Championing children’s safety

She started her career as an ambulance volunteer and paramedic in Europe. Now living in Perth, Professor Britta Regli-von Ungern-Sternberg is a world authority on making children’s experiences with anaesthesia and surgery safer and more comfortable.

By Ara Jansen

Paediatric anaesthetist Professor Britta Regli-von Ungern-Sternberg broke family tradition by studying medicine amid a family of German judges and lawyers. 

Curious about medicine, at the age of 14 she completed a nursing aide course after signing up with a friend who never showed. She started working as an aide and trained as an ambulance volunteer for St John Ambulance before starting her paramedic training during high school. She was the only female paramedic working in Freiburg in the Black Forest at the time.

Britta gained experience with the ambulance service, working nights and weekends and continued while studying medicine. This also exposed her to many anaesthetists working as emergency doctors.

“Because of my exposure while working within the ambulance team, I met a lot of anaesthetists and got interested in what they were doing,” says Britta. “They played a significant role in my decision to study medicine and later to complete my anaesthesia training. 

“One night, while working as a paramedic, I repeatedly bumped into an anaesthetist after dropping off patients in the intensive care unit. He was intrigued that I was a female paramedic and kept quizzing me about what I wanted to do and why. 

“By the night’s end, I had agreed to start a medical research project and doctorates in experimental anaesthesia over several years in parallel to medical school.”

While studying in Germany, she grabbed multiple opportunities to travel and work in different hospitals in Europe and overseas. During one of her electives in 2000, she found herself working in two adult hospitals in Sydney. One of the consultant anaesthetists invited her to The Children’s Hospital at Westmead as he thought Britta would love working with kids. He was right, she did. 

After obtaining her medical degree, she trained in Switzerland. Following her specialist training, Britta and her husband decided to move to Perth at the end of 2006 for a post-grad research year to finish her Swiss academic training. She worked at PMH in paediatric anaesthesia. They both enjoyed their work and the city so much, they decided to stay. 

Britta holds the Foundation Chair of Paediatric Anaesthesia at UWA, the first of its kind in Australasia, and now leads the newly founded Institute for Paediatric Perioperative Excellence. She is a specialist paediatric anaesthetist at Perth Children’s Hospital. She co-leads the Perioperative Care Program at Telethon Kids Institute with Professor Fiona Wood and leads the Perioperative Medicine Team at TKI. 

Her paediatric anaesthesia research program is highly active and one of the internationally leading research groups with a strong focus on continuously driving improvements in safety and quality of care along the perioperative pathway. 

Thanks to an interest in being able to look at a problem or an issue from every angle, Britta’s research team is multidisciplinary and includes anaesthetists, surgeons, physicians, nurses and allied health professionals, but also the likes of engineers, scientists, computer scientists, psychologists, statisticians and other professional groups. Together, they search for tangible, applicable practice changes with actual health benefits for young people.

“It’s fantastic to work with people from a variety of backgrounds. My research team is relatively large and comes from different professions and schools of thought. Everyone brings a new or different personal and professional perspective to the table. That’s what makes our team effective at tackling complex issues. Many different pieces are required to solve a problem.

“In medicine, there is hardly ever only one way. Sometimes, you must try multiple ways to see if one is better. And more often than not, combined aspects from multiple paths lead to the best solution.

Britta’s primary research interests relate to predicting and preventing respiratory complications in paediatric anaesthesia, lung function changes during anaesthesia, evaluating different airway devices, the impact of anaesthesia in early life on a child’s neurodevelopment as well as improving perioperative pain control and the overall perioperative patient experience. 

If there’s one thing you probably hear her say a lot, it’s that three-quarters of critical incidents for children in surgery are related to breathing or that up to 80% of children are anxious or very anxious in the perioperative period. She wants to change that. 

“What gets me out of bed every day is to try and make sure that every time a child needs surgery, we make it as safe and comfortable as possible. It is important to work as a team, including the child, their family and all the health professionals involved in their care, to help make that happen. We can make a difference simply by how we interact with and listen to them.”

She enjoys the variety and the challenge of working with children across a spectrum of presentations and children who range in size, age and weight. Becoming a mother has also lent added understanding and dimension to her work. 

“All my research and ideas come from my clinical work and listening to children, their families and my colleagues. I work closely with our consumers, both adults and children. To give some examples of our consumer involvement in my research program, we have a diverse Anaesthesia Consumer Research Reference panel and Youth Consumer Ambassadors.

“We hold youth consumer conversations, meet the researcher sessions as well as perform kids’ voices projects where we talk to children as young as four years old about their own experiences in the perioperative period. Even my kids are often involved. They come up with many creative ideas from a child’s perspective. 

“In my mind, if you want to do clinical research, you must be an active clinician and listen closely to consumers and staff. That’s how you learn what the real issues are. Unfortunately, it is not rare that people research or develop things that do not align with clinician or customer needs.” 

She is passionate about improving the overall outcomes for children and giving everyone the best chance to a happy and healthy start to life.

“We can make such a difference in their physical and psychological health and how they interact with healthcare now and for years to come. We know if a child has positive healthcare experiences (even if they do have to have surgery, which is not necessarily nice), that as adults, they will be more likely to seek help and be calmer about the experience.”

Britta’s husband is intensive-care specialist, Clinical Associate Professor Adrian Regli, and the pair have worked hard to balance two hectic careers with three children, aged 11, 12 and 14. It has been made that little bit harder by not having any immediate family in this hemisphere.

She credits great friends for a support system and the couple sticking to one unbreakable rule – they are never on call or away at the same time. 

“We’ve stuck to that. We both work very long hours and are often away, but our family still comes first. There are those rules we don’t break. For example, if I promise to be somewhere, I will be there. We have clear boundaries with what we say yes and no to. 

“We have rules around travel, and I travel a lot less than many of my male counterparts. Luckily, some of my work is flexible – I work in a very collaborative, international environment around many different time zones. Some days, I talk to people until 2am, other times, I can be at home when needed.”

Britta’s children have grown up being exposed to their parents’ work. She was doing a job interview for a new postdoc when her youngest was only a week old. When the team writes documents to be read and understood by children, she gets her kids to road-test them. They’ve also had some input into an app being created for children. Britta says they’re good at being honest critics of what she brings home to be tested.

Equally, Britta says while she and Adrian are happy to expose their children to parts of their job, they’re cautious not to push medicine on to them as a profession. She’s determined to keep their pathways open for whatever they genuinely want to do, while being passionately conscious not to force any gender stereotyping on either her boy or the girls. 

“The gender stereotyping seems to be much stronger here than what I have ever experienced in Europe. So many things here are gendered, whether it’s the men gathering around the barbecue or this insistence of labelling it a girls’ night out rather than just a night out.”

When there’s family time, the five make the most of it by going to the beach or river, enjoying a hike, or riding their bikes. Outside work, they travel for pleasure, visiting friends and family around the globe. 

Britta speaks a range of languages, including English, French and German, plus plenty of Latin and has a basic understanding of Italian and Spanish. The rest of the family are at least bilingual, and they only speak German or Swiss German at home unless they have visitors. 

“To me, it’s more than learning a language. It’s a vehicle to understand other cultures, other people,” she says. 

On meeting Professor Britta Regli-von Ungern-Sternberg, most people are highly curious about her name, which, in fact, is even longer. It’s a very old name with its roots in Baltic German nobility, long enough that she has to get special dispensation on her various passports and can hardly ever fit it onto forms. 

“It’s not a very practical name in everyday life, but I love the tradition and history of it,” says Britta.