My Last Night Shifts

It’s been a very busy two weeks.

My sister (a.k.a The Keen One a.k.a Kenny) shared my last blog post on her Instagram, and I’ve been blown away by the responses to it. So many people have reached out to show support and check in with me, and I’ve been so moved and overwhelmed by their kind words.

I don’t really share my blog with people I know in real life, as the majority of readers and followers of this blog are strangers from all over, so it’s always surreal to me when people message to tell me they’ve come across some posts. As always, I appreciate anyone for stopping by, and hello to you all!

Since my last update, my jobs have changed. I was informed by my TPD (Training Programme Director – we’re all assigned one as GP trainees) that my hospital job next year has been changed to a GP post. I was meant to be doing 4 months of Medicine for the Elderly from December to April next year, but because requirements for GP trainees mean we now have to do up to 24 months in primary care as part of GP training, that hospital job has now changed to a GP post.

So what does this mean for me? It means that after next week, I will have no more hospital jobs until I become a GP (by God’s grace!) – the only out of hours shifts as a hospital doctor I will be doing will be locum shifts if I want to, which means NO MORE NIGHT SHIFTS.

No more ward rounds, no more ward cover, and NO MORE NIGHT SHIFTS.

As you can imagine, this made my final set of nights last week fly by, because I just kept thinking, almost there…

So so grateful that the nights weren’t too stressful either – I’ve really not been enjoying being on my base ward over the last couple of weeks, so being in AMU last week was a breath of fresh air, and a reminder of how much I love my job when I get to clerk and spend time with patients, without feeling rushed to do ward jobs or being pressured to complete discharge letters. I really needed that reminder because it’s been tough.

After my final shift, the Consultant doing the post take ward as we were handing over said I’m the most cheerful post night shifts junior doctor she’s ever worked with, and that really made my day. I’m feeling more like myself at work again, so here’s hoping my final shifts on my base ward before rotating to GP in April go as smoothly.

I’ll leave you with some pictures from our GP Trainee Gala Dinner a couple of weeks ago – SO MUCH FUN!

Junior Doctor Anecdotes: The Mezzo-Soprano Who Needed a Cannula

HELLO! It’s been a little while since I last updated this blog – it’s been a busy couple of weeks getting used to working in hospital again, but loving life on Gastro so far! It’s definitely been better than Psych because it’s great to be part of a team again, so it’s been nice to have more support and seniors to call when I feel out of my depth with patients. I’ve also spent the last couple of weeks finalising my plans for life after F2, which has all been very EXCITING, but more to come on that soon…

Anyway, since I started on Gastro, I’ve completed my AMU oncall block, which involved long 12 hour shifts. As the ‘post take’ doctor, it was my job to see new admissions with the Consultant, and then do the jobs for them. It also involved keeping track of the patients being clerked by the ‘clerking doctor,’ as I’d get bleeped to see them with the Consultant when they were done.

As you can imagine, I was kept very busy during these shifts because the patients who needed post taking were from all over the hospital, so definitely a lot of walking, meaning that I got to know my way around the hospital pretty quickly! It really taught me how different staffing levels can be in smaller hospitals, because my F1 jobs were in a big teaching hospital that had a massive Acute Medicine department, so AMU shifts there always had a lot more doctors around to do the jobs and clerking.

A patient that stood out during my AMU long days was an elderly woman, who I was called to cannulate. Various nurses had attempted but were unsuccessful with getting the cannula in, and she really needed one for a CT scan, so I said I would give it a go. Anyone who has followed this blog for a while will know that I reallllllyyyy struggled with cannulas last year, and after 8 months of GP and Psych, rotations where I didn’t have to do any cannulas, I was seriously out of practise. So why did I volunteer to try, you ask? Well I decided to back myself and give it a try if she was willing – practise makes perfect, right?

Yeah… so my first try was no good… as was the second #peak

The lovely lady told me to give it another go, even though I was ready to give up at this point. As I was setting up the equipment, I was chatting away to try and put her more at ease, as one of the reasons that my cannula attempts had been unsuccessful was that she kept flinching/tensing when I inserted the needle, so I thought that if I got her to relax a bit, it might just work.

As we were talking, she joked that we might be more successful if I sang to the veins “to get them out of hiding,” which immediately reminded me of that time I sang with a nervous patient to get a blood sample from her. So I was suddenly struck with some inspiration.

I asked her what her favourite song was, and she replied that she was “old school” and more into musicals, so OFCOURSE I had to ask her what her favourite musical was, and it was Les Miserables, one of my favourites as well! I suggested that it might help if she sang her favourite song from it in her head to distract herself from the needle, but she became visibly emotional at this.

She told me that she had been a mezzo-soprano and had sang in choirs for most of her life, but then she got diagnosed with Parkinson’s Disease, and her voice was the first thing to go. She added that she still loves singing, but it makes her sad because she doesn’t sound as good as she used to be, so doesn’t like singing to herself as much. Then she asked if I would sing with her.

So that was how the both of us ended up singing I Dreamed A Dream from Les Miserables together in the middle of the ward, and this ex mezzo soprano showed me that she still had quite a voice on her.

And guess what? I got the cannula in on the third attempt.

I Saw a COVID-19 Patient Without PPE

It happened last week. I signed up for locum shifts in AMU during my annual leave to get out of the house (I live alone and couldn’t deal with a week of being in my flat, so thought I would help out in AMU over the weekend).

During one of my shifts, I was asked by a nurse to review a patient who wasn’t responsive – they had been admitted with reduced eating and drinking, which had worsened their Parkinson’s symptoms. I must stress that this patient had no respiratory symptoms – no cough or fever, so we were treating them for acute kidney injury caused by dehydration.

