Episode Transcript
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Music.
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Of New South Wales Health Podcast. I'm your host, Frances Wood,
and today I'm bringing you a conversation I had with Edna,
a senior medical officer at
a hospital, and we had this talk on Darawal country on a bit of a rainy,
dreary day, but the conversation certainly brought some sunshine to my day,
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and I hope it does the same to you. Enjoy. joy.
All right. Hi, Edna. So what brings you to hospital today?
I'm a senior staff specialist here working at Wollongong Public.
In my role, I supervise a team of doctors.
So there is a registrar, there's a junior doctor, sometimes medical students
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also come with us for a ward round.
And my role is sort of supervision and I am responsible for every decision making
in terms of patients' healthcare.
And I've been in the shoes of a junior doctor as well.
And I know, you know, what goes on, you know, behind the scenes in their minds and things like that.
So I guess it is making sure that they are comfortable in what they're doing
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and trying to teach them as well and not treat them just as someone working
for you, but having a team spirit.
And I don't really believe in hierarchy, sort of believe that we are all horizontal
and, you know, We all work together as a team.
And I do take feedback, even from the junior doctors, even the junior most.
And I guess we all have to constantly improve what we do. And there's a lot
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more things to learn for each of us. So that's what I believe in.
And I spend a lot of time with a patient. So it's not a quick five-minute or
a 10-minute walk around.
And especially on the post-take day, we spend at least 20 minutes to half an
hour with each patient and try to give some quality time and listen to them.
So why do doctors work in teams and round the way they do? It's quite unique to a hospital setting.
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Yes, I guess if you do not, there was a time in COVID where we actually did
ward-based care, where the junior doctors would just run with multiple people
and remain in the same ward, so they didn't belong to a team.
But they were not really happy with that setup, and they actually find being
in a team much better. They function much better as a team because they feel
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like they know the patients better.
So mostly each team would be some sort of a speciality.
And they know what is expected of them and their roles and responsibilities
are better explained in each term.
And they feel a sense of who to go to.
Like they could go to the same registrar, same consultant. And otherwise it'll
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be like working for different, and they won't be doing justice to care because
each people would round at a different time and they wouldn't get their head
around different patients.
Complex presentations if they work for different teams in award-based care.
But here there's a sense of responsibility to a certain person and the problems
are usually similar, sort of like everybody has different problems,
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but sort of they know what the expectations of the team is, what sort of investigations
to order, how the management is usually like, what's the expected date of discharge.
And they sort of know this and everybody's style varies and it's easy if they
work with the same team to understand that.
And the collaborative approach is much better that rarer than one-on-one care.
So it sounds like we work in teams because it's really a way to be constantly
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teaching and learning and collaborating together,
you know, whereas a patient might be used to seeing their GP one-on-one,
but then come into hospital and be under the care of a team.
And it's good for them to know that it's about that constant learning and development
to continue the future of medical care.
Is that how you would describe it? Yeah, I think so.
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And also the continuity of care is better.
Like you might see the same patient in the clinic, in the outpatient setting,
in the community setting, and also as an inpatient.
So there's that continuity of care as a team.
Yes. I think that empowers them and they know a lot more what to do in the future as well.
So as a senior doctor, you would potentially see a patient in hospital while
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they were admitted and then have follow-up care with them in an outpatient setting.
And what does it take to be a senior doctor? Is it a certain number of years or qualifications?
What's the journey like to becoming a senior doctor?
Any doctor's journey is long. You should really be, you should really,
you know, have a mindset to, you know, to know that it is a long process.
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But I guess it depends on each individual. You can take it as slow as you want.
You could try different things before you get into a certain training pathway.
But I guess it is at least eight to 10 years to sort of become a senior staff specialist.
It's fairly unique, like thinking about other types of careers.
It's a long time to sort of in that seniority, whereas in other pathways,
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you might be able to be promoted sooner, depending on your aptitude for the role.
Role what is it that about medicine that maintains that passion and that drive
towards being a senior doctor and working as a senior doctor?
I guess the mindset the positive growth mindset is extremely important and I
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guess most of us at least in my case you know from beginning that that's what
you want so from from the time of childhood I always wanted to be a doctor so
I couldn't imagine myself as somebody else.
