Author name: Stevan Bruijns

I am an Emergency Physician and systems strategist who views the hospital as a complex adaptive system rather than a simple queue. From pioneering the South African Triage Scale and founding the African Journal of Emergency Medicine to my current role as Regional Specialist Advisor for NHSE (South West), I have spent my career building the bridges between clinical safety and operational flow. Today, I balance frontline consulting at a district hospital with strategic advisory roles for the CQC and NHSE. I specialise in the interface between data and practice, applying complexity science to solve the friction of ED crowding and system-wide bottlenecks. Whether I am auditing regional pathways or writing for St Emlyn’s, my goal is to translate high-level strategy into practical solutions that work for staff and patients alike. Outside the ED, I bring that same problem-solving mindset to homeschooling my two children and managing a household that includes two rogue chickens currently winning a war of attrition against our vegetable patch.

Two people share a simple meal of pap and shebo at a wooden table, seen from the diner's point of view, illustrating a piece on holding on in emergency medicine.

The limits of holding on to realism and hope alone

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Great review from Stevan.

Emergency medicine clinicians are increasingly asked to balance brutal realities with hope for a better future. Drawing on the Stockdale paradox, NHS Staff Survey data, moral injury research and personal experience, this reflective article explores burnout, leadership, crowding and why surviving difficult systems depends not only on resilience, but on having colleagues who have our back.

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