Under Pressure — Vellumwise series cover

Under Pressure

Isla wonders whether exhaustion is changing her judgement. Her hospital wants a quick fix; she discovers the problem is partly hers and partly the system’s, and that speaking up has costs of its own.

Planned · not started yet

I want to read this

Psychology & mental health Living with uncertainty Hard choices Ethics & integrity Hospital or clinic Workplace Tense Reflective

The premise

Isla wonders whether exhaustion is changing her judgement. Her hospital wants a quick fix; she discovers the problem is partly hers and partly the system’s, and that speaking up has costs of its own.

The protagonist

Dr Isla Fernhough — Fourth-year surgical trainee after a near-miss in theatre

The council

Every council member is an original fictional character. None represents, quotes or is endorsed by a real person.

Dr Benedict Oyelaran

occupational psychologist

Systemic thinker; blames rotas before people

Prof. Hanne Ruud

decision scientist

Precise about how tired brains cut corners

Mr Callum Daventry

senior surgeon

Old-school; changes his mind and admits it

How the story moves

A near-miss inquiry runs through the series; Isla’s career and health are both at stake, and the inquiry’s findings change the whole department.

What readers take away

  • The stress response and performance
  • Burnout: definition and evidence
  • Fatigue and error
  • Checklists and human-factors design
  • Speaking up and psychological safety
  • Organisational versus individual interventions
  • Professional help-seeking
  • Returning to work after burnout
  • Use a structured handover
  • Apply a simple fatigue risk assessment
  • Recognise moral injury
  • Find confidential support services for clinicians

The books

  1. 1The near-miss Planned
  2. 2The rota Planned
  3. 3Speaking up Planned
  4. 4The inquiry Planned
  5. 5Choosing Planned

Book titles are working titles and may change before publication. No book is on sale until the complete series is finished, checked and released.