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Mind The Medic: A Junior Doctor's Blog

Discussion in 'Weblogs' started by The Medic Mind, Jun 27, 2016.

  1. The Medic Mind

    The Medic Mind New Member

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    10 Survival Tips For F1 (Part 2)- Mind The Medic
    Here is another list of 10 tips for surviving F1

    1. Don’t do things just because you feel pressured. You’re new, you don’t know all the rules yet. If something feels wrong, then there’s probably a legitimate reason why. Don’t be pushed into signing something or giving a medication you’re not comfortable with. I was asked to prescribe an anti-emetic that I didn't know. The nurse told me the route and the dose and gave me the prescription chart. I respect that the nurse knows her stuff, but I wasn’t comfortable just signing off on a drug I’d never heard of before. It might be hard but take a moment to step back and pause. Say something like ‘OK, let me look into it’ and move away from whoever it is that’s piling on the pressure.
    2. Don’t be afraid to say no. No doesn’t come easy to me. I feel like I’m being rude or inconvenient but sometimes you have to be clear. It’s hard and it gets even more difficult depending on who you’re saying it to. I talked about one experience here where I had to say no to a consultant. Hard. Something like ‘sorry, I’m not comfortable doing that.’ I’ve learnt to say no more and more on my current placement. I’m often left working on my own on the ward and the nurses will often bleep me as the first point of call for every query and I’ve had to apologise and redirect them to someone else.
    3. Book annual leave and plan things ahead of time. If you need to have a certain weekend off for a prearranged event that is non-negotiable, make sure you’ve looked at the rota way ahead of time and made swaps where necessary. A lot of people miss annual leave days. Don’t let it be you. Don’t just rely on emailing the coordinator to warn them, a lot of the time that doesn’t work.
    4. You’ll be under a lot of stress. The things you’ll have to do and experience won’t be easy. They’ll come home with you. Exercising, meditating, drawing anything that makes you feel good and takes your mind off work is non-negotiable. Whatever it is that you do, don’t let it slip. You’ll need it now more than ever.
    5. You don’t know everything. Be comfortable saying ‘I don’t know’. You’ll be working with other health professionals who’ll be able to help. You’ll get that one job from the ward-round which will take ages to sort out. I’ve been there, going round and round in circles. Sometimes, it’s just easier speaking to someone directly who might know the answer. If the query is about a drug, ask a pharmacist. They might be able to help you in seconds, if not, they’ll know how to get the information. Use the team around you, it will save you a lot of time.
    6. Just as above, nurses can be super useful especially in the beginning. They can help fill the gaps left behind from the long induction you’ll be made to sit through. They’ve been working longer than you have and know how the hospital works: how to request scans, where the family service office is etc. In the beginning it’ll be overwhelming and unless you’ve worked in that hospital before it can take a while to learn ‘the system’.
    7. Be cautious. Not only are you a new colleague, you’re also a new doctor. In my experience, I think it’s meant that some members of staff feel they can take advantage or treat me differently than they would a more senior doctor. I’ve not had too much trouble and this is just my opinion. But be respectful (particularly with nurses) and be patient. They outnumber you.
    8. There will be a lot of pressure on you to do 5 things at once. Some things can wait, some things can’t. There would be times nurses would hound me for discharge letters and act like it was the most important thing, taking precedent over everything else and that’s rarely the reality. But in the beginning when I didn’t know any better, it made me feel so overwhelmed. I would get it from all sides: cannula, discharge letter, pharmacist. Everyone wants something and now. You get used to it. You prioritise.
    9. There might be a time when you need to rely on your documentation and at the very least, you want to be able to read what you’ve wrote. You’re going to be seeing so many patients, you won’t be able to remember what happened with every single one of them.
    10. Finally, ASK. Ask. Ask. Especially in the first few months, everyone expects you to know nothing. This is the best time to play that part. I used to ask the medical registrar the simplest of things but she made me feel comfortable enough to approach her. You’re not working at a desk making a PowerPoint presentation, you are caring after real people with real conditions. Don’t fall into the trap of being silent.
    Bonus

    • Question everything. If someone asks you to do something, ask why. I’ve been in so many situations where I’m asked to do something, I go on my merry way until I’m questioned and I realise I’m not really sure what the rationale was. Trust me it makes it that much easier to convince someone to do a scan or to review a patient if you know the questions you want answered. Apparently ‘because my consultant wants it’ isn’t a good enough reason.
    These are all based on my experiences as a F1. My colleagues could relate to some of them but maybe not all of them. But I hope this goes some way to make this year a tiny bit easier. Good luck to everyone starting a new F1 post. You’ve done amazingly well to get this point.
     
  2. The Medic Mind

    The Medic Mind New Member

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    The Last Day of F1 - Mind The Medic

    The last day was a mix of emotions. Overwhelming gratitude and relief that I’d finished a difficult placement but also a slight melancholy that I was leaving. I was happy, don’t get me wrong, I’d started a countdown midway through the four months. But while I was working through the final jobs, I kept thinking of how everything was coming to an end. Not only was this the end of a placement but it was also the end of the academic year, the majority of doctors would be moving on to new hospitals. The people I’d worked with over the last months, the relationships I’d built, the comradery, it all felt like it was coming to an end.

