One Year As A Doctor

I started life in GP land as an FY2 doctor last week, and it’s been a welcome break from how hectic hospital life has been over the last couple of months. I’m now fully registered on the GMC register, meaning that I can now discharge patients on my own, as well as write out paper prescriptions, so it’s only up from here tbh.

Still can’t believe I’ve been working as a doctor for a year now, and what a year it has been! From moving up north on my own, to dealing with the COVID pandemic and the exhausting changes it brought to our rotas, it has really been quite the start to my medical career.

As always, the glory goes to God for seeing me through it all; a year on and it still feels surreal to introduce myself as an actual doctor. It sometimes feels like a dream to be doing what I’ve wanted to do since I was 5 years old, and I feel so so blessed everyday.

I definitely feel like my confidence in my abilities has sky rocketed too. I had a lot of imposter syndrome when I first started, but I can say with confidence that though I may not be the “smartest” doctor, I am a good and safe one; being a good doctor is about more than being able to reel off facts about disease pathology. So for new doctors, don’t stress out if there are things you don’t understand, no one can know everything.

So, some reflections after my first year:

Current job – General Practise

Useful Things I Wish I’d Known Earlier: 

1. Some nurses can do skills like venepuncture, cannulas and ABGs, so that’s another reason to make sure you’re nice to them, because they will help you when you struggle.
2. Before you call to make a referral or seek speciality advise (ESPECIALLY from Micro), make sure you have all the bits of information about the patient ready, or you will get absolutely wrecked by disgruntled seniors. Trust me, speaking from experience #peak
3. TRUST GUIDELINES. Not just for antibiotics, but step-by-step guides on managing electrolyte disturbances, diabetic patients, ACS protocols and so much more can be found on the Trust intranet pages, so it’s always helpful to look there first before calling busy medical registrars…

What am I good at? – Speaking to patients and putting them at ease. Shout out to the years of experience working at my local theatre because it really helped build my people skills, as well as my confidence with speaking on the phone. I can now also say that I don’t struggle with cannulas as much as I used to, yay! The struggle was so so real but finally got there in the end! I had to swallow a lot of pride, and kept asking colleagues to watch me do cannulas to give me improvement tips, and they really helped. So I must stress that asking for help is not a sign of weakness.

What makes me nervous? – Signing off on chest x-rays on my own; always the creeping fear that I’ve missed a small pneumothorax…

The last time I cried at work was? – My last day on the Respiratory ward; the Discharge Coodinator got me chocolates as a leaving present and told me I was her favourite junior. It was the loveliest surprise after what had been a pretty busy day, and a great end to my time on that ward.

A memorable non-med related thing I have done: I went to the beach on my own during one of my days off and it was so great. Got some fish and chips and read for hours by the beach and it was brill. Will definitely do more solo days out in the future!

 

9 Months As A Doctor

Time flies, right?? Can’t believe I’ve been an F1 doctor for more than 9 months now- seriously WHAT THE HECK.

I’ve been resting at home over the last couple of days and it has been so great. Sleeping, reading, watching TV and films, and just having so much needed down time has been much appreciated. I’m definitely feeling more refreshed and ready to go back to work tomorrow.

As I did at the 6 month mark, I thought I would reflect on my milestones so far. So here we go:

Current job – Officially still Respiratory, but based on a Gastroenterology ward most of the time, and I cover Renal and Respiratory during my on call shifts.

What am I good at? – Getting patient discharge summaries done/prepped on time- no patient waits for their TTOs on my watch! Also good at speaking to patients/their families, especially when it comes to difficult conversations – shout out to the years of working in customer services at the theatre for this.

What makes me nervous? – Still annoyingly very hit/miss with cannulas tbh, grrrr. Much better with ECGs now though (yay), but liver patients and their clotting abnormalities also make me v. nervous.

Useful thing I’ve learnt? – I CAN DO ASCITIC DRAINS 😀

The last time I cried at work was? – Last week, when one of my favourite patients finally got discharged after spending nearly two months with us. A very pleasant 95 year old man- he would always take the time to ask everyone he spoke to how they were, continuously thanking us all for his “excellent” care. We were all sad to see him go, but very glad that he was finally getting to go home, and COVID negative too!

My happiest work moment so far was? – I know I keep going on about this, but putting that drain in successfully on my first attempt was such a satisfying moment. The Registrar supervising me thought I did really well too, so I was very very happy after this.

A memorable non-med related thing I have done: Just before we went into lockdown, I was able to go and surprise my little brother at one of his university art shows, so that was pretty fun. He had no idea I was coming, and I was able to see some of his work- he is so SO talented! Don’t just take my word for it, you can check him out here, and here.

(Side note, this is also my 300th post! COOL).

6 Months As a Doctor

I’m on night shifts at the moment so my days and nights are kind of blurring into one, but it was brought to my attention that this week makes it six months since I officially became a junior doctor. I started in AMU and now I’m back here again, how time flies!

So, half a year in; here are some of my milestones:

Current job – Respiratory, but on my acute block in AMU at the moment. 5 nights down, 2 to go…

What am I good at? – Transfer clerkings/reviews of patients when they get transferred to my ward; still getting told that my writing is very clear and legible! I can confidently say that I can get most bloods and blood cultures from patients without help now.

What makes me nervous? – Interpreting ECGs, inserting cannulas and presenting patients at AMU handover.

Useful thing I’ve learnt? – Interpreting ABGs- having to do a teaching session on this has made me more comfortable with them.

The last time I cried at work was? – 2 days ago; I had just finished a hectic AMU night shift covering a zone on my own, and the consultant pulled me aside for a teaching point on how I should have put a patient on IV and not oral antibiotics, but said I had done a good job overall with my clerkings and patient reviews so I should be proud. (These were happy tears!)

My happiest work moment so far was? – See above.

A memorable non-med related thing I have done: I’ve visited the penguins at Yorkshire’s largest aquarium 3 times so far. I am OBSESSED.

The End of My Time in Ophthalmology

4 months later, and I have finished my first rotation as a junior doctor, time flies!

How best to sum up how much I enjoyed being the Ophthalmology F1? Well by the end of the rotation I had one more day of annual leave I could take, as I had only taken eight of the allocated 9 days we get per rotation, but I didn’t end up taking it because I didn’t want to miss a day on the ward, so if that’s not love I don’t what is tbh!

Ophthalmology has really been the nicest start to life as a doctor. The ward wasn’t too busy, so I didn’t feel overwhelmed when I started, and with getting to go to clinics, and theatre, as well as having medical outliers on the ward and AMU/ward cover shifts, I got eased into working life, and also got to see a variety of different things. The best of both worlds, really!

On my last day, the registrars surprised me with a cake with a ‘T’ on it for Tai… yeah, I cried. Best. Team. EVER.

My First Time In Theatre As A Doctor

Guess who got to help intubate in theatre???

As you can tell, I was quite excited about this, haha. Nearly two months into life as one of the ophthalmology ward doctor, and I’ve gotten more confident/into a routine, so I get to do cool things like go into theatre and clinics.

I still don’t think ophthalmology is for me, but cataract surgery and cornea cross linkings are SO COOL.

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!