Michael Farquhar
@DrMikeFarquhar
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Consultant in Sleep Medicine @EvelinaLondon @GSTTnhs Kids' sleep #FightFatigue @RainbowNHSBadge 🏳️🌈 He/Him 🏴
London, UK
Joined July 2016
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Pinned Tweet
Sleep/shiftwork/fatigue resources for NHS workers
Why We Need To Talk About Fatigue
@RCoANews
Editorial
@Anaes_Journal
Practical tips
@ArchivesEandP
#FightFatigue
@Assoc_Anaes
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I have two twitter accounts: a professional one (this one), a personal one, and I run a third account for
@RainbowNHSBadge
I’ve been trying to decide which account to post this thread from but I think it has to be this one really
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My work lanyard gets a lot of comments, and people spotting something on it and asking about it has started a lot of conversations over the years
All of the badges are there for some reason or another ... here's the updated story for them all
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.
@Keir_Starmer
“important not to force through changes that go against public will”
My rights as a gay man in UK today were won despite 75% of UK adults in 80s thinking homosexual activity “always or mostly wrong”
Leadership is about doing what’s right, not what’s most popular
EXCLUSIVE: Starmer says Labour has a 'very clear position' on how to balance the rights of women
He said it is important not to force through changes that go against the public will.
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My name’s Mike Farquhar. I’m a consultant paediatrician, specialising in sleep medicine
I have a couple of professional side-interests in parallel to my main job
One is the impact of shiftwork and sleep deprivation on NHS staff
The other is around advocating for LGBT+ people
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Dr Caroline Johnson has been appointed a minister in Department of Health
@drcarolinej
’s voting record, considering her dual role as a consultant paediatrician, is one which has attracted attention in the past
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I can’t really describe how much it would’ve meant to teen me to see John and Johannes not just dancing, but talking openly about who they are and how they feel
Whoever wins, Rose or John, there are kids seeing people like THEM on that stage tonight and it matters so much ❤️ 🏳️🌈
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One of our admin team spoke to me today concerned to get correct name/pronouns of a trans young person on letter about to go out to them
We will continue to respect identity and dignity of trans/gender-diverse young people as we do all those under our care, despite Govt rhetoric
'We shouldn't be bullied into believing people can be any sex they want to be, they can't. A man is a man and a woman is a woman', says Prime Minister Rishi Sunak.
📺 Sky 501, Virgin 602, Freeview 233 and YouTube
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This is absolutely why Southgate’s team taking such a clear positive stance on social issues, including race and LGBT+ rights, is so important
The racist response to a team who achieved more than any England ⚽️ team in my lifetime is sickening
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I'm gay
I'm also Scottish, a paediatrician, a total geek
None of those are ideologies, they're just part of who I am
Being gay means I'm v aware LGBT+ people's access to and experience of healthcare can be challenging and affect outcomes
That's what
@RainbowNHSBadge
is about
RAINBOW BADGE SCHEME AXED
We all pay tax so that basic services can be provided to us by Government. We don’t pay tax to further an ideology or a pressure group.
It is welcome news that this rainbow badge scheme is being axed . This money can now be used for medical care
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I walk by this storage room at St Thomas’ on my way into work each morning ... one of
@GSTTnhs
’ surviving iron lungs, from an era when critical care was created to deal with another viral epidemic, for which the definitive solution was vaccination
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Disrupted sleep is a completely normal response to the extraordinary circumstances we are currently living through
For
@nhs
staff in particular, trying to optimise our sleep is likely to be important in the months to come
Some suggestions here:
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“The psychological wellbeing of the medical workforce is being completely ignored”
We must look after those who provide healthcare to provide safe, effective and efficient healthcare to patients. It’s not a luxury, not optional.
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As a Minister for Health, it would be good to hear a clear explanation for each of those voting decisions, and why she felt they were the best action for children and young people at the time
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So, I do not stand with JK Rowling
As a cis gay man, I stand with my trans siblings
#Pride
As a paediatrician, I stand with trans young people who need to be seen, need to be heard, and who need voices to advocate for and with them
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30 minute teaching session on nightshifts/sleep/fatigue in a tweet!
Why We Need To Talk About Fatigue
@RCoANews
#DrivingTired
@insideoutsouth
Practical tips
@ArchivesEandP
@NHS
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I’ll gladly talk to Chair/CEO of any
@nhs
trust who still explicitly ban their staff from using power naps at night to protect both their own health and safety but also that of their patients to explain why this is outdated and displays a lack of understanding of basic physiology
As SHO was warned not to sleep on nights, managers were coming in 3am to look for sleepers - who were (apparently) then subject to disciplinary action.
