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A clinical director

A day in the life of a clinical director

Gus Vincent, clinical director and consultant in ITU/Anaesthesia, at the Royal Victoria Infirmary, Newcastle, shares a typical day with us. 

The day begins

In strict chronological order, Friday morning begins at 06:00 – like Ken Dodd said, I do all the exercises – up, down, up down, then the other eyelid. Some of my colleagues clearly have the time management schtick sorted, read the book etc – 'Look at your email only once a day, set aside 30 minutes in the morning' – the phone is pinging by 06:30 from this crowd – I feel the smugness radiate from these messages as the inbox levee once more threatens to break. No problem – 'you're always behind the curve, never in front, if you think you're on top of it you’ve forgotten something massive' – this from the surgical clinical director (CD) during his gentle induction when I started a year ago. Big slug of coffee and we're on the bike, wind behind me, across the town moor to the big hospital in toon in the shadow of the Gallowgate. 

Staffing issues

You would think that 74 consultants, six specialty docs and 38 trainees should be enough to get the work done but this is a bums on seats game – and we have not enough posteriors for the chairs of anaesthesia. This week we have 300 lists to cover and have 15 empty sessions staring at us next week, the shame of an anaesthetic cancellation implicit in their stare. I have weapons at my disposal to cajole my colleagues into the extra work – cash, charm and threat – but I am mostly good at the first two. The 'in-house waiting list' is our euphemism for the overtime payments – good for the ski holiday for many, bad for the work-life balance of a few – I am grateful my colleagues stick their hands up. 

Clinical_director_cartoon_page_content_Sep_2018


The never-ending list of problems

OK – some morning problems to see off; that study leave payment is NOT WHAT WE AGREED, the locum payment hasn't arrived, there is a new car parking machine and ParkingEye is now going to charge us £2 for an on-call shift (oh no you're not), the commissioners WILL NOT PAY for those facet injections any more, the awkward colleague has looked at a trainee funny overnight, HR are hassling for the retire and return irregularity, 'can I see you for a job I might want in two years?', the grumbling orthopod whose list went down for an organ retrieval bleating from the ethical low ground, the computerised expense system to swear at. A text from the MD saying well done for something; nice, wherever you are on the food chain we all like a stroke.

Meeting of minds

In our stride now, it's meeting time, ideally titled by acronym to confuse those not invited – CPG, SIRM, DCGM, AMSC. Choose a strategy – the quiet man to pay attention to when they speak or the bossing alpha – don't worry I've done this course – seek the win-win position, which in your head is really I win you lose. 

The best bits now

Plotting a project with a pal over a coffee, squeezing baby Gwyneth (that's enough mat leave surely though now mum!), sorting a job plan to make Tuesday at home easier for somebody, chatting and listening to someone having a hard time, hopefully leaving them feeling better, smiling with my ITU friends who now think they're architects.

I have a proper job too though don't forget – into the hubbub of theatre for the afternoon and the pride and pleasure of working with such fantastic colleagues. 

I slip into the anaesthetic room for the familiarity of the checklist, the cannula, the white medicine and the scope. Away from email for a bit and thoughts of that pint waiting later in The Trent. A proper Friday hospital pub for a proper great department.

This article was originally published in Anaesthesia News, June 2018.

Cartoon courtesy of Eoin Kelleher, Trainee Committee.

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