Tips and tales from the foundation years #1

Before me and a lot of my friends begin our first jobs around the country as junior doctors (where on earth has the time gone because this is terrifying) I thought some blog posts from people who have been there before would be in order.

Hope you find them useful and feel free to share these posts! Also if you’re on Twitter (and if not get involved, I’m such a fan) follow #tipsfornewdoctors for more gems.

Today post was written by my friend Hattie

Firstly, congratulations to all the new doctors, you’ve earnt your new title! F1 is a bit like learning to swim at the deep end but with arm bands. It’s a big step. You know the theory but actually doing it is different. However you are not the first batch of new doctors to learn to swim. Your SHOs, SpRs, and even consultants will remember, however vaguely, what it was like. They are your arm bands. They will support you, guide you and save you and your patients on countless occasions this year as you splash your way through your first diagnoses, prescriptions and decisions. If you don’t know something, just ask, help is only a bleep away. Just make sure you’re got the information at hand to help your colleague make decisions. (Notes, drug chart, obs, examination findings, any imaging, bloods and in an acutely ill patient the ABG result). Everyone feels like an imposter at some stage.

You will get scared/tired/feel useless at some point and you are not alone, we have all felt like this. When this happens, speak to your fellow F1s or SHOs, they will support you, reassure you and tell you they feel or have felt the same. There’s nothing quite as demoralising as not being able to bleed a patient or get a canula in. But it’s happened to us all, don’t be too disheartened. The nurses and especially senior nurses are some of your greatest allies. They’ve been there, done it and have the t-shirt. If they say a patient isn’t well, listen to them.

Never be rude to a colleague whatever their job role or grade – it’s unprofessional, not conducive to good team work or good patient care. Mistakes happen, be supportive and sympathetic of your colleagues. One day it will be you making the mistake.

F1 is a rite of passage. You are the most junior doctor in a team. You do the jobs that have to be done. Sometimes you may feel like all you do is paperwork and canulas, but you will still learn a lot of clinical skills. The year will fly by.

e-Portfolio is something we all have to do. Start early and chip away at it and link the curriculum as you go. It’s far less painful than doing it all last minute, when invariably you’ll be on nights, oncall or have a cold.

Look after yourself and don’t let work consume you. Keep up that hobby/sport/activity that you love. It’s easy to come home feeling too tired to do anything but make an effort and it will help you realise work isn’t the be all and end all. Socialise; vent about your frustrations, discuss things you’ve found hard and talk about things other than work! Eat well and sleep.

The first time I was asked to see a patient in pulmonary oedema, their breathing sounded bubbly from the end of the bed. I had never seen or auscultated proper pulmonary odema before. I thought it was pulmonary oedema but still asked the sister if the patient sounded wet to her. She replied calmly and without being patronising, that they did. Then I stood, looking at her, so calmly she asked me if I would like her to give some fruesemide…50mg? Needless to say she was guiding me, not asking me. On her return she said gave me an x-ray form and told me that she’d rung the radiographer to come to do a portable. I hadn’t asked for a form or thought of an x-ray at this point, but she knew what needed to happen, prompted me through my first acute pulmonary oedema and kept that patient safe. She also handed me an ABG syringe with the x-ray form!

There will be many firsts, just do your best, enjoy yourself and ask for help whenever you need it. You will be fine!

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Big thank you to my friend Hattie for kindly taking the time to write this. 

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