Dr Nat 💙🌞
@sugarplumNat
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• my dog is everything 🐶 • views are all mine 🌈 •
England, United Kingdom
Joined March 2010
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I'm at the end of the foundation programme and here are my thoughts and rambles and ruminations:
Firstly, the foundation programme felt like a prison sentence to me. (This is going to long and multiple tweets, potentially many tangents, forgive me)
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I'm leaving my current role in a community hospital due to safety concerns that have not been addressed adequately. I'm sharing this because I'm deeply concerned about what is happening in the NHS and I'm worried about the risk our patients are facing.
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got told today by my MALE consultant that men don't respect me because I'm too attractive... what the ACTUAL f*** 🙃🙃🙃
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Just finished a week where half the doctors on my team are sick bc of COVID, patients are receiving care for COVID - we are under huge amounts of pressure. There are not enough doctors to cope with people believing this is over. Please do your bit and help us.
#PandemicIsOverUK
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Thanks for reading and apologies for the long tweet. I'm aware of the backlash I may receive from the trust for posting this. We are encouraged to speak up but not when it's something this big. But silence and apathy will not help our patients.
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What's the actual point of training to be a doctor now? I look on LinkedIn and find multiple PA jobs which are paid better than I would be as a Dr. I look at doing getting a PA qualification - those with medical degree aren't allowed to apply?!
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Or leave? Go to Australia to work. Or leave the profession entirely? What do we do when we are trying to ensure patient safety but no one is listening? This leads to moral injury. I'm really worried for the future of our profession and most of all, the safety of our patients.
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do you know what's terrifying? men thinking persistence is cute...
went on a couple dates with someone at work last year, wasn't really feeling it, I went on holiday and said maybe we should call it a day... (continued)
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Frailty medicine is complex and requires knowledge from all specialities... you can not train someone in frailty without prior training in cardio/resp/gastro/ortho/MH/neuro etc - this is why Drs go to medical school, do post grad training and sit post grad exams
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This is someone from my workplace, a healthcare professional who I will most likely work with again in the future.
Please, to all, don't be persistent when someone tells you they are not interested, it isn't romantic to ignore a person's boundaries.
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We are no longer trying to prevent harm. We are allowing our patients to suffer. This is a nationwide issue - huge funding into replacing Drs with MAPs... especially in community settings and frailty wards - these patients are amongst our most vulnerable
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Many pts I would see on a Monday would be inappropriate for a rehab ward. There was a pt diagnosed as sciatica by an ACP in A&E - complete left arm&leg loss of motor function - pt actually had two cerebellar strokes. This is only one example.
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I spoke to the senior management about all of this... but of course, I am one doctor trying to fight a government agenda. Doctors are no longer respected - our concerns surrounding the safety of our patients are ignored again and again.
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But without a supervisor, how would I be trained? Running an MDT, working independently, diagnosing, managing, discharging, palliating... all for ~£40k/year. Who would take such risk & responsibility to be paid the same as a CHCP you are supervising and are responsible for?
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You need to know what you DON'T KNOW to be a senior clinician. How can we expect a "frailty trained" MAP to be confident in acute presentations if they are only training in a community setting?
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My concerns raised around patient safety were essentially dismissed as 'no patient harm was caused'. I believe there has not been a significant event because I have been there to recognise an unwell pt and transfer accordingly... my concern was what happens when a Dr ISN'T THERE.
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I was hired as an SHO in a community hospital - I was told the patients were medically fit and receiving rehabilitation and a Dr was needed to do prescriptions, TTOs and reviews if they became unwell with the aim to escalate to acute setting if needed.
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I explained that all patients in a hospital should be under a senior clinician and that I didn't think it was safe. I explained that I was not a GP, not a consultant... I was hired as an SHO - the definition of this role is a Dr who works closely with other Drs and a senior Dr
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The patient referrals were made by 'flow practitioners' or therapy staff in the acute setting. The nurses would accept/decline referral. I noted that many patients arriving were not medically appropriate for a community ward that did not have 24/7 medical cover.