And I guess the passion is extremely important to continue in the profession.
And some people, you know, do different professions and they know that's not
right for them and they really want to do medicine and that's why they change
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career pathways when they're 40 or 50 and then they're really passionate about it.
So I guess the passion to do it is extremely important for the long haul.
Otherwise, it's really, really hard.
And I guess most people know the difference between, you know,
how medicine is relative to the other professions. So they know it is tough
and it's going to be long, but I guess it is rewarding when.
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You save a life or it doesn't have to be saving life. It could be simple things
which make a difference.
So the positive impact that you have on people, I guess, is one of the drivers
for people who do medicine.
So are there any sort of moments that stand out to you where you really felt
good about having a positive impact on someone's life?
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Yeah, I do remember one particular instance. This was quite a while back when
I was an advanced trainee.
I don't know if I can share like the exact situation, but I can be like not
specific, but be general.
So I was the first one seeing this patient in emergency and I found out that
this patient had a problem, which was actually not the presenting problem. And it was very subtle.
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And that made a big difference. And I stayed behind to sort this patient out.
And I ordered investigation when my supervisor was a minimalist and hated if
you didn't do the right investigation.
So you have to choose really wisely and why you do it. Like,
you know, there needs to be some meaning for that investigation.
And it actually, so I was a bit scared to do it because, you know,
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what if it wasn't the right thing to do because that's not even the person to complain.
And this patient was seen by other senior people not long ago,
like a week ago or something.
So it was a bit nerve-breaking to do it, but I still ended up ordering it.
And then it actually turned out to be a positive thing for the patient where
we found out the patient had a problem and then had to be transferred from a
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peripheral facility to actually a tertiary center, like all of them.
So which made a big impact.
And the patient, I mean, patient wasn't with it. So the patient's family was really grateful.
That really was quite rewarding to make a difference.
So you really had to have the courage and the confidence to really advocate
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for the patient in that moment and through the process.
And you've spoken a lot about your collaborative team-based approach to working with junior doctors.
What's your approach to partnering with patients in their care?
Yeah. So that is very important.
I think it's really important to listen. I really strongly believe in listening
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to patient stories, not just the problems that they're coming with.
We usually talk about something personal, like, you know, doesn't have to be
always medical, the problem at hand.
Talk about a pet bird, pet dog, what's the name, who is looking after them.
So it doesn't have to be relevant to...
Came in with and I think that actually takes their mind away and
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also if there is the procedure or something that we are doing I make sure that
they understand you know what it is about and I do ask them you know is there
anything you want us to do so to take some feedback on you know anything else
we should be doing for you so it's all about listening to them being empathetic and also
taking feedback on, you know, what else can be done to make it better.
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And what's your approach to, I guess, the many competing time pressures that
are on senior doctors in hospital?
It just seems to be very demanding. How do you take care of your own health
and well-being in that sort of space and juggle everything you might have else
going on in life? Yeah, good question.
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It's a tricky one. One, it is hard to do that sometimes and you feel like you
fail personally sometimes if you're good professionally.
But I guess you try your best. And it's always hard to, even with roles,
you're doing different roles.
You're doing clinical role, you're doing an administrative role where you're
looking up to junior doctors, training and education.
Are you doing better at both the roles? Are you doing justice to both the roles?
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Can be tricky. But I guess you try to allocate like the main thing is to plan,
has to have a plan in place of how the day is going to be like,
how are you going to make sure you do this and that.
And sometimes you prioritize one role over the other, depending on which is
important, more important.
So I guess my administrative role sometimes does take more importance than the
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clinical role during sometimes like now with orientation for all the junior
doctors. So that's 75 of them coming next week.
So that's important to me, although I'm extremely busy clinically this month.
So it is going to be tricky but I guess planning ahead and making sure you're
available for both is important and always you can't you know at the end of the day you need.
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Yourself and you know I definitely make sure
I have a break I definitely have breakfast I have
lunch breaks and coffee by break I don't mean
I take half an hour out I do work side by
side like check my emails when I'm drinking my coffee but I
make sure I eat that's one thing I feel like that gives me the energy through
the day I used to be like this hot chocolate milo person since I had my second
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child the coffee really helps to coffee a day yeah it really helps oh yeah so
I I guess having breaks has really been one of the kind things that I do to myself.