Crossed 3 lanes going home. Was lucky; empty road, hadn’t felt too tired to drive, didn’t realise I was!
Don’t drive now!
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The
@gmcuk
Duties of a Doctor tell us we must make patient safety our first concern, and to take action if that is compromised.
The
@nhs
is underfunded and understaffed. Patients are at risk every day.
We stand in protest and call for better.
#SaveOurNHS
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While I’m proud to be a signatory of this letter, I’m dismayed it ever had to be written
More than 2,000 paediatricians and
@RCPCH
members have signed a letter supporting
@MarcusRashford
in his campaign to extend free school meals.
Pleased to see it on the front page of
@ObserverUK
Thanks to everyone who signed. Full story 👇👇👇
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It’s
#WorldSleepDay
Sleep is absolutely essential to your physical and mental health.
Sleep’s rhythms underpin everything you do, ensuring your brain and body are working at their best.
But we’re often bad at recognising that, and prioritising sleep in our lives
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I'm hugely proud of what
@RainbowNHSBadge
has achieved since it started, on Twitter and
@EvelinaLondon
Work of Phase 2 team has been phenomenal and, while not surprising, it's sad to see this Government choose not to continue to support it
We go on🏳️🌈🏳️⚧️
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I started my work raising the impact of sleep deprivation and fatigue in the NHS while you were health secretary Mr Hunt.
I was far from the first.
I am very pleased you now loudly declare the issue, but some responsibility for how we got here lies with you too.
If you don't train enough doctors and nurses, this is the price you pay 👇
One in four NHS doctors tired to the point of impairment, survey finds
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As paediatricians, I think one of our most important responsibilities is to give voice to children/young people where they themselves find it hard to speak up and be heard
We know having just one supportive adult in their corner can make a world of difference to LGBT+ teens
"research also shows having just one supportive adult in their lives reduces suicide risk in LGBTQ teens by 40%. That supportive adult doesn’t have to be a parent. It can be a teacher" 💗
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I’m still gobsmacked by this 😁💕
Young people from
@RCPCH_and_Us
also chose
@DrMikeFarquhar
as their Voice Champion of the Year at the
@RCPCHtweets
conference to recognise all the work he put in at weekends, evenings and all over the country meeting with them to help inform the
@RainbowNHSBadge
#NHSVirtualPride
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Whether you’re the parent of a toddler (or an adolescent) or, like
@WelshGasDoc
, an overtired shiftworker, many people know the frustration of trying to get themselves or someone else to sleep but, no matter how tired they seem, they just won’t do it
Sleep has rhythms
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The
@RainbowNHSBadge
project was developed within NHS *because* LGBT+ people have worse healthcare outcomes
As with most inclusion work, it aims to improve individual care by addressing systemic issues, raising awareness and showing how simple changes can make big differences
🔴 NHS trusts will be judged by the controversial charity Stonewall on their LGBT “inclusion” in a £220,000 taxpayer-funded project
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I cannot over-emphasise how my life, and so many of my peers, was affected by a conference speech by a Tory PM in pursuit of a bigotry and ignorance fuelled agenda
Thatcher's speech that launched Section 28 was met with same thumping applause as Sunak's today
It's just as wrong
One reason LGBT+ History Month is so important is that it places things happening now in their proper context
I grew up in the 80s, when a Conservative Government embraced negative attitudes towards gay people, and passed hostile and harmful laws
This all feels v familiar 🏳️⚧️🏳️🌈
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Modern hospitals increasingly design spaces like messes and lecture theatres out
These spaces, and spaces for all staff to get proper rest breaks, are essential for the healthy functioning of the whole hospital
Their value may be less immediately obvious, but just as important
The future of doctors’ messes: A private space for doctors to rest is still a vital resource for both them and their patients, finds
@Abi_Rimmer
Share photos of your messes too using
#GiveUsABreak
@drjosiech
@DrMikeFarquhar
@RachelLiebling
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It’s
#WorldSleepDay
Sleep is absolutely essential to your physical and mental health
Sleep’s rhythms underpin everything you do, ensuring your brain and body are working at their best: an MoT every night!
