inaugural anti-bullying awareness day what thethe bleep ... · winter lead nchd workshop 3...

WhaWhatt thethe

BLEEP?!BLEEP?! NCHD Newsletter

ISSUE 2 | SPRING 2019

Spark Ignite!

Inaugural Anti-BullyingAwareness Day

Women in MedicineConference

coming to Cork!

32872_NDTP_newsletter_Layout 1 13/03/2019 14:51

ContentsLetter from the National Lead NCHD 2

Winter Lead NCHD Workshop 3

Introducing the Medical Intern Unit 4

Leaders in Healthcare Conference,Birmingham 4

The Importance of Service LevelAgreements for NCHDs 5

Ignite 6

Spark Seed Funding Projects 7

Change Your Mind Festival 8

Joint working group on Bullying in the Workplace 9

Inaugural Anti-Bullying Awareness Day 9

Wikipedian in Residence 11

Hackathon Poster 12

Limerick Wellbeing and Innovation Evening 13

My Most Memorable Patient 14

Women in Medicine in IrelandNetwork Conference 15

Letter from theNational LeadNCHD

As National Lead NCHD I’m privileged to be a part of this publication

which seeks to spread the word of exciting opportunities and

developments in our health service. In this second edition we are

focusing on the varied and wonderful contributions to NCHD welfare

by means of workshops, conferences, innovations and awareness

campaigns. The following features are by no means an exhaustive list

of the revolutionary leaders, movers and shakers but merely a

snapshot. If I’ve learned anything this year, it is that there is a rich

tapestry of ideas, support and initiatives underway to improve NCHD

life and ultimately our healthcare service. There are approximately

6500 NCHDs across the country and along with consultants, nurses,

midwives and all allied healthcare professionals: we make up the

backbone of the healthcare service. We are the eyes and ears of the

frontline, and our perspective and voice is of paramount importance.

I would like to acknowledge the network of Lead NCHDs, the entire

team at NDTP and the Quality Improvement Division of the HSE for

their tireless dedication in uniting us all as an empowered group with

an important voice. The following features are by no means an

exhaustive list of the people and projects which are happening at the

moment. If you know of a development or opportunity that you

would like to share with NCHDs in this quarterly newsletter, please

don’t hesitate to contact us: [email protected].

I’d like to kick this newsletter off on a high note by expressing

congratulations to my colleague Dr Christine Kiernan (photographed

here with the team), National Fellow for Innovation and Change.

Christine’s hard work

on the Spark

Programme was

recognised recently

as she was nominated

for a CIPD HR Award

for Employee

Empowerment and

trust.

Dr Eva O’ReillyNational Lead NCHD /NDTP Fellow

UpcomingOpportunities

• Do you have an article you’d

like to submit to ‘What the

Bleep?!’? Particularly we are

looking for funny,

heartwarming or feel good

stories about being an NCHD

in the Irish system- a little pick

me up! Please contact

[email protected] with your

submissions.

• Are you interested in doing a

junior doctor/medical related

literature review for our

newsletter? Please contact

[email protected] to express

your interest.


As Christmas drew closer, the Lead NCHD Networkcongregated once again for the second Lead NCHDWorkshop of 2018-2019. A dedicated group of over 50Lead NCHDs travelled from far and wide. The theme ofthis workshop was Innovation. NCHDs have a vital rolein innovation as we are the future of the healthcareservice. Design thinking and user centred design arefeatures of innovation which will help us contribute tothe evolution of the health service in a way that ensuresengagement, efficiency and quality improvement. Themeasure of any organisation is the emphasis it placeson innovation. This brings me nicely to our first speakerof the day. Trevor Vaugh of Maynooth University,focused on Innovation in Healthcare with a slant ondesign thinking. Trevor is the director of masters indesign innovation in Maynooth as well as a partner andfounder of the innovation consultancy ‘Actionable’. Hehelps clients understand the role of design as an agentof change and innovation. We learned about theimportance of user centred design in the making of anyinnovation plan in order to create change that is assustainable as it is achievable. Trevor charminglyreferred to the perfect doctor innovator as a “grumpyoptimist” Unhappy enough with the need for change todo something about it, but hopeful enough to see light

at the end of the tunnel. How apt! Of note TrevorVaugh also coaches candidates for the Spark Seedfunding in Talent Garden Ireland. Being a grumpyoptimist has it’s upsides!