Yes. Well, thank you. And, you know, you've transitioned nicely to kindness,
which is really what we want to talk about.
And I'm wondering if there was an act of kindness that you observed or experienced
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at work that you could share with us.
I guess little gestures make a big difference.
So like patients just saying your name, like they call me, like,
you know, they have a nickname. But anyway, they use your name and that's like,
oh, wow, they know my name.
And also they say, I would love to follow up with you because,
you know, I found that you took care of me very well or my family member very well.
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So which is really nice to hear.
So I guess appreciating the simple things that we do and just saying thank you is great.
And also sometimes I've seen patients asking, how are you? You know, don't work too hard.
Make sure you take a break. So those kind of things really feel like,
wow, they do know how hard we work and they are acknowledging that,
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you know, we are trying to do our best.
So those simple things have been, yeah, great.
Yeah, it is wonderful. There are so many of those beautiful interactions between
patients and families and carers and healthcare staff where they do express
a lot of concern and care for the people that are caring for them.
Yeah. And it's really special. And you spoke before about making sure,
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you know, you nurture yourself.
Is there anything else you can tell us about how you're kind to yourself?
Yeah, if I'm really down, I go for a facial and a massage.
Or I guess just watching a movie. Just see, just... Yeah, or talking to friends
and, you know, reading a book or just having a glass of wine help.
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But during work, it's mainly those breaks that really helps.
And also connecting to people, not medically or clinically, like at work,
you know, just talking about how was your day? Like, how was your weekend? What did you do?
This is my plan for the holiday. Like talking about something,
which is nice when you're so stressed, actually de-stresses you.
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So I think we talk about the future holidays or what we had, what we did during.
It is really important. Earlier on in my career, I think I undervalued that
a lot. I was like, I'm so busy, I'm here to work.
But actually, the older I get, the more I've learned to value those little incidental
conversations and that really connecting and understanding where each other
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are coming from and building that trust and rapport actually adds to the efficiency
and the effectiveness of the workplace.
But I think it's something you could probably take for granted earlier on.
Yeah, absolutely. Absolutely.
And is there one thing we can do for you here in hospital to show you kindness?
Yeah, I guess acknowledging that we are quite busy and, you know,
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there's competing priorities, there's emergencies.
We are on call 24-7 and then we come back the next day for work and on weekends
we work. So I guess, or shift work.
So I guess acknowledging that we might might not have slept well and they're still working.
And so it's not, so knowing that it's not that one patient that war,
but there's, you know, maybe other people who are sometimes more sick than us.
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So I guess acknowledging that and being a bit patient if sometimes we are not
there the time the family is there or patient needs us for a question,
which is, you know, not urgent if they're a bit more patient and not demanding.
Yeah, and I think that's what comes through in these conversations is that our
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doctors are so passionate and are working so hard and doing the best they can
within the situation and that little bit of patience and understanding goes a long way.
Absolutely. Well, thank you so much for speaking with us and helping us look
on the kind side of health.
Thank you. I hope you enjoyed my chat
with Edna and I'd just like to invite you
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to take a moment to think about
something that stayed with you about what it's
like to be a senior doctor working in a
hospital and also what Edna shared
with us about kindness how much she
appreciated little things like patients using her name or asking her how she's
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going and how she She discovered coffee after having her second child and how
important it is to take breaks and connect with people.
Edna also talked about being patient and understanding that our senior doctors
are working really hard to care for lots of patients in lots of different wards
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and that some, unfortunately,
may be a lot sicker than others.
Take care and thank you again for
joining us on the kind side if you feel
like you need to talk after listening to this episode
please reach out and speak to someone
trusted in your life or you can call lifeline
on 13 11 14 24 hours
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a day seven days a week take care this
podcast was recorded on darawal country i'd like
to acknowledge and pay my deep respects to the
elders past present and future and extend that respects to any aboriginal or
torres strait islander people listening i'd also like to acknowledge the lived
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experiences and the wisdom of all the people who spoke to me for this podcast
and those listening thank you.