department who is particularly interested in caring for our patients at end of life (EoL). Since 2018, Jo has been leading an EOL Follow-up Service in ED with DonateLife SA, the organ & tissue donation authority. Jo talks with us this week about her experience in EoL in ED, the service she provides and how we might be able to emulate the work she does in our own EDs

This week on This Emergency Life we are very excited to bring you another variation in your podcast’s format. Today we are joined by Cedar Partington who will be popping in to TEL regularly throughout 2021. Cedar is a newly registered RN who has just started her Graduate Year Program in ED at Lismore Base Hospital, Northern NSW. We will be following Cedar's journey as a new emergency nurse in episodes called Cedar's New Emergency Life. Despite the obvious challenges to come, we hope that Cedar's introduction to nursing and emergency care at a Level 5 Emergency Department is gentle, warm and rewarding. So without any further introductions join us as we meet one of our newest emergency colleagues, Cedar Partington.

This week on the show we are bringing you the first of several new and different episode format types to the TEL podcast feed. Every few weeks, we will release a version of the show called Clinical Updates. As the name suggests, the Clinical Update episodes will focus more on the core business of the emergency care. We hope that these episodes will provide a helpful addition to our clinical knowledge and skills in short and sharp discussions with emergency experts speaking on a range of topics related to your practice. While we cannot deliver anything like the detailed content provided by your ED site educators, universities or colleges, this is not our goal. We do, however, hope that the content will provide useful and entertaining additional resources for emergency clinicians, clinical educators and postgraduate course coordinators. To kick off the Clinical Updates we spoke to Fellow of the Australasian College for Emergency Medicine, Dr Peter Fritz about managing difficult airways. An Emergency Physician at Alfred Health ED in Victoria, Peter describes what good preparation looks like and how the team can minimise the risk of badness happening during every rapid sequence intubation. Peter is also a co-author of the Vortex Approach which is "a comprehensive array of resources to facilitate all phases of airway advanced airway care including airway assessment, development of an airway strategy and performance of airway interventions in both the routine and emergency setting". As with any useful cognitive tool, the 'magic' of the Vortex Approach lies in its simplicity, ease of use and no-nonsense effectiveness. We hope you enjoy the new format and Peter's insights. And as always, let us know what you think and what you want us to cover in future episodes.

Wayne Varndell is Clinical Nurse Consultant at Prince of Wales Hospital Emergency Department, Honorary Lecturer at the University of Technology Sydney, and Associate Executive Director of the College of Emergency Nursing Australasia. Wayne has held various educational and advanced practice roles in emergency nursing, and is a renowned emergency nurse clinician and researcher. His research interests include patient safety, with a particular emphasis on the relationships between educational preparation and the accuracy of clinical decisions; and, health workforce development, particularly advanced nursing practice and nurse practitioner roles, transition to specialty practice, and emergency department service delivery models. This week on This Emergency Life we speak with Wayne about managing your time, the overwhelming work that the COVID-19 Evidence Taskforce Guideline Leadership Group are doing and how they translate their work to practise. Wayne also describes the role of the emergency Clinical Nurse Consultant and the importance of having a seat at the table, and therefore a voice which affects change and improved emergency care. It was great to talk to Wayne and we hope you enjoy hearing his views on emergency care.

After a short break from the podcast, This Emergency Life returns for its second season in 2021. To start the season we bring you a conversation with Emergency Physician, author and Fellow of the Australian College for Emergency Medicine Dr Michelle Johnston. Born and trained in Perth, Michelle works at Royal Perth Hospital, an inner-city trauma centre. Her specialties are “meetings-avoidance, mess, critical care, violence, and the crumbling fabric of society”. She is also heavily involved in teaching the fellowship program to the “bright young things of Emergency Medicine”. Her area of interest is literature: writing, story-telling, uncovering the poetry in pathology and finding the beating heart of creativity in critical care medicine. In this first episode for 2021 we spoke with Michelle about how we manage errors in the ED and her first book, Dustfall, published by UWAP in 2018. Dustfall is a story about both medical and corporate error, set up in the razed asbestos mining town of Wittenoom in Western Australia. The book was UWAP’s third biggest seller and was short-listed for the MUD literary prize. Her second novel titled A Small Matter of Faith is completed and with a literary agent for spruiking. Michelle also writes a regular column for Emergency Medicine News, and contributes to the literary section of the medical blog Life in the Fast Lane. She also runs workshops for both doctors and normal people about creativity and writing skills. Michelle was a delight to talk to and we highly recommend that you read her novel and catch up with her internet scrivenings and Twitter posts - you won’t be sorry.

We have been very excited about releasing our discussion with Dr Dianne Crellin for some time now. Di is an emergency nurse practitioner at the Royal Children’s Hospital (RCH) and senior lecturer coordinating the nurse practitioner program at Melbourne University’s Department of Nursing, and as you will hear she has an incredibly broad reach to her clinical and research interests. A past Executive Director of the College of Emergency Nursing Australasia who has received the Julie Finucane AOM Medal for Leadership in Emergency Nursing, Di has way too many strings to her emergency nursing bow to cover in this brief introduction. During this episode, John and Cliff cover a lot of ground with Di about pain assessment and management in children, distraction techniques, her experiences with AUSMAT and VMAT responding to disasters in South East Asia and Pacific regions as well as the ENP team at RCH ED. Luckily for us, Di is a self-described person who loves to chat and we hope you enjoy listening to her insights as much as we did.

This week on the show we spoke with Claire Rankin. Claire is an emergency clinical nurse educator and Registered Midwife who received the Jean Smith Prize for Excellence in Midwifery at The Royal Women’s Hospital in 2010. Claire talks to John and Cliff about balancing midwifery and emergency care, the differences in caring for pregnant women in the ED and her experience of working in remote Western Australia. Claire was a delight to chat with and we think you will agree that she is just the kind of person you want in your ED when a baby’s on its way! Links Obstetric Triage Decision Aid