Mastering Intensive Care 37 - Michael O'Leary - Dealing with the frustrations of the changing ICU landscape (SG-ANZICS special episode)
Our ICUs might be growing larger in size but there seem to be the same number of very sick patients to care for overall. All of which means we seem to be admitting a greater proportion of less unwell patients to our ICUs, especially in the larger tertiary ICUs. Given we also suffer from "bed block", where there are no available beds in the hospital to transfer patients to, when they are no longer critically ill, our ICUs can become holding bays for effectively "ward-level" patients. This may be great for the patients but it means longer ward rounds, and a level of frustration for intensive care teams, who may feel like they are not making a significant enough difference for these less sick patients.
When A/Prof Michael O'Leary started out in Intensive Care nearly 30 years ago, he remembers being enthusiastic and busy, performing many interventions on mostly sick patients. Having now moved across the world and gained a few decades of experience, he has a great perspective on some of the challenges our larger ICUs face.
Michael is former President of the Australian & New Zealand Intensive Care Society and a Senior Specialist in Intensive Care in Sydney, working at Royal Prince Alfred Hospital and St George Private Hospital. He is Clinical Associate Professor at Sydney Medical School, The University of Sydney, and Co-State Medical Director of the New South Wales Organ and Tissue Donation Service. Michael trained in anaesthesia in the United Kingdom and holds a Fellowship of the Royal College of Anaesthetists (FRCA). His intensive care training commenced in the UK in Cambridge and continued in Sydney where he achieved Fellowship of the College of Intensive Care Medicine of Australia and New Zealand (FCICM). Michael was a Research Fellow at St Bartholomew's Hospital, London, UK where he completed his MD degree with studies into the metabolic response to sepsis and use of glutamine and growth hormone in the amelioration of catabolism. In recent years his main interests have been in end-of-life care and organ donation in the ICU.
This episode was conducted in May 2018 as a live interview in front of a conference audience at the 5th SG-ANZICS Asia Pacific Intensive Care Forum. Thanks to that meeting's Organising Committee, representing Singapore's Society of Intensive Care Medicine (SICM), Singapore, and the Australian and New Zealand Intensive Care Society (ANZICS), I was invited to conduct several such live interviews for this podcast. Many thanks to Tan Hon Liang and David Ku for this opportunity.
Apart from his observations about the growth and change in Intensive Care over the last few decades, Michael and I talked about:
- How the SG-ANZICS meeting came to be
- His career history
- Being a part-time intensivist
- Playing the role of Co-State Medical Director of an organ donation service
- The characteristics of good intensivists
- Being President of ANZICS and the importance of being involved with professional societies
- Some perspectives on good communication and clinical care.
The Mastering Intensive Care podcast is aimed to inspire and empower intensive care clinicians to bring their best selves to the intensive care unit through conversations with thought-provoking guests. I genuinely believe we can help each other to improve, as both professionals and as people, so as to give the absolute best possible care to our patients.
Please help me to spread the message by simply emailing your colleagues, posting on social media or subscribing, rating and reviewing the podcast. To connect, leave a comment on the Facebook "mastering intensive care" page, on the LITFL episode page, on twitter using #masteringintensivecare, or by sending me an email at andrew@masteringintensivecare.com.
Thanks for listening.
Andrew Davies
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Show notes (people, organisations, resources and links mentioned in the episode):
Michael O'Leary on LinkedIn: https://www.linkedin.com/in/michael-o-leary-a1222b11/?originalSubdomain=au
SG-ANZICS Asia Pacific Forum: http://sg-anzics.com/
Episode 36 with Hayley Gershengorn: http://masteringintensivecare.libsyn.com/episode-36-hayley-gershengorn-allocating-icu-resources-to-optimise-patient-outcomes-and-job-satisfaction
Mastering Intensive Care podcast: http://masteringintensivecare.libsyn.com
Mastering Intensive Care page on Facebook: https://www.facebook.com/masteringintensivecare
Mastering Intensive Care at Life In The Fast lane: https://lifeinthefastlane.com/litfl/mastering-intensive-care
New Normal Project podcast: http://newnormalproject.libsyn.com/
Twitter handle for Andrew Davies: @andrewdavies66
Instagram handle for Andrew Davies: @andrewdavies66
Email Andrew Davies: andrew@masteringintensivecare.com