JCF in EM and resus ๐ฉบ A sucker for PHEM, global/humanitarian medicine, and rugby ๐ซ๐ Affectionately known as Dr Smiley or Dr Lunch (both are good)
Hello ๐ซ
As many of you will be aware, this little girl has been my reason to get up every morning for the past 11 years and 7 months. She is my best friend and my whole world, and there is nothing I would not do for her.
๐งต๐ซ
๐งตWhat pushed me over the edge in the NHS today:
A v unwell pt needed an urgent echo today. I chased the report at 4pm and realised it hadnโt been done. A colleague asked the cardiology consultant if he wouldnโt mind doing it and he said he would if I got the machine from CCU
my neighbour has pcos. when her gp found out she didnโt want biological kids (sheโs adopting), she said โokay so why do you want us to treat your pcos?โ ๐ ah yes because a womanโs purpose is to manufacture babies, not to have a decent quality of life
It seems so pathetic in hindsight but my GOD it just feels like everything is such an uphill battle at the moment and no matter what good you try to do for patients it comes back to bite you. The fact that something objectively ridiculous has made me sob in my car should show-
and how it wasnโt a sick pt I was getting stressed over, but a locked door. But itโs just every ! day ! thereโs another uphill battle to try and make sure patients are looked after safely. Nothing is ever straight forward, itโs like things are designed to be hard at the moment
how bloody STRESSED doctors are!!!! Why is everything so HARD!!!! I am so tired !! Patients are so sick !! All I can think about is how Iโm back in tomorrow to do it all over again, and then on nights Fri-Sun with no break and no time to breathe.
The pressure is ON when youโre seeing a patient whoโs a retired GP, sonโs a doctor, daughterโs a doctor, and wifeโs a retired nurse, and theyโre all watching you try to come to the same diagnosis you know theyโve already diagnosed ๐ฎโ๐จ
I got home at 19:30, need to eat, shower, then sleep and repeat it all tomorrow. Show ! me ! the ! upside !
(the only upside actually is I got home to my
#PayRestoration
ballot ๐)
Iโve been learning and then practicing medicine for almost 7 years now. I think Iโm actually pretty okay as far as foundation doctors go. But Iโve been working in A&E for 2 days now and seeing undifferentiated patients has thrown me.
How are PAs doing this safely?
iโve been reported to my supervisor by the matron because at 7am on my night shift i momentarily rested my head on the desk in resus* ๐ฅฒ
*the only pts in there i had looked after all night, they had finally settled and were asleep and unaware of my momentary horrific behaviour
The lovely bed manager calmed me down and told me finally where I could find a disused closet to stash the machine in and she would personally return it tomorrow morning for me and vouch that I tried my best to return it.
Iโve obviously turned this over and over in my head cos Iโm so embarrassed that such a ridiculously trivial thing has tipped me off the edge??? but I was SO stressed and all I could think about was how I didnโt have dinner ready and my dog was home alone-
someone who knew the code but no one did. So at 18:45 I called the bed managers to ask if they knew it and immediately burst into tears because I was stressed and tired and hungry and my poor dog was home alone!!!!!-
Saw an elderly patient today who said they saw their GP a few days ago but I missed what he said so I clarified โyour GP?โ and he said โyes, I made SURE I was seeing a doctor, not some other professionโ.
Gorgeous gorgeous patients make sure they see gorgeous gorgeous doctors
My new house is in a cul de sac of 4 houses and between me and my neighbours we have:
A teacher
An ex-RAF engineer
A doctor
A Royal Marine
A police officer
A mental health nurse
And 2 dentists
Feeling pretty confident weโd thrive in an apocalypse
asked if there was any way I could leave it in the locked unused office overnight, then come in early tomorrow and bring it back to the unit. They said I was โshirking responsibilityโ and was โon my ownโ. I dragged the machine around for another half an hour trying to find-
Sure taking a history from a patient whoโs a doctor / has a Dr relative is bad, but have you ever tried redressing a wound when their retired A&E nurse wife is watching?
