Episode 7

[00:00] Sarah: Hello and welcome to this Multidisciplinary Life. Friends, we are back with season two, but first a thank you. I‘m grateful you‘ve given this podcast your attention, and it‘s my commitment to you to continue sharing insightful, genuine, and fascinating conversations with people involved in and leading multidisciplinary teams.

[00:19] I‘ve loved the feedback so many of you have shared with me about season one and the conversations that this podcast surfaces. If you haven‘t already subscribed to the podcast on YouTube, Spotify, or Apple. Please take a quick moment to click that button. Okay. Let‘s get into this episode. I‘m very excited about my conversation with today‘s guest.

[00:38] Danielle Corden is General counsel for the Royal Women‘s Hospital, one of the oldest and most distinguished women‘s hospitals in the world. Danielle is involved in some incredible work, but also some incredibly challenging and very human-centric work. Her role involves working with all kinds of specialists while navigating different fields of expertise.

[00:56] Providing exceptional patient care for women, girls, and their families is truly a profoundly multidisciplinary practice. But today‘s conversation has valuable lessons for leaders of all kinds of teams. We cover questions such as how do you provide a sense of structure and safety when no two days are the same?

[01:15] What happens when multidisciplinary work is challenging and not the shiny success story we might hope for? Or generally hear about? How do we ensure our teams are looking after themselves when faced with confronting and difficult situations, and what can we offer to help our teams continue to build their resilience?

[01:34] This conversation elaborates on all these ideas and more. But let‘s get into things and chat through this multidisciplinary life with Danielle Corden from the Royal Women‘s Hospital.

[01:50] Danielle, thank you for joining me today. I‘m so excited we‘re having this conversation. Thanks for having me, Sarah. I‘m really looking forward to it. So we have a lot to talk about. Before we get into some of the detailed topics that we‘re gonna cover, I‘m really interested to know what brought you to the law?

[02:06] Danielle: What brought me to the law, or what was the catalyst for me to apply to study law at uni? Was not because I wanted to practice as a lawyer. I was really interested in. Crime and crime prevention and laws that centered around why people were committing committing crimes. So that was what brought me to apply to study law.

[02:32] Sarah: Wow.

[02:32] Danielle: And I did do a dual degree in law and criminology and criminal justice at the time. But by around halfway through that double degree. I did start to form a passion with advocacy and prac, and the idea of practicing in the loss became something that was a bit more appealing for me then.

[02:55] I was also quite young, so I was 16 when I needed to put my preferences in for uni. So the idea of practicing law at that age was not something that I, that had occurred to me true as I was developing and studying law. Then I started thinking of areas of law that I might want to practice in. And by around my third year, I discovered taught law.

[03:19] And that really interested me. I loved reading the cases around medical negligence and I think, to be honest, it was the stories, there were real people involved. It wasn‘t company A selling shares to company B or someone wanting an easement over this part of the property. There were real people that I could relate to.

[03:43] And that‘s when I thought. If I was going to practice as a lawyer, that this might be an area of law that I would be interested in practicing in. Wow. Wow. Yeah, so that‘s what initially brought me into the law. And then perhaps what kept me in the law was what I discovered during those initial years of studying law.

[04:05] Sarah: Fascinating. And you‘ve spent most of your career within health? Within health law as well.

[04:12] Danielle: Yeah, so my final year of the double degree, I was already noticing this passion for health law and I did my honors paper on a health law topic. It was about like disclosing health information to family members without a patient‘s consent.

[04:30] So I was already at that point thinking, I‘d like to see this in practice. It‘s not the easiest area to get straight into. And it does require a knowledge of medicine or health systems to be able to give advice. Whether that‘s to doctors or to hospitals or nurses or any other clinician, you really need to have a good understanding about the system in which they work.

[04:59] And I think by the time I graduated, I was. 22. So at 22, I probably hadn‘t been admitted as a patient in the hospital before either. So I had a lot to learn and I started in health and in a team that was health and aged care and disabilities.

[05:19] And once I had been admitted as a lawyer and I had completed my graduate diploma of legal practice, then I started my masters of law and I majored in health law.

[05:29] So I think the passion for health has always been there and I continued to learn whilst I was doing my masters and started practicing then.

[05:40] Sarah: It‘s really interesting that you describe. Health law as n needing to know the system in order to practice within it. ‘cause it is quite unique in that sense that it‘s an area of law that is quite specialized and you really do need to understand the people operating within that sector and within the space and how the systems work.

