Over the last couple of months I’ve had the chance to experience life as a patient because of various hospital referrals and investigations. From bloods, to ultrasound, to xrays and endoscopy, your gal has had quite a lot going on, and so far I’m all good, so I’m grateful to God for that.
It’s all made me very reflective about life and how short it is, so as cliché as it sounds, it’s so important to make the most of each day because tomorrow isn’t guaranteed.
Also, long live the NHS.
I didn’t have a great start to this rotation because I was told 10 days before I started that it was changing from a community to an hospital based post, but the upside was that I didn’t have to do on calls. I was also told that I could do outpatient clinics weekly if I wanted to, and I agreed to do one a week under supervision of a Consultant Psychiatrist.
3 days before these clinics were to start, I received an email informing me that I was now doing two clinics a week. No explanation or apology for the late notice; it was pretty much a ‘For Your Information’ thing. Ofcourse I was not having it, and refused to do the extra clinics because this wasn’t what I’d agreed to, it hadn’t been discussed with me, and it was unprofessional and just plain RUDE that this was being sprung on me like this.
I feel like this just sums up life as a junior doctor because you’re made to feel like a name on a spreadsheet being moved for service provision, without any consideration of the inconvenience or unfairness of it all. I have a life – being a doctor does not define it! It’s very unfair and I think I was absolutely justified in responding with emphasis on my disappointment in the poor communication and how badly it had all been handled. I am a doctor and deserve to be treated like a professional – the infantilisation and how junior doctors are treated in the NHS is really not okay.
So what was the resolution?
I decided to do the extra clinics because they’d already booked patients for them, and it would have been unfair on the patients to have their slots moved. If they hadn’t already booked these appointments, I would have definitely fought it more, but I chose to let it go.
Psychiatry 2 – 0 Tai
If they backtrack and say I have to do oncalls though, it is definitely NO and I’m ready to escalate to the BMA if necessary. Enough is enough!
Hello, old friend.
This is probably the longest it’s been since I updated this blog, and it’s definitely been a tough couple of weeks. I’m feeling better now so I think I can go back to more regular updates.
A picture says a thousand words, so here are a couple to recap some of the things I’ve been up to:
Exactly 10 years ago I had my interview for medical school, and over the next three days I’ll be joining the junior doctor strikes. My 17 year old self would have never seen this coming – refusing to go in to work, really? Goody-two-shoes me who has dreamed of becoming a doctor since she was 5? Never! But nevertheless, here we are. So I thought I should explain why.
First things first, a junior doctor in the UK is any doctor who isn’t a Consultant or GP. It annoys me that the media tries to put across the narrative of junior doctors as ‘young’ or ‘inexperienced’ doctors who are fresh out of medical school, and this isn’t true. I graduated 4 years ago and I am still a junior doctor. My Registrars who are nearly 10 years post graduation are junior doctors. I know GP trainees and doctors who are in their mid/late 30s – we are all junior doctors, so let’s get that straight to begin with.
Next, let’s talk about pay- since 2008, pay for doctors has gone down by about 26%. So a newly qualified FY1 doctor, after 5-6 years of medical school and graduating with nearly £100,000 in debt, gets paid about £14 per hour. As an ST1 GP Trainee with nearly four years experience as a doctor, I get about £19 per hour, and a Registrar (ST6-ST8 with eight to ten years of experience) gets £28 per hour. The BMA is calling for pay restoration, to bring junior doctor pay back to the level it was in 2008. This is because with the cost of living crisis and the cost of being a doctor (many people don’t know we have to pay hundreds of pounds yearly for exams, indemnity insurance, and to keep our registration), a lot of doctors are struggling.
It’s due to this that many are leaving to work in Australia and New Zealand because doctor pay is better, as are working conditions, because as you can imagine, people are more willing to work if they know they’re getting what they deserve for their skills.
Now I’m well aware that I’m so blessed to have a secure job, and many people can only dream of getting what I get paid. But being a doctor isn’t an ordinary job – it comes with so much additional stress and responsibility, that I even struggle to talk about the toll it takes on me some days (I’ve always been better at writing how I feel). Knowing a decision you make could cost someone their life is so SO hard, and I feel like a lot of the general public just don’t understand this. So is it too much to ask to be paid to reflect this?
Having a National Health Service with the majority of services being free to access is one of the greatest things about the UK, and I’m so proud to be part of it. But without enough doctors to provide services, the NHS as we know it isn’t sustainable, and that makes me so sad.
But that’s not the main reason I’m striking. I’m striking because I think I’m beginning to show signs of burnout.
I’ve been more irritable and snappy on the wards, and I’m worried that this is slowly starting to creep into my life outside work because I’ve been getting more short-tempered, easily annoyed with people around me, and I just want to be away from everyone some days. Also, I’ve been crying for no reason sometimes, what’s up with that??
