I'm seeing a lot of leaks from nurses and doctors to the media in NSW. This happened in Vic last year, and while I personally don't believe in leaking (because it leaves you with zero control over your message, to be manipulated at will), I understand why. 1/
Healthcare workers are usually the *last* people to leak to the press. Non-disclosure clause in contracts aside, we all truly believe in what we do, and we understand that the relationship people have with us is one built on trust. It's very easily eroded, so people stay quiet.
Except when things are reaching crisis point and they feel like no one is listening. The only thing that will make a healthcare worker leak to the media, is if they are scared their patients are going to die from preventable systemic problems and that no one is listening.
After a flurry of leaks hit the media in Vic last year, things changed suddenly. As a state we became more transparent, and the message of healthcare workers were heard even in the pressers. And once heard and responded to, the leaks stopped.
Again, going back to my previous comments on listening to the people out in the field, with eyes directly on the problem - these are the ones at the epicentre of it all, who truly know what is going on. There is no spin. There is cold, hard reality.
Healthcare workers are a finite resource. The system may well 'cope' in the end, but the cost may well result in too many leaving the system. Maybe even before. There are already shortages. We might get through covid, but we may not make it back to usual care.
And culturally, state governments across the board pride themselves on running public health departments on the smell of an oily rag. It shouldn't be this way. Cost cutting in health is not to be congratulated, it is a failure to keep up with the population, and the times.
We can't do this any more. We cannot continue this culture of how do we throughput more patients with less staff to care for them. We need an end-to-end approach starting in the community with healthy work environments, more GPs, and ending with how we approach illness recovery
Because right now we have double hits of excessive covid cases in NSW colliding with that extreme cost cutting culture and something is going to give. Healthcare workers intrinsically know this when their own burnout starts to get out of control. I hope everyone is listening.
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Because I love a good Twitter thread, I'm going to delve into why I think people fall for snake oil treatments, doing what I do best, drawing on personal experience. Because I haven't always been a doctor, I have been a really stupid teenager too. 1/
Another lifetime ago, I was an angry and disinterested teenager, with parents who had split up when I was 4. My Dad had moved overseas when I was 12, and then returned when I was 17 because he had metastatic melanoma and he'd used up all his money on American clinical trials.
I saw him on and off over the next year, at varying points of treatment. Well and playing the piano one time. Pale and crying in a bed in Box Hill hospital another. Well and playing the piano again (he was a musical genius).
I'm going to tell a story about last year that is on my mind and asking to be told today. I have changed details to protect privacy, and it's a common story played out countless times. Content warning: distressing and discusses death.
Last year at our site outbreak, I went to cover a service whose team had been suddenly furloughed. It had its first positive cases there, and I'd been looking after covid patients on another service already, so it made sense for me to go.
I arrived with my two junior doctors (the word junior does them a disservice, they were outstanding). I got them to start swabbing everyone so we knew what we were dealing with, then started seeing everyone to work out who was symptomatic.
In all of the history of science, new discoveries, and indeed knowledge, has started with direct observation of the phenomenon you want to know more about. Writing down the position of the stars each night, drawing the different shapes of plants as they go...
...and observing how a completely new virus affects humans. Never before has the front line been more relevant and crucial. The people looking after hundreds and hundreds of covid patients are our field scientists right now. They are the experts, and we need to listen to them.
We need to listen to what they've seen in their direct observations. This goes for epidemiogists and public health scientists who are working directly on it. There are so many 'expert' voices out there who've not been anywhere near a covid patient, let alone multiple.
I keep seeing this 'opinion' of "why did we vaccinate the elderly first because now the young are unprotected and everyone in this outbreak are younger". It's wild that I have to explain this, especially as it's coming from corners of the medical community, but here goes. 1/
Putting aside for the moment, that dying from coronavirus (not dying with, but from), is horrible. And the fact that the death rate in the elderly is 20-30%, not 3%. Because in some circles, this distressing fact is not enough to justify vaccination, even though it should be.
Older people make up a fairly big proportion of our population. If they are in a nursing home or in hospital, then chances are they have multiple complex medical problems and have high nursing care needs. This means that when unwell, they often need 1-2 nurses to care for them.
At the risk of getting eviscerated like last time I talked about the AZ vaccine, my suggestion for NSW is this. If you are eligible, get it. It is a good vaccine for a large outbreak. I wont insult your intelligence with comparisons made to risk of other things. 1/
What about deadly blood clots? People are calling it a "clot shot" right?
First of all, major props to everyone who has rolled up their sleeves, taken a deep breath, and gotten it. Major bravery on display there, major.
I want you to think about the way this is reported. Every time someone lands in hospital or dies with a blood clot, it gets reported in the news. Someone asked me if not reporting it was 'suppression' aka censorship...
I know there are people curious about TikTok but see it as inacessible for a variety of reasons: unfamiliarity, what's the point, their own self-view as being non-tech, security concerns...but are still curious. The content is really good for the soul imo. Quick guide:
1. Download the app and make an account. Enter as minimal information about yourself as possible. I keep a separate email account for online shopping (to reduce spam) and use that. Don't use real birth date. Then...
2. Down the bottom of the screen, you'll see a magnifying glass or the 'discover' tab. Go into it and type in a topic that interests you with a hash in front of it. Suggestions: #melbourne, #sydney, #medicine#dancechallenge, #indigenous