We’re often bad at recognising that, and prioritising sleep in our lives
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We’ve known for a long time that NHS staffing is inadequate to meet demand, and it’s only getting worse
In words of
@AoMRC
, we have “normalised the unacceptable” … staff are consistently working at >100% but feel like they’re failing as it isn’t enough
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That’s where
@RainbowNHSBadge
came from
Kids like I was need people to listen, to understand, who will help and be a voice when they’re too scared to find it for themself
LGBT+ young people today need *us* to be those people, to make
#TinyChanges
that start to make a difference
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Whatever else you think of the clocks changing back to GMT, returning that evening light back to the morning is probably better for keeping your circadian clock in tune a little longer as winter approaches: early morning light exposure one of the keys to a healthy internal clock
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My name’s Mike Farquhar. I’m a consultant paediatrician, specialising in sleep medicine
I have a couple of professional side-interests in parallel to my main job
One is the impact of shiftwork and sleep deprivation on NHS staff
The other is around advocating for LGBT+ people
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Sleep/shiftwork/fatigue resources for NHS workers in a tweet
Why We Need To Talk About Fatigue
@RCoANews
Editorial
@Anaes_Journal
Practical tips
@ArchivesEandP
COVID19 sleep
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Recharging *my* batteries, with my first annual leave since the pandemic struck, at home in the Highlands and Islands
... back at work 1st October
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And she voted against Marcus Rashford’s attempt to improve access to free school meals, a policy wholeheartedly endorsed by
@RCPCHtweets
and >2000 child health colleagues
More than 2,000 paediatricians and
@RCPCH
members have signed a letter supporting
@MarcusRashford
in his campaign to extend free school meals.
Pleased to see it on the front page of
@ObserverUK
Thanks to everyone who signed. Full story 👇👇👇
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So, this absolutely matters
I want my trans followers to know that I and so many other people around the world see you, respect you and love you for who you are.
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That if we’re going to give the best care to our patients, we have to invest in the health and well-being of the people delivering that care - and sometimes the need of the healthcare worker is greater than the immediate need of the patient
What are the most complicated concepts in medicine? (physiology or pathology)
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New Sleep paper:
Sleep <7hrs in 24, your risk of crashing when driving rises
Get 4hrs sleep or less in 24hrs, risk of crashing rises 15-fold
How much -often low-quality- sleep does a typical
@NHS
night-worker get in 24hrs?
#FightFatigue
#DrivingTired
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We know that growing up in 80s and 90s caused harm to huge numbers of LGBT+ people
The story of the damage it causes is literally told in scars on my body
BUT:
Thatcher was wrong
Section 28 was wrong
The media were wrong
The churches were wrong
The prevailing attitude was wrong
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And this absolutely matters
(Daniel Radcliffe has worked with the
@TrevorProject
to reduce risk of suicide in LGBT+ young people for some time now)
“78% of transgender and nonbinary youth reported being the subject of discrimination due to their gender identity. It’s clear that we need to do more to support transgender and nonbinary people” 👏
Thank you Daniel Radcliffe for all your support 💗
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Investing in sleep pods emphasises a Trust/hospital is serious about importance of breaks, rest and managing fatigue
Key though is they must be backed by actions to support staff to actually *have* regular breaks in the first place
#FightFatigue
@TheBMA
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If individuals commit offences they should be prosecuted, whoever they are
We must not demonise an entire group of people because of an inflated sense of perceived threat by some
Trans people just want to be themselves and to live as safely and happily as they can
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Just because powerful voices say something, just because the media echo and amplify, just because official voices prevaricate or pontificate, it doesn’t mean they’re right
What I needed more than anything as a kid growing up was to hear voices of people standing in opposition
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The attitude towards trans people in this country today is hostile, driven by ignorance, often by bigotry and by a determination by some to portray all trans people as a threat, to individuals and to society
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Sleep/shiftwork/fatigue teaching resources for
@nhs
workers in a tweet
Why We Need To Talk About Fatigue
Practical tips
@ArchivesEandP
COVID19 sleep
GSTT Medical Education
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"I think it’s a statement of fact that when people think there's unfairness - particularly if they think there’s unfairness in high places - of course people get angry"
- Prof Chris Whitty
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Delighted to receive funding from
@GSTTCharity
to develop the
@NHS
🏳️🌈 badge project to the next stage -look for this as an
@EvelinaLondon
initiative over the next few months!
@GSTTlgbt
@RCPCHtweets
I had 300 🏳️🌈
@nhs
badges made as a pilot
Response has been hugely positive
Simple symbols of inclusion can make big differences: read
We’re now working to expand the pilot into something much bigger. It involves a wee redesign; please bear with us!
