66 - Todd Rice - Learning and teaching how to “not just do something, stand there”
Release Date: 02/22/2021
Mastering Intensive Challenges - Run Larapinta - Episode 9
Mastering Intensive Care
Thank you for listening to the ninth and final episode of the Mastering Intensive Challenges - Run Larapinta series. If you’ve listened to the series, you’ll know my friend Ed Litton and I entered a four-day stage trail running event, the Run Larapinta Stage Race, and ran, climbed, descended, scrambled and walked with 200 other enthusiastic participants along a mountainous and rugged trail in the spectacular red centre of Australia. Ed and I thought these conversations on the podcast might help others in setting and completing endurance exercise challenges, something we both prioritise in...
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Mastering Intensive Challenges - Run Larapinta - Episode 8
Mastering Intensive Care
This is the 8th episode of the "Mastering Intensive Challenges - Run Larapinta" series and if you’ve been listening to the previous ones, you’ll know that this episode is coming out after the four day stage race that fellow intensivist Ed Litton and I set ourselves the challenge of running many months ago. Two Intensive Care doctors, both novices at trail running, looking for something moderately hard, something we could do together, and something we could talk about on the show to hopefully inspire you and other listeners to go for a run or to set yourself your own exercise challenge....
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Mastering Intensive Challenges - Run Larapinta - Episode 7
Mastering Intensive Care
Fellow intensivist Ed Litton and I signed up for a big challenge 10 months ago when we registered to run in the Run Larapinta, a 4-day stage race in central Australia. We’ve both completed many endurance events, however neither of us have done any serious trail running nor have we ever run 130km in 4 days on a rocky and mountainous trail like the beautiful Larapinta trail in the Northern Territory of Australia. It’s now only a week away so Ed and I had a conversation to update each other on our recent training before answering 5 questions we thought were worth asking each other at this...
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Mastering Intensive Challenges - Run Larapinta - Episode 6
Mastering Intensive Care
To help Ed Litton and I get really prepared for the Run Larapinta stage race we are only a few weeks away from competing in, today we bring a seasoned ultra trail running doctor on to the podcast to share her advice. In this sixth episode of the Mastering Intensive Challenges series, we welcome Dr Cheryl Martin, who is an Emergency Medicine specialist, a podcaster and has huge experience in trail running, including ultra marathons. Cheryl’s podcast, the Mind Full Medic podcast, explores health, wellbeing, optimal performance and professional fulfilment, with a focus on doctors and...
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Mastering Intensive Challenges - Run Larapinta - Episode 5
Mastering Intensive Care
This is the fifth episode in the Mastering Intensive Care - Run Larapinta series. Ed Litton and I are back on opposite sides of Australia, and neither of us has had the perfect three weeks since we last chatted. There are now less than seven weeks until the event starts, so we chat about our training, then swing over to what we are each thinking about the logistical challenges we will be presented with. We hope you’ll enjoy listening to the conversation, even if you prefer the couch to your running shoes. If we can inspire you to get out for some exercise, that would be even better. Thanks...
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Mastering Intensive Challenges - Run Larapinta - Episode 4
Mastering Intensive Care
Here is another episode in the Mastering Intensive Care - Run Larapinta series. For this one, I travelled to Perth to meet with my Run Larapinta co-participant Ed Litton and to head out for a few runs together over a three day weekend. We also set up the microphones to update each other with our preparations and to discuss our perspectives on the social aspects of exercise, mainly endurance sport. We talked about group training, family support, and even using the social media platform Strava to share inspiration. We hope you’ll enjoy listening to the conversation, whatever exercise you...
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Mastering Intensive Challenges - Run Larapinta - Episode 3
Mastering Intensive Care
This is a follow on episode as Ed Litton and I continue our discussion about the Run Larapinta Stage Race we will be participating in soon. Ed and I tell each other how our running training is going. Then we talk about our general views on nutrition and sleep, especially as we lead into a multi-day endurance event. One of us has picked up a little niggle. And each of us has a different approach to what we consume during long runs. It might not be what we talk about on regular episodes of Mastering Intensive Care but we hope you’ll enjoy listening to the conversation, whether you run, walk,...
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82 - Will Bonavia - An ICU trainee’s perspective on learning, culture and wellbeing
Mastering Intensive Care
This episode features the wise perspectives of an Advanced Trainee in Intensive Care Medicine, Dr William Bonavia. The discussion covers: Why he chose medicine and Intensive Care His training journey and his learning strategy What makes a good ward round Learning from colleagues The principles of good communication and collaboration The value of work being fun Making mistakes Dealing with the pressures of the job His thoughts on sleep, exercise, resilience and burnout Gender inequity in training The future of his career Tips for fellow trainees Will Bonavia is an Intensive Care Trainee at...
