Back to school

It's especially strange to think that tomorrow is my last day in my current job and as of Wednesday I'm an FY2 doctor who is fully registered on the GMC website.

Since I'm changing hospital trusts again it has an odd feeling of starting a new school year.

I've bought my new pens, selected and ironed my clothes, scheduled my bed time, polished my shoes and filled the car up with fuel.

This extra preparation won't make a difference though as I will still be bricking it tomorrow evening for a new job. I'll also be back to my usual self next week and forgetting to make myself some lunch and prepare clothes the night before.

As much as I've really hated my current job, I really love the people I've worked with. I think we shared a mutual dislike of the particular speciality and made the best of it. Possibly one of the best bunch of people I've ever worked with and the patient care has been genuinely excellent.

I'm going to miss having the time to chat to patients, make sure they get a drink while we're there (yes we really do do this as we know the nurses are manically busy) and explaining things to family without massive time pressures. I won't have this luxury in my next job.

So all in all I've learnt a hell of a lot in the last year - probably more than I ever realised. I think I've kept most of my personality and humanity despite working in a couple of tough specialities and as much as I've had some really stressful times, I wouldn't change it for the world.

So here's to medicine and making hopefully the correct decision for me when I was choosing between being a doctor and a paramedic.

Don't get ill in August...

365 days in the blink of an eye

From August 1st I will have a full GMC registration (F1 doctors in the UK hold provisional registration until they have been signed off as competent after 12 months). This means I'm technically an SHO (senior house office), albeit at the bottom of the pile.

The plus side of being hellishly terrified is that I get a payrise for having been through hell for the last year.

I think the reason I'm so scared is that now there are people more junior than me that aren't medical students! This means I have to pretend to actually know some stuff and not just stand quietly behind the SHO.

The good news is that I rotate jobs and I'm hoping it will be more interesting than my current one. If I find something I don't particularly enjoy then I don't learn a great deal - my current job falls into this category.

So for everyone new as an F1 on Wednesday welcome to the working world of the NHS and prepare to have your eyes opened.

How quickly a year passes

A year ago I hadn't quite graduated, was rather unwell and didn't have a provisional GMC number.

Since then I've worked for 50 weeks and just been informed that the GMC is happy to fully register me from 1st August (black Wednesday).

It's all gone incredibly quickly and with only intermittent amounts of stress and exhaustion.

Best of luck to the new F1s doing their preparation for professional practice soon!

And tomorrow is another day

Tomorrow is the BMA day of action. As previously stated here I will be taking part in the industrial action as it is something I feel passionately about.

In the last year I have regularly worked on rotas that are in excess of 60 hours per week, and my personal best was in the region of 94 hours. For this I get a salary much lower than you would actually expect a doctor to be on. My basic pay is similar to that of a newly qualified nurse although I get 'banding' for jobs that have antisocial elements to them. I can guarantee it really isn't worth it.

By the time I am 68 I don't want to be busting a gut to carry on working my backside off just so I can claim my pension. My pension, which by the way, is being reduced by the government to an average salary pension and I am now paying greater pension contributions from my wages.

At the moment the long term prospects in medicine seem less than rosy, and this needs to change.

If you want impassioned doctors who care about patients and who aren't exhausted, jaded and financially much worse off in our older years, then support doctors tomorrow who are taking action.

I became a doctor because I always knew that this is what I wanted to do. I adore working with talented and well educated staff to make patient care our first priority, but something has to change. If it doesn't, we're all screwed.

Longevity

I have just realised, in my usual observant way, that I have been blogging now for over 7 years. Beer anyone?

The list

It's that time of year where my current group of F1 doctors are all desperately trying to get our paperwork signed to get us into F2. It's irritatingly tedious but for me it's mostly done.

So for those of you about to start F1 in August there is something you will need to know - you need to know the rules of the list.

1. DO NOT LOSE IT
2. DO NOT TAKE IT OUT OF THE HOSPITAL (see point 1)
3. Your boss will want a copy of it so keep it reasonably up to date
4. Have most recent blood results and investigations on it
5. Go through it regularly with colleagues and divvy up the work.
6. As an F1 you will often be doing mini ward-rounds on your own. Initially this is terrifying but sometimes the list is all you have without reading the notes.
7. Most importantly see points 1 and 2.

Your list is your life as an F1

Support from colleagues

The topic of industrial action came up again today at work. It was discussed amongst my team to ascertain who would and who wouldn't be taking action.

It turns out that despite a large vote in favour of action, no one else in my team is taking action. Sadly they also do not seem to support the action.

Given the representation of members from the BMA ballot it would seem possible that my team colleagues may not have voted. In fact I know of several people who not only didn't vote, but who cancelled their BMA membership out of principle.

While I respect that everyone has a right to their own opinion I think it's incredibly rude to slag other people off due to their decisions. While I haven't been at the receiving end of verbal abuse yet, some colleagues have made scathing remarks about shirking work and putting patients at risk.

When we're all screwed over our pensions and working lives then we'll all be in it together, whether we agree with each other or not.

It's nice to feel supported by your colleagues

48 hours

The European Working Time Directive says that we should work no more than 48 hours per week. Doctors can opt out of this if they want to, but my rota isn't written beating this in mind.

The hospital gets around this by saying that the 48 hours is worked as an average over a month. As much as I would think this was normally amazing I reckon I'm due a week off soon.

Last week I worked my rota of 70 hours in 7 days but never managed to leave on time. I ended up working closer to 80-85 hours in that time.

While you might think this is a rare occurrence I have the hell period coming up again where I work 12 days in a row. That's 107 hours if I manage to leave on time every day for 12 days. It won't happen. It has nothing to do with time management or prioritising, it's just that patients seem to get sick at the most inopportune moments.

I can't speak for other hospitals and departments but this is how my rota runs.

And as a result of this doctors have no social life and make mistakes due to exhaustion.

This is why there is burnout and compassion fatigue amongst NHS doctors.

Roll on 21st June

It's really come to this

Who knows best?

I know that the days have passed where doctors know the best for their patients, but I am so bloody fed up of relatives shouting at me. I have had over a month now of relatives yelling at me because I'm on the ward and know the patient in question. Sometimes you just can't win- I've been yelled at because we were still investigating the cause of an illness, and then also yelled at (sometimes by the same person) for solving the problem (or at least identifying it) and trying to discharge the patient. The problem is that although the relatives know the patient infinitely better than I do, they don't understand the disease (usually). On the plus side, my communication skills have got better, as have my instincts about when to get out of the way or call security!