Real life story - first week as an F1 doctor
Dr Anirban Pal writes about his first week in the job.
Most of the time, you will be covering the wards. Understand which wards you’ll cover and map a rough geography of their layout so that you can do your own rounds during the on-call.
My first week as a foundation doctor was better than I had expected. I had a supportive team of seniors and nursing staff; they made the transition to what was my first ‘real’ job so much easier. Understanding that you are going from what is essentially a self-driven environment in medical school to a team-based working environment is one of the key differences and leaps you have to make when you start work this year. Remember always that respect makes a team tick, and if you show respect you will soon become a favourite amongst equals.
Sometimes, even though it is exceedingly rare, your team may not be very supportive of you or your fledgling status – there are always other forms of support that you can access. Speak to your educational supervisor, speak to the ward sister or matron, or even a member of your family. Remember that you should never suffer in silence.
We had numerous induction sessions during the first week. These sessions, whilst mind-numbing at times, are a must. There are people there who have been working at the hospital for far longer than you have and they will have some gems of advice for the coming year. A lot of the time, they also hand out some useful kit at these sessions – I remember an antibiotic guideline card which I still carry with me. In all likelihood you’ll have to fill out a number of forms and sign just as many; get used to it as your signature will become a hotly contested thing in this coming year. Dealing with the administrative machinery is one of the less pleasant experiences of the first week, but it is also absolutely necessary to ensure that the rest of your year goes smoothly. Make sure all your documents are correctly filled in and that occupational health has your correct address! You’ll have to jump through a lot of hoops this coming year so get used to it and accept the suffering as part of the experience.
Back on the wards, you may feel nervous dealing with acutely ill patients in a foreign environment. Always know that you are not alone. Get help whenever you can. You’ll learn best from watching expert seniors at work Your skills at assessing patients, practical skills etc will naturally improve during the year but always get senior help when you feel overwhelmed.
Your principal jobs as a houseman are the ‘house-keeping jobs’ (blood rounds). I spent my first days just getting comfortable with the computerised systems in use at the hospital so that I could access results, order investigations, and look at x-rays without needing any help. Also, learn the layout of your ward – where the essential equipment and crash trolley are kept, where the stationery is, and where the tea and coffee are stored.
You may be asked to perform on-call duties during the first week, and almost certainly in the first month. Key to being successful during an on-call is to be organised. Getting a good hand-over is useful but may not always happen. Most of the time, you will be covering the wards. Understand which wards you’ll cover and map a rough geography of their layout so that you can do your own rounds during the on-call. Do one round of all the wards when you’re free (from having done a consultant ward round on weekends, or when handover is finished on nights), picking up any jobs that are there. A good time to go on your own round is always after a nursing drug round (usually 8am, 2pm, 6pm, 10pm)!
Carrying the crash bleep is an unpleasant experience for most people. You have to be prepared and know your ILS guidelines by heart and have some familiarity with the crash trolleys in the hospital. At a scene of cardiac arrest, you should always have seniors present to direct affairs. If you’re the first one, just get on and do A-B-C and try to get others around you organised until senior help is on the scene. Remember that your cannulation, venepuncture and ABG skills need to be sharp to be successful in this stressful environment.
Equally important during these first few weeks is to get to know your fellow foundation trainees. Be sociable and open. A good beginning will win you a lot of friends for the rest of the year. You will need all the friends you can get to swap on-calls, cover shifts, and just generally to ‘discuss’ the frustrations of work.
What makes a good foundation trainee, my consultant told me, is not a genius but a person who is honest, reliable and trustworthy. Aim to be all of these things during this year and you will make the right impression on the right people