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Mastering Intensive Challenges - Run Larapinta - Episode 2
Mastering Intensive Care
In this second of a different style episode, Ed Litton and I continue our discussion about the Run Larapinta Stage Race we will be embarking on in August 2023. Ed and I talk about our preparation and then tell each other why we run, and what we get out of it. Ed is a multi-sport endurance athlete whose reasons for getting out in nature are deep and truly inspiring. We hope you’ll enjoy hearing this conversation, whether you run, walk, cycle, hike, work out in the gym, or do whatever is your style of physical activity. Thanks for listening. Andrew Davies ...
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80 - Tub Worthley - A pioneering “Grand Master” of intensive care
Mastering Intensive Care
This episode features the memories, experiences and wisdom of Dr Lindsay ‘Tub’ Worthley, AM. The discussion covers the following: Tub’s training to become an intensivist when no specific training existed His experience at a time when Australian ICUs were in their infancy The difference between the beginning and the end of his clinical career His eventual transition to retirement His writing of textbooks, scientific papers, editorials and a memoir What he learned about humanity in the ICU Working and communicating with various team members Enthusiastic leadership and the importance of a...
info_outlineThis wide-ranging episode, covering many angles of how we should consider doing less interventions to our patients and more transparent communication to their families, features US intensivist Todd Rice.
Dr Todd Rice, is an Associate Professor of Medicine in the Division of Allergy, Pulmonary, and Critical Care Medicine at Vanderbilt University Medical Center (VUMC) in Nashville, Tennessee. Todd is a clinical intensivist, the Director of the Medical ICU (MICU) and the Medical ECMO Program, and leads VUMC’s MICU strategy for the care of COVID-19 patients.
In addition, Todd leads a substantial research program as a clinician scientist, and is co-chair of the Learning Healthcare System at Vanderbilt where the motto is "Learn What We Do and Do What We Learn." Professionally, he is proud of the evidence he has generated to improve the care of critically ill patients and the mentorship he has provided to other physician scientists. He loves ice hockey (watching, not playing) and is completely into enjoying life with his two sons.
Todd graduated from the University of Notre Dame and completed Internal Medicine residency at Indiana University School of Medicine. He completed Pulmonary and Critical Care Medicine fellowship training at Vanderbilt University where he obtained a Master’s of Science in Clinical Investigation.
Other roles Todd serves in include:
- President of the American Society of Parenteral and Enteral Nutrition
- Vice President for Clinical Trial Innovation and Operations in the Vanderbilt Institute for Clinical and Translational Research (VICTR)
- Critical care principal investigator for the Prevention and Early Treatment of Acute Lung injury (PETAL) clinical center at VUMC
- Medical Director of VUMC’s Human Research Protections Program
Todd and I recorded this conversation in March 2020, just before the COVID-19 impacted fully in our respective countries. I didn’t feel I should put this episode out during the crisis of 2020 so I held it back until now. I also asked Todd if I could interview him a second time now (in February 2021) to freshen up the interview with some perspectives on how COVID-19 has affected he and his colleagues in Nashville.
I hope you will gain immense value from what Todd speaks about on this episode, including:
- Why he’s considered an ICU junkie and how he’s changed over the years
- The principle of “Don’t just do something, stand there”
- Understanding the confidence/competence balance
- His 4 box method of understanding a critically ill patient’s situation
- The concept of the second victim with mistakes
- How transparency to families builds substantial trust
- Why he praises nurses in front of patient’s families
- The structure of the ward round at his ICU
- The importance of empowering nurses to ask questions
- His note-writing practice, and it’s benefits and risks
- His practice to look after himself during periods of clinical service
- The benefit of a mix of clinical and research work
- The importance of pragmatic trials studying things we are already doing
- His institution’s Learning Healthcare System and how it is used
- Some overall career tips
- How COVID-19 has affected his ICU
- How the ICU team is taking care of each other
- His ICUs struggle with harsh visitor restrictions and how they relaxed these safely
Please enjoy listening to Todd Rice.
Andrew Davies
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About the Mastering Intensive Care podcast: The podcast aims to inspire and empower you, through conversations about the human side of Intensive Care, to bring your best self to the Intensive Care bedside, with a focus on compassion, collaboration and personal wellbeing.
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Links related to Todd Rice
Todd Rice on Twitter @toddrice_icu
Links to other resources (in order of mentioning)
ARDSnet low tidal volume strategy study
Links related to Mastering Intensive Care podcast
Mastering Intensive Care podcast
Mastering Intensive Care page on Facebook
Mastering Intensive Care at Life In The Fast Lane
Andrew Davies on Twitter: @andrewdavies66
Andrew Davies on Instagram: @andrewdavies66