Ruth-Anna
@doctorrah
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Enthusiastic, imperfect human trying to make the world a better, fairer place. Staff well-being ➡️ safer care. East London Obstetrician & GOSW. HFE/safety geek.
London
Joined September 2009
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Pinned Tweet
*NEW*
@TheBMA
guidance for doctors who are pregnant or breastfeeding, and their employers:
Full guidance here:
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Seven weeks after I was run over whilst cycling home, I'm back in my happy place, helping babies earth-side ❤️
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When I gave evidence
@gmcuk
against a doctor accused of sexual assault against a colleague, the panel was all male and the alleged (later proved) perpetrator was allowed to cross examine me directly for several hours. He asked me what I was wearing that day. Nobody said anything.
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I missed my graduation on Friday to take my eldest to his taster day at secondary school, do a diabetic antenatal clinic and then watch middle perform at the school fair.
But I can now officially say I have an MSc in Patient Safety and Clinical Human Factors with Distinction 😁
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The NHS sick leave guilt really is a whole other level of grim. Why are we like this.
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2 years ago the Govt invested £10m into improving rest facilities for junior doctors. Each Trust got a MINIMUM of £30k. Is it time for
@BMA_JuniorDocs
local reps to do an audit, 2 years on, to see exactly where that money went?
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This case seems to sum up everything wrong with the GMC process. A popular locum Consultant with an unblemished record held responsible for not reading notes that weren't available, during a very busy shift in a very busy unit, held responsible for another doctor not noticing>
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Seconday care staff. Did you know that anyone with an email can use
@Accurx
to send texts to patients?
I use it all the time to send patient information leaflets and links to videos and support groups, especially when doing phone clinics.
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One of the things that's fairly unique about obstetrics (& midwifery) is that you will go from one room where a family are having the best day of their life to one next door where they are having the worst day of their life, and you need to be able to give both what they need.
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I hope it goes without saying, but I'm fully behind my nursing colleagues taking industrial action. Nurses are hugely undervalued and underpaid. We are right behind you.
#FairPayforNursing
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If you are a junior doctor in England, your Trust has an obligation to provide you with post-night accommodation (or alternative arrangements) if you say you feel too tired to drive.
If this is not happening where you work, please escalate through your JDF, GOSW and/or LNC.
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So distressing to read the details of the Chandraharan case and the bravery of the poor IMG junior doctor who came forward at great personal, career and financial risk to herself.
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Maternity units are basically a whole hospital in a department, aren't they? Emergency walk in care + elective admissions + surgery + ambulatory care + outpatients. All with a totally unpredictable population + multiple intersecting staff groups so your team is never the same.
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My MSc research (currently being written up so I hope I'm allowed to say this!) found that junior staff have lost faith in 'raising concerns', not (generally) because they are afraid, but because they have learned time and time again that nothing ever happens when they do.
"I am asking midwives...to look around them & ask themselves is the care being provided where you work safe? If it’s not, I need you to have the courage to speak up" - An excellent response to
#ockendenreport
by
@GillWaltonRCM
and
@MidwivesRCM
#Shrewsbury
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Doing ice lolly rounds of the maternity unit as the on-call Consultant is my current favourite thing 🍦🥰
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Just heard this quote for the first time and wow it's 100% the NHS.
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A truly heartbreaking read. It's very easy to respond defensively, but at the heart of this is a previously healthy teenager who died, and a grieving family.
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Why has there not been a "work from home if you can" announcement re next week's weather? The tube will be unbearable. It'll be bad enough just with those who cannot work remotely travelling. Feel incredibly sorry for teachers & schoolkids.
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Do Consultants get called in for a special chat without coffee when they get into Twitter spats too, or is that just reserved for "juniors"?
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Labour: in what should be the easiest election win in history, let us see how hard we can try to put off all 1.2 million NHS employees from voting for us.
Not the headline I expected...
The BMA needs to accept that Labour’s plans to train 7,500 more doctors a year must be met with higher standards for patients.
In contrast, other health unions are being reasonable - it’s the government who are stubbornly refusing to negotiate.
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It's just over 4 months since I was run over and my leg crushed under an NHS transport ambulance whilst cycling home from work.
I am extremely pleased to be able to be back to my busy, over-committed self 😁
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@ImogenDempsey39
@LucyGoBag
@gmcuk
Well he was struck off, and all the allegations were found proved
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Today is exactly 6 months since I started as a Consultant after 15 years as a junior doctor.
