My, my, how things have changed....

The last time I wrote here was before the pandemic - and didn't the world change through that time. 

We worked and slogged ourselves to the bare nerves of our existence in the NHS, while politicians and policy makers drank wine from purchased fridges in the gardens of our heads of nation. 

We were applauded weekly and neighbours banged pans with spoons to thank all the emergency and key workers that kept the UK going through a truly dark time. 

But that seems to have been forgotten now, and the NHS seems to be on its absolute knees with constant criticism from the general public. 

After starting this blog in 2005 and dreaming my way through medical school, I've now been a fully qualified doctor for nearly 15 years. I've found my tribe and my area of interest, but I still go to work sad and downtrodden by the system that seems to want to take more and more from us for no extra benefit.

Am I moaning because I'm about to start a long stretch of shifts? Probably. But am I wondering with dread how much longer the NHS has got in its current form? You bet I am. 

It's terminal.

Still just mooching around

its 01:25 and I’m at work at 0800. New Year has thrown me off kilter with my times and days so I’m just going to have to keep slogging through until my body clock works itself out.

Both 2017 and 2018 were shit in many ways - some of which made me reconsider my career pathway, and some which made me consider quitting medicine completely. 

But... at the moment I’ve found myself a little niche that seems to be making me happy.

🥳 happy new year if anyone is still reading this. I’m going to try and blog regularly again, but please leave me a comment if anyone is still there. 

💋 Merys 

It's been a while

I regularly find myself answering the question "so how long have you been a doctor?" from a patient or their relatives. I'm never quite sure whether it's polite conversation or trying to suss out my experience level compared to my age (given I was a mature graduate to medicine).

The answer usually startles me when the words leave my mouth: nearly six years....

I find it really hard to believe that I've been qualified since 2011, and that I started this blog while I was still studying for a BSc and trying to get into medical school.

What pains me more, is the amount of stress, angst, discomfort and tears that working as a doctor has caused me. If I genuinely knew at aged 18 what I know know aged 30 (something), I would want to reconsider my choices.

I don't know what I would do instead though. Medicine has entirely taken over my life. My spare time is spent at work, completing eLearning, listening to podcasts for work, attending courses that I have to pay for out of my own pocket (as the study budget is terrible), completing exams, working on presentations and posters.

Medicine gives you a purpose, but swallows your soul.

Do I sound jaded at all?

#ImInWorkJeremy

Dear Jeremy*,

Thank you so much for criticising doctors (and particularly consultants) in the NHS for not working weekends, and in particular for saying that the absence of consultants leads to 6000 deaths in the UK each year.

I've been a doctor in the NHS for four years now, and let me tell you of my experiences (I'm going to bullet-point it so that it's easy to understand):

• I have never worked a weekend in a hospital where I haven't worked with a consultant.
• The last set of night-shifts that I worked, the consultant was still in the hospital when I arrived at 10pm, I spoke to him again at 2am, and he was back in the hospital again at 8am.
• I've seen the medical director for the hospital at 3am on more than one occasion, and many, many senior nursing staff in overnight at weekends.
• I have never worked a weekend where a patient needed an urgent intervention or senior decision and it wasn't possible.
• I've missed family weddings (my cousin), my grandmother's 80th birthday, and multiple birthday parties for nieces and nephews.
• My mother still hasn't truly forgiven me for missing some of them.
• I don't think that we're badly paid, but trying to suggest changing our contract again so that we all get a pay cut is fairly low. Especially in the same week that all politicians get a backdated 10% pay rise.

I've worked hard to get where I am today, and I care passionately about the NHS, but perhaps Jeremy Hunt needs to look deeper at the sacrifices that doctors, nurses, physiotherapists, occupational therapists, pharmacists, healthcare assistants, porters, radiographers, paramedics and technicians all make in order to try and make our NHS great.

Read more information about the backstory on this in The Guardian article

*Jeremy Hunt, Secretary of State for Health

10 years ago

Ten years ago today I was working in a hospital, cleaning up and finishing off domestic work. I hadn't started medical school at that point, and it was summer break from university.