After a quick caffeine boost we were up on our feet foran engaging and interactive session entitled ‘MakingQuality Improvement Work for You’ with Lisa Tolandand Lorraine Murphy from the Quality Improvementdivision of the HSE. They say far away hills often seemgreener, regardless of their actual colour, we canalways learn a lot from how other healthcare systemswork. Angela Carragher, consultant surgeon and recentAssociate Post Graduate Dean in Northern Ireland,accompanied by Foundation Year Junior Doctorrepresentative Michael Doris, travelled down fromBelfast to enlighten us to the journey’s they have madeto better structure life for junior doctors in NorthernIreland. It was hugely beneficial to get an overview ofhealthcare in Northern Ireland and lessons Learnedfrom the NI Foundation School. I hope we haven’tbombarded the lead NCHD’s with too many ideas but ifthe current projects underway in the NationalCommittee are anything to go by, there is no shortageof good things to come!

Winter Lead NCHD Workshop 2018By Eva O’Reilly, National Lead NCHD

www.hse.ie/doctors 3


The Medical Intern Unit was established in 2018 tooversee and manage the operational delivery of interntraining as well as to implement strategicrecommendations of the Medical Intern Board, who havethe ultimate strategic control of the intern year.

There will be many new and exciting developmentswithin the intern year and we will keep you posted withregard to progress on various projects.

Introducing The MedicalIntern UnitBy Gozie Offiah, Clinical Lead, Medical Intern Unit

Pictured at Career’s day last October: The Medical Intern Unit Team:Marie Gunning, Sara McAleese, Gozie Offiah & Filipa Vinagre

Nine lucky NCHDs (photographed below) got theopportunity to attend the BMJ Leaders in HealthcareConference in Birmingham from 14th to the 16th ofNovember 2018. This was the third Leaders inHealthcare conference which is produced by both theBritish Medical Journal and the Faculty of MedicalLeadership & Management. This conference focuses ontopical issues in healthcare and their relation to thefuture of healthcare leadership and management.

The three days consisted of a masterclass day and twodays of keynote speakers including the UK Secretary ofState for Health and Social Care, the Rt Hon MattHancock MP. There were also numerous interactivesessions, exhibitions, poster presentations andnetworking events.

We learned a lot and had a blast as a group, all thanksto NDTP for the sponsorship and the continued beliefin NCHDs as leaders in our healthcare system.

Leaders in HealthcareConference, Birmingham By Eva O’Reilly, National Lead NCHD

L-R: Dr Ciaran Judge, Dr Eva O’Reilly, Dr Colm Geraghty, Dr Christine Kiernan, Dr James Ralph, Dr Geraldine McDarby,Dr Maria Costello, Dr Lylas Aljomani & Dr Samantha Davis

4 What the Bleep?! Spring 2019


Service Level Agreements (SLAs) are a vital governancelink between HSE workforce planning and funding (viathe NDTP) and the training bodies.An NCHDs trajectory isoverseen by three major stakeholders: the HSE, theMedical Council and the Training Bodies. NCHD’s rightswith regards to HSE employment is set out in the NCHDContract 2010. In order to be employed the NCHD mustbe registered annually with the regulator; the Medicalcouncil. In order to maintain competencies all NCHDsmust either be in training or comply with the ProfessionalCompetence Scheme as regulated by the medicalcouncil and overseen by the various training bodies. Oneof the most important links that the training bodies havewith the funder, who provides an NCHD with theircontract of employment, is embodied in the SLA.

To meet legislative obligations, the HSE has establishedformal, highly structured contractual arrangementswith any agent providing medical education andtraining services and these arrangements have beencomprehensively and formally incorporated into annualService Level Agreements (SLAs) between the HSE andtraining bodies. The SLA structures and mechanismsallow the HSE to align the stakeholders needs (of whichinclude NCHDs and patients in Ireland) and bediscussed with Training Bodies to leverage theirinfluence and input in improving training, conditionsand retention within their remit.

There are a number of ‘outcomes’ set out in the SLA’son an annual basis that includes but is not limited tooutcomes such as the following:• The requirement that training bodies review posts

to ensure that the full terms and conditions of theNCHD contract can be honoured

• A pre-approved list of out of programmeopportunities is to be published on the medicalcareers website before the end of December

• A trainee on an out of programme experience mustbe kept on the training bodies register, the DoctorsIntegrated Management E-system (DIME) and theMedical Council Specialist Register

• Training bodies must publish eligibility andshortlisting criteria in advance of the opening of theapplication stage: there should be no ambiguity inrelation to what is required to meet the shortlisting/eligibility requirements

• Anti-Bullying policies must be published andadhered to in order to reduce the prevalence of thisharmful culture which inhibits trainees fromreaching their potential in a safe learningenvironment

• Training bodies must identify a named individualwithin the college with the responsibility for NCHDshealth and wellbeing. Supports and servicespertaining to wellbeing must be clearly signpostedby the relevant college

A strategic objective of both NDTP and the Medicalcouncil is to further develop and enhance the standard ofmedical education and training for the benefit of traineesand ultimately, patients. An example of this is therequirement, as per the SLA, that training bodies enabletrainees to complete assessments and feedback eachyear. Feedback reports must then be compiled by trainingbodies and fed back to the NDTP for review.There are two SLA review meetings per year; Autumn andSpring, where outcomes are reviewed and thestakeholders get the opportunity to collaborate onchallenging issues and debate the correct path for theimprovement of matters effecting medical workforceplanning, retention and a supportive training and workingecosystem for doctors into the future. While trainingbodies have the expertise in the training requirementsspecific to specialties, the way in which the NDTPenhances NCHD careers via the SLAs pertains toworkforce planning and retention strategies. There is also a mechanism included in the SLA for dealingwith performance against the outcomes set by the HSEand this includes the possibility of some funding beingdeducted from Training Bodies should certain objectivesor targets not be met within certain timeframes.

It is the intention of the NDTP to continue to be adriving force for high standards of training andeducation for all NCHDs via continued collaborativeengagement with the training bodies. Of course, this isan evolving journey and NCHD input is always valued interms of feedback and suggestions going forward.

If you have any queries pertaining to SLAs or would liketo get involved; please contact [email protected]

The Importance of ServiceLevel Agreements for NCHDsBy Eva O’Reilly, National Lead NCHD & Jared Gormley, Business Manager, NDTP



Ignite was held in Saolta this year in collaboration withHealth Innovation Hub Ireland (HIHI). A call was issued toall healthcare workers to submit their project ideas. 32applications were received and this was shortlisted to 10projects that were then enrolled on a mini-acceleratorprogramme. This programme offered mentorship, adviceand skills to develop these projects further. The projectswere then pitched to a panel of judges: Dr Paul Nolan, Dr Anthony O Regan, Tayna Mulcahy, Dave Shanahan,Elaine Brennan, Dr Christine Kiernan.

It was a particularly difficult decision for the judgingpanel with some really exciting projects selected.

Individual Winner: Liam Connolly To use a specific belt and monitor that would instruct andguide GERD suffers on how to perform diaphragmaticbreathing at home.

Team Winner: Prof Derek O’Keefe, B Tuohy, FKirrane, M Kerin, P McCarthy To develop an handheld medical device that willaccurately tell if a Naso-Gastric (NG) tube has beenplaced correctly in the stomach before NG feedingcommences.

High Potential Prize: B Reid-McDermott, E Ryan& L Dann “BETTY-BEAR” is a teddy-bear backpack for children withtype 1 diabetes. The bear is designed with an injectablesimulated skin pad on his stomach for practice ofadministration of subcutaneous insulin injections.

Judges Prize: One To Watch: Frank Kirrane & Aine Binchy A new device that is placed inside an neonatal incubator,to provide the (currently not available) tangible linkbetween the noise levels experienced by the infant, andthe associated infant startle in response to the auditorystimulus.

Judges Prize: Novelty: Clare KinahanThe development and delivery of a pharmacist ledHolistic Medication Review service to elderly, frail,multimorbid patients in line with the process outlined inthe SIGN polypharmacy guidance 2018.

Congratulations to all who were involved in thiswonderful event. We look forward to further events incollaboration with HIHI in the future.

Ignite By Christine Kiernan, National Fellow for Innovation and Change



Spark Seed funding provides funding and mentorship for NCHDs with innovation projects who are seeking support.These projects can be anything that you would like to explore. We encourage projects that will create value for thehealth service, deliver best practice, improve patients experience or improve doctors working and trainingconditions. The calibre of projects being submitted is incredible high. NCHDs are making real and tangible benefitsto the care of our patients and in creating value for the health-service. Here are just some of the projects we havesupported in the last year.

Spark Seed Funding ProjectsBy Christine Kiernan, National Fellow for Innovation and Change


TraumaDoc: Dr Shane Broderick:ED SPR

A decision assistance tool formanaging major trauma inthe ED. This project hasincreased the use oftranexamic acid from 50% to100%, reducing ICU stays,transfusion rates and lengthof stays. It has been endorsedby IAEM and NOCA and hasnow been implemented asthe new national standard formanaging major trauma inIreland. NOCA’s datacollectors will also use thisvaluable project in their datacollection for the nationaltrauma audit. This project willdeliver improved standards ofcare for patients, aid in theimplementation of bestpractice and deliver value forthe health service.

Re-thinking thepathway for themanagement ofspontaneouspneumothoraxpatients:Dr Ben Shanahan:Surgery BST SHO

Dr Shanahan and hiscolleagues are implementingand evaluating an IntegratedCare Pathway for patientspresenting withpneumothorax. They aim toalign care with internationalbest practice and introducenovel concepts such as EDdischarge with chest drain insitu and patient attendance atnurse-led chest drain clinics.They predict an improvementin patient experience andreduction in the economicburden on the healthcaresystem, reducing Length ofstays (LOS) from 7 days to 0days creating value for ourhealthcare system andimproving patient care andexperiences.

Micro-Surgery Lab: Dr Kenneth Joyce:Plastic andreconstructivesurgery SPR

Micro-surgery is a difficultskill to master and accessingtime operating is increasinglydifficult. Dr Joyce hasdeveloped a micro-surgerylab in the Mater hospital forthe use of all NCHDs thatrequire it such as plasticsurgery, orthopaedics andcardiothoracic NCHDs. Itallows for training on site atregular intervals so that skillscan be developed. It’sproving a valuable resourcein the Mater.

This is just a small flavour ofprojects that Spark hassupported. There are manymore under developmentthat are sure to be veryexciting projects to see cometo fruition in the future.Congratulations to allinvolved. If you have an idea,look out for the next roundof seed funding which willopen in July 2019.

1 2 3



The idea behind the Festival is that Prevention in mentalhealth and the fight against Stigma are fundamental inPsychiatry and furthermore, that they can bring peopletogether. That’s why Change Your Mind Festival isabout fun, happiness, positivity and friendship. Thefestival boasts a lot of music, magic shows, balloonmodelling, face painting over 60 stalls of any kind,yoga, mindfulness, mental health experts and all sort ofactivities you can imagine. Mental Health is notsynonym of medication, madness, self-harm, asylums.Looking after your Mental Health is about having fun,bringing people together, talking about wellness,exercising, spending time with family and friends,listening to music, cooking nice meals and sharingthem with loved ones. We have to Change Our Mindsand thinking about Mental Health in a new andcolourful way. This is the simple embodiment of the

Festival: knowledge,sharing, fun andacceptance.

Applying for SparkFunding is easy as itseems. You shareyour idea with competent people whohelp you develop it and who support you. When Iexplained my idea regarding the Festival, I foundenthusiastic professionals who were thinking in aconstructive fashion. No ifs, no buts. “Let’s make it work”,I felt that was their motto. And this positive attitudespreads in all the activities they promote. Thank you tothe Innovation Fellow- Dr Christine Kiernan, the TalentGarden Ireland and the team at NDTP for supporting mewith this project.

Change Your Mind FestivalBy Ignazio Graffeo, Lead NCHD and Spark Funding recipient, Sligo/LeitrimMental Health Services



The Health Service Executive (HSE) and the IrishMedical Organisation (IMO) have recently established aJoint Working Group to look at bullying of doctorswithin the workplace. The group is jointly chaired byMs. Rosarii Mannion, HSE National Director of HR andMr. Anthony Owens, IMO Director of IndustrialRelations. The group includes representation fromConsultants, Training Bodies, HSE HR and NationalDoctors Training & Planning including the NationalLead NCHD.

There have been many surveys on bullying within theworkplace in recent years, for example the ‘YourTraining Counts’ study conducted by the Irish Medical

Council consistently showed that one third of traineesreported being bullied or undermined in post and overhalf of trainees had witnessed someone else beingbullied or undermined and harassed in post.

The group’s main objective is to shine a spotlight onbullying and ultimately to reduce the prevalence andincidence of bullying of doctors. The group arecurrently collating the data available on bullying andare meeting with colleagues form the UK/NHS whohave successfully reduced their levels of bullying withinthe workplace, in order to learn from their experience.Further updates from the group will follow.

Joint Working Group on Bullying in the WorkplaceBy Eddie Staddon, General Manager of NDTP

Results from our 2018 organisational wide staff survey"Your Opinion Counts", indicated that bullying andharassment are significant issues in and across theorganisation with significant numbers of staff reportingexperiencing/ witnessing bullying and/or harassment atwork. As a response to the feedback, an organisationalwide Anti-Bullying Taskforce was established to look atthe issue. The issue is complex and will require multi-factorial approaches, a range of measures and dedicatedfocus during 2019. Our first Anti-Bullying Awareness Dayon 28th February 2019 was a great success. Thesymposium event was oversubscribed and well attended.Contributions on the day included speakers from themany areas working diligently on addressing this issue.Throughout the country there were many eventsscheduled at local areas which included;• Local initiatives at hospitals and community areas

included:

– On-going initiatives driven by service staff/champions in promoting anti-bullyingpractices, conversations at team meetings andthe opportunity to complete the Dignity atWork eLearning module.

– A focal point that facilitated the staff voicewhich included feedback through a whiteboard to national level with solutions to#cutitout

• Local distribution of Anti-Bullying packs containingbanners, flyers, posters and lapel stickers -#cutitout. These packs offered information aboutthe important facts and services to assist anyoneexperiencing or witnessing bullying at work.

Next Steps1. A national taskforce to advance the issues of respect

at work is underway. This will involve the work of

Inaugural Anti-Bullying Awareness DayA joint initiative by the IMO and HSE



the taskforces for NCHDs, Nursing and midwiferyand all HSE staff. This involves revisiting the policiesand guidelines to ensure they are in line withGovernment policy and international evidence. Aparticular interest from the symposium that needsto be developed in the policy is the phenomenon isthe contemporary work relating to the role of the‘bystander’ and ‘toxic leader’ in the workplace.

2. National HR will work through a re-prioritisation ofexisting resource, identify dedicated resource tosupport the work of the national fora and link withthe operational system.

3. Information and solutions offered by the staff on theawareness day are being collated and thematicallyanalysed. The results will be shared with all staff.

4. Presentations from the symposium have beenrecorded and will be available shortly on HSELand.This information will also be shared via a road showto ensure all staff have the opportunity to beinformed.

5. A consistent request for more visible support to be

available to local areas to support respect in theworkplace and to respond to this request, NationalHR are collaborating with the service deliverysystem to support and plan further local eventsduring 2019.

The National HR division was proud to present theInaugural Anti-Bullying Awareness Day on 28thFebruary, 2019. There were a number of local eventsheld, where staff was encouraged to join in and sharetheir views on how we can create a positive workenvironment for all. There were local and nationalevents happening across our health service to promotestarting a meaningful conversation about how we can#cutitout. Promotional materials were distributedthroughout the country, and HR Staff positionedthemselves in canteens and foyers and asked staff towrite a response to the overarching question ofAddressing Bullying at Work - Join the Conversation”#cutitout. The Anti-bullying Task Force will use thisinformation going forward to respond to staff.



In July 2018, I was appointed as the NationalHealthcare Wikipedian in Residence (WiR). Thisinitiative, is fulfilled by a doctor on a 0.2 full time basis,and is a spin out of the Spark Innovation programmebetween the HSE National Doctors and Planning Unit(NDTP), the HSE National Healthcare Libraries andKnowledge Services (NHLKs) and Wikimedia Ireland.This is the first such project of its kind in the world, andits overarching arm to promote open access tohealthcare information on a National and Internationalbasis. There is a special focus on healthcare topics ofparticular interest to the Irish population.

The patient-doctor paradigm is changing, informed byimproved health literacy and increasingly by onlinehealth literacy. All evidence suggests that this is a verypositive thing and contributes to better clinicaloutcomes.

Wikipedia as the world’s largest encyclopaedia iscentral to this, for example there were more than 4.8billion views of healthcare topics on Wikipedia in 2017alone. Of these visitors many will be from healthcareprofessionals and students.

In my role as Healthcare Wikipedian I have sought topromote the benefits of open access to informationand the importance of supporting improved healthcareliteracy within the general population. The Wikipedianmission is to provide access to the entire sum of humanknowledge for everyone on the planet- this aligns withthe role of the doctor or healthcare professionalconcerned with improved health literacy.

In my experience, healthcare professionals suspiciousof Wikipedia have concerns about accuracy and fearthat ‘anyone can edit’. However healthcare content onWikipedia is broadly as accurate as UpToDate andarticles of public importance are protected from editingwith malicious, inaccurate or commercial material.

Healthcare content articles on Wikipedia are curatedand maintained by editors within the WikiProjectMedicine community. The majority of these editorshave a background in healthcare or science and aim toensure the distribution of quality healthcareinformation in an open-access format. There is always a

need for neweditors,particularly fromthose withhealthcarebackgrounds. I wouldencourage all colleagues to consider participating inthe Wikipedia project. The role of the Wikipedian is still evolving and manyprojects are currently running. We are engaging withthe university sector in order to provide training onWikipedia and improve science communication skills tohealthcare students. This has been very successfullytrailed in the University of California, San Francisco andat the Sackler Faculty at Tel Aviv University withresultant improvement in the communication skills.

Wikipedia training sessions are a part of the WiR jobdescription and to this end Wikipedia editing trainingwas provided to all regional healthcare librarians inNovember 2018. NHLKS staff are the central to theprovision of quality information, and therefore naturalallies to Wikipedia. It is hoped that regional libraries willbecome the hubs to support further ‘edit-a-thons’ andprovide Wikipedia training to healthcare professionalson a national scale. Our first ‘edit-a-thon’ recently tookplace in January and was facilitated by the library teamat Dr Steevens Hospital. During this session weupdated the topics of HPV and the HPV vaccine inIreland in addition to anti-microbial drug resistance inIreland. These topics are of particular importance giventhe recent public health challenges faced on this front.Further ‘edit-a-thons’ are in the pipeline and a broadrange of topics are agreed upon. Another project in themaking is a very interesting collaboration withcolleagues at UCD which involves the creation of adata mining tool for various databases to produceevidence and knowledge summaries for specific clinicalquestions. This is something I am very excited about.

We are always interested in potential collaborationsand invite anyone to make contact with the project [email protected]

Wikipedian in ResidenceBy Niall O’Hare, HSE Wikipedian in Residence



Limerick Wellbeing and InnovationEveningBy Caoimhe Costigan, Lead NCHD UHL

On February 27th a “Wellbeing and InnovationEvening” for NCHDs was held at University HospitalLimerick, hosted by the Lead NCHD trio and kindlysupported by the UL Hospital group. The purpose ofthe evening was to bring NCHDs together and provideinformation on innovation resources and opportunitiesavailable to them within the hospital group, as wellfocusing on NCHD Wellbeing and raising awareness ofsupports available to NCHDs.

Invited speakers included Ms Christine Kiernan,National Fellow for Innovation and Change, thefounders of The University of Limerick InterdisciplinaryForum For Healthcare (ULIFH), Dr.Grainne McNallyOccupational Medicine SpR, and Ms. Katrina Quinlan,project team coordinator with Values in Action. We alsoheard from our own Chief Clinical Director Prof PaulBurke and from current NCHDs undertaking innovativework within the hospital with the assistance of theSpark programme. This was a follow on event to the“Wellbeing and Innovation Evening” last Septemberwhich included guest speakers Dr Eva O’Reilly, NationalLead NCHD, Dr Peter Lachman CEO for theInternational Society for Quality in Healthcare(photographed in action below) and Prof DerekO’Keefe, Consultant Endocrinologist and professor ofMedical Devices from Galway. Both events were well-

received and hugely informative evenings, which wehope to make a permanent part of the NCHD calendargoing forward.



Dislaimer: names have been changed for purposes ofanonymity.

My most memorable patient was Mr Will Leavy*.Favourite patient would be too strong of a sentiment inthis case. He was an 83 year old former professionalorchestra conductor presenting with a bad deliriumsecondary to a urinary tract infection. It’s a commoncase, I know. We’ve all been there. What’s somemorable about an elderly man feeling like he’speeing tiny shards of glass?

