What did you want to be when you were at school/growing up?
I always wanted to be a GP but it became apparent at medical school that general practice didn’t match my personality. I prefer a fast paced environment where you have a lot of information quickly and see immediate results after any intervention. I liked the fact that anaesthetics allowed a nice blend of manual dexterity (doing practical procedures) and using your intellect.
Can you describe your work in 1 sentence?
Caring for patients undergoing operations or procedures and making them feel at ease, comfortable and listened to during what is a stressful time for them.
What makes you skip to work?
For me it is all about the people – operating theatres are wonderful environments if you enjoy working as part of a team. No one can do their job without the other team members and that camaraderie and shared goal is really important to me. I like a modern approach to hierarchy in theatres so prefer to flatten it as much as feasible.
What are the top 3 things you love about your job?
The team. I have some amazing colleagues and it’s always such a pleasure to be at work with them. We have a really supportive department and I know during the covid-19pandemic it was the interaction with colleagues each day that kept me sane.
Supporting patients through a significant event in their lives. Using your interpersonal skills to help put them at ease is really rewarding and as important as your knowledge and practical skills.
Variety. Having patients from a wide demographic with a wide range of pathologies keeps it really interesting. My working week can cover obstetric anaesthesia, paediatrics and trauma, so I frequently see patients of all ages. A day at work is a bit like Forrest Gump’s box of chocolates; in that you never know what you’re going to get.
What are your top 3 frustrations at work?
Barriers that prevent you getting on with work. Theatres are complex and dependent on team work so there are often a lot of things out of your control that can cause delays.
Cancelling planned operations on the day. I always find this really hard. I know how stressful and frustrating this can be for patients and, even though I know most of the time it is unavoidable, I feel guilty that as a team we haven’t been able to do what was planned.
In the NHS, it can be slow to introduce meaningful change. I think in anaesthetics we have been ahead of the curve with recognising the importance of staff wellbeing and rest facilities. It frustrates me when you see that way of thinking is not taken up so quickly or enthusiastically by other departments.
Why would you recommend your career to a young person?
I would not hesitate to recommend anaesthesia as a specialty. Roughly two thirds of patients in a hospital will encounter an anaesthetist during their stay and the work we do is wide ranging and interesting.
In theatre we only ever have one patient at a time to look after, which allows you to give them your full attention and care. We use a range of monitoring equipment and can really see human physiology in action.
Why are anaesthetists important?
Anaesthetists have a set of skills which can turn around an emergency scenario and literally save a life within a short period of time. I can’t think of a time when I’ve attended an emergency situation and the other professionals already there have not been pleased that I have arrived.
What are anaesthetists like?
It is fascinating how wide ranging the personality types of my anaesthetic colleagues are; some are real attention-to-detail types and others are more broad-strokes, bigger picture personalities. It is an inclusive specialty and there is room for all types of people and working patterns.
What has been your biggest career disappointment or challenge and why, and how did you overcome it?
I was commissioned into the British Army before I started my A-levels, having achieved a medical scholarship to attend a military sixth form. This involved a wide range of military training whilst also studying for A-levels.
Towards the end I faced several personal challenges that led me to withdraw but I found the decision extremely difficult to come to terms with. It felt like I had failed and that self-doubt stayed with me for several years.
Now, when I reflect back, I know it was the right decision and my life would look very different now if I had continued on that path.
What was your best career move?
Standing for election to the council of the Royal College of Anaesthetists (RCoA) and, later, the Board of Trustees. This has really expanded my knowledge and skills. The college is a really supportive and progressive institution and I have learnt so many non-clinical skills.
I have found the role really rewarding and have been very lucky that my trust has been so supportive of me undertaking these additional activities outside of my own department.
What’s the benefits of joining a Royal College?
It provides opportunities to network and connect with peers, both online and in person. This helps to foster a wider sense of community and belonging and allows sharing of knowledge and experiences.
I think the exposure to people and ideas outside of your region is really important to help with diversity of thinking and sharing good practices.
What qualities do you think you need to do your job well?
You need to be able to stay calm under pressure and demonstrate clarity of thinking even during highly acute and stressful scenarios. You have to be decisive but prepared to be wrong. Not making or delaying a decision can be dangerous in anaesthesia, as can tunnel vision and task fixation.
