Jellybeans. Conversations with Care. The Jellybeans started here and are now also hosted on lifeinthefastlane.com (The Original) & www.IntensiveCareNetwork.com This is the complete collection. Sometimes containing more controversial offerings.
Jellybean 84; Talking about talking about dying with Dr Steve Philpot.
Talking about talking about dying with Dr Steve Philpot, Master of Communication.
In the week that one of the states in Australia has pretty much managed to pass assisted dying legislation I had to reach for this Jellybean recorded at the College of Intensive Care Medicine ASM in Sydney this year. The state of Victoria, where I personally reside, has almost passed the assisted dying bill. It has been a fractious and bitter process at times. But it is all but done. I have been waiting patiently for this. I have been very sad to watch patients waiting for this. Patients that couldn’t be patient.
As you can imagine this law will impact ICU medicine. We, by which I mean anyone nursing/doctoring etc that’s directly or indirectly involved in intensive care medicine, will be having difficult conversations about this with our peers, our bosses, our friends, our patients and their families. We had better get our heads around this. Communication is key and it will extremely important not to f**k it up! So we need to learn what to do, practice doing it and get feedback on how we are doing it. Given that ICU consultants need to be brilliant at communication how do we manage to keep supporting and training ourselves and our colleagues in this area.
Charlie Corke, President of the CICM of Australia and New Zealand has been a pioneer in this area. The person that has succeeded him is Dr Steve Philpot.
So how do you train an intensivist, with maybe 30 years of medical experience, to improve their communication. In fact, how do you even suggest to such a character that they would benefit from some training in the area. Let’s face it, it is not that easy to tell an ICU consultant what to do at the best of times.
So I asked Steve, because this is a big part of what he does. He ran a series of workshops at the CICM ASM for Consultants around communication skills. It was really very good. He also runs the “How to run an effective family meeting” course available through CICM. (You can find it under “Communication Course” through the members portal on http://www.cicm.org.au .)
Of course Donate Life also run an excellent course which has a lot of communication training embedded and Steve has been very involved in Donate Life too.
All this earnest, breaking bad news, family talk stuff can be very serious but refreshingly the people leading the way are not afraid of a bit of humour. You can’t help but notice this with people like Charlie Corke, Stephen Warrilow and Steve Philpot. Brilliant!
Having said that some of the questions that I ask Steve really require a cool and calculated answer so the humour switch needs to be flipped. There is a conspicuous moment in this Jellybean when Steve had to fend off one question with an entirely appropriate “you didn’t tell me we would be talking about (that)”. Which is true! I didn’t tell him, in fact I never really tell people because I rarely ever know. The conversations are always spontaneous and real. I wasn’t trying to catch Steve out here and I apologise for putting him on the spot. That’s just the way a Jellybean Podcast goes.
Other fun stuff that came up includes ‘faith based health services’, ‘doctors that are also actors’, ‘medical ethics at Monash Uni.’ and the bizarre news that empathy levels in medical students drop from first year to final year before they even get unleashed on the real world. So the way we are preparing future doctors actually decreases their empathy. What? Really? Steve is actually trying to to do something about that too.
Thanks to Xavier Rudd for his tune Time to Smile and indeed thanks to his instrument technician James Looker who got to play the banjo part that dominates the intro you heard. You can find more by Xavier Rudd on iTunes but I don’t know where you can hear more James Looker. (Sorry James.)