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I had worked with a CHCP who was aiming to become a tACP within the trust. She had attended a meeting for the tACPs where they said, "would you rather be looked after by a shit locum Dr or fully trained ACP?" - I started to feel that the trust did not respect Drs at all
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There were no changes for many months. I DATIX'd everything. I documented defensively. I raised concerns via email many times. I was told to contact the ACPs at the other hospitals within the trust as they were 'my seniors' if I had any concerns about a pt.
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I raised concerns about the assessments being performed in A&E - this pt had not been seen by a senior clinician prior to being deemed medically fit. I raised concerns around the lack of medical cover over the weekend.
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I received an apology from the senior management of this trust in question - after I handed in my resignation due to safety concerns. They are now trying to ensure weekend medical cover - 8 months after I first raised the concern. They did try to offer me a job on contract...
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There was no medical cover over the weekend. Patients were arriving on Friday eve and not being clerked until Monday. The nurses were told to contact OOH for any concerns - however, CAS could not access our system or prescribe and would often send the pt to A&E.
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I started reviewing the referrals to ensure they were suitable. Many times after refusing a pt, this would be escalated to management by acute who would then overturn this and the patient would arrive anyway.
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The ward was meant to be staffed by ACPs but recruitment was low and many had resigned due to concerns with workload/lack of supervision/management/bullying. When I started the job, there was a locum consultant geriatrician overseeing three community wards within the trust.
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Any other medics feeling a bit nervous about watching
#BREATHTAKING
tonight? I think of the patients I treated who died of COVID almost every day...
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Many inappropriate referrals to A&E meant that the paramedics arriving via 999 lost respect for the ward and would question referrals that I would make and that really did need to go to A&E - ie ?sepsis/NOF #/stroke/acute chest pain
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The 'robust review' took a few days to complete - no one came to the ward, no one spoke to me or the staff to gather information...
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I was working independently. There was a GP who came onto the ward twice a week for a few hours. My consultant came once a week to do a ward round. I was able to contact him with any concerns. However, there were issues from the start.
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So what do we do as Dr's? Locum and potentially work in unsafe jobs with no progression... go into training (if you're lucky to get a training post)... work as a trust grade and risk no progression and pay that doesn't represent your experience/risk you are handling...
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Eventually, a DATIX alerted someone higher up within the trust and a review of the ward was completed. I was told a 'robust review' of the medical model was completed and found that they did not need Drs and could continue with ACPs and no appropriate OOH cover.
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I raised concerns again that I felt a senior doctor - preferably a consultant geriatrician - should be overseeing the wards and the medical plans for pts. Was told there was no plan to rehire.
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My consultant left the post around this time. I asked who would be my supervisor going forward and was told CAS (?!), the virtual frailty team (of a different trust) and the patients own registered GP would all be options...
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This CHCP resigned as felt the ward was unsafe. She had no supervisor apart from myself, a locum SHO. Most of the ACPs were very good but I felt there was no parity amongst them and I had dealt with a few misdiagnoses/errors made by tACPs/ACPs.
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he also spent the ward round asking me whether I worked out and whether I had a boyfriend, told me that he is divorcing his wife and I should stay in touch with him so that he can show me "the niceties of life". Also been sending me pictures of his car and watches... thoughts?
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just want to clarify that the consultant in question is not part of my parent team 👍 I won't delete the tweet for now as I don't like the thought of silencing other women who have raised their experiences. It's an important topic to discuss and be aware of.
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A hospital I work at has been asking PAs to cover doctor shifts during strikes next week. What do I do about this?
@BMA_JuniorDocs
@TheBMA
@drcolinm
@RCPhysicians
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First week of
#FiY1
done eeee, I think being a doctor is SO much better than being a medical student. I've only just realised how stressed and unhappy I was during my studies. To all those who are thinking med isn't work then, see what you think of the job before leaving! 🌸🌷🌞
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thanks for all the advice so far. It's difficult because I'm fairly certain I will be working with this consultant again next week... he also finds opportunities to make me leave the ward with him alone, to discuss cryptocurrency and explain how he can improve my life...
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I'm about to start GP training in August. Can someone please tell me why I should bother?
@rcgp
NHS England director admits GP trainee jobs ‘are not there for them’
#GPworkforce
#GPaccess
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@probesandjelly
I went to the freedom to speak up guardian, I wrote emails and copied in every senior manager including MD and COO. My next steps were to speak to CQC, CCG and then the parliamentary and health service ombudsman if I felt they were not being addressed. Good luck.
