28 - Simon Finfer - Querying clinical decisions and maintaining humanity in an intimidating environment

Mastering Intensive Care

Does each bedside decision you make actually help your patient to feel, function or survive?

Have you considered how frightening and intimidating the Intensive Care Unit environment is to your patients and their families?

Do you feel empowered by the people you work with and the culture in your ICU?

Simon Finfer loves telling a tale. In this episode you’ll hear the story of the serendipitous and multi-national route Simon took to end up working for 25 years in one of Australia’s premiere Intensive Care Units. An Intensive Care Department where his colleagues and the culture they developed has fostered him to become one of Australia’s prominent intensive care researchers. You’ll also hear how he teaches his junior colleagues to question everything they do at the bedside to ensure their decisions truly help the patient.

Simon is a Professorial Fellow in the Critical Care and Trauma Division at The George Institute for Global Health, a Senior Intensivist at Royal North Shore Hospital and Director of Intensive Care at the Sydney Adventist Hospital in Sydney, Australia. He is an Adjunct Professor at the University of New South Wales, a Clinical Professor at the University of Sydney and is a past-Chair of the Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group. Simon is a world leader in Sepsis and is an international expert in the design and conduct of large scale randomised controlled trials in Intensive Care.

Simon has collaborated with me (and many others) through the ANZICS Clinical Trials Group, so we caught up at the Group’s recent 20th Annual Meeting on Clinical Trials in Intensive Care at Noosa Heads in Queensland. We had a fascinating conversation in which Simon talked about:

• His early career in London where he was simply working too hard
• The circuitous route he took to Royal North Shore Hospital in Sydney
• The magnificent people-oriented culture inspired by Malcolm Fisher
• His early collaboration with the George Institute for Global Health
• How showing you care is what matters most in an end of life discussion
• His thoughts on having family at the bedside for ward rounds
• How the golf course is the only place he doesn’t think about patients
• How moving to a property with animals has brought relaxation and peace
• The rekindling of his passion for motorbike riding
• Why he got a Twitter account and how social media is both a force for good and an echo chamber
• How it’s almost “too easy” to write a paper in modern times
• The unlikelihood of a magic bullet arriving anytime soon
• His advice to look after our selves, to embrace uncertainty and to maintain our humanity

My genuine hope with this podcast is to inspire and empower you to bring your best self to work and to consider adopting some of the habits and behaviours my guests give their perspectives on, with the ultimate purpose of improving outcomes for all of our patients. Please help me to spread the message by simply emailing your colleagues, posting on social media or rating and reviewing the podcast.

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 [e-mail].

Thanks for listening on the journey towards mastering intensive care.

Andrew Davies

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Show notes (people, organisations, resources or links mentioned in the episode)

5th SG-ANZICS Asia Pacific Intensive Care Forum: www.sg-anzics.com

ANZICS Clinical Trials Group: http://www.anzicsctg.org/

More information about Simon Finfer: https://www.georgeinstitute.org/people/simon-finfer

Twitter handle for Simon Finfer: @icuresearch

SAFE study: https://www.ncbi.nlm.nih.gov/pubmed/15163774

NICE-SUGAR study: https://www.ncbi.nlm.nih.gov/pubmed/19318384

SMACC: https://www.smacc.net.au/

Mastering Intensive Care podcast: http://masteringintensivecare.libsyn.com/

Mastering Intensive Care at Life In The Fast lane: https://lifeinthefastlane.com/litfl/mastering-intensive-care/

Email Andrew Davies: [e-mail]

Twitter handle for Andrew Davies: @andrewdavies66