Mastering Intensive Care 011 with Colin McArthur

Do you give feedback to your intensive care colleagues when they do their job well?Have you become overscheduled because you have trouble saying no to new tasks? How well do you listen to the views of the intensive care nurses in your ICU?

The first international guest of the podcast series, Dr Colin McArthur, is a highly experienced intensivist, anaesthetist, researcher, administrator and leader from Auckland in New Zealand. In this episode he reflects on many aspects of his career and gives loads of useful advice about aspects such as giving both positive and negative feedback, learning to say no so we don’t exceed our work capacity, and listening to and respecting the views of the intensive care nurses in our ICUs.

Colin is a senior intensive care specialist and past-Clinical Director in the Department of Critical Care Medicine at the Auckland City Hospital in Auckland. He is the immediate past Chair of the ANZICS Clinical Trials Group, with which he has been actively involved since its formation in the mid-1990’s. Colin currently leads research governance for New Zealand’s largest clinical research facility at Auckland City Hospital, and holds adjunct/honorary appointments at Auckland and Monash Universities. He is married to Juliet and has 3 sons in their early 20’s. Colin is currently in transition from being a keen runner to (in his words) a mediocre cyclist.

Colin is wise, thoughtful, hugely supportive, skilled in many areas, and highly experienced, making what he says all the more useful to intensivists and trainees at all levels. Having been a leader for much of his career, he encourages trainees to find out how intensive care is delivered in many different institutions, both locally and internationally; he describes how although self-reflection is important, hearing the views of others on our performance is even better; he discusses his attitude to sleep and how the hours before midnight count most; and he tells how the benefits of running for him have included ensuring regular exercise, helping manage stress, and weight control. Also hear him speak about how:

• He found ICU an intimidating place when he first transferred patients from surgery as an anaesthetic trainee but began to like the people who worked there
• He worked for 2 years in Hong Kong and learnt from Dr Teik Oh, a pioneer and true master of intensive care in the Asian and Australasian region
• Senior mentors in our career can teach us about communication, interacting with others and the other highly important non-technical skills
• Working in an ICU that might be considered strong has good and bad aspects but does provide leadership in looking after the sickest patients
• Intensivists need to grow in their careers to operate at a level above simply having basic clinical skills so as to allow the main focus to be overall patient management through coordination and communication
• We can learn from seeing things done both well and done poorly
• The days in which he feels he is not at his best are usually related to what he has brought to work by not being well rested, not being well fed or not having done exercise
• He likes to get to work a little bit early to enable social interaction prior to the work phase of the day
• Though he finds it to keep the details of more than 12 patients in his mind
  A really good stress management strategy is to carefully pick our battles
• Most intensivists would benefit from having a string to their bow other than simply clinical work
• Speaking to families and patients requires regular and multiple interactions, honesty, frankness, recognition of uncertainty, recognition of the limitations of medical knowledge and the need to value what the families bring to the conversation

My genuine hope with the Mastering Intensive Care podcast is to inspire and empower you to bring your best self to the ICU by listening to the perspectives of such thought-provoking guests as Wes Ely. I passionately believe we can all get better, both as carers and as people, so we can do our absolute best for those patients whose lives are truly in our hands.

Feel free to 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 andrewATmasteringintensivecare.com.

Further reading and listening

• Full podcast collection on LITFL and Libsyn
• More conversation on Twitter (@andrewdavies66) and Facebook