Press Release

Press Release 

01/09/2019

THE BELOW TEN THOUSAND WAY TO A CLINICIAN LED SAFETY CULTURE’ By Pete Smith

Available now on Amazon!

I am pleased to announce the publication of my new book.

‘Below Ten Thousand’ sprang to life from a simple conversation between two clinical nurses working in Recovery on a day like any other.

John Gibbs and I were having a discussion about our recent experiences with noise and distraction, an endemic problem in many operating theatres during surgery and anaesthesia.

Our conversation unearthed an observation that noise and distraction eroded the effectiveness of our high risk environment and compromised our quest for an enduring team safety culture.

It had a negative impact on patient safety as well as clinician wellbeing.

During the conversation I was merely a wall to bounce an idea off. My only contribution was to challenge John in a few simple ways:


“What would such a thing look like?”

  • “Let’s reverse engineer the steps and design an effective strategic situational awareness tool.” 

  • “Let’s see how far we get with this!”

John’s simple solution came from a concept within aviation, where noise and distractions unrelated to the task of flying a plane at altitudes below ten thousand feet are prohibited in order to fully augment the task-rich focus environment.

The book has arisen from an openly collaborative space I call a ‘cognitive laboratory’.

It is only through open collaboration with John, and also with Rob Tomlinson who fuelled the ongoing discussion from the UK, that I was able to find the words and ideas that infiltrate this confrontational tract on safety culture and nursing philosophy.

How can such a simple book be confrontational?

Challenging notions involving the delusions of safety in healthcare is indeed a dangerous sport. It takes courage, passion and persistence to break through the glass barricades of pedagogy.

As part of the risk assessment in publishing this book, the need to advocate was of paramount value.

‘Pete Smith’ is the only name on the book because I am the only one who can dwell at ground zero with respect to any fallout.

Rob Tomlinson and John Gibbs are still shining lights in clinical operating theatre nursing practice. They work relentlessly and with stunning effectiveness at the clinical interface, mentoring, communicating, networking and growing the next generation of nurses who, if people like John and Rob are allowed to continue their safety culture advocacy unfettered, will enjoy a career empowered by compassionate systems of work that will allow them to care well for themselves, their loved ones, their colleagues and their patients inclusively.

Because of their future potential in redesigning healthcare philosophies from the ground up, I chose not to risk their current careers by implicating them in the expression of words I fully chose and which I brandish at my own risk. 

The world needs inspiring nurses like Rob Tomlinson and John Gibbs.

‘The Below Ten Thousand Way to a clinician led safety culture’ is my gift to them.

For more information contact Pete Smith belowtenthousand@gmail.com 


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Below Ten Thousand

An international collaboration

Empowering clinicians in safety culture