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And the rest. I start my F3 job tomorrow at a locum rate. I'm gonna save for a house and live a little. I'm not usually a moaning b*stard but I think these issues are important. Felt lime I could speak now without impact. Peace x
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today, a patient on my ward told me that I was a great doctor. she said that she was grateful that I had taken time to get to know her and thanked me for being so caring ❤ this is why you do 5 years at med school - it's all worth it in the end! 🌸🌷💕
#MedTwitter
#fiy1
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he did the classic "show me a scan" trick - any other women experienced this one? Where they stay seated in front of the computer so you have to lean over them to search for a test result. Makes your skin crawl.
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today, he has followed me on twitter... I wasn't aware that he had a twitter account and noted that he had liked a few of my retweets from a month or so ago. Feel weirdly violated to think he has been lurking here when I thought I had blocked him everywhere (continued)
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We met in a car park as he refused to get a coffee. He sat in my car and told me that he wished me an unhappy life and that I would live to regret the decision I had made. He tried to kiss me, I dodged it and told him to leave my car. Thought that was the end of it (continued)
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he sent flowers to the hotel I was staying at (could be cute) but then started saying he was going to get on a flight to join me at the hotel... I was on holiday with my family. I had only been on 3 dates with him (continued)
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I explained that it was all a little too intense and that I wanted him not to buy a flight. He begged me to see him when I came back home. I agreed, thinking I would explain face to face which may give him some closure (continued)
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that it was my fault because I had 'f***ed with his head' and made him drink and drive. I blocked his number, removed him from social media and hoped nothing else would happen (continued)
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I contacted him to ask him to stop messaging, sending gifts etc. I felt slightly unnerved and also was aware that he knew my address so started to feel more anxious. He sent me a message to say that he got caught by the police for drink driving (continued)
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A couple of weeks later, a gift arrived at my home with a handwritten letter apologising and explaining why we would be perfect together, saying that he wanted to have children with me (continued)
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We haven't got over any of this. The disdain the government and some of the public feel towards us is very difficult to process when most of us tried really f*cking hard to save as many people as we could. The scandal is only just unfolding.
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To all prospective medical students from state schools- please don't lose hope, we need doctors like you🌞your stories,history,culture and experiences of prejudice will make you a GREAT doctor🌞 the way you're being discriminated against now is all the more reason to not give up!
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@iowmillie
thank you ❤ I'm just angry to be honest, I pride myself on being the person to tell creeps to f*ck off but in this situation I felt helpless... completely different when they're your boss.
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She asked me how I could treat people in this way. I felt sad that the public perceives us as part of the problem. We are the ones holding the system up and ensuring patients receive treatment.
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intrigued by responses to me saying I'm interested in child psychiatry - eye rolling & "you're one of those" &"why would you even want to do psych?" & "psychiatrists are weirdos"- why is there stigma associated with a career in psych? esp. from doctors?
@Choose_Psych
@rcpsych
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The 'flow matron' who moved a COVID pt to my acute oncology ward which resulted in 6 of our patients dying in the space of 2 days. I made the phone calls to devastated families. They were never held responsible.
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This has been a bit of a rambling thread, I have so many thoughts on being an NHS doctor, being an ex- 'council houser' who is a doctor, sexism and harassment at work, infantilisation of juniors, patient safety and more. Thanks for reading.
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But I do have £90,000 of student debt. I don't have many savings and I'm a long way off getting a house. I'd like my pay to reflect the 6 years of university and the responsibility I hold.
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Is it any wonder that junior doctors are leaving? I do not blame them. I don't want to leave. My job is a privilege, I'm good at it, I make a difference and I can make someone smile in the darkest moments.
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just been offered an
#FiY1
job at
@nottmhospitals
🌞🎉🌷 looking forward to starting and getting my
@TheBMA
rainbow lanyard hehe! (thanks again
@BMAJamesP
@BMALouiseC
- I'm never gonna stop going on about it) 🌈🌈🌈
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@apprenticesurg
How do you fight back? This is a government working to erode the NHS. The management are extension of Tory government - same tactics, same underqualified individuals making huge decisions that impact patient safety and care.