She said my dressing was lovely but I when I walked by a few minutes later she was redressing it herself ๐ฎโ๐จ
CCU said I could only have the machine if I would make sure it was back in the office before I left. The pt NEEDED the echo so of course I agreed. The lovely consultant did the echo at 5:20 (20 mins after my shift ended) then said he had another echo on another ward and would-
only be 15 mins. The echo was more tricky and the consultant didnโt bring the echo machine back till 6:30pm. I was already super tired and hungry after a ridiculously busy day so I hurried it back to CCU. When I got there the offices were shut and locked.-
lol I mentioned โdoctorsโ to an acquaintance today (who doesnโt know Iโm a doctor) and she went off on a rant about how โdoctors are useless, itโs nurses who treat the patients. Doctors donโt do anything, why donโt people know thisโ while I sat there like ๐๐ thank u for that
I asked all the nurses if they knew the code to the door so I could leave it there and they said they couldnโt. After an already exceptionally stressful day I explained how I was told it was my responsibility to get it back to the unit before I left, and-
as a female doctor i knew a lot of patients were gonna call me a nurse (often an unintentional mistake) but i was not prepared for my (female) GP to say โyou nurses must be so busy rnโ when i mentioned in my telephone appt that i was on shift in a&e at the time
On my first day of F1 I had to call microbiology. Iโd heard the rumours, I knew how scared I needed to be, so I studied my patientโs notes thoroughly so I had ever piece of information theyโd ask for.
The call went wonderfully. He asked me if it was my first day- ๐งต
nurse: Iโve got family in London
me: oh cool, whereabouts?
nurse: Kent
me, ODP, and anaesthetist: ๐ถ
anaesthetist: Iโm also from London
me: where in London are you from?
anaesthetist: India
went to sleep chuckling to myself. we love a funny anaesthetist
Moral of the story is know how many days your pt has been on abx, Cr clearance to 4 decimal places, exactly what body % was covered in a rash when they had penicillin at 4yrs old, the tensile strength of their Achilles tendon, and their stance on lowering their seizure threshold
just seen someone say nhs doctors donโt know what theyโre doing bc when she went to ED for lower limb numbness, she was assaulted as a doctor did a PR on her despite her insistence that it was a neurological issue, not a bowel problem ๐ช
I contacted my clinical fellowship job to confirm my salary and they said nodal point 2 (F2 pay, Iโll be an F3). I self-advocated and said I think I should be paid in line with nodal point 3 / CT1 and they emailed back today saying theyโll pay me at nodal point 3!!!!
Big win!!!!
me: hi iโve just been bleeped?
nurse: no you havenโt
me: uh yeah like 30 seconds ago
nurse: no no one bleeped you
me: are you sure?
nurse: yes iโm sure. no one bleeped u.
is this GASLIGHTING ? iโm not making up this bleep babe
as a junior doctor would you prescribe a medication that youโve never heard of, is not licensed for the management of this electrolyte derangement and your consultant refuses to explain why he wants it? he told me heโd report me to my supervisor for not prescribing it ๐
is this โฆโฆโฆ. legal???? i worked an extra hour because the clocks went back and apparently the trust has agreed not to pay doctors?
escalated it to the jr dr group chat and was told itโs because โif we pay you for the extra hour, we need to deduct the pay in springโ okay???
me in september: pls pls pls can you consider not putting me on call over xmas bc i miss my family and worked last xmas and i would love to go home this year
rota person: aw sweetie of course letโs get you home this xmas!!! โบ๏ธ๐ซถ๐ป๐ฅฐ
rota person: so youโre on nights all week
should i get my ES, who is an orthopaedic surgeon who specialises in upper limb, carpal bone magnets to say thanks for being a great supervisor or iS THAT WEIRD ๐ซ ๐ฎโ๐จ
I was given BBB predicted grades the day I scored very highly on my UKCAT aptitude test. Convinced them to give me the AAA I needed to get my foot in the door of interviews.
Walked into the common room one day to find people ranking the 8 aspiring medics-
I want to hear some underdog stories. Tell me about your 12th grade advisor who said you wouldnโt get into college, your premed advisor who said you wouldnโt get into med school, etc. tell me all the ways youโve turned their doubt into fuel ๐ช
bought a washing machine on marketplace and the guy said โwhatโs a doctor doing buying a second hand washing machine? youre telling me you canโt afford to buy new?โ
cue the pay restoration speech. he ended by saying โok yeah i get it a bit more nowโ
Oh BOY tune in for my incredible year ahead as a Clinical Fellow in Emergency Medicine + โspecial interestโ ๐
Expect lots of very enthusiastic tweets about my job this year because I had my first official day today and I cannot get over how exciting the year ahead is
Long๐งต
When I left the cubicle I did hear them say โsheโs a lovely doctor isnโt sheโ so I canโt have done too badly. I asked him if heโd sign a CBD for me.
is fy1s needing permission from the bed manager to speak to a pharmacist overnight unique to my trust or is that a normal nhs thing? why must advice be gatekept ๐ฅฒ
in order of most likely to get into med school. I was last of course.
