Talking SMACC – A nurse eye view. 4

In what felt like being part of a spectacular experiment, the SMACC 2013 program launched in style with an opening plenary to end all others, imploring us all to consider what make critical care so different? For the uninitiated, SMACC 2013 was the inaugural Social Media and Critical Care Conference, held at the Sydney Convention and Exhibition Centre 11-13th March. It was a gathering of passionate healthcare providers who engage largely in social media and whose day jobs are mostly in critical care. The build up was the most amazing multi-pronged social media campaign I have seen and the conference exceeded all expectations.

First of all, I need to declare something. I am a male nurse. I am well accustomed to being in the minority. Even in critical care, my gender predisposes me to being the lower number in a ratio of 5:1. From a very superficial analysis of attendance at SMACC 2013, I would estimate about 20-30 maximum representation of nurses at a conference of approximately 600 delegates. This is ok. I heard whispered (tweeted) laments of imbalance in the program. Who cares? Am I a self loathing nurse? No. Am I a frustrated wannabe doctor? Also no. The jobs are different. I know, who’d have thought? Does it make me a SNAG? Well, my wife thinks so.

My view of critical care, is that we are meeting patients and, more often, their families at the lowest moment in their life, isolated, scared, confused and disempowered. Hospitals swallow people and turn them into bed numbers. I see the role of the critical nurse as something different all together. If in any way I can make the darkest time of someone’s life more bearable, I am up for the challenge. I have had more rewarding moments from facilitating a good passing than resuscitating a patient. One of the most fulfilling moments I have experienced was when caring for an elderly man, whose prognosis was awful and cessation of treatment was imminent. His family, who I had come to know as jovial and upbeat people even at the worst moments, where all in huddled around the bed in awkward silence (I know, breaking the rules, be damned the 2 visitors only epithet – I’ve had to sit in an ICU waiting room, it is rubbish). Taking a chance and trying to read my audience I asked “what sort of a bloke is Bob? (pseudonym obviously). I haven’t really had a chance to meet him properly, he’s not been real chatty (he was invasively ventilated and unconscious). The sons and wife burst out laughing and I breathed a sigh of relief at what could have made me come off as an insensitive moron. “He is the sort of bloke who would love that you just said that.” “It’s not a church”, I replied, “you don’t have to be silent and there is no right or wrong way to deal with the fact that Bob is in this predicament.” That was enough to start the ball rolling with funny anecdotes about Bob’s life, tales from his profession, laughter and tears for the rest of my evening shift. Yes @emcrit “We are critical care”.

We don’t just instil fluids (not too much or the wrong ones thanks John Myburgh). We don’t just give propofol (the devil’s semen, thanks Cliff Reid), it’s not all about Ketamine and airway (Sorry Minh) and we don’t just use complex gadgets like transpulmonary thermodilution catheters (Roger Harris had everyone squirming in their seats for different reasons with this talk). I love to learn the physics, chemistry and biology behind the interventions I deliver. Not because I wish I was a doctor, but because it makes me a better nurse. It makes me a better data gatherer and analyst. It reduces the cognitive load and turns things from complex tasks I didn’t understand into planned executions of a bigger overall strategy. It makes more able me help save lives. It makes me quicker and more efficient, which means I get to sit on my butt and do nothing? No, it means I can talk to my patient and family. It means I can use that extra time to check and recheck for things that could go wrong and it means I can fill that time with more learning.

I love to learn from other nurses. This is one of the best things I have been given by the world of social media and it’s application for things other than posting selflies and pictures of food. This is why I got so much from SMACC and this is why I am happy to be in the minority. Meeting the likes of Ian (@impactednurse) and Kane Guthrie (like me has no fancy Twitter handle) among others at SMACC, my passion for being a critical care nurse found a bit of a counterpoint.

A common theme from SMACC 2013 was questioning dogma and being a subversive campaigner for change. For these two reasons, I don’t think much needs to change in the world of #FOAMed (other than maybe offsetting the cost of free – donations anyone?). How can you regulate change? How can you formalise subversion? My humble thoughts… why would you want to? On this theme of subversive ideas, my applause go to super nurse Sarah Webb, Resuscitation Coordinator at Royal North Shore. Getting up in front of a room full of emergency and intensive care physicians and pointing out that nurses too can make excellent leaders in resuscitation. The data on comparing ICU and ED Nurses and other disciplines certified as ALS providers at RNS was a moment that caused embarrassed gasps from the heavily under represented medical fraternity.  To confront this topic with style and grace (and a calm exterior) was pretty damn impressive. So to those who were concerned that nurses were under-represented at SMACC 2013, you probably weren’t looking in the right rooms. How about we do something about it and shout it from the rooftops for SMACC 2014. Lets drag our colleagues kicking and screaming into the world of Life In the Fast Lane, ICN, Impacted Nurse and the other plethora of great resources that can help broaden our often specialised focus and provide some insight into areas that are different from our own environment.

The measure of a successful conference is a feeling of reinvigoration for your work/cause and even with snot and sore throat, I returned with passion to teach today. I feel motivated, if not obligated to add to the bank of resource, thought and comment as we move to a new world of true evidence based practice rather than journal/eminence based. In all disciplines this is vital.

My only regret from SMACC 2013 was that, as a simulation educator, I missed Sim Wars (SONOWARS was a spectacle to behold), but lo and behold I can watch it for free http://prehospitalmed.com/2013/03/15/simwars-smacc-2013-download-280mb/. To finish up, I can genuinely say I understand the concept of FOAM now. To quote Scott Weingart, “don’t just dip your toes in, jump in the river and try and drink it!” I am thirsty for more, bring on the videos of all the awesome sessions I couldn’t see and bring on SMACC 2014.