You can’t really have much of an ego because, if you do your job well, most patients forget you. A year on from their operation they are unlikely to remember your name but will likely still be able to recall the name of their surgeon. That said, they will always remember how you made them feel and how you made the experience for them.
What 3 words would your colleagues use to describe you?
Efficient, dedicated and compassionate.
What’s the best advice you’ve ever got from a patient or work colleague?
“Learn to say no.” Three months into my anaesthetic training my educational supervisor told me that I had an effervescent personality so colleagues would want to involve me in their work. I would need to determine which projects to take on and which ones to say no to. Over time I came to appreciate what he was saying and have certainly heeded that advice. He has retired now but we are still friends (having worked on several big projects together).
If you could go back in time and give one piece of career advice to your younger self, what would it be?
When I started at medical school I didn’t feel like I belonged. My parents were not university educated and, at times, I felt ashamed that I was not more middle class.
Medicine felt so elitist to me. But having more working class experiences growing up has benefited me as a doctor. It’s important to be able to connect with a wide range of patients and medicine is no longer such a hierarchical profession. If you feel like you don’t belong in a situation that is exactly why you deserve to be there as diversity is so important.
What do you do to relax/de-stress?
I live with my husband, two teenagers and two Bernese Mountain Dogs and spending time with them is how I de-stress. We love playing card and board games together (especially escape room types) and getting muddy on a walk in our local park. I also enjoy open water swimming in a local lake with friends and colleagues.
What do you hope will be your legacy to your profession and colleagues?
I want to make the culture and working environment better for those who follow me. I try to share experience, wisdom and advice with my younger colleagues and students.
I think if you can help them develop their skills and achieve their goals you ensure that your own knowledge and values will continue to influence the profession long after you have moved on.
Is the thought of retirement a dream or a nightmare – and why?
I don’t see retirement as a nightmare. I am the type of person who finds that when one door closes another one opens. I know I’ll continue to be busy, happy and fulfilled whatever direction I take after I stop clinical work. If I were a betting person I’d say it’s a safe bet to assume I will still be a dog owner though, as I can’t imagine life without my four legged friends as they bring me so much joy.
Do you have a morning routine – something you always start your working day doing?
Yes! I am naturally a really early riser so my day starts around 5am and I fit quite a lot in before I have to leave for work. Ageing well is important to me and I have built things into my routine that could prevent cognitive decline.
Every morning I do some brain-training exercises using an app, complete the Wordle, and do some language lessons on Duolingo.
I then take the dogs out for their morning walk and come home and have a coffee and do any simple admin or emails that can be done before the rest of my household is awake.
Do you believe in early-to-bed?
I try to turn off my devices before 7pm and not do anything work related in the evenings. I think I have a healthy work life balance and these days I am often in bed before our teenagers, as getting enough sleep is really important for me.
Who has been your biggest inspiration?
I have been lucky enough to work with a really inspirational anaesthetist who has mentored me through my anaesthetic training and early consultant career. Dr Sally Millett is one of those people who just makes everyone around them feel alive.
She is kind and open and has an amazing sense of humour. Clinically she was the font of all knowledge and was everyone’s “go to” for advice and a sensible pair of hands. I am so grateful for the positive impact she has had on my career. When she retired our department really felt her departure.
Toni Brunning is a consultant anaesthetist at Worcestershire Acute Hospitals NHS Trust.
She studied medicine at the University of Birmingham, qualified in 2009 and completed her foundation training at Worcester Royal Hospital, which is part of the trust she now works at. She went on to do her anaesthetic training at the Birmingham School of Anaesthesia, gaining her Fellowship (FRCA) in 2013.
As a trainee, she enjoyed several roles as a representative or advocate. She developed an interest in education and completed a Master’s degree in medical education at the University of Dundee in 2017.
After completing her consultant training in 2018 she took up her current consultant post, where her clinical work is broad based and includes obstetrics, paediatrics and trauma.
Her education roles include college tutor in anaesthesia and member of the senior education committee at the trust, part of her role as the “champion of flexible training.”
She also has a wider interest in clinician wellbeing and is her departmental wellbeing officer. She is a certified lifestyle-medicine physician and the director for two medical educational conferences – Educating Anaesthetists and Promoting Wellness, and Educating Doctors and Promoting Wellness – which mix clinical content with sessions on self-care.