As a result of this, I examined this patient like I would any other patient without suspicion of COVID-19, so I wore no gloves, or apron or mask, and got quite close to them to do a full ABCDE assessment, then called my Consultant for help when I couldn’t quite figure out what was going on. Like me, the Consultant also didn’t wear any PPE, and we re-examined the patient together, and came up with a management plan.

After the shift, I thought no more about it and had forgotten all about the patient, until I got a call from one of my F1 pals in AMU, who told me that the patient had been tested for COVID-19 and came back positive. My friend had called to let me know because she knew that there would be no contact tracing done, so wanted to make sure I was aware.

As you can imagine, this was quite unsettling news for me to hear. Since my AMU shifts, I had been in contact with many other patients, not to talk about my fellow colleagues on the ward, so I started freaking out about the possibility of me being an asymptomatic carrier and spreading it to people.

I called Occupational Health for advice, because surely I shouldn’t be working if I’ve been in contact with a confirmed case without protection, right? Wrong. They said that as long as I had no symptoms, hospital and government policy stated that I should keep going to work as normal. Yupp. I emphasised my concerns about being an asymptomatic carrier, but they said that patients and staff in “high risk areas” are current priorities for testing, so I should carry on as normal.

So here we are. A week on and I still have no symptoms, and I won’t be tested. Hospital PPE guidance has now changed though:

Long story short, we are now to see every patient wearing PPE, regardless of whether or not we’re suspecting COVID. In my opinion, we should have started doing this weeks ago, but atleast we’re there now. Here’s hoping I don’t develop symptoms…

Anyways, today’s good news? Shout out to Uber Eats for the free meals for NHS staff this week! I have definitely had too many takeaways, but at least I didn’t have to cook as much… ALSO, I had my end of rotation catch up with my clinical supervisor this week, and it went really well, so grateful to God for that, yay! 🙂

Junior Doctor Anecdotes: A Rare Compliment

I’m currently on long days in the Acute Medical Unit and ‘long’ is definitely right because two days in and I’M SO TIRED.

Anyway towards the end of my shift yesterday – it had been a pretty hectic day with some breaking of bad news to patients that was really tough, and so many jobs to do that I didn’t have lunch till about 5pm, my Consultant pulled me aside and said, “You’re good, very good, and you’ve done well today. I just wanted to let you know that, well done.”

(I cried).

Surviving Being On AMU (Acute Medical Unit)

Three weeks into life as a junior doctor, and I have come to the conclusion that being good at making lists is a very useful skill to have.

So you can only IMAGINE how low-key smug this has made me, because I have been teased and mocked for years for being so Type A – I make daily ‘To Do’ lists for different aspects of my life to get things done, and I get very particular when it comes to organising things/ scheduling events. And it turns out that this has given me an advantage, yay!

It was particularly useful during my long day (12 hour) shifts in AMU. For anyone who doesn’t know, AMU is the Acute Medical Unit, and this is where patients who need admission from A&E are sent, as well as patients who are referred to hospital from their GPs. As patients are usually there for a short stay before being discharged or admitted to specific wards in the hospital, AMU is usually very busy, with new patients to clerk and numerous jobs to stay on top of.

(Two shifts in, and I discovered that writing jobs/printing the handover list on coloured paper really boosted my mood, and made ticking off completed jobs so much more fun, so I recommend trying that!)

I had done two days of shadowing in AMU before I officially started, and ofcourse I had similar placements in EADU in final year so I was sort of prepared, but it is definitely a whole different ball game when you’re qualified! Seriously, the number of times nurses would ask me questions and I didn’t realise they were talking to me because they addressed me as “doctor” was quite funny…

And that brings me on to my next survival tip: BE NICE TO NURSES.

They are so much more experienced than us starting doctors, and definitely know more about their patients because they’re the ones who spend the most time with them, so lose any ego you have and start showing them the respect they deserve; they are invaluable sources of help. (And the same goes for other healthcare professionals! Just don’t be a douche tbh.)

My days in AMU consisted of clerking patients, and doing jobs like bloods, cannulas, blood cultures etc, so I’d advice you to make sure you use the time you have on placements during med school to actually practise the skills, because when you qualify you’ll be doing these constantly.

I learned the hard way about making sure you have all your patient’s details before calling radiology/requesting scans, because boy oh boy did I get an earful from a very annoyed radiographer when I tried to request a CT scan… yikes.

Overall I really enjoyed my AMU shifts, even though it was a bit of a baptism by fire, but I think it’s definitely prepared me well for moving to my base ward (ophthalmology), which is much less hectic, but more on that soon…

The Night Before My First Shift As A Doctor

“What if a patient goes into cardiac arrest?”

“Omg do I remember my Advanced Life Support training?”

“What if I’ve forgotten how to interpret an ECG?”

“How long should the QT interval be again??”

“Do I remember how to do neuro exam?

“OH CRAP what if I have to do a cranial nerve examination on someone and can’t find a pen torch?”

“Will the consultant pick on me? What if he does and I cry in front of everyone??”

Questions like these and more have been on repeat in my head all day, so to say I’m a bit nervous would be an understatement.

I officially begin my career in the NHS tomorrow, and I start with a 12 hour shift on call in the Acute Medical Unit (AMU), so getting stuck in straight away.

I’m also quite excited too- I’ve dreamt about this day for so long that a part of me still can’t believe it’s here. All thanks to God, ofcourse, so I’m writing this to remind myself that God has not given me a spirit of fear, so whatever happens tomorrow, I will be encouraged by this and face it with confidence.

Another top tip to remember (and this applies to all aspects of life and not just starting doctors), asking for help is never a sign of weakness.

Bring on tomorrow!