[06:06] Rather than just the law and how the law is applied to different situations it‘s much more intricate and complicated.

[06:13] Danielle: Very. And the knowing the law is, maybe half of it. And I remember as a junior lawyer T trawling through at that time, they were medical records that were hard copies and needing to read the medical notes and no.

[06:32] How to work my way through a file. So a patient‘s file, I learnt where progress notes were kept. I knew where a medication chart was kept. I knew where alerts were and I would need to work my way through. I needed to know the acronyms that were used. I needed to know. What a registrar was and a resident and a consultant and I worked across three jurisdictions.

[06:57] So I‘ve worked in Queensland, in Western Australia, and now in Victoria. And even across those three states, they use sometimes different titles for different positions as well. I needed to learn what they all were. And I haven‘t told you yet, Sarah, so it is a bit of a disclaimer now, but my husband is a doctor and so I do think that has helped me definitely to understand training programs that doctors go through.

[07:23] And what it means to be an advanced trainee, what it means to be a registrar. I can relate sometimes to registrars if I‘m having to take a statement from them about an incident. And I can say I know you‘re working the night shift and who else was on with you? I don‘t make any assumptions that people were there.

[07:41] And I am, I‘m able to ask some of the questions about their training program or where they‘re up to. I think it helps them to know, I know the system that you are working in.

[07:52] Sarah: Yeah. And that you understand their pain points and if they are facing a difficult area of their training or their development that.

[08:02] You are aware of that path that they‘re on as well?

[08:06] Danielle: Yeah, definitely. The path that they‘re on, the hospital that they are in. I‘ll know that they may not have been at that hospital for long, that they are rotating through. And I‘ll ask those questions. How long have you been here? Where were you beforehand?

[08:21] Did they have the same system as this hospital has? How long did it take to get an MRI at that other hospital and how long does it take here? I don‘t assume that anything is ever alike and they‘ll be able to tell me some of those pain points and. Assist me in those cases if I am defending a claim.

[08:39] Sarah: Yeah. It‘s very much like you‘ve learned another language alongside learning the law and practicing law. You‘ve also learnt. The systemized language of health. And the terminology.

[08:52] Danielle: Definitely the terminology, the pronunciation. I found it was really important to be able to pronounce the words right.

[08:58] Especially as a very junior lawyer, if I I often felt within myself that perhaps there was this obstacle for me to prove that these doctors who may have been. Investigated. And then they‘re coming to meet the lawyer and they see this young person in their twenties and thinking, is this the lawyer that‘s representing me and my medical career?

[09:20] And not that anyone ever said anything like that, but I certainly felt it. And so I would over prepare and I would research the procedures, the surgeries that. That had taken place and make sure I knew every bit of the anatomy. So when they didn‘t need to explain that part to me, they could just tell me what happened intraoperatively and using the right language I think helps as well to build the trust that was so important when they are in such a vulnerable state.

[09:52] Sarah: Yeah. Yeah. It‘s interesting going back to your interest around crime. I remember when I applied to study law and I had such an interesting crime as well, and I thought maybe I‘ll, whether I go into prosecution or criminal defense and do I, what do I go into?

[10:09] And as I started learning about it and reading case law and really getting into it during law school, I thought. No, this, that, that is not for me. And I have a lot of admiration and respect for for criminal lawyers and what they face each day I think is it‘s tough and interesting and, but the human side of the law in many respects, similar to health there‘s so much human focus and patient focus on aspects that, could be very dry if we only view them as legal. But there, there‘s always humans at the core, at the center of it.

[10:43] Danielle: That‘s right. And there wouldn‘t be a day that goes past in the decisions that I make that aren‘t patient centered now with the health or have a human. Factors consideration whether that‘s within the medical teams or nursing and midwifery teams, allied health that‘s at the center of the decisions that I make.

[11:04] Sarah: Danielle, I‘m conscious your work is very broad and varied at the Royal Women‘s Hospital. Can you tell me a bit about what a typical day or a day might look like as general counsel?

[11:16] Danielle: So it‘s very hard to describe a day. Truly no two days are ever alike. And the work I can try and prepare for what my day will be like in terms of the meetings that I might have.

[11:31] But the sheer nature of working at a hospital means patients are coming and going 24 7. And so I never know when I might receive a call and someone asking me to assist with a patient who is there right now, or a visitor who‘s present. My, the role of the, of a general council at a hospital is broader than providing some advice to the clinical team.