It's complex to unpick what's related to the role and what is related to the unit but it's fair to say I'm really enjoying my job right now.
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Some news: in 2023 I'll be saying goodbye to wonderful friends at
@NUHmaternity
to take up a substantive role at
@BHRUT_NHS
as Consultant in O&G with a special interest in Patient Safety. I'm really excited to be heading back to BHR for this brand new post as part of a great team
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A message for anyone seeking maternity care in the next 72 hours:
Hospitals will be safe. You and your baby will not be put at risk. You should still seek help if you have any concerns about your baby or yourself via the usual channels.
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Potentially controversial opinion: human factors/ergonomics as applied to medicine has got too bogged down in sounding clever by using jargon rather than focusing on 'making the right thing the easy thing'.
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@SuhanaAh
Thank you for being brave enough to share. We don't talk about our human vulnerability enough in medicine.
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Tomorrow I am doing two things that I haven't done since I was hit by a man speeding on an e-scooter, 5.5 weeks ago.
1. Cycling to work.
2. Operating.
Hoping my hand & wrist behave themselves for both 🤞 Can't wait to feel more like "me" again.
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Consultant colleagues: if your response to calls for industrial action by juniors is anything other than full support, why not put your money where your mouth is and offer to pay off some of their loans or fund a property deposit?
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Just had (one sentence of) feedback from a Datix I submitted in September of last year, whilst still a Reg, at a different Trust.
No wonder there is a huge sense of 'what is the point in reporting'.
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Most useful things for juniors rotating into O&G?
List of acronyms
Drugs not to prescribe in pregnancy
Just say no to interpreting CTGs
If the emergency buzzer goes, generally the most useful thing to do is get IV access
We're relying on you for up to date gen med stuff 😉
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I asked a bunch of 9-12 year olds the different ways people could die. (in a first aid teaching session) Guess how quickly I regretted that question? 🤣
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I know some of you will have seen this on my personal account, but now the fog is starting to clear a bit, I wanted to update on here as well.
8 days ago, I was cycling home from a night on-call and was hit from behind whilst waiting to enter a roundabout. 🧵
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About 10 years ago a Trust I was working in changed from stocking the sponge holding forceps on the left, to the ones on the right (plastic), in ED and other non-theatre settings.
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Yes this was an incredibly tragic case, but it reads as though he's been made the scapegoat for multiple systems failings here.
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"the BMA estimates that a substantial proportion (27%) of NHS clinicians lose over four hours a week through inefficient IT systems."
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Some people buy themselves a designer handbag, jewellery or sports car when they CCT. My sole financial concession since transitioning to life as a Consultant is an Uber home instead of a night bus, about once a fortnight when I'm on a 24h on-call 😅
#splashingout
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A happy surprise this morning
#dissertationwatch
#humanfactors
Thanks everyone at
@edinsurg_online
especially
@CoxonDomenica
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@CatrionaRennis1
Lots of comments on tiktok asking if clinical staff have access to the same. I don't even have a lock on my office door let alone a lockable snack drawer 😂
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Already angry about all the things being cancelled including long awaited training courses for healthcare staff. How does that help anyone?
(Tabloids - feel free to cancel me)
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It's easy to feel that things have only got worse for junior doctors over the last 15-20 years, but the fact that this is no longer allowed has to be a win.
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@crabby20someth1
I spend a huge amount of time telling people I couldn't care less about the amount of hair around their genitals (professionally rather than personally)
Unless their shaving/plucking/waxing habit has caused them issues in which case I try & persuade them to stop.
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Seen a claim on here that it's 'common' in UK maternity services to use "language which erases women".
Can I just say that this is absolutely, categorically, not true.
Most services struggle to even add a "and birthing people" to a tiny fraction of their information.
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For all those babies, mothers, parents and families who I carry with me.
The sound of a heart breaking is something that you can never forget. 💔
We work towards a world with fewer broken hearts.
#BLAW2022
#WaveOfLight
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Today I bumped into a medical student who worked with me for one day several months ago.
She a. Remembered my name b. Stopped me to thank me for doing a Greatix for her (she was really helpful!) and c. Is planning to apply to O&G 😍
Honestly made my day.
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Another cohort of medical students - a new opportunity to attract them all to the dark side by letting them cuddle the baby as we
#waitforwhite
at LSCS and then cut the cord ❤️ (yes I'm shameless in my promotion of obstetrics as the BEST specialty)
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9 years since I delivered 'against medical advice' in the midwifery-led-unit and got the bus home with my newborn 6 hours later. Never forgotten the slightly odd advice l got during NIPE to put socks under her babygro "to get the fluid off her chest". Happy birth-day middle one!
