Communication is an innately fascinating and, on occasions, a somewhat mysterious topic. At its heart, it is the means of expressing, both to ourselves and to others, how we perceive the world and how we influence the world around us. It is a tool for exchanging information and meaning, but also a way to connect with others. While obviously a means to an end, it is also an end in itself—without the ability to share with others, life would be greatly impoverished. The many human dimensions of communication— the practical, the social, the linguistic, the lyrical, the subliminal, its ability to soothe and to injure, to inform, to entertain, to terrify—are what make this topic so challenging. Anaesthesia has come a very long way since the 1840s. The advent of safer and more selective drugs, coupled with ever more sophisticated technology, has made the practice of anaesthesia safer, yet also more complicated. The patients that we treat are often older, have multiple co-morbidities, and are undergoing procedures that would have been unthinkable 20 years ago. Yet with the increasingly complex workload have come the additional pressures of time and resource allocation. Patients are admitted on the day of surgery, leaving minimal time for anaesthetic assessment. Anaesthetists are frequently busy, isolated and unavailable when working in theatre, or find themselves working at multiple sites with little opportunity for interaction with colleagues. Similarly, theatre staff rarely work in the same operating room with the same team on a regular basis. The hospital administrators are under constant pressure as they strain to contain costs and reduce length of stay, while wards are increasingly understaffed and overworked. In the midst of all this, patients are left wondering who is actually caring for them, and if anyone is listening to their concerns. Anaesthetists play a crucial role in multi-professional teams in a wide variety of clinical settings of which theatre is only one. There is the high dependency unit (HDU), the labour suite, paediatrics, the chronic pain clinic—to name but a few. In almost every aspect of anaesthetic clinical practice the ability to communicate effectively is a vital component of patient care.
The Anaesthetic Assessment, Management and Risk Factors of Bariatric Surgical Patients requiring Postoperative Intensive Care Support: A State-Wide, Five-Year Cohort Study