[11:54] So I also sit on the executive committee and we report to the board. And so there‘s a number of board subcommittees that I‘ll attend and I report to about legislative compliance. About legal claims or cases that the hospital might have, and also the strategic part of a hospital and running a hospital and what that, what the hospital might look like today and in three years and in five years, and making sure we‘re setting up for that.

[12:21] Sarah: It‘s interesting. It sounds like there‘s such a mix of really being. Facing patients and being on the floor with the team and understanding that context, but also the executive and operational and systems layer of. Organizational wide and what that looks like for the hospital and then being within the two day to day, depending on what‘s happening as well.

[12:44] Danielle: Yeah. So there is definitely a juggle with that. And sometimes I‘m running from one floor to another and I‘m very. Fortunate that the hospital is very welcoming of legal presence. So I‘ll attend every week. What is called the laws meeting. It has nothing to do with the law. I discovered after my first meeting, it‘s a learning opportunity and review of like adverse or sentinel events.

[13:10] And it‘s really important and helpful for me to sit and listen and hear when the team are investigating or considering why something happened or what, whether it was a, some systemic issue. And I can sometimes take those issues back to the executive team.

[13:26] And I can also assist from a legal perspective if someone‘s asking questions about.

[13:31] The way care was provided or if if there‘s some concerns about a transfer of a patient to another hospital and I can sometimes assist once someone asked me, I think a patient‘s family member had recorded their birth, which is not uncommon but hadn‘t asked the rest of the staff if they were okay with being in the recording.

[13:52] And then that was later published online, right? With the staff members faces and name badges. Clearly visible. And the hospital does have a policy about that. And so that issue was looked at in that meeting and I was able to assist. But most of the time in that. In that meeting, I‘m listening.

[14:09] I do a lot of listening. I attend sometimes multidisciplinary team meetings where there are complex so patients with complex needs and often very multidisciplinary. It will, there will rarely, I rarely be one discipline. And me or my team, it will be multiple disciplines within the hospital.

[14:31] And same with the executive team. It is it is really important that at that table. Yes, there is a legal presence, but there is a finance presence. There are people matters, pe representatives. Quality and safety is at the forefront of every decisions that we make. As long and as well as our CEO and operations.

[14:51] Sarah: Yeah. Quite a mix.

[14:52] Danielle: Definitely. Yes.

[14:54] Sarah: There were two things you mentioned just now that I‘m keen to go back to. In the abbreviation for laws, you mentioned adverse events or sentinel events. What is a sentinel event?

[15:04] Danielle: Oh, sorry.

[15:04] Sarah: The language the lingo, the terminology.

[15:07] Danielle: Yeah. And it does differ between states as well.

[15:09] In Victoria we have what we call the SAPSEs. And again, it‘s reviewing an instant where a patient may have had a, an outcome that was unexpected. And so we are looking at that outcome to say how did this happen? And should this have happened? Is this a known risk or complication of a procedure that the patient was aware of?

[15:30] And in the future, is there anything we can do? To prevent this from occurring again. And sometimes they won‘t be, sometimes this is just the nature of medicine. That it carries risk. Yep. But how do we make sure patients then know that these risks exist? And. Certainly at the women‘s hospital, they‘re very good at having conversations with patients about the risks and what are the material risks for that patient, and having a discussion with them at the time that they are consenting to a procedure.

[16:02] Sarah: It makes a lot of sense. And hence the learning upfront in that meeting. Super important.

[16:07] Danielle: Yes. Learning opportunities is the beginning. So definitely nothing to do with any law. Nothing to do with the law. No. No.

[16:16] Sarah: And the multidisciplinary review that you described, what types of disciplines would you typically see in that review?

[16:23] What does that look like?

[16:24] Danielle: It really depends on what the incident. Was and what was involved. But it could include members of the medical team. Which might be for the women‘s hospital, typically obstetricians and gynecologists, it might be members of the neonatology team. It might be pain specialists, it might be in attendance.

[16:45] And additionally, the nursing and midwifery teams, they often really lead those multidisciplinary reviews. I‘ll hear them. And there‘s also allied health members involved. Sometimes we might have, depending on the nature of the investigation members from the access team about, the flow of patients through the hospital, right?