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It's a weird thing because I am sure I was a first year medical student about five minutes ago, but it seems that not only am I apparently a fully qualified Consultant these days, as of tomorrow I will also have a child at secondary school.
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Watching old ER episodes. They just called the surgeons because cardiology were stuck in traffic 🤔
Trying to imagine the carnage that would ensue if an English ED did the same 😂
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I've just had my first AL since I started my Consultant job (which itself I went into <24 hours after my last Reg shift) and I have to say I wouldn't change many things about the last 5 months but I would take some AL a bit sooner if I was doing it again
#tipsfornewConsultants
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It's possible to campaign for higher pay for doctors without comparing us to other people in a way that implies we are "better".
(especially when comparing a basic, unenhanced hourly rate, with a zero hours job that has no sick leave, no annual leave, no maternity leave, etc)
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I don't know Mr Yeh but I feel like this could have been any of us.
And, the GMC said, that the chance of 'recurrence' of his supposed lapse in standard of care was almost nil, but that they had to "send a message to the public" by suspending him.
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Obviously when I say, this could have been any of us. We all know that actually if it had been me, the chance of it reaching an MPTS tribunal would be rather lower 🙄
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All the tweets about
#LiveableNHSbursary
have taken me right back to sitting hours in the library reading lists of grants in the hope I would be eligible, the demeaning process of submitting every bank statement for hardship grants, having to work while others were revising. 1/2
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Three Christmas babies helped into the world today and now three whole days off! An NHS luxury ❤️
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Oh and when men work fewer than 5 days a week in the NHS, to work privately, do research or serve on national committees etc, it's applauded and their professional status increased. If a female Dr does the same to care for their children, she's considered uncommitted.
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Ah man it is so good to hear juniors organising. We've got your backs 👊
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Today marks one year since starting as a Consultant. I know some people don't enjoy the transition but I've loved nearly every minute. I really enjoy the increased autonomy, being able to make changes & improvements, teach and supervise and have much more continuity with patients
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Devils advocate. Isn't encouraging women to tweet '"my" childcare bill is X" and calling it the
#marchofthemummies
just exacerbating the idea that childcare is a women's problem?
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If men did an equal share of parenting and took up shared parental leave and LTFT working in the same numbers as women, this wouldn't even be a consideration.
Unfortunately it's a tiny minority who even consider compromising their career progression to look after their children.
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@Medic_Russell
I love my job! Best job in the world 😍 I feel lucky to have found my "Ikigai"
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an abnormality during surgery? And a number of blatantly obvious system failings. (Where were they notes? Why wasn't the consent done prior to an emergency admission? What was said during the WHO checklist? What was the follow up?)
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However, waiting times for non-emergency care may be longer than usual.
Please be patient, and if you find it frustrating, I encourage you to write to your MP to ask them to ensure the Government properly fund the NHS, including paying staff properly.
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I also want to make REALLY clear on here, that if anyone needs ANY support with a situation like this, please just DM.
I have done it for other people and I will do it for you. Whether we 'know' each other or not. Whether you are an FY1 or SAS Dr or Clinical Fellow or Consultant
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Do we warm blankets in the UK? I've never seen it
Sometimes this feels like the most meaningful piece of equipment in the whole hospital
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@oli_m_sims
@Louisdebernard
I often say I am totally useless without equipment, a theatre and an anaesthetist. Even if someone's having a baby, it will come with or without any assistance. My only intervention would be to stop people rushing to cut the cord.
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Now when I respond to Datixes as part of my job, I try to be really clear that I'm grateful for issues being raised with me, that it isn't the responsibility of junior shop floor staff to solve systemic issues (though if they have ideas for improvements I am all ears).
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Used my injury as an excuse to download
@amateuradam
new book. Never thought of how "sick" means very different things to medics!
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When you continue to work under impossible working conditions: Hadiza Bawa-Garba
When you raise concerns about your working conditions being inadequate:
JDUK highlighted an MPTS tribunal which has me SHOOKETH
- Indian doctor asks for a laptop
- used the word "promised" when actually they had noted her interest for one previously
- gets GMC'ed for dishonesty and suspended for a month?!?
WTAF
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The NHS has been put in an impossible situation and nobody is a winner here.
