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Do your best to maintain a good working relationship with ward staff and colleagues
It will take effort but it’s worth trying to build some friendships within your team as you will be spending most of your time with them for the 4-12 month block. The job will go smoother and quicker, you’ll have people to have lunch or grab coffee with and it will ease the burden.
In the same vain you should learn about your consultants, find out their hobbies, and talk to them about their experiences as a junior. Remember they are also human and have undoubtedly made a few mistakes in the past.
Nursing staff have a wealth of knowledge, be nice to them and they will help you out. There’s also room for humour, timed well. Don’t be afraid to be yourself every now and then, there is no reason why you shouldn’t be able to enjoy yourself at work.
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There is always time to eat
You must make time to eat. If you don’t eat, your brain will get tired and a tired brain makes mistakes. Unless you have been called to a crash call, everything else in the universe can wait 15-20 minutes for you to eat.
If you explain you haven’t eaten yet to the nursing staff they usually understand and will sometimes, on rare occasions, try and feed you.
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You have more time than you think
When you see an unwell patient you have more time than your OSCE’s would have suggested. Sounds obvious. Take your time when examining, go through DR ABCDE slowly and methodically, don’t be afraid to start again at the top, and breathe.
It is extremely unlikely your patient will crash in front you. That said, you can always get some help from others on the ward, bleep senior members or put out a peri-arrest/arrest call.
To judge how urgent everything is, talk to the patient and the nursing to staff to figure out how quickly the patient’s condition declined, and take your guidance from there. The main thing is to take your time.
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Death and End of Life at work, will feature heavily in your life from now on
This is a time when all patients deserve to be well looked after and given the chance of a comfortable passing when the time comes. As a junior you will be more attuned to your patients than your seniors, particularly on some specialties, and are more likely to recognise when discussions about DNACPR’s need to be had.
It’s important to not be afraid of these situations or discussions and to seek support where you need it. Your hospital should have available guidance on this.
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Organise your social life, take back some control
It’s paramount you try to organise your time outside of work due to your rota clashing with most of your peers, medics and non-medics, or activities you would like to pursue.
Time away from work is essential. My biggest piece of advice would be to plan early and send what annual leave you would like to your rota co-ordinator before or at the beginning of your next placement, so they have a chance to accommodate your request.
Book weekends in with your mates. Take part in activity’s after work, like a sports team, art classes or whatever else floats your boat. Putting in this effort to have time away from work, doing what you want to do, will make you a happier person.
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Become a master of prioritisation
There is nothing worse than looking up at the clock at 4pm knowing you have a whole heap of tasks left to do, with a potentially unforgiving consultant.
If you can, utilise your mornings, it’s where many of us are the most productive. Your top priorities should be getting your bloods out for the phlebotomy ward rounds, and getting imaging and referral requests in early.
When going through your long list of jobs try to recognise what absolutely 100% has to be done today, and what can be left until tomorrow. Ask yourself, will chasing a staging CT scan report at 6pm change your management over the course of the evening? Probably not. Whereas a 10-hour Troponin I is completely necessary. As with anything, there are exceptions. It’s okay to hand over jobs to the on-call team, but just think about what it is you’re handing over.
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Cannulation
Your ability to cannulate is not a true reflection of your ability as a doctor. There will be times when you have a bad day, week or month and it will cause you to question medicine as a career. “Am I a failure?” The answer is, no. Just roll with it, give it a go and then ask someone else to help. Your cannulation dexterity will return, just be patient.
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You’re not expected to know everything
There are other more senior doctors and nurses who have been doing the job a lot longer than you and have far more letters after their name. Just make sure you are safe, recognise when you don’t know something and look it up. If you’re still not sure, run it by a colleague and learn from it. Registrars do this all the time, and so should you.
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Practice handovers
Effective communication will make everyone’s life easier, on paper and in person. When you hear a good handover from your senior, try and remember why it was and practice this.
The master of handovers will become the master of life. There is nothing worse than when someone gets to the end of their handover and you still have no idea what they want you to do. Only you can make sure you will not be this person.
Remember - SBAR. SBAR. SBAR.
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Handwriting
Sort yours out before it’s too late. If someone cannot read your writing mistakes will be made.