[17:07] Let‘s say there‘s a delay in moving a patient from one ward to another ward or to the birth center and they can comment on what was happening at the best center at that time or what was happening in the operating theaters that. Cause this patient to have to wait for their operation to, to start.

[17:25] Yep. Sometimes the social work team are involved. So that might be to do with social issues that the patient might have and they can assist the clinicians in knowing how to provide. It might be a trauma informed care or other matters that might be happening in that patient‘s life.

[17:42] Whether they might have children at home that are. To be cared for or they might have issues with their partner and they might be making decisions about who they want to visit them. And so the social work team might be involved in that multidisciplinary review of an incident, or sometimes we meet before an incident has occurred and we plan about how patient‘s care what their path within in the hospital will look like.

[18:06] So before they‘ve even stepped foot in the hospital. We sometimes have spent hours planning for that patient‘s arrival. Not just about medically what procedure‘s going to happen, but how their journey in the hospital from the second they take a first step into the hospital, who is going to meet them at the door sometimes Wow.

[18:26] To, when they‘re discharged home and who‘s gonna follow them up.

[18:30] Sarah: Wow.

[18:30] It‘s genuine patient-centered care, isn‘t it?

[18:33] Danielle: It truly is. Yeah. And now, like I worked previously in private law firms and I acted for a number of hospitals, but being at the Royal Women‘s Hospital I really see how decisions are made.

[18:47] And how patients‘ needs are at the forefront of every decision.

[18:53] Sarah: Yeah.

[18:54] Danielle: As they should be.

[18:55] Sarah: As they should be. Yeah. Absolutely. Through the years of your experience, have you developed a bit of a sense or a feeling of when you are approaching one of those multidisciplinary reviews you know who is likely to be in those based on.

[19:12] The case or the situation that you‘re walking into. Have you developed that experience over the years as well?

[19:18] Danielle: Yes, I have. And that‘s because I have worked on a number of cases, so I will know a particular type of case. Will involve the anesthetic department, for example. And so I‘ll know that they‘ll need to be there.

[19:33] I‘ll know that sometimes the pain specialist isn‘t anesthetist. Okay. And I know that from my experience in other cases and understanding the differences between obstetrics and gynecology, they‘re very obvious to me now, but they often are referred to as obstetrician and gynecologist as the one title.

[19:52] The same type, yeah. Yes. But they‘re very different disciplines. And some clinicians will work across both. And that‘s not uncommon, but some will focus on one area. Sometimes at one part of their career, and then they might move to another, to the other area later.

[20:08] So I can usually work out who should be at some of these meetings.

[20:14] And I think having the right people at the table when you‘re discussing the cases is really important. I can imagine. Yeah. So in the planning stage, sometimes I have more of a role in the investigative stage. I think I should have less of a role. And I‘m only there to provide assistance if it looks like the investigation is going to move down to a more litigious or legal path.

[20:41] Sarah: Yep, yep. And then you can provide that lens with expertise.

[20:45] Danielle: Exactly. And guide the team on where things might go.

[20:49] Sarah: I have this theory that lawyers working in multidisciplinary teams or within multidisciplinary environments are better at navigating change because you are working with so many different perspectives and different backgrounds and viewpoints on a daily basis.

[21:07] How do you feel about that? Do you feel like you‘re better at managing change because you are in this type of environment? What does that look like for you?

[21:15] Danielle: I think I‘ve been working on managing change for decades. I remember reading a book who Moved My Cheese and that would‘ve been in the early two thousands.

[21:26] So it‘s an area that I feel uncomfortable with change, but surrounding myself with people who have differing views. It doesn‘t concern me. It helps me. I like hearing other people‘s views on something. I‘m not often asking people just to agree with me, and if people disagree, that doesn‘t cause me any alarm.

[21:53] I want to know more then tell me why this isn‘t gonna work for you. Yep. And so I think in my early career or working in a law firm, I was surrounded by other lawyers. We tended to agree with each other. Unless of course they were acting on the other side of a matter, then that would be very odd.

[22:13] But. In the hospital setting, it‘s, I think it‘s important to work within the team and to navigate. So when I go to some of these meetings, I‘m not going to say, this is how it needs to be. I‘ll say, tell me. I might go in there thinking that I know how it needs to be, and then I‘m often proven wrong. And that‘s okay.

[22:39] So I will go in and seek their views, ask them. What would happen if I suggested this? And hear what they have to say, and then I might change my position.

[22:53] Sarah: Yep.