Well to start with, his nickname was Will “Will-gardiumLeavy-OH-sa” Leavy. Yes, that’s right. The patient’sdelirium resulted in hallucinations, making him believehe was one of the main characters in the plot of theHarry Potter series. His grandchildren made him watchit A LOT when he was babysitting them. A specialthanks to little Timothy and Elsa for that one. Hecouldn’t remember his name, age or location whenasked, but could tell you all the complex Latin names ofspells, potions and charms in any movie from one toseven (including seven part 2), even when not asked.His favourite spell, and the most effective one I mightadd, was wingardium leviosa**. He would not onlyrecite the script of Harry Potter for us ver batum, butwould also give us his best impersonations during theward round.

Mr Leavy was a fairly mobile 83 years young, and wasvery animated when he talked. He was an orchestraconductor for over 30 years after all. Unfortunately, thehospital was in short supply of wands, and MrOllivander wasn’t around to prescribe any“dragonstring”, “phoenix feathers” or “unicorn hair”.But when some see obstacles, others see onlyopportunity. Resourceful, Will-gardium Leavy-OH-sahad successfully sourced his filled plastic urinal whichhe had hidden behind his bed for when he was ready todo some over-age magic. Now, just in case you hadforgotten, this patient presented with a urinary tractinfection. This urinal is a literal goblet of fire.

“And ‘swish and flick’”

I got soaked. Again. This is getting Riddikulus. I stoodthere dripping in urine to the sound of child-like gigglesfrom an 83 year old, and stifled chuckles from my

consultant. Great. That’s another outfit destined for the‘yellow bins’. There was no way my blouse was going towithstand my attempts to wash out the E. Coli. I threwit away and had to change into a scrub top for the day.The shoes, however, were a problem for after work.

Another morning I had arrived to do the ward roundand found Mr Leavy very upset, almost crying. This timeI remembered to stand slightly to the right where anearly bit of macular degeneration keeped me out ofdirect eye-line. He was muttering to himself.

“Stupih, stupih, stupid”“What’s wrong Mr. Leavy?”“Stupid, stupid, stupif”

Not advancing in the conversation, I presumed it wasanother Harry Potter-related hallucination and that hewas trying to “Stupefy” me. Well, his spell had worked. Iwas shocked and stunned that I didn’t have a urinalthrown at me this time. Twice was enough.

Several weeks into his hospital admission and ‘Will-gardium Leavy-osa’ had gone back to his old self again.

“Yesterday, doctor, I dreamt I was a wizard”“Oh really?”. Just yesterday.“Yes, but my family just told me it wasn’t real, and I’mreally disappointed. I wish I could have my magicalpowers back.”

When he said that, I took a moment to look at Mr Leavysitting there with a big toothless grin on his face, in hisporridge-stained hospital gown, surrounded by thechaotic ward environment and utterly unaware of thedrama “his magic” had caused for the past few weeks.

“Magical powers?” “Sure who’d want that”

I walked off remembering then, that I still had to figureout what temperature I needed to get the E. Coli out ofmy canvas shoes…

My Most Memorable PatientBy Dr Síle Kelly, NCHD


WiMIN in Cork

Saturday 23 March 2019 10am to 4:30pm

Fota Island Resort

Kindly sponsored by IMO Financial Services and Medisec

Dr Clíona Ní Cheallaigh, Specialist in Inclusion Health at St James Hospital, will give us insights into health inequality in Ireland

Dr Emma Keelan, a Belfast-based Respiratory SpR, will be telling us about her experiences on the frontline in Palestine and Israel with Physicians for Human Rights

Nives Paic from IMO Financial Services will help us to look after our own financial wellness

Aisling Timoney, Legal Counsel, will be discussing the issue of open disclosure and the Patient Safety Bill

Sibéal Carolan from the HSE’s Workplace Health and Wellbeing Unit will tell us about their mentoring programme

Dr Gabrielle Colleran, Paediatric Radiologist, will discuss pay inequality and tips for trainees

This conference offers:

• Free childcare and breastfeeding facilities

• 5 CPD points

• Great food and location, with discounts on accommodation and spa treatments

• Fantastic opportunities to meet with other medical women from around the country, of all grades and specialities

• Pharma-free sponsorship

• Delicious dinner and optional dancing in the evening - if you cannot come to the conference, why not just come for dinner!

• Advice, support and encouragement from peers and heroes

Check out www.wimin.ie


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