My Last Shift As A Gastro FY2 Doctor

What a whirlwind the last couple of weeks have been! I am officially in my last week as a FY2 doctor – tomorrow is my last post-take on call shift and then I will be DONE; we thank God!

Last Tuesday was my last shift on the ward, and I’ve spent the last couple of days visiting my dear aunty Funzie for a much needed retreat – it was so much fun and I’ve come back feeling refreshed and ready to change over jobs next week… but more on my post FY2 plans later.

In the month it’s been since I last updated this blog, I started and completed my on call night shifts, and my goodness, the hectic day shifts on the ward were definitely a breeze compared to how overwhelming the nights were. 1 doctor (me), covering 10 medical wards… it was A LOT.

I’m not going to go into detail about how they went because it took me a while to recover from how awful some of the shifts were, so here’s a haiku to sum up my nights:

Never ending bleeps,

Yay for helpful registrars,

Site team are the WORST.

Yupp. And in the words of Forrest Gump, “That’s all I have to say about that.”

Moving swiftly on, how was my last day on the Gastro ward? I started the day hoping for a calm, relaxed shift; I was only meant to be working till 3pm because of allocated self development time, so surely the ward would be fine till then, right?

Yeah… WRONG.

My last day on the Gastro ward involved a patient self discharging, then being brought back to the ward by the Police because they had tried to take their life. This same patient also snuck alcohol on the ward, which they downed with some Paracetamol and Anadin, ofcourse. They then required holding powers (a.k.a sectioning) by me because they became aggressive and tried to leave the ward; all this whilst continuously threatening to take their life. Yupp. And this was just one patient.

Also on the ward that day was a patient who had an upper GI bleed that required an urgent endoscopy, as well as other acutely unwell patients with ascites and liver cirrhosis. Basically, it was all kicking off and with the Registrar dealing with urgent referrals around the hospital, I had to manage most of this by myself, whilst also being shadowed by the new FY1 doctor, so I even had an audience watching me trying to juggle everything!

I guess I can laugh now at the irony of me having to section a patient whilst on a GASTRO rotation – I really thought I was done with Psych after the draining four months of it I had but NOPE, I had to bring back a lot of my knowledge of holding powers to be able to correctly section the patient. I was the only one on the ward who knew how to do it, so I guess that was God trying to tell me that though my experience of Psych was quite distressing at times, I really learnt a lot from it, because I was able to apply a lot of my patient management skills from there to the suicidal patient on the ward.

My last day wasn’t all doom and gloom though – I got to do my first ascitic tap! It’s funny because I’ve done quite a few ascitic drains now but never a tap, so glad I was able to do it before leaving Gastro.

Despite how busy it’s been, I’ve really enjoyed my time on Gastroenterology. I find it so so interesting and I’ve learnt so much over the last four months. I would really consider it as a speciality if I didn’t have to go through being a Medical Registrar as part of training for it. Yeah Med Reg life, especially in a district general hospital, is most definitely not for me… *shudders*

Here’s to more regular updates now that my foundation training is coming to an end and I have a new job… but more on that in my next post 😉

2 Months As A Psychiatry FY2 Doctor

It’s been nearly eight weeks since I rotated from GP land to Psychiatry, and in those eight weeks I have had normal day shifts, as well as eight very eye opening on call shifts. Some might even call them harrowing/low key traumatising to be honest, so here are 8 lessons I have learnt so far:

1. My least favourite words to hear when I’m on call are “new admission”.

2. I am much better at interpreting ECGs then actually doing them.

3. You must be able to prescribe rapid tranquilisation when needed- know your doses well. Rapid tranquilisation meds are given intramuscularly to quickly calm aggressive/violent patients, so they’re usually given ASAP in emergencies.

4. Following on from the point above, don’t let nurses pressure/intimidate you into prescribing anything you don’t feel comfortable prescribing. Yes, a lot of them are more experienced than you in Psychiatry, but remember that it is YOUR name that will be on the prescription, so if anything goes wrong, you’ll be the one in trouble, not the nurse. So always speak to your Consultant and DOCUMENT THIS before prescribing unfamiliar medication.