[22:54] Danielle: And I‘m okay about doing that. I think that makes me a better lawyer.

[22:59] Sarah: It‘s interesting how you described asking the team what would happen if this were your view and really testing that assumption or testing that almost experimenting with scenario. Playing out to say what happens if we go down this path?

[23:15] Danielle: Yes. And I guess that has come from experience and also being married to a doctor who will often tell me, the law makes no sense sometimes in the practice of medicine.

[23:27] He works in an emergency department and I‘ll sometimes question, the legal side of whether something happened the way. The law says it should. And he‘ll explain to me why. There‘s no way that would ever happen in practice. So it‘s important for me. I can, I, I know some examples where I have suggested that it might be legally right.

[23:50] And okay to proceed down a certain path. So that could be something like taking someone to have a cesarean if they had. Lost capacity to make decisions or have someone get a blood test taken. And they might be not agreeing to do that, but they have la they don‘t have capacity to make those decisions.

[24:10] So there‘s been a clinical decision made that the individual does not have capacity, and that is the first question I will ask. Does the patient have capacity to make these decisions for themselves? And if they do, then that is the decision we follow. If they don‘t, then sometimes I‘ll say the law would allow you to do this.

[24:31] But that doesn‘t mean that it‘s that straightforward. No. And that‘s why it‘s important for me to say, what would it look like? Logistically, and sometimes if even something as simple as taking someone‘s blood will have. An anesthetist present. They‘re very good at getting access to patients and being able to take blood.

[24:51] And so they would be the best person in the hospital to do that.

[24:54] But we might also have a social worker there. We might also have the medical team there. And so it‘s about working together to say this, the law allows you to do this, but what support would you need to get to where you need to go.

[25:11] Sarah: So it sounds like no pathway is ever straightforward. It‘s never really a yes or no decision. It very much depends on what the patient needs in each case as well.

[25:22] Danielle: Yeah, there are occasions where I can give some very clear and advice about. What the law says about a particular case, but how that is used or interpreted will apply differently to different cases.

[25:38] And the medical team might tell me this procedure is important. It is lifesaving, for example. Then my advice will be tailored to that. If that changes. If that procedure is now no longer life changing, my advice needs to change too. So as the patient‘s journey goes around and up and down in a rollercoaster.

[26:03] Sometimes my legal advice will do the same thing. And sometimes we end up back at the beginning of the first advice that I had given. And as a lawyer that can sometimes feel uncomfortable when you have given your legal advice and then you need to now change it. Based on new information that‘s come to hand.

[26:21] But ultimately you‘re wanting to make sure that the team are equipped with the knowledge that they need and the safety net to proceed down a particular path. And that‘s the most up to date and accurate advice.

[26:34] Sarah: Absolutely. And I can imagine. The advice needs to change where the risk changes as well so that you can balance the risk.

[26:42] Danielle: Yeah. And that would occur every day. The medical teams will be balancing those risks every day for a patient. And same with the legal risks. Yeah. And as a hospital, they will then consider and manage risk as well. For each individual case or it might not be patient specific, but it might be to do with an entire unit and how a particular unit will function and what impact that might have.

[27:07] Sarah: I can imagine also being able to change your advice based on new information and communicate that change. Helps to lift the knowledge and context and understanding of the multidisciplinary team that you‘re working in and the different medical professionals, their understanding of you and your expertise as well, because you can take that new information and know that the advice does need to change.

[27:34] In this instance, it‘s not just regardless of the information. This is the advice it that would be really helpful to the team. I could imagine.

[27:42] Danielle: I think so, and I think they appreciate my inquisitive nature of asking questions about the case. And also often that might mean if someone emails and says, oh, this is my legal question.

[27:56] Can I record this in the medical records? I will give the person a call and say, tell me about what‘s happening. And tell me more about the patient. And the patient requested that this not be in the record. Tell me why. Okay. And these are your legal obligations to make sure medical records are accurate and up to date, but you are now balancing that with a patient who has asked you not to put certain information in their medical record.

[28:22] That medical record belongs to that patient. And so we talk about whether it‘s clinically relevant, the information and does that need to be, is it important that the next person who‘s gonna provide care? ‘cause it might not be the same person who took the note. Do they need to know this information?

[28:38] So absolutely there‘s always this balancing of risk respecting patients‘ rights and autonomy and providing a safe system for staff to work. And educating the staff too about what the laws are around certain areas and how they can not worry too much all the time about Yeah. If they‘re going outside the law.

