Sean G. Smith, MSc, CCRN, CEN, CPEN, RNC-NIC, is a nurse at Critical-Care Professionals International in Graham, Florida, USA. He has been actively involved with the Society of Critical Care Medicine (SCCM) since 2011 and is a member of the hemodynamic monitoring course task force. His hobbies include homesteading, languages, scuba diving, tropical/travel medicine, and working on vintage vehicles and guitar amplifiers. His clinical interests include resuscitation, shock, and trauma. Mr. Smith provides advice for those getting started and reflects on his critical care career journey.
Why do you love being in critical care?
Cross-pollination! As a nurse-paramedic triple-boarded in critical care medicine in neonates, pediatrics, and adults, with a background in molecular biology and nuclear engineering technology, I believe critical care should be truly translational among various research and practice arenas and patient populations. We can all learn from each other, and there are always new things to learn and novel avenues to apply knowledge.
How did you get into critical care?
I can't say exactly why but, even from early childhood, I honestly don't think I ever considered anything other than patient care in critical care and emergency medicine. Even outside the ICU, I have always viewed various patient arenas, such as prehospital and humanitarian medicine, through critical care lenses. After undergraduate work in molecular biology, I joined the military and, among other roles and responsibilities, I cross-trained in a medic capacity.
On the civilian side, I went straight into critical care and never looked back! I have been blessed with incredible mentors and role models every step of the way who inspire, encourage, and enable continual, relentless forward progress. I only hope I can quietly do the same for others.
What do you see as the most challenging issues facing critical care?
I see at least three:
1. Lack of focus on foundational first principles in both education and practice, resulting in a concomitant lack of intimate understanding
2. Volume-driven revenue streams that dehumanize and de-emphasize the patient
3. Emphasis on publishing or perishing leads to gaming the system; garbage in, garbage out errors; and quantity, not quality in the literature (to say the least)
What advice do you have for those starting their critical care careers?
Smith's Laws (the shortlist):
1. Optimizing cerebral perfusion pressure is always the right answer!
2. Remember the H’s: Be humble, hungry, and hardworking.
3. Channel your inner two-year-old and be utterly fearless in your psychological safety to always ask why and make sure you understand why you are doing what you are doing.
4. Be a clinician, not a technician!
What are the top advances in critical care since you started your career?
Aside from the evolution of damage control resuscitation, my personal focuses revolve around global health, critical care education, and optimizing outcomes. Thus, to me, some of the top advances in critical care include increasing awareness of/focus on truly comprehensive safety/process improvement systems, point-of-care testing, and point-of-care ultrasound. Bonus round: From a pure geekatudinous goodness point of view, attitudes and advances in circulatory assist science, technologies, and applications have come a long way since the CESAR trial, etc.!
What is your biggest professional achievement?
Making a difference in the lives of others. Aside from my patients and students at home and abroad, I have led and/or participated in over 50 capacity-building medical missions in eight different countries over the past 12 years, training hundreds of clinician-educators, treating hundreds of patients, and serving during Haiti's 2010-2019 cholera epidemic as well as working with the World Health Organization in the Hot Zone during the 2014-2016 Ebola outbreak.
What industry trends excite you about the future?
Aside from the specific advances I already mentioned, in general I am passionate about team dynamics, performance optimization, and individualized patient-/family-centered care. Focusing on each of these areas has the potential to produce a wide spectrum of genuinely holistic and meaningful outcomes.
What do you love about SCCM membership?
Unparalleled opportunities for networking, engagement, and enfranchisement in meaningful work
Connect with @Sean Smith on SCCM Connect.