The news said that there had been power surges all over the underground in London, and that further news would be updated.

It was the day after the UK had won the bid for the Olympic Games for 2012.

I didn't think a great deal of it at the time. I carried on working, along with other staff.

Only as the morning went on, did we hear more about what had really happened.

I remember being horrified at what we were hearing; co-ordinated terror attacks on public transport.

My thoughts are with the families of those who died, and the survivors who are reliving it today.

Burnout

Burnout (or 'carer fatigue') is a subject close to my heart. 

Of my colleagues who I started with as a foundation doctor, I don't know a single one who, at some point, hasn't felt drained and exhausted to the point of becoming unwell.

I know that I've wanted to quit medicine a fair few times over the last 3.5 years, and I'm sure that's something that will happen again during my career.

The strain placed on doctors to work effectively despite (often) very demanding rotas seems counterproductive:  nursing staff are even often surprised by our unusual working schedule, and have frequently asked (across all of my many rotations), 'do you ever go home?' The answer often feels like 'no'. 

I've worked stints of shifts where you work 12 days consecutively, followed by 2 days off, and then another 12 days. Many of these days are in excess of 10 hours rota'ed.

The problem with junior staff complaining about this, is that consultants often feel that we are complaining unnecessarily, and that when they were junior doctors there was no European Working Time Directive. It's a difficult issue to address.

I've just completed the BMA burnout questionnaire (you can find it here), and the result wasn't particularly unexpected. 

Just food for thought.

Plodding along

I realised last week that it has been almost a year since I posted here.
In honesty, I don't have the heart to say goodbye to the blog completely, but don't have the time to blog as regularly as I like.

I'm still working as a junior doctor (senior house officer) in the NHS - trying to combine a personal life with jumping through the hoops (and paying the money) to keep my portfolio updated and my skills up to date.

I will be back....

The big stigma

Anyone who's read my blog knows that during medical school I suffered from depression.

Yet at work, all the time I hear people dismissing depression and patients with it.

It's at times like this that I like to make people feel uncomfortable. I'm not afraid to point out that depression affects everyone, including doctors.

And yes, I will turn around and point out that since 2007 I have taken anti depressants. And to the people that point out that I don't appear depressed - well antidepressants seem to work for me.

So before you make sweeping statements about depression and mental health problems, remember that not all disabilities can be seen with the naked eye.

Depressed and happy

Jaded

The more time I spend working the more time I wonder if I made the right decision all those years ago.

I nearly started training to be a paramedic, and while I'm not sure that would be a 'better' career choice (given how much grief the ambulance service gets on a daily basis), I can't help but think it might be more satisfying and easier to leave than medicine. 

Don't get me wrong, I love my job. I've just got career jaded from working in the NHS for all of 30 months.

I almost wish I'd been an artist or designer now.

Insomnia (again)

This is getting ridiculous now. I have a long Monday ahead of me and I'm wide awake (went to bed at 2230).

It happens a lot and it's like my brain can't switch off.

If it continues for the next few hours I'm going to be exhausted by the morning. I'll have a whole new patient list after the weekend with no idea why they have been admitted.

I'd love to take a duvet day but I'm guessing that would be frowned upon :(

So there's only 2 ways to deal with it - strong coffee and a forced smile on my face. Oh, and lots of makeup!!

PAT dogs

In hospital they have PAT dogs - pets as therapy.

My dog is anything but therapy. He is the reason I am awake now.

This is possibly the best example of why

The first three are 100% accurate, in number 4 the dog would be between my legs and in number 8 it would be me that would be replaced by the dog! He's an evil little shit but I love him to bits. Even if he is the reason that I've been awoken at 0400 on my day off. As a result of which I have left satan's canine offspring upstairs and have relocated to the sofa.

Revenge will be mine - I decide when he gets fed.

Changed plans

The plan for today involved a good night's sleep (in bed at 2230) before a busy day ahead.

The plan was altered by a hyperactive terrier who decided he wanted a toilet visit.