[28:59] Sarah: Yeah. They can focus on doing what they‘re good at, knowing that there is the safety net and the support structures in place.

[29:06] Danielle: Yeah. Without that fear, that might sometimes sit there.

[29:09] Sarah: Yeah. I wanna change direction a little bit. Danielle I‘m really interested to know, because of this varied landscape that you operate in, how do you maintain your resilience working as general counsel at the hospital?

[29:26] I can imagine. It takes certain strategies and techniques and ways of being to ensure that you stay well and healthy and optimistic as what too.

[29:38] Danielle: Yeah. I, it‘s not hard to be optimistic. Working at the women‘s hospital, I see such great care being provided every single day. And so I know when there is a case that I‘m working on that, that falls into the minority of cases.

[29:53] I think my experience before coming to the women‘s hospital has definitely assisted, so I worked in private practice in health law, in medical negligence space. I worked in the disciplinary space too, where I defended doctors who were being investigated by the medical board. And I think that area really built my resilience.

[30:13] I saw the stress that those clinicians were under. And I also worked in the coronial space. For those that might not be aware that the coroner‘s court was, investigating unexpected deaths. And obviously mine was very focused on the health area. And so I think for me it was about knowing this is not my story.

[30:38] And I learned over time not to worry that what was happening to patients would necessarily happen to me. And that became tricky when I fell pregnant. And was having my first baby, because up until that point, everything I knew about obstetric care was when things went wrong.

[30:59] So 99% of what I knew was when something had gone wrong.

[31:03] And I needed to remind myself. Multiple times a day that that represented a tiny percentage Yeah. Of what happens in the world. Yeah. It‘s easier now at the women‘s, I see all the beautiful positive stories and the wonderful home birthing program that the women‘s has and the caseload program.

[31:26] So I can see great outcomes and uneventful pregnancies and labors and deliveries. But when I first fell pregnant, I wasn‘t working at the women‘s hospital, but I was working in obstetric medical negligence cases. So I had to teach myself as I was reading cases to, to say, this is not my story.

[31:46] And I could close the file and then put it back on the shelf as I did then. Now it‘s all electronic, but as I did then, and then get the next one. And work on it. Sometimes in some really difficult cases where there may have been a death or a very bad outcome. Sometimes I would listen to a guided meditation to begin with.

[32:10] It was like a five minute meditation and it was to ground me. And. To make sure I wasn‘t already in a fight flight response. Which is not uncommon in a law firm. When you are working on lots of cases and you‘ve got your billables and you‘re just go. And then if you‘re like go pick up a case.

[32:26] Whoa, this hits you hard.

[32:28] Sarah: Yeah.

[32:29] Danielle: Sometimes you won‘t know when you first open the case, what it‘s going to be until you start reading it. So some, it was important for me. If I knew that the case that I was about to read could be triggering for me, then I would stop and take a breath and remind myself of my role in this case, and then at the end tell myself, this is not my story.

[32:55] This is not happening to me.

[32:57] I can still have empathy for the patients, even when I am defending the hospitals. Yeah. And I think that makes me a good defense lawyer. People often think that if you‘re on one side or the other, I. If you‘re acting for the patients, you‘ve got this big soft heart and you with high empathy, but actually I have very high empathy and I don‘t shy away from that. So I will acknowledge that something is really sad. If that‘s how I feel, that doesn‘t mean somebody will get a big payout. But I can still acknowledge that something is sad or it‘s not the way that they thought their health journey was gonna go.

[33:39] Sarah: Yeah. That‘s so there is so much insight and powerful work in everything that you‘ve just described. Being able to do that work yourself and being able to do a grounded meditation, have that. That phrase that it‘s not your story and be able to, whether it‘s physically close the file or even just metaphorically close the file and know that, i‘m putting that down and not take it with you, but then also acknowledge your feelings about a particular case. Regardless of who you‘re representing. Know that those feelings, acknowledging those feelings is really powerful. Yeah. And it doesn‘t necessarily change the outcome.

[34:24] Danielle: No, it doesn‘t. And I don‘t think, as lawyers, we should shy away from that, particularly in the coronial space where family members will be present in court during a coronial investigation or an inquest.

[34:37] I remember working on a case that we had, I‘d worked on for months and the inquest went for about two weeks and it was, in a terrible circumstances and I had held it together until the last day when the father of the deceased made a statement and talked about having.

