How to manage conflict in Critical Care: Ronan O’Leary

In this entertaining talk, Ronan O’Leary discusses conflict in critical care.

Ronan explains how to make a team decision about whether or not to perform a decompressive craniectomy.

Undertaking a decompressive craniectomy is perhaps one of the most challenging decisions we face within critical care.

Ronan contends that we do not know if we should do the operation. As he explains, even if we think we should do it, we don’t know when, or even how.

Perhaps more importantly, intensivists do not perform the operation, the neurosurgeons do. However, we frequently put them in the position of doing the operation when we are at our wits end. Alternatively, they do the operation without asking us when we still feel we have space to play.

Ronan poses the question - how can we resolve this, in a workplace environment which is already fraught with competing interests, beliefs, values and approaches?

Evidence based medicine is not going to provide an answer soon and it is unlikely that a superficial approach to improving teamwork will either.

An important component will be the future structure of clinical training. Our current systems reflect the way hospitals worked decades ago and the specialties we now have exist almost independently of the training which leads to consultant posts.

Ronan posits that training should involve exposure to collegiate decision making and consensus building.

However, this will be difficult to achieve within our current nationally co-ordinated training schemes.

How to manage conflict in Critical Care: Ronan O’Leary

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