The job

Well the wee hiatus of the past 4 weeks has been largely so that any stories I post cannot be linked in a time-wise manner to any specific patients etc, and also because adapting to the job of an Fy1 takes some time.

Firstly, time:

You start at 9 and finish at 5 most days, or as most of us do, 8.40-6ish (6ish meaning between 5.30 and 7). It' snot just that we are relatively inefficient as we are new to the job, but also because the boring mundane jobs tend to get left til last, like printing blood forms for the following morning, