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With the rise of the Black Lives Matter and #MeToo movements in the last few years, media attention has been drawn to the abusive behaviours that have become embedded in our culture. Under the Equality Act 2010, it is against the law in the UK to discriminate against anyone because of nine ‘protected characteristics’. These are race, age, gender reassignment, being married or in a civil partnership, being pregnant or on maternity leave, disability, religion or beliefs, and sex and sexual orientation.

A survey among doctors and medical students highlighted that 76% had experienced racism in the work place at least once in the previous two years.¹ Similarly, 91% of woman doctors in the UK have experienced sexism at work,² and a survey among European surgeons revealed that 20% had considered quitting their job due to discrimination.³ While surgery is a specialty where discrimination and harassment concerns have been well documented, these issues have not been explored widely among anaesthetists.

They're the fresh faces of anaesthesia and the future of our specialty.

We introduce you to some of our newest anaesthetists in training. We hope all of them and the rest of our trainees have very long, rewarding, and fulfilling careers as anaesthetists.

Author: Dr Dave Murray, Consultant Anaesthetist South Tees NHS Trust; Chair NELA

The National Emergency Laparotomy Audit (NELA) is 10 years old this year, so this is a timely point to review progress, highlight achievements, and look at the persisting challenges ahead.

In the beginning

NELA was commissioned in 2012. One of the key pieces of evidence to support its funding was the paper published by the Emergency Laparotomy Network.¹ This observational study of more than 1,800 patients highlighted a 15% mortality rate, but with a nine-fold variation in mortality across the 35 trusts. Consultant presence was 74% for surgeons and anaesthetist presence was 64%. Half the patients were admitted to critical care, and patients returning to the ward had a 6.7% mortality rate.

We're delighted to announce that since September 2022 we have welcomed new elected and co-opted Council members.

The main purpose of Council is to provide clinical leadership to the specialty, set standards for education, learning and examinations, and ensure adherence to evidence-based practice.

It is the role of Council members to make sure that the College represents the needs of members and the profession. Find out more about new Council members in this article.

Wellbeing is a fashionable term at present and for some will cause instant eye-rolling. We sympathise with this reaction – the word has a lot of unhelpful connotations including, probably most problematically, that it offers yet another opportunity to fail at something else in your life. You are already overwhelmed by work and home stressors, and now you’re also not getting your wellbeing right and that’s why you’re struggling.

Please know this gentle advice comes from a place of compassion and acknowledgement of the wonderful job you all do. After everything anaesthetists have had to deal with over the last few years, we tip our hats to the courage and resilience of our profession.

Here are some top tips for anaesthetist wellbeing (in no particular order):

At Newham University Hospital there were extensive refurbishments taking place in order to make the theatre complex compliant with current fire-safety regulations. As well as this, there have been a number of fires in intensive care units in the UK over the past decade requiring full-scale staff and patient evacuation.

We realised that we were unsure ourselves of how we would manage such a situation, and so we looked up whether there were fire-safety guidelines specifically for anaesthetists. We came across the recent Association of Anaesthetists fire-safety and emergency evacuation guidelines, published in May 2021. One of the key recommendations was that all healthcare workers should have ‘practical walk-through and/or simulated evacuation training’ at least every two years.

I am a huge fan of the Beano and sent feedback to the Royal College of Anaesthetists about a special collaborative edition I had read, Dennis has an anaesthetic. My Granny was in hospital at the time, and I was worried about her. She had broken her ankle. I read the Beano comic to help me understand and feel better about her being unwell and having an operation.

Children’s anxiety related to hospital admissions and procedures is a huge problem and affects up to 80% of children. 75% experience anxiety in the anaesthetic room, and 60% develop ‘new’ dysfunctional behaviour in the three weeks after surgery. Sadly, 12% still display this new behaviour one year after surgery. In the US, surveys show that 25% of children are held down for a general anaesthetic.

Dennis has an anaesthetic teaches children about:

• finding out about the operation
• getting ready for the operation
• having the anaesthetic and operation
• waking up and going home.

Understandably, well-being means something different to all of us, but does it have more awareness and recognition than 20 years ago?

Dr Marie Nixon, Consultant Anaesthetist and Dr Thom O'Dell, ST7 Trainee discuss their experiences of wellbeing and what it means to them.