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Please listen to trans people
Emily’s Story, from the
@Mermaids_Gender
team is a good place to start
@Genderintell
is also a great place to find information and support
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Sleep during an on-call shift: longer to get to sleep, lower quality, more wakenings, less restorative - even if no actual calls
Which is familiar to anyone who’s ever done on-call, but do we acknowledge its impact? Can affect next-day function++
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She voted against
@AlfDubs
motion asking that unaccompanied child refugees stranded in Europe be able to join relatives in the UK
I struggle to understand why the Government opposed this amendment
@drcarolinej
, as a consultant paediatrician and an MP who voted against, can you please explain why the Government could not support this?
What will you now be doing to safeguard these children?
@RCPCHtweets
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Get less sleep than you should, and the next day you are more likely to interpret neutral interactions in a negative way.
Better sleep ➡️ better relationships
Over time, short sleep ⬆️ risk of depression/anxiety
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There is a failure of leadership from the PM down that means now, again, all we can do is ask already exhausted healthcare professionals to give their all and more to try to reduce the harm of COVID as much as they can
When it’s all over, there has to be an honest reckoning
London's exhausted nurses and doctors urged to work extra shifts in a ‘call to action’ by
@NHSEnglandLDN
#Covid19UK
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Just as in the 80s gay men were caricatured as being a threat to children, much of the public discourse about trans people today is filtered through a lens of concern about trans people being a threat to others
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And as a comic-loving sleep physician,
@neilhimself
’s Sandman has a prime position on my office bookshelves - the magic and wonder and brilliance of sleep and story, all bound together
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Sleep during an on-call shift: longer to get to sleep, lower quality, more wakenings, less restorative - even if no actual calls
Which is familiar to anyone who’s ever done on-call, but do we acknowledge its impact? Can affect next-day function++
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My office Rainbow Batmen in attendance for this afternoon’s
@RainbowNHSBadge
steering group meeting 😁🏳️🌈
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I run an adolescent sleep clinic
If you’re trans, your chance of having disrupted sleep also goes up significantly; sleep is often affected when dealing with stresses and worries
I talk to trans teens, and their families
I hear their stories, do my best to understand and help
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I get a lot of comments about the badges on my lanyard from “wow” to “your neck muscles must be strong...”
All the badges are there for some sort of reason ... here’s the story for each of them
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Unexpected visitor in my
@EvelinaLondon
sleep clinic this afternoon!
Kept coming back too!
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You can hear a pin drop.
Hawking is warm, witty and utterly inspiring as he relates his story.
#TalkNHS
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Reminded of this today - extract from “The Nursing of Sick Children” on the personal qualities necessary to be a children’s nurse
“Not everyone can nurse sick children,” a spokesman of
@theRCN
explains. “They will cover you with jam”
The more things change...😁
@RCPCHtweets
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We have a responsibility to educate ourselves, to be aware of the issues, and to be able to clearly advocate on behalf of young people who absolutely need us to be an ally
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In 2019 she actively voted against NI equal marriage (rather than abstaining as several of her colleagues, such as
@theresa_may
, did)
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Seems a good time to remind yourself that how you are thinking and feeling is likely a NORMAL response to EXTRAORDINARY circumstances
There is support and help out there
It is absolutely OK to not feel OK, but don’t ignore it
@DrShreeUnadkat
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As
@RCPCHtweets
renews its call for Government to act on the devastating impact of poverty on children’s health on this country, I would hope having a senior paediatrician at the heart of DoH means the voice of children and young people is truly heard there
We’re calling on Government to take vital action on child health inequalities and poverty across the UK.
With the number of children living in poverty expected to reach 5m by 2030, its time to
#ShiftTheDial
on child health:
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Spaces for
@nhs
staff to relax and recharge were always essential, but have been squeezed out of hospitals over time
Recreating and protecting these spaces was a simple and effective part of COVID19 response
Maintaining them, allowing staff space to connect, is next challenge
What doctors’ messes mean to them: "The mess is just as important to patient care, in a different way, as an x ray room or extra patient bed,” says
@DrMikeFarquhar
Share photos of your messes too using
#GiveUsABreak
@Abi_Rimmer
@drjosiech
@RachelLiebling
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Hugely honoured to receive a Members Award
@RCPCHtweets
#RCPCH22
this morning, for work across paediatric sleep medicine,
#FightFatigue
and
@RainbowNHSBadge
🏳️🌈
@EvelinaLondon
@GSTTnhs
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I cannot say this often or loudly enough
Acute and chronic child and adolescent mental health services are woefully under-resourced
Young people and families end up trapped in Kafkaesque situations where clear acute need is unable to be responded to appropriately
@MattHancock
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3.2 million people work at night to make sure your lives run safely and conveniently; almost a third of them are over 50.