[34:59] Seeing his, like he had flashbacks of seeing his child as a baby in a cot when he returned home from work and I was in court and I couldn‘t help it. Yeah. I was teary in the courtroom and I looked over and a number of the barristers and other lawyers also were, and I thought we shouldn‘t.

[35:17] Pretend that this doesn‘t affect us, it‘s okay that it does.

[35:22] It should. This is really sad. It doesn‘t mean that we represent our clients in any different way. But to acknowledge this family‘s loss and to share that feeling with them, it was really powerful. Yeah. I just took the rest of the day off after that.

[35:41] I can imagine. I definitely need to, I, it was the end of the inquest. I remember calling the partner and of the law firm and he said, take the day. Yeah. Have the rest of the day off. Yeah. It‘s been a long inquest at that point.

[35:54] Sarah: Yeah. Just let yourself decompress and process.

[35:57] Danielle: Yes. Yeah. And then and tell myself, this is not my story.

[36:01] I can feel for this family still, and I can be. A good lawyer representing a hospital in this situation as well. And still give the same legal advice about what could or shouldn‘t have happened. Even though I know the outcome. Yeah.

[36:19] Sarah: There is that. I can‘t remember who said it and I absolutely wish I could right now, but there is that idea of being able to hold two seemingly opposing ideas in your mind at the same time and still function is really beneficial and powerful and important to be able to do it.

[36:36] Danielle: And in this space, it is important in the health space. Families might be dealing with a tremendous amount of grief. In the women‘s has a a NICU and the grief there for parents of of babies that, might not make it out of the hospital.

[36:54] And they might be looking for answers about what happened. Yeah. And acknowledging the pain that they are going through, but at the same time ensuring that a very robust investigation occurs, whether that‘s for our hospital, or it might be that the baby‘s being transferred from another hospital or maybe they had a private home birth at home.

[37:15] Whatever has happened.

[37:17] Because we owe it to each other, to other humans to make sure that there is o openness and transparency when something like this happens and acknowledging their pain. But at the same time, making sure they know that nothing could have been done differently or we think something could have been done differently, but we don‘t know if that would‘ve changed the outcome.

[37:39] Sarah: Yeah.

[37:39] Danielle: That is a very common situation, and I think that‘s acknowledging that‘s also hard for families to hear.

[37:48] Sarah: Yeah. A difficult truth.

[37:49] Danielle: It is a difficult truth.

[37:50] Sarah: Yeah. Danielle, we‘ve talked about some of these tensions around being able to acknowledge your feelings in these difficult situations and still do a good job as.

[38:07] As general counsel or as a lawyer where you are representing someone, what else is challenging about working in a multidisciplinary environment for you? Because I think it‘s, we often hear about really positive stories and positive outcomes and I think even the tension that you were just describing, there are beautiful moments in that and important moments in that.

[38:29] What do you find challenging about a multidisciplinary environment?

[38:34] Danielle: I think with health and the medical industry, people will come with their own knowledge from their specialties. And when we are looking at whether something could have been done differently, I. Sometimes people from some multidisciplinary areas will leak into other areas that they may not have the specialty in.

[38:56] And they may think that if this happened, then there would‘ve been a different outcome, but that this doesn‘t fall within their area of expertise. But because you are all working together. All at the same table. You are talking about all of the areas. Yeah. And so I can, sometimes I do see that there can be a tendency for someone to cross over into an area that they don‘t have the expertise in.

[39:22] Sometimes that might be the law I find very interesting when people tell me oh, but I had a duty of care. And there‘s going to be more to it. So I do find that part interesting. It‘s rare that people try and crossover into the legal space, but I do hear it sometimes. That they think they have that, but I might see it in other disciplines.

[39:45] Where they‘re crossing over or they wanna make a decision about the care and that decision will impact another team, and they might not know what impact that‘s going to have on that other team. So whilst the majority of the time working in a multidisciplinary team ends up with a really good outcome, there are rare and rare cases where we need to pause and step away and then come back.

[40:13] And it could be that we stop and redirect the flow of the conversation. And say, okay you are commenting on the care that the physio team, for example, is going to provide. We don‘t have anybody here from physio. And we need to hear from them about what that will mean for their team.

[40:32] Yep. And that stops then I think people from crossing over into areas that they don‘t have the expertise to comment on.