Sadly he then wanted to play. Sadly for him, he then got put downstairs in his crate. Sadly for me I then felt guilty and he's now back on the end of the bed looking smug and plotting.

This doesn't help me with my 3 hour ward round with the grumpiest consultant known to man, who *huffs* at you if you need to have a toilet break of your own.

Ah well, let caffeine be the sponsor of my day to come!

Neglected

This blog has been very neglected in the last 2 years since I qualified.

I've had some ups and downs (lots of downs) and had to rethink my career a few times.

I'm on a training pathway now but whether I will end up quitting it is another matter.

To anyone still reading, I wish you a Happy New Year and hope that 2014 is better for anyone who has had a shit year in 2013.

See you around from time to time

Coming of age

The joy of birthdays.

Today I turned 30. I've been working as a doctor for just over 2 years now and am watching the NHS crumble under our feet.

Who even knows what the next 2 years hold, but it bet the NHS is barely recognisable in 30 years time (I'll probably still be working since we can't retire until aged 68).

Some sage advice

I know it's been a while since I've posted here, but the last six weeks since Black Wednesday have made me aware of some sad facts.

The following pieces of advice are a result of events that have made me cringe:

- I've said it before and I'll say it again: Be nice to the nurses, they will stop you from killing your patients.

They also know where the secret stash of biscuits are kept and will keep you fed and watered when you've not stopped in 10 hours. But only if you're nice to them.

Nothing spreads faster than the reputation of a rude junior doctor.


- Listen to your colleagues. An FY2 doctor may only be a year above you, but that's a whole year more of learning from mistakes.

- The converse can also be said: just because you're an FY2 does not mean you can dump all your rubbish jobs on the FY1! Six weeks ago you were an FY1. Just because it happened to you doesn't make it right, it just gives you an opportunity to do the right thing.

- Everyone hates long shifts. Remember to eat, drink and pee. No-one can do it for you!

- And just to reiterate the first point: be nice to the nurses, you will want their help with getting your portfolio signed off!

Happy doctoring to all the newbies!

Whenever there's a problem.

That time of the year

In August a new start for all. FY1s become FY2s (and are classed as SHOs) and FY2s go on to career pathways (or locuming/travelling).

There is one thing standing between each of us and those plans: ePortfolio sign off.

The most irritating online system ever of evidencing anything you have done that the curriculum requires you to have done.

Loosely this relates to bribing registrars and colleagues to sign forms for you online.

It is a damn nightmare and will be taking my time for the next few weeks.

Love and hugs to all

Sent from my iPhone

A political statement

I'm not a great follower of politics, although I do just remember Margaret Thatcher being in power.

Whatever your thoughts on her political views and policies, think on this: she was elected. Several times.

She did not take power forcefully, nor was she a dictator.

Her political opinions and policies aside, she was an elderly lady who had been suffering from memory loss and who died following a stroke.

I'm appalled to have seen some of the Facebook statuses and tweets in the past week, and have deliberately stayed out of discussions at work.

But needless to say the state of humanity upsets me

All change!

It's grey Wednesday today. Not as bad as Black Wednesday, but there will still be fun and games!

Good luck to everyone changing jobs today!

Social Media

In March this year the GMC (General Medical Council) released new guidance on social media. As well as all the usual stuff (don't make friends with patients on Facebook, don't give advice over twitter, don't breach confidentiality etc) it gave guidance on doctors posting anonymously on the Internet. Now here is a dilemma: if you search the GMC website for Dr Merys Jones, the person that you find is not me (I have no idea if such a person exists and I haven't checked the GMC database). This is a pseudonym, and one I have had long before even going to medical school, never mind being a doctor. I started this blog in 2005 when I was still an undergrad the first time around. I wasn't even sure I would get into medical school, never mind qualify.

During that time I have never breached patient confidentiality. I don't discuss patients and I don't give medical advice. Ergo I'm not quite sure where I, or this blog stand.

If anyone has any advice then please let me know.

The full guidelines on social media can be accessed here