    We had a small get together at lunch with cakes and drinks and it felt like the end of an era.

    The hospital can be really sociable. Just walking down the corridor, I’m bound to run into someone I used to work with. I enjoy that aspect of working in hospital.

    My next placement is in GP which will be a massive change of environment. It’s always been the one thing that’s bugged me about general practice: the fact that there isn’t that community of peers around you. But I’m still looking forward to the change of scenery. I’m hoping GP will give me some of the learning experiences I’ve felt like I’ve been missing. Plus, surrendering my bleep for the next four months feels like a huge bonus. Not having the constant paranoia/palpitations every time I hear that beep anywhere around me and immediately look to see if it’s me that’s being summoned to some unknown problem. I just want to actually learn and do some medicine. Listen to a problem, take my time, explore the issues and be guided and taught as well. All whilst being sat down. I’m really hopeful.

    I had the new foundation doctors shadow me on Tuesday and I honestly tried to be as positive as possible. I tried to give them all the necessary information they needed but I know they’ll learn it all as they go along. Luckily, the consultants are lovely so they should be fine.
     
  3. The Medic Mind

    The Medic Mind New Member

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    Locum Shift - Mind The Medic

    I worked a locum shift during the weekend. Nothing stressful, just an admin shift. I pretty much sat around all day, flicking through paper and typing entries onto a computer. I expected it to be a chilled shift, so I didn’t even bother wearing my stethoscope. I was sort of spread across different wards, but I didn’t have any clinical duties, so I wasn’t seeing patients anything like that.

    That all changed one minute to the end of my shift. I was called over by a nurse to review an unresponsive lady. I felt so unprepared. Like I said, I wasn’t expecting to do anything clinical, I’d left my stethoscope in my bag. And I know the training that we get gives us what we need to do when a person becomes acutely unwell. I don’t know why, but in that moment I felt really unprepared. I went over and kind of went through the steps of assessing this elderly lady. To me, she wasn’t unresponsive but it’s hard for me to know how well she’d been an hour before. I don’t know how she’s like normally. I try to examine her, whilst giving some instructions to the nurses and dodge around 3 family members. It all felt very haphazard.

    The medical registrar came and took over, and he must have thought I was slow or something because he just did everything himself.

    Driving out an hour later then I should have been, I just felt deflated. I felt like I could have done so much better. And I use the excuse that I’ve feel like I’m out of the loop after having done surgery for so long but really, is that a reason?

    I was thinking about it all the way home. Just picking over the situation again and again.

    It’s hard to remember exactly what happened because my mind was somewhere else. So this is was what I think happened: I’m trying to join a dual carriageway with three lanes. I can see two cars, one blue car in the middle lane and another in the furthest lane (right lane). I look right, then left and then start to pull out. Then I break suddenly, to stop myself crashing into the blue car speeding past in front of me. I’m sure it wasn’t there before so I wonder whether it swapped lanes when I looked away.

    And I mention this because, it made me think. I was so concerned about how stupid I looked and how I did a bad job. I took that issue which was self contained (the patient was ok, the registrar had reviewed her) and I made it affect my driving to the point where I could have been in an accident. That would have been a much bigger problem and I’m really glad I narrowly avoided that.

    So, this really is a lesson for me, more than anything else. Be more careful and don’t make a bigger mess of things.
     
  4. The Medic Mind

    The Medic Mind New Member

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    General Practice - Mind The Medic
    We had a lot of exposure to general practice (GP) during medical school. Usually, I'd have one day a week based at a practice and sometimes a couple of four week blocks would be allocated for general practice alone. So I’ve seen a fair share of different practices, some were better than others. But overall, I felt like I had a better appreciation of what it would be like to be a GP.

    Throughout medical school we were told that at least half of us would be GPs. On its own, the statement doesn’t sound bad, but in context, a lot of the time it felt like we didn't have much choice in the matter. 50% of us would be GPs regardless of whether or not we wanted to. Some people took offense, I didn’t particularly, even though at the time I thought wanted to be a paediatrician.

    A few years later, now a F2 on my GP placement, I can see the appeal. 9 to 5 every day plus one afternoon off every week. I don’t have any night shifts or weekend shifts. There's 30 minutes to see each patient, all the while sat down in a room with plenty of opportunities for tea/coffee breaks. I know this isn't fully representative of an actual GP but it's generally a much better working environment than what I’ve experienced so far working in hospital.

    So part of me wants this to be it for me. Do GP, have a great work life balance and be financially stable. I really wish I could fall in love with it. At the moment, it just doesn’t excite me. Some of it does. I hear a lot about GPs who have more unusual working patterns, that go beyond seeing patients in a clinic. But if I go for general practice, I want to be really for it, not just the good bits. It's like buying a cake with icing but only being excited for the icing. And then throwing the cake away when all the icing has been eaten.
     

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