5. Racist hallucinations are a thing??? A patient I assessed last week told me the dead voices she was hearing and seeing were white, and because of this, they didn’t like me talking to her. I felt like I was in the Sixth Sense, your gal was SHOOK.

6. Suicidal patients can be very creative when it comes to ways to hurt themselves. Horrifyingly so. I’ve struggled with sleeping sometimes because images of some of these graphic foiled attempts, and the subsequent restraining required by staff, keep playing in my mind when I close my eyes.

7. Some patients will relapse shortly after you’ve discharged them as okay to go home, but you shouldn’t blame yourself for this. Sadly some patients will appear better and be deemed low risk, but because healthcare professionals aren’t mind readers, it is difficult to know if they’re just saying what we want to hear.

8. I am very sure that acute psychiatry is most definitely not for me. Nope. Only two more months to go…

A Much Needed Break From Psychiatry

Two weeks into my Psych rotation and I am feeling DRAINED.

When I’ve explained how it’s draining to people, I’ve been able to summarise it like this:

My time in Respiratory during the first wave of COVID on that awful COVID rota was physically draining because of the long shifts. GP was more mentally draining- I had shorter days but was using my brain a lot more because of how much more independently I was working/reviewing patients on my own.

So far, my time as a Psychiatry SHO has been emotionally draining. I work in an acute psych unit, where we have a lot of acutely unwell patients with psychotic symptoms, so I’ve felt more on edge.

We were told in our induction to constantly be on our guard- we carry alarms all the time, are never to have our backs to patients, should always sit closer to the doors, and should always review patients with a chaperone. So it can get pretty intense!

I have an oncall shift once a week, which involves me being the only doctor around to cover the acute site, as well as the elderly psych and eating disorder units. As my oncall shifts vary between 16 and 24 hours in length, I live too far away to go home, so I stay in the doctors’ rest rooms provided for us:

Sooo nice! It really does feel like a hotel, haha.

Anyway, I’m off this weekend and Boss and I have recently gotten into making and decorating gingerbread men, so much fun!

New Rota, Same Me?

HELLO! A lot has happened since the last time I posted on here so I think some updates are needed.

First of all, regarding the COVID-19 patient I saw without PPE. Over two weeks later and I still have no symptoms so I’ve been going to work as normal. The Consultant I saw the patient with has tested positive for COVID-19 though, and been self isolating for the last couple of days. I texted him to send my well wishes and check how he’s doing, and he said he’s not feeling too bad, so hoping he stays that way.

Second update: my rota changed quite significantly last week. We (FY1s) have been unofficially promoted, so our rotas now match the FY2 and more senior doctors in the hospital. I now have three different shift patterns: 8am to 4pm, 4pm to 12am or 12am to 8am, and we have less breaks between them (four days on, one off, then five days on, then one off and then back to four days), so working a lot more because we’ve been told weekends and bank holidays are now no different weekdays re: staffing levels.

This means that all my annual leave has been cancelled indefinitely- I’m doing a lot more on call shifts and nights, and I counted that I’m working 13 weekends between now and August. THIRTEEN. That’s a lot.

Also my base ward has changed from Respiratory to Gastro, and I’ve been moved to a ‘cold zone’ of the hospital, meaning that I won’t be seeing COVID patients for now. During my on call shifts, I still cover Respiratory and Renal wards though, so this week I swabbed a patient for COVID for the first time, which was …a learning experience. I felt so sorry for the patient- it’s not a very pleasant experience. If you’re interested in seeing how it’s done, click here.

However, on a positive note I’m no longer working nights on my birthday!!! By some miracle, one of my off days happens to fall on Tai and Kenny Day, so YAY for that!

We now have to wear scrubs all the time now (so much more comfortable tbh), so get ready for some more #scrubselfies:

Until next time! 😀

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!