Stay open for everything, be resented by some of your staff for making their lives extremely difficult (especially parents) - if they can make it in - or interfering with their right to a day off.
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A few people seem to have misread this and thought that I'm the victim. Just to be totally clear, I was there as a witness.
His question about my clothing the day of the incident turned out to be part of a claim related to his defence, but that wasn't clear to me at the time.
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In August 2007 I walked into
@NUHmaternity
as a fresh-faced brand new doctor. I fell in love with O&G here, stepping up to Reg and later Consultant. Today was my last day as a locum Consultant before heading on to new adventures
@BHRUT_NHS
. Forever grateful for everything ❤️
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I still feel guilty!
But also angry that the people who actually held the power to make a change made me feel like it was something I had to do myself.
It put me off submitting Datixes for a long time.
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Wondering if the people who object to being called cis also object to being called white? 🤔
My theory: yes, because it (correctly) feels like being asked to check your privilege.
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More students allowed to cut the cord and take the baby during CS - more potential future obstetricians 👍👶🏾
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We need fewer e learning modules on 'situational awareness' and more energy dedicated to designing systems, processes, and physical spaces that enhance our ability to gather, appraise and interpret information.
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Six years ago junior doctors were also in dispute with the Government and I was cycling myself in to hospital to be induced at 40+1
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First day at
@BHRUT_NHS
today, in my new role as Consultant Obstetrician (no gynae!) with a special interest in patient safety and human factors. It's lovely to be back 😁 Looking forward to catching up with familiar faces and meeting new colleagues over the coming days & weeks.
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I'm sure my junior colleagues wouldn't doubt it for a second, but just to make crystal clear, I am totally behind you taking
#IA
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Posted this on my personal Facebook page and I would encourage other Consultants/SAS/GPs to share something too. There's still very little media coverage and what does come will inevitably be skewed.
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I would share my "how my social media posts were used to derail my training and undermine/bully me" story, but I've six years later, I'm STILL afraid of the ramifications if I do.
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Fewer investigations bemoaning staff not following guidelines, more writing guidelines that are accessible, up to date, easy to read and understand, and don't take half an hour to get to the relevant part.
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Last day of my month of Funemployment between jobs. I have done approximately zero of the work-related things I had planned to, but I have walked 62 miles with this floofball so overall I think it's been time well spent.
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In my second year as a Consultant, I will engage with the appraisal process before the last possible minute 😬
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@charliersmith1
So many of us rooting for you Charlie. Glad your mum has come to be with Vicky. Thank you for sharing with us 💗
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I'm not sure how long I'll take to recover (will gratefully accept any educated guesses).
If I owe you a work related email/call/Thing, I'm sorry.
I'm sure my brain will recover before my body does so I'll get round to catching up on everything, but not yet.
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I knew (from here) about being able to give 600mg Ibuprofen, but I didn't realise it could be QDS. It's this just my ignorance, or is there a culture of systemically under-dosing? Shouldn't we be going up to max NSAID dose before adding opiates?
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Do you have a positive reporting system (Greatix or anything else) that works really well (ie people actually use it)? If so, please can you tell me and
@PennyBliss6
about it?
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In a testament to a. My amazing bone mineral density and/or b. My "cyclists calves", my bones have escaped intact, as have, importantly my tendons.
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Hi
@RCObsGyn
it's been a week since the details of Mr Chandraharan's employment tribunal were made public. Have I missed a statement?
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"You cannot ask people who do not feel valued, to value others" Great finishing thought from
@JenniferIzekor
#BICS22
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I also feel awful for the Reg (or maybe now Consultant) out there who actually did the op, and missed the cyst, and has now seen a - by all accounts hard working and popular - colleague suspended by the GMC.
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I think about that reply a lot.
I don't know if they genuinely thought that this was a realistic thing to task an SHO with.
Or they were trying to kick it into the long grass.
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Could your process/guideline/computer programme/SOP/piece of equipment be performed/followed/understood/enacted/used correctly by an overworked, unrested junior member of staff at 5am?
If not > redesign it.
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I would also like a chat with "Dr C" the "expert" fellow Consultant that the panel seem to have relied on.
Specifically it would be good to know, have they ever worked in a unit like Northwick?
May be unfathomable to them in a quiet unit with a well functioning notes system.
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Whether my personal pay is protected or not is irrelevant. I won't be shafting my junior colleagues. Bring on the ballot papers
#yesyes
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