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*MEGA THREAD PART 3, forgive me*
So then it was F2, I was an S H O. Yikes. First day on call, was in theatre, didn't have access to computers the standard. But, at least I was getting ~£16/hr now.
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I look back over the last 2 years and can not count how many times senior doctors, patients and nurses have been rude and disrespectful. From seniors, the majority preach this 'back in my day' rhetoric and think it's ok for us to have terrible working conditions.
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First placement in surgery complete - love this piece of feedback! 🌞🌻
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PS. I was asked to write a report to my university regarding the bursary I received. This was during my F1. I sent a very long report - have a look if it interests you. My university ignored it, never responded. If that doesn't prove my point then... 🙃
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TW: homophobia.
Just found out that a guy I'm dating (no longer I assure you) is homophobic. "it's just wrong" - was the phrase he used. I am saddened that someone so young (32) has this view. In the words of Florence Given:
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got my start date today for
#FiY1
at
@nottmhospitals
- 1st of June 🌞🙏🎉 gives me a lil time to settle into a new house & some time to read! any book suggestions for me? 📖
#BookRecommendations
#medstudentcovid
#covidcohort
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I have a lot of colleagues who make daft comments about 'poor people' or 'council housers'. Nurses who 'bitch' about other doctors being 'rubbish' because they were unable to do a job whilst covering over 100 patients out of hours - ON THEIR OWN.
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Received a phone call from the bursary department. Had -£396 in my account. They said I have been awarded a scholarship. £25,000!!!! Over the next 5 years. Felt like a millionaire. Was told my first payment of £5000 would be given ASAP.
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THREAD PART 2 (rambles on training in the NHS etc):
So I moved out. Became pretty isolated as my non-medic friends had graduated. Would walk into the hospital and my heart would be pounding. Saw my doctor, started propranolol.
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just finished my 13 hour Christmas day shift - really sad day today, families saying goodbye to relatives & COVID making people extremely unwell. Merry Christmas and a big thank you to those that have sacrificed time with family today to protect the vulnerable.
#christmas
#NHS
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Update - thank you all for your support and advice - it is greatly appreciated. I wanted to let you all know that I have reported the incident and have been completely supported by my trust in doing so. This is being investigated and dealt with.
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Just wanted to say that if anyone needs peer support right now, I am more than happy to be PMd - our wellbeing is so important right now.
#MedStudentCovid
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My mate (another medical student) at the time was saying how broke he was. I told him that I was struggling. He said I should dip into my savings. What savings? He said he had 16k in his bank, "how do you not have savings?"
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*continued on a new thread* - if you've read so far then wow lol, you must be bored x
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Another time, I was told by a senior to ignore a patient who was asking for help as we saw admissions. I ignored him, helped the patient. He told me I was a 'rubbish junior'and needed to prioritise 🙃🙃 I told him where to stick it
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I have loved being a doctor. Its a lot easier than being a medical student. I found studying made you inherently selfish as you are forced to concentrate on 'sign-offs'. As soon as I was on the wards, everything fell into place. I was glad I stuck it out.
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@mancunianmedic
But not all Dr's want to progress to consultant anymore... SAS/middle grade/portfolio medicine looks more appealing but the opportunities aren't there. Not without £££ on exams and competitions ratios that quite frankly, put many of us off
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The night shift where instead of 15 doctors, we only had 6 due to staff sickness with COVID. There was an entire ward of patients who weren't suitable for ITU and were dying..there was nothing to do. A pt asked me if she was dying and I said no and held her hand whilst she died.
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@saynotoa2ndwave
This is awful. That's why we need to do our bit so that the NHS has capacity to help those in need and protect them from COVID-19
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I'm registered with the
@gmcuk
! One thing ticked off the list ✅ Now let's just wait for a job...
#medstudentcovid
#fiy1
#MedTwitter
#covidcohort
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There was no Christmas lunch for us. I ordered a wagamamas after three 12 hour shifts over Christmas, it was 10pm, the deliveroo driver said he couldn't find me and put it in the bin. I cried my eyes out in my car. Final straw and all that.
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