This Emergency Life

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