Still, got 4 med school interviews and out of the 3 interviews I attended I got 3 offers so ๐
I love my underdog story so very much
my dog has more swollen glands + toothache so i called the vet and he said โoh are you the doctor?โ and i said โyeah, why?โ and he said โyour old vet transferred the notes over and thereโs a note on it saying โmumโs a doctor, knows what sheโs talking aboutโโ LOL
and congratulated me for my referral. He said, and I quote, โthis is the best referral Iโve had from an F1 Iโve ever had. You knew your patient, had the relevant information, well done.โ
Bolstered by my glowing feedback and success I offered to call micro for a colleague.-
iโve got my rota for my final F2 rotation, and i have literally no idea how iโm supposed to house hunt 300 miles away whilst still working??? itโs not like i can request leave now, because that might not work for the lettings agent, how the HELL are drs supposed to do this ๐ซ ๐ฅฒ๐ซ
Oh I do like it when Iโm allowed to submit my own ID photo ๐
EXCELLENT vibes from my new trust so far. Blown away by the EPR system that seems to have been designed with??? Patient care in mind???
But I am coming from a trust that uses Lorenzo so maybe the bar is just very low
@sentdefender
I think you should stick to reporting objective facts rather than subjective speculation. We donโt know your credentials, and the clear bias reduces your reliability.
You are an excellent source of information but your credibility becomes questionable with posts like this.
my consultants said if any of the juniors turn up during strikes next week theyโre sending them straight home and wonโt let them work. adore them for it
day 4 as an f1 and the swiss cheese model has failed and i got the buck for it xxxx
thought i could avoid crying on the job a little longer than this but ๐ฅฒ๐ฅฒ feel like pure shit ๐โค๏ธโ๐ฉน
because I could fall back on almost 7 years of education and experience. Thereโs no way in hell Iโd expect a 2nd year medical student to work out that it was a cardiac sx, because 2 years is not enough experience to see undifferentiated patients and try to diagnose them.
I always heard the argument against them seeing undifferentiated patients, but until I got a taste of it myself I naively had NO idea just how difficult it can be. I have a renewed shock that some PAs proudly tout how confident they feel on day 1 of this job (or GP).
limited results back, are often too confused or unwell to give a history, etc.
I cannot imagine doing this job as an FY1 with 5-6 years experience with medicine, let alone as a PA with 2 years of โmedical modelโ training.
Again, how is this remotely safe???
Brand new FY1. Pt deemed MFFD on ortho ward round. I did the paperwork and ticked them off on the system as MFFD. Pt had a fall on the ward on the way out. No one informed me. The patient left. I was datixed for an โunsafe dischargeโ bc no falls review before he left.
I have no doubt that EPIC would pay for itself quickly. Less time wasted chasing external results/letters, shorter hospital stays, happier staff, more retention. Improved patient safety by having ALL the info in front of you. Even things like less-
Everyone complains (justifiably) about NHS IT systems, and how we use a different system for each trust and none of them talk to each other.
Any SHO could tell you the pain of trying to get clinic letters from another trust.
Why doesnโt every trust just use EPIC and link up?
thinkin bout the time the ortho reg consented me for my ORIF and didnโt recognise me, despite the fact that i had just completed 18 weeks as a med student on her ward/team ๐
Why is emergency tax a thing?? Why are payroll and HMRC planning to fail? If you just do your job right and get the tax correct the first time, surely emergency tax would not need to exist ๐ฅฒ๐ฅฒ
Sincerely,
A severely underpaid doctor
ive been avoiding twitter for the past month bc everyone else was getting their results and i was convinced i failed the OSCE butโฆ
am i a doctor now??? ๐ฅน
Youโre going in completely blind. You have to be able to look at sign or symptom and work out if โitโs like one object becomes twoโ is cardiac sounding, neurological, ophthalmological, ENT, etc. I only concluded it was likely a cardiac presyncope-type symptom-
imagine losing a baking show because you donโt know how to manage an open fire ๐ and three dips? is this bake off or masterchef ๐๐
#GBBOFinal
my 96 year old patient today attended a speed awareness course last week. she even told the guy running the session that maybe if he lived a little more recklessly he might not have been late to the course. queen
i made a typo in a ptโs discharge letter yday which i stumbled across today. i was so stressed trying to sort it out so i called the pt to apologise and he said โoh dr hannah? the witty, happy doctor? oh i liked you i could never be mad at you!!โ
CUTE
I know all rotating doctors feel completely out of their depth when they rotate so I wasnโt expecting to find it easy and seamless from day 1. But something that wouldโve been an โeasy jobโ for an inpatient is so much harder when the patients are undifferentiated, have no bloods-
iโm sure people would understand if they worked 11 hours they get paid for 11 hours, if it meant those working 13 hours get paid for that instead of 12?? it was also a contract breach because the shift became 13h15m (maximum is 13)
i find this comically out of order?????
