Welcome

Welcome to Cardiff's Adult Critical Care unit. I'm Matt Morgan, your clinical supervisor for this placement. I am one of the critical care consultants with an interest in research and writing.

"Medicine is the most humane of sciences and the most scientific of humanities." - Edmund Pellegrino.

Intensive care is a wonderful, new, exciting specialty that cares for the sickest people in hospital. Although we use a lot of machines, drugs and equipment, humanity is equally as important. So even if you are a passionate scientist, love procedures or enjoy communicating with patients there is a lot for you here.

• How do I arrange an initial meeting?

It would be great to meet within the first few weeks of you starting. Monday's around 11am or 2pm in my office above are generally a good times. Please email me to arrange a meeting with at least three dates. Can you also include in your email a little about you, where you trained, what you have done before and what you enjoy most. Bring some ideas along to our meeting about what you want to get out of your time with us. Can you also make sure I am assigned as your clinical supervisor on TURAS. If not, you may need to speak to the team or your educational supervisor.

• What will I get out of my time in ICU?

Our ICU is a big, busy unit with complex patients. You will have excellent supervision with a consultant on-site every hour of every day. The things people find most satisfying about their time with us include management and recognition of critical illness, practical procedures (including arterial and central lines under registrar supervision), experience in ultrasound and involvement with project work. I really want you to spend time with our excellent research team also, shadowing them as they enroll patients into critical care trials.

• How can I arrange to shadow the critical care research team?

Get in touch with Rhys Davies who is the lead critical research nurse for education. Here is what he will cover. It would also be great if you did the online Good Clinical Practice (GCP) training here.

• Where can I learn more about ultrasound?

There is a great free resource online here. Completing this during your time would be a great achievement. If you want to take training to the next level, the lead for critical care echo in our unit is Dr Chris Gough.

• What project can I help with?

There are always a large range of active projects ranging from quality improvement cycles to major research studies. The ones active right now you could help with include:

• • For quality improvement project go here.
  • Help educate the doctors in training about all our current trials. Have a look at them here.
  • Help turn research consent digital.
  • Help a Cardiff University mathematics PhD student with predicting critical illness.
  • Help with a project looking at how easy it is for patients to understand research information sheets.
  • Develop an online research course for the ICU.
  • Think about writing an opinion piece for a journal such as the BMJ about something you are passionate about. Some further  free tips for writing are here.

• What is a clinical supervisor compared with an education supervisors?

Your educational supervisor oversees your entire year and produces the final end of year report. Your clinical supervisor is there to help with each separate clinical placement and completes an end of placement report which then gets seen by your educational supervisor.

• How will my foundation year work?

The foundation years aim to cover the 13 aspects of the program below through your different clinical placements. These are supported by a variety of means including Supervised Learning Events (SLEs) including assessments like a DOPS, formal teaching, simulation and self-directed teaching.

• What about the numbers of Supervised Learning Events assessments?

There are no specific numbers of SLEs needed but you do need evidence that each of the 13 areas have been covered. Here is example of what that evidence can be:

• What about a TAB?

One TAB is needed in the year and should be done in the first placement. Other assessments will make use of the placement supervision group (PSG) who are a group from the wider multi disciplinary team who will feedback to the clinical supervisor. This should be done in the second placement.

• What is a PSG?

In post two a Placement Supervision Group (PSG) assessment is required. This replaces the second “TAB”. At the clinical supervisor's induction meeting the members of the PSG should be identified.

The minimum for a PSG is 3 colleagues (at least one consultant) and we would generally advise 4 - 6 responses depending on the nature of the post. Suitable PSG group members would be:

• • Where there are rotational consultants working with a trainee clinically 2-3 should be included in the group
  • For trainees with LIFT / medical education elements / academics at least one colleague from the relevant department should be included
  • A senior trainee, non-career grade (post foundation)
  • Senior Nursing Colleagues, pharmacists or AHPs

The clinical supervisor does need to set up the group which should be agreed with the trainee. The PSG will be requested towards the end of the placement and a successful assessment is required to complete each foundation year.

• What else?

All foundation Drs should prepare and agree a PDP for each post. For F2 trainees specifically we would anticipate this should include an explicit discussion of how the self-development time (SDT) will be used and defined outcomes agreed. With 3 hours per week significant projects/outcomes are anticipated.

 

• What does the year look like?

• Any other things I should think about?

You should keep a summary narrative throughout your year. You should have 30 hours of formal teaching in the year alongside 30 hours of self-directed learning. More details about these issues are in the main handbook.

• Where can I find out more about my foundation programme?

Read the full handbook and watch the video here.

• How should I manage night shifts?

Critical illness doesn't work only 9-5. We need to care for people and their families no matter the time of day or night. This can be tough and people adapt very differently to shift work at night. The key is to stay safe and to keep your patients safe. To do this, rest is important and we encourage it at times that appropriate working together with the team. Some really important tips about night time working are here.

• Anything else I should think about or read?

There are some great books and documentaries about critical illness. If you are a reader, have a look at the list of books here that I will add to. There is a wonderful documentary called "Between Life and Death" here.

• Where do I find help?

I will be your clinical supervisor during your time with us. Although you may be new to critical care, Cardiff and the hospital, help is always at hand. If you ever want to talk about clinical or non-clinical issues,  just get in touch with me in person, by email or on 07760 220095. My office is in the "Peter Grey" office area, 3rd floor, C block with my name on the door.

• What do I do at the end of a placement?

The end of placement meeting should now be complete (or at least timetabled), please also ensure the summary narrative is included and discussed in this meeting.  All trainees must have completed it and if not will need to arrange a further meeting for this to be facilitated.