[40:41] Sarah: It sounds like there‘s a real culture of, labeling and saying what or saying what you‘re hearing and putting that observation out there so that something else can then, so a different direction can be taken.

[40:55] Danielle: Yeah. A different direction. I think the advantage for me is that the goal is always the same. Which is to provide the best outcome for a patient.

[41:04] Sarah: Yep.

[41:05] Danielle: And I never doubt that‘s. What‘s in the minds of all the people at the table. And so sometimes it‘s about coming back to that shared goal that everybody has about how can we provide the best care to this patient today.

[41:23] And I think redirecting people back to that can help.

[41:27] Sarah: That anchor point is so important.

[41:29] Danielle: Absolutely.

[41:32] Sarah: Danielle, as we start to wrap up, I‘m interested to know. What what tips do you have or suggestions might you have around a lawyer who is looking to move in-house, potentially into health law?

[41:45] How do they navigate that multidisciplinary environment? If they‘re just starting out what would you suggest for them?

[41:53] Danielle: My suggestion would be, do it. It‘s a great area to work in. I love it. And I love all the people that I work with. It‘s really important that the teams trust you and want to invite you to be present at their multidisciplinary review meetings.

[42:12] And so when you first go. Make sure you go and you listen and you hear what‘s being said, rather than thinking you are going to tell them how things are going to to go or what the law says, and therefore they must do something a certain way. So my advice would be to go listen be involved.

[42:34] I sometimes people ask me, or how many people are in the legal team at the women‘s and they say or how many people are in your team? People will ask. I‘m like which team? Because I have the executive team that I work with, but I also feel like some days I‘m part of. The social work team and other days I feel like I‘m part of the maternity team.

[42:53] Or the neonatal team, the women‘s health clinic team, and I‘m at their team meetings sometimes. And I think that‘s really important that if you are an in-house lawyer at a hospital, that you don‘t sit on the side. Legal doesn‘t sit on its own. It sits within all of the teams to help them be able to provide the best care for the patients.

[43:19] Sarah: Did you get invited to those meetings straight away? Was it something that you built over time? What did that look like?

[43:25] Danielle: Yeah, I had to, I did build it over time, so I might‘ve heard that there was a meeting that had happened and I. Sometimes would say, oh I‘d love to come watch what happens at that meeting.

[43:38] And then they would say, sure, you‘re welcome to come and watch. And maybe the first time or the second time, I didn‘t say anything. Wow. And I just watched and then I. Then as time went on, I might make a comment about something. Now when I‘m there, I feel like I‘m constantly being asked questions about every single case, and I am reassuring them that I don‘t need to be there.

[44:04] But I love being involved and it helps me to hear what‘s happening within the hospital. I also attend every morning the operational huddle meeting and like the bed access. So it starts with saying, what‘s happening at the hospital today? What‘s happened overnight? And then they‘ll go through and talk about how many patients are on each ward and how ma how many staff are there.

[44:25] That will also tell me, oh, the birth center is full today. So the staff there are going to be very busy. Today‘s probably not the day that I wanna ask someone to take a statement about something or I might hear something in the nicu. I heard once that there was triplets being born. And so I approach, I saw the director of the NICU and I asked how did those triplets go?

[44:47] And I think it helped, helps the teams to know that I do care about what‘s happening for them and their teams beyond just, or what are the legal issues that you‘re facing? Yeah. And that way they feel comfortable to come and ask questions. And they certainly do that now all the time, which I laugh.

[45:06] Sarah: That‘s wonderful. That‘s wonderful. Danielle, this has been absolutely fascinating and insightful, and I know I‘ve learned so much just talking to you today. Thank you so much for joining me on today‘s conversation.

[45:19] Danielle: Thanks, Sarah. It‘s my pleasure.

[45:27] Sarah: That wraps up our episode of This Multidisciplinary Life. If you enjoyed this podcast, please give it a thumbs up, a like you know the drill and subscribe for more episodes. And if you‘re interested in being a guest on the show to share your multidisciplinary life, you can get in touch with us through the links in the show notes.

[45:44] This podcast was recorded on Wurundjeri Land and brought to you by Sarah El-Atm, researcher, consultant, and speaker on multidisciplinary teams. It is created in collaboration with balloon tree productions and marketing expertise from August. This multidisciplinary life wouldn‘t be possible without the support from the wonderful guests who share their stories and perspectives, as well as the brilliant multidisciplinary team who helped me bring these important stories to life.