first day as a proper fy2 tomorrow and iโm covering the SHO led medically fit elderly ward by myself, pure vibes, ready to knock out some laxatives and ask everyone to tell me their life story
lmaoo a very delirious patient keeps walking around the ward thinking itโs her home and shouting at me saying โwhy is a CHILD in my HOUSE trying to tell me to go to BED!!!!!!โ
yeah fair tbh what am i doing
(just trying to gently redirect her to her room so she doesnโt fall)
update: i emailed my supervisor in the spirit of candour to just give him a heads up and to tell him that iโll reflect. but never let it be said i wonโt defend myself so if it does come down to it iโm armed with a defence and well-being/BMA guidance evidence ๐ค
@G_S_Bhogal
reading time: 7 minutesโฆ unless you are compelled to google every single thing to learn more about it, in which case reading time: ~1.5hrs
i have found a potentially PERFECT house for fy1 but the agent said it got over 60 enquiries in the first 12 hours of being posted so this is an appeal to everyone to pls keep ur fingers and toes crossed that my application is shortlisted ๐
Worked on it from 8pm-4am, slept for 2 hours then got up at 6am to continue, but HAVE FINALLY FINISHED MY F2 PORTFOLIO 2 HOURS BEFORE MY FINAL SIGN OFF MEETING !!!!!!!!!
I cannot emphasise the WEIGHT that has been lifted knowing every single box has been ticked finally ๐ซ๐ฎโ๐จ๐ฅณ
@DrAmberStebbing
my friend revealed it to the group later as a โhannah is leaving our club to pursue a fancy doctor job down southโ and i saw her quickly divert her eyes from me lmao she didnโt talk to me for the rest of the night
@mattspx
Iโve been talking to my network provider daily because I have had shocking service recently. Iโve been told thereโs โservice congestionโ that started on the 28/07 in my area and is due to continue โuntil they fix itโ multiple times ๐ they are fully aware of it ๐ซ
Figured I knew what questions heโd ask and I thought I mustโve been a naturally gifted microbiology referralist (/s) so I called again without doing nearly as much background research on the patient.-
not my ES confirming i have every right to be anxious about ARCP (my rotation 2 CS decided he didnโt want to supervise anymore and so no one can sign me off ๐๐ฅฒ๐๐ซ )
my calculations for how much in the hole iโll be before my first paycheque at the end of august currently stand at ยฃ3.5k. my widowed nurse mother cannot afford that, my savings have already been cleared out just finding final year. idk how iโm supposed to live/
i was following the guidelines for the management of said derangement n he said not to question it as he is more experienced and iโve only been a dr for 6 months but โฆโฆ itโs my name on the prescription
i know i bang on about this (at least in person but)
๐ฃI LOVE MY JOB๐ฃ
my mental health is thriving with patients and itโs just everything i dreamed about when i was a litte depressed teenager and iโm finALLY where i want to be in life and i ADORE IT!!
@YSTeachingNHS
๐๐
#FY1
Not to be unbelievably transparent in where Iโm going with this but these night shifts this week have been the best shifts Iโve ever had, despite having some of my sickest patients to date, all because I had an โassistant*โ, the wonderful H
@N
nurse practitioner
#TipsForNewDocs
Start saving your thousands of unwanted BMJs in your third rotation because they make an excellent eco-friendly alternative to bubble wrap for when you move house in August and need to pack your glassware
today i soft launched my small summer business so i can buy food and have a roof over my head, since apparently the people running the NHS bursary didnโt get the memo that things cost money.
#LiveableNHSbursary
Iโve realised one of my โthingsโ as a doctor is making a nice comment and then following it up with a โselfishโ one liner.
Like if a patient looks like theyโre about to fall Iโll say โare you alright?! No falling please, it looks bad on our departmental statsโ
@PolitlcsUK
@MailOnline
Absolute bullshit. We work as fast as we can while maintaining safety. We donโt show favouritism to patients because of their political views and saying something like this publicly can genuinely lead to repercussions for that doctor. I HIGHLY doubt this happened.