Working at night takes a toll, and we should be much better at protecting those who work at night
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Very excited to be on my way home to Scotland for the
#ProudScotlandAwards
and absolutely honoured to be nominated in the Inspiration category
V much looking forward to what should be a great night 🏴🏳️🌈
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Two versions of
@rainbownhsbadge
, always intended to be a simple clear symbol that I'm a good person to talk to about issues relating to sexuality/gender
The rainbow badge came about partly because of patients starting conversations with me because I was wearing 🏳️🌈on my lanyard!
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Circadian lighting in hospitals is a key step in trying to improve the quality of sleep in inpatients.
We’re already talking about how we can include this in plans for
@EvelinaLondon
as we grow - first steps coming soon!
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Thank you for all the positive messages and stories of how
@RainbowNHSBadge
has made a difference, v much appreciated!
I think our project, and the countless people who've supported it and made it work, reflects some of the best of the NHS and its values; thank you!
🥰🏳️🌈🏳️⚧️
I'm hugely proud of what
@RainbowNHSBadge
has achieved since it started, on Twitter and
@EvelinaLondon
Work of Phase 2 team has been phenomenal and, while not surprising, it's sad to see this Government choose not to continue to support it
We go on🏳️🌈🏳️⚧️
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About 25 years ago, on my first ever clinical placement (ICU, RIE Edinburgh), my consultant told me to ignore everything else and read “The House of God”
One of the characters makes this point, in response to the brutalising American intern system
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How do you make an
@EvelinaLondon
consultant grin like a loon?
... install a huge Lego model of our hospital in the atrium 😁
@fairybricks
@LEGO_Group
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Pilots use strategies to
#FightFatigue
, including in-flight naps, on long-haul flights to ensure they continue to function safely, effectively and efficiently
Why has it taken so long to think same way about healthcare professionals working long shifts?
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I've lived in England since 2006 (😲) ... but I'm Highlands-born and raised, Edinburgh-trained and made into a paediatrician in Glasgow
You can take the doctor out of Scotland but you can't take Scotland out of the doctor 🏴😊🏴
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“You get to exhale now?
Growing up LGBT+ in the UK today”
This is a
@TwitterUK
version of the talk I gave
@RCPCHtweets
Conference this month
#LGBTMoment
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I came out late in life; I grew up in this country at a time when the idea of being gay was viewed with a huge degree of negativity and hostility
At the time that I was realising I was gay, the prevailing cultural idea was that gay men were a threat, specifically to children
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Utterly gobsmacked to have won the Inspiration Award 😮
Thank you so so much
#ProudScotlandAwards
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Absolutely blown away by this - thank you so much! ❤️🏳️🌈
Paediatric sleep consultant, Mike Farquhar & school nursing service development lead, Kathryn Dean have won individual ‘Respect others’ awards for their work to support our LGBTQi children and adolescents. We’re so proud of their work to make
#TeamGSTT
a more inclusive place.
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If you’re a young person realising they are gay, growing up with that political and cultural attitude around you, it causes harm
It makes you afraid, makes you scared to speak about how you think and feel, internalises all of that negative emotion - and that has consequences
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“I am Sam. I am not Down Syndrome. I want just the same stuff as everybody else”
@RCPCH_and_Us
#RCPCH18
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This sums up a lot of what my badges are about
Visibility matters. Being able to be who we are matters, for us, but also for those who come after us and need to see it's possible
My badges, some silly, some not, have started conversations which matter and have made a difference
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I'm a geek 😊
My Xavier's School pin is partly because I always enjoyed X-Men stories for the action, but more because they spoke to someone who felt different
Stories of "people like me" matter hugely, and X-Men comics were the closest I had for a long long time
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Like
@RainbowNHSBadge
, small but visible signs of inclusion like this can help start conversations
My current pronoun badge on my lanyard has led to teenagers telling me they are trans in clinic where otherwise they wouldn’t have felt comfortable to disclose that
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Be kind.
Even when you can't cure, can't solve everyone's problems, being kind can make a world of difference to someone
#TipsForNewDocs
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When Freddie Mercury died in 1991, Joe Haines (a former Labour press secretary) wrote this column, published in the Daily Mirror
“For his kind, AIDS is a form of suicide”
I was 15 years old
This was still seen as an acceptable way to talk about people like me
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Another gift badge!
Jamie may have been my first hero, but the Doctor has been my hero the longest
"Never be cruel, never be cowardly
Never fail to be kind
Never give up, never give in"
I've always tried to aspire to that!
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