We had a GP teaching day on wellbeing last week, and one of the talks listed symptoms of burnout. I cried because I could relate to quite a few of them.
You see, working on a ward with inadequate staffing means I’m looking after too many patients, and this is very stressful. It’s also really unsafe because if doctors are too stretched and tired because they don’t have time to eat or drink properly during busy shifts, things can get missed. And if there is no continuity of care because the ward has different locum doctors working there everyday, patient care suffers. This is what is happening across the NHS at the moment, because there just aren’t enough staff because the Government isn’t doing enough to retain them, and patients are dying because of this.
I knew very early on in medical school that I was never going to be top of my year or anywhere near that, but I knew I would be a good doctor because even though I wasn’t as “brainy” as some of my colleagues, I genuinely loved interacting with and spending time with patients. I’ve always seen being compassionate and empathetic as my strengths, and the day I start to lose that is the day something needs to change.
Well that day has come much sooner that I thought it would because I was snappy with a patient last week due to being stressed on the ward, and I actually made them cry. It was like an out of body experience because I felt like I was looking at myself and thinking, “Who are you?”
So I feel like the day for something to change is here, because if I start to lose my compassion then where does that leave me?
(P.S – I immediately apologised to the patient after snapping and she was so so kind about it – “It’s okay, you’re all doing your best, I know it’s busy.” Reader, I cried.)
Just over two hours left of 2022, and as I start writing this I am on my break at work. Contrary to what the media might have you believe, the NHS is still pushing on and we’re all doing our best to keep patients safe… but I won’t go into all that in this post.
What I do want to talk about is the importance of kindness, and how that (and the grace of God, ofcourse) have gotten me through a lot of this year.
It’s been quite a year for me too, with some big moves and changes and I’m grateful to God for getting me through to the end of it.
My time in the Emergency Department was draining, but it’s definitely been one of my favourite jobs so far, and that was largely because of the people I worked with. From supportive seniors to hilarious nurses, and colleagues who I can now call friends, as well as the patients who took time out to write me thank you notes and feedback (I cried lol), I really had a great time.
Outside work, I’ve been so blessed by the people around me – from my Model Bestie, who helped make my move to this new city so smooth, to my new friends at church, who insisted on cooking dinner for me during night shifts, and MRCRi, whose home I’ve always felt welcome in, I’ve really felt the love over the last few months.
I want to end this year by reminding anyone reading this that life is so short, and you really have no idea what people are going through. So as clichè and corny as it sounds, just be nice, you know? A kind word can really make someone’s day, so here’s to a 2023 filled with more of these. See you all on the other side!
This is a question I’ve been getting a lot since I started my new job, so I thought it was time I explained exactly what I do on my non-clinical days.
I’m working as a Clinical Teaching Fellow this year, which means that I have one clinical day on the wards (AMU), two days a week teaching medical students, and the rest of my week is spent working for the Improvement Team of the hospital, which means I get to work from home.
So far I’m really enjoying the #WFH life, as it’s been a welcome break after my hectic FY2 rotations. I’ve mentioned previously that my work for the Improvement Team involves creating teaching resources and working on projects focusing on equality, diversity and inclusion, but what does this actually mean on a day to day basis, you ask? Well, allow me to elaborate!
At the moment, I’m working on a quality improvement project aiming to increase awareness of FY1 doctors in the Trust of where and how to report racist incidents and microaggressions they experience at work – I definitely got (and still get) a lot of these, but I found speaking up about them really overwhelming as an FY1. Being new to working as a doctor, and also being new to the Trust was quite intimidating, and it was made tougher by not knowing where or who to turn to for help, so this is something I want to improve for current FY1s, to be hopefully rolled out to other groups of staff. My Trust is now doing more to support staff when it comes to these issues, so one of my goals this year is to make the whole reporting/escalating process a lot easier and more straightforward.
Part of my work for the Improvement Team involves being a representative for foundation year/junior doctors in various board meetings; trust me, A LOT of meetings happen at executive level in the running of NHS Trusts. It’s been quite eye-opening to be part of these meetings, as they influence the day-to-day lives of staff in the hospital, but there is usually minimal representation of junior doctors. So my job is to bridge the gap between management and junior doctors, and I’ve been giving input on the practical aspects of proposed changes from things like discharge planning and discharge letters, to induction packages and team restructures, so that’s been very cool.
As for the creating resources part of my role, I am currently in the process of conducting interviews with staff across the Trust who comes from under-represented backgrounds. The exhibition we put together last month is part of an ongoing project to improve the experiences of staff who are minorities in the Trust. So these interviews will be used for training of line managers and supervisors, to help them better understand how they can offer more support to their colleagues and employees.
All of this work is linked closely to my role within the medical school, as I’m helping to develop bystander training and communication skills, so the eventual goal is to have the work we do with the students transferred across to train staff at the hospital, which is all very exciting.
