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

blogs.bmj.com/bmj/2020/03/16…
(usual caveat that, because this was published in the BMJ, “healthcare professionals” was changed to “doctors” in the headline but, clearly, this isn’t just about doctors)
And this, more than ever:

“When the pandemic is over, and we return to some sense of “normal” again, we will need an even more vigorous discussion about what safe staffing, safe resources, and a safe model of care really mean in the modern NHS.”
Excellent thread from @DrShreeUnadkat explaining why # many of us are feeling the way we are as the second COVID19 wave continues to strengthen, and practical suggestions to help
“Being kind” is important but it may not be sufficient

When we are exhausted, our ability to empathise is impaired and, when we can’t, we can feel we’ve failed even more

As with #FightFatigue, we need individual AND systemic supports for this, or else “be kind” can become empty Image

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More from @DrMikeFarquhar

24 Oct 20
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 Image
How sleepy we feel, and how much we *need* to sleep don’t always match up

The simplest example of this is the post-lunch sleepiness many of us feel

Even if we don’t sleep, we usually feel *less* tired a few hours later when we’ve been awake longer

Weird, huh? Image
Sleep is a complex process, but we can simplify how we think about it into what is called the “two process” model of sleep

This describes sleep/wake as the interaction of two elements: Sleep Pressure (S), and Circadian Rhythm (C) Image
Read 39 tweets
23 Oct 20
The @gmcuk annual training survey is out, looking in particular at the impact of COVID19 on medical trainers and trainees

gmc-uk.org/-/media/docume…
As always there is lots of granular data in the report but at the high level:

~25% of trainees & ~20% of trainers score “high” or “very high” on Copenhagen Burnout Inventory questions in the survey

40% of both trainees and trainees describe work as emotionally exhausting
And almost half report feeling tired/fatigued at the end of the day

(though, as always, I think the phrasing of the question “are you exhausted in the morning at the thought of work” is quite an existential way of asking it!)
Read 10 tweets
22 Oct 20
Maybe I’m not educated enough either but I genuinely struggle to understand how this Government can’t find money to support this, when so much has been frittered away elsewhere

That Tory MPs, including a consultant paediatrician, can in conscience vote against this amazes me
Also: @RCPCHtweets @RCPCH_and_Us ... I know @MarcusRashford has an MBE now, but surely he deserves recognition from us as well, in view of how determined he is to give voice to children and young people and advocate on their behalf?
Very relevant @bmj_latest article, quoting @maxdavie @RCPCHtweets amongst others, on this, from a few weeks ago

bmj.com/content/370/bm…
Read 4 tweets
11 Jun 20
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
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
I’ve spoken about what I’m about to speak about here before; much of the content comes from a plenary talk I gave @RCPCHtweets Conference last year

But, for reasons that will hopefully become clear, I think it’s important to restate some of this again

twitter.com/i/events/11327…
Read 25 tweets
20 May 20
I had a wee stint in our adult ICU team as part of COVID19 redeployment and, for some of that time, had an actigraph on

Actigraphy, worn like a watch, uses a number of sensors (mainly motion and light) to give an overall impression of sleep routine and pattern
Shift pattern was 3 long days/3 days off/3 nights/3 off, then repeat cycle

LOTS of caveats about this data:
- on shift, actigraph was in a scrubs pocket, often under PPE
- it isn’t directly measuring sleep
- one day I forgot to put it on at all...
- etc

But...it gives an idea
Some other points/caveats:
- black lines: motion/activity
- coloured lines: light exposure
- blue shading: sleep
- yellow: wake
- red: night shift
- purple: day shift
- I took some time to rest/recover on “off” days, but was generally doing “normal job” work on those days as well
Read 21 tweets
28 Oct 19
The joys of the Internet!

Great to be watching @harvardmed sleep medicine legend Chuck Czeisler delivering a celebratory lecture on “A Brief Journey Through Circadian Time” @BrighamWomens, from the comfort of my office 💤 💡
Prof Czeisler talking us through the history of human circadian research, starting with some of the early experiments confirming the tendency of humans to “free-run” if deprived of external cues about day/night, light/dark
The factors regulating sleep are complex, and we *still* don’t understand them all.

Prof Czeisler demonstrating how this early data was already hinting at some of the multiple oscillating processes underlying our circadian rhythms
Read 21 tweets

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