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1/7
A short thread on management styles
I spent many years as a paediatric critical care nurse in all sorts of settings
When stakes are high, the decision making process is crucial
A short thread on management styles
I spent many years as a paediatric critical care nurse in all sorts of settings
When stakes are high, the decision making process is crucial
2/7
A healthy ITU will run multidisciplinary ward rounds with input from doctors of various levels, pharmacy, nursing and sometimes other disciplines
Some times there are arguments. I never had a problem with that. We argued because we cared
A healthy ITU will run multidisciplinary ward rounds with input from doctors of various levels, pharmacy, nursing and sometimes other disciplines
Some times there are arguments. I never had a problem with that. We argued because we cared
3/7
The process of debate allowed different perspectives to be considered and risks assessed
Sometimes one member of the team would "win", we would adopt their strategy. Sometimes we'd compromise. Sometimes the consultant would overrule everyone as senior clinician
The process of debate allowed different perspectives to be considered and risks assessed
Sometimes one member of the team would "win", we would adopt their strategy. Sometimes we'd compromise. Sometimes the consultant would overrule everyone as senior clinician
4/7
There are far more unknowns in critical care than most people realise. There is a place for data and statistics, but it's a brave consultant who will, for example, ignore the intuitive gut feeling of a seasoned front line critical care nurse
There are far more unknowns in critical care than most people realise. There is a place for data and statistics, but it's a brave consultant who will, for example, ignore the intuitive gut feeling of a seasoned front line critical care nurse
5/7
Private PICU's gave me the fear. A single clinician would make all the important decisions on the case usually with no input from other clinicians or nursing staff
Only in "complex" cases where the shit was hitting the fan would they seek other opinions
Private PICU's gave me the fear. A single clinician would make all the important decisions on the case usually with no input from other clinicians or nursing staff
Only in "complex" cases where the shit was hitting the fan would they seek other opinions
6/7
Yet all critical care is complex. We are dealing with human bodies and minds. We must consider ethics. We fight death yet concede to its final arbitration
We listen to families. We advocate for what we believe are the patient's best interests even if that causes conflict
Yet all critical care is complex. We are dealing with human bodies and minds. We must consider ethics. We fight death yet concede to its final arbitration
We listen to families. We advocate for what we believe are the patient's best interests even if that causes conflict
7/7
Complex enterprises need people of differing perspectives coexisting on the same team
That team needs to be able to communicate openly in a structured way
Cliques, bullying and power struggles (while inevitable to some extent) are all inversely related to team performance
Complex enterprises need people of differing perspectives coexisting on the same team
That team needs to be able to communicate openly in a structured way
Cliques, bullying and power struggles (while inevitable to some extent) are all inversely related to team performance
