In MMTM Part 1, two-step cognitive appraisals were explained. This process dictates whether one enters a challenged or threatened mindset in the event where an immediate performance is required under acute stress. Feeling challenged, of course, is one of the two chief components of a mentally tough individual. “I am 100% committed” “I feel challenged” In this post, we will […]
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‘My Mental Toughness Manifesto’ Part 1: Understanding Cognitive Appraisals
It has been an exciting period for me recently. Last month I was at the International Special Training Centre (ISTC) in Pfullendorf, Germany, where I had the honour of speaking to a group of Special Operations Combat Medics in-training from eleven nations across NATO. Staying at the base, meeting the guys, and contributing to their fantastic 26-week course was […]
Primary Survey March 2017
It’s March 2017 and time for a quick review of the best of the EMJ this month Under pressure: does cricoid improve laryngoscopy? Whether or not we should use cricoid during emergency intubation is fast becoming one of the greatest modern controversies in Emergency Medicine. While we await data from randomised controlled trials, in this […]
Are nurses always right?
As a junior doctor, I have had, and still have some fantastic senior colleagues to work with, who generally give important and valuable advice. Over the placements and years, their advice is slowly turning me into the doctor that I aspire to be, an amalgamation of all the good bits from every doctor I have […]
BBC visit UK emergency department and experience Winter pressures
It’s not really news that UK Emergency departments are under pressure, but those realities are often hidden from the general public. However, in the last week the BBC was granted access to the Royal Blackburn hospital to see first hand how it feels to deliver emergency care in an overcrowded environment. Follow the link below […]
The One-Upping Blind spot.
Sometimes you see things on twitter that upset you. This week I noticed this post from the excellent Shaun Lintern on ‘one-upping’ in hospitals. It’s not a phrase I’ve heard before but it essentially means putting an extra patient on wards above their intended capacity. "One upping" is not acceptable @RMayNurseDir tells HSJ saying it […]
Primary Survey Feb 2017
Highlights from this issue Ellen J Weber, Editor in Chief Teaching how to think Somewhere between entering medical school and leaving specialty training, a young doctor makes a transition from being a complete novice to a physician capable of making diagnostic and treatment decisions more or less independently. How exactly does that happen? Two […]
The ‘Deliberate Practice Mindset’
Performance improvement is an interest of mine. I have previously blogged and podcasted about the strategies I employed to lift my game (from rock-bottom) when working in an extreme environment – a South African township ED. I first became aware of ‘deliberate practice’ after reading an excellent St. Emlyn’s post last year. I had never encountered the concept before, but […]
The 4-hour standard. Why can’t you get it right?
If you were hoping for a solution to flow in the ED then this is not the post for you. Rather it’s an appeal and a cry of pain from all UK clinicians who work in emergency departments for politicians and journalists to understand what the 4-hour target is. It is the percentage of patients […]
Primary Survey January 2017
Highlights from this issue Simon Carley, Associate Editor Another fabulous year in Emergency starts with a new world order and new challenges for EM and prehospital care wherever you are in the world. This month our contributors tackle systems, cases, prognosis, analgesia, urine collection and more. Here’s the highlights. Scoring systems and nurses intuition I’ve […]