So yeah, just a bit of insight into what I do when I’m working from home – I feel so blessed to have been given a year out of training to do a role I feel so passionate about, and I’ll definitely be updating on what we get done as the year progresses 😀
And I think one thing I’m really bad at is admitting when I’m feeling overwhelmed, which then makes the stress worse, and I become snappy and not nice to be around. Not good. So I’m writing it here to be more open about how I’m feeling in the moment: I’ve been feeling low lately.
With new work pressures/expectations, as well as general life stuff, things have been feeling a bit much for me over the last couple of weeks, and I’ve been struggling. But I’m starting to feel better now, so here are some things that have helped:
In other news, my first official project with the Improvement Team was launched last week, and it’s an exhibition celebrating diversity in the NHS. It includes portraits, paintings and sound clips of various staff members from various groups within the Trust, sharing their experiences of working in the area, information about their backgrounds, as well as how the pandemic has affected them.
The exhibition was put together in collaboration with the local art college, and will be on display for free to the public for the next month. I’ve been so honoured to be part of this project (organising it all has been super stressful but we got there in the end!), and I also got the chance to be photographed as well, which was so much fun:
Here’s to future projects with the team, and yay for celebrating diversity!
I’ve officially come to the end of my first year as a junior doctor (more on this to come in a separate post), and I was given the opportunity to be interviewed by BBC Look North last week, for a piece on racism in the NHS.
Ever since I did a presentation to junior doctors at my hospital on micro-aggressions I’ve personally experienced, the last two weeks have been a whirlwind of meetings with my hospital’s Medical Education team, the BAME Leadership Network, the Trust Organisational Development team, and the CHIEF EXECUTIVE.
It’s all been a bit overwhelming to be honest, but the long story short is that my hospital is now trying to raise more awareness of micro-aggressions and more subtle manifestations of racism, as part of new diversity and inclusion initiatives, as these are all too commonly experienced by ethnic minorities.
I’ve been so honoured to be asked to be part of a steering group and the committee driving this, as it is an issue I feel very strongly about, and I’m feeling super positive about the potential this has to make a difference.
So it was great to be able to talk about all this on the news, as part of the ongoing discourse. Still very strongly believe that the onus shouldn’t always be on the people on the receiving end of offensive comments to keep calling them out though, so to all new doctors, make sure you speak up on the wards if colleagues/patients say problematic things.
(And as they’ve always done, black lives STILL matter by the way, even if your newsfeeds have gone silent.)
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! 🙂
Apparently my face is too small, so none of the masks I was fit tested with made a tight enough seal around it, and this is slightly worrying.
For anyone who doesn’t know what I’m talking about, a fit test is done to check that masks worn by healthcare staff in hospital fit properly, to make sure that they’re fully protected from infected patients. It involves being tried with masks and different things being sprayed in the air, so you fail if you can smell/taste them, because that means your mask isn’t tight/secure enough.
I didn’t even get to the spray part of the test because all the masks were too big #peak
So what does this mean? At the moment I have two options:
Really hoping we get more of those masks, because I really really don’t want to get moved. I know it would make you feel better, mum, but I love my team and I love working in Respiratory, so it would suck to leave them for another ward.
In other news, a quick rant on the importance of social distancing:
Seeing people on social media still going out unnecessarily has been frustrating and quite concerning. Hopefully this will become less of a thing with the Government closing things down today, but I can’t stress enough how vital it is to stay at home if you can. I understand that not everyone has the privilege to be able to work from home, and that there are many key workers who need to still go out, but if you can, STAY AT HOME.
“Why?” you ask- “If I’m young and healthy, surely I’ll be fine” is what a lot of people must be thinking right now, and yes, COVID-19 will most probably not affect you severely if you do get it, but that doesn’t mean there isn’t a chance it could, because it could be you or someone you love requiring ventilation to help you breath. We’ve heard scary rumours of F1 and ICU doctors in London dying, and new data is showing that more and more young people are getting really ill with it, so please take this more seriously.
You see, the aim of social distancing is to reduce the number of people who get infected, because that will reduce the burden on the healthcare service, and make more ICU beds and ventilators available for the people who get really sick. Because if you require ventilation to help you breathe and can’t get it, chances of survival are very slim.
Some numbers to drum this in a bit more:
I’ve accepted the fact that I will probably not see my family and friends at home for a long time, because I need to stay away from them to make sure I don’t infect them and vice versa. Many of my colleagues have said their goodbyes to their parents and families and moved closer to the hospital, because they know social distancing is one of the best ways to reduce the impact of COVID-19.
So, PLEASE, be a bit more considerate and just stay at home.
I’ll conclude with something uplifting: feeling so grateful to all the restaurants and stores showing support for NHS staff with free food, drinks and discounts at the moment. It really does feel like the whole country is rooting for the NHS right now, and it’s really heartwarming.
Life As A Junior Doctor 