Do as I write, not as I do

During a recent clinical shift in the ambulance service, I attended a patient. You know, doing the thing that people consider to be real work (as opposed to the rest of what I do). And something about this patient set me thinking.

The patient’s case was pretty straightforward, there was nothing dramatic, no cars were on fire, no helicopters involved, no rushing to hospital. I assessed the patient, documented my observations, handed the patient over to the transporting crew, and they went to hospital. I was even pretty pleased with myself as I included a National Early Warning Score (NEWS) which is something I have done some of my academic work on so I felt good about that.

It was only later when I thought a bit more about it all and reflected on how my work on NEWS had influenced my decision to apply it in that situation (feeling happy) that I suddenly realised there was something fairly obvious that I had missed (now feeling not so happy). It was nothing that would have dramatically changed the patient care at the time, but it struck me because it was something that I should have done better. Especially as I have done quite a bit of research around why paramedics don’t do this particular thing.

So here I am, writing papers and presenting on why paramedics should do X and why we keep missing Y and then I go and do it myself. Doh! This set me thinking about how I apply what I learn in one area of practice (the academic bit) in the other area of practice (the clinical bit). And more specifically, how do I think I will get other people to do things if I can’t even do them myself?

The difficulty in translating and applying research in clinical practice is a concern for me. I know that if I want my work to have any patient impact (which I do) then I need to have some confidence that there are ways of getting my peers to change their practice. I can sit behind a desk and type merrily away and feel very pleased with myself if I manage to get a publication out of whatever project I am doing. But if it doesn’t lead to some change in the way that patients receive care then I think I have missed the point really. I think this come back to the heart of what I think a clinical academic is. To me a clinical academic is somebody who can work across settings and apply what they learn in academia to patient focussed clinical practice.

I guess I just hadn’t thought about how we can sometimes embody the worst of what we find in our academic lives whilst living our clinical ones. I know this is one isolated incident and as the common saying goes ‘the plural of anecdote is not data’ so I am confident I will remember this next time I see a similar patient. I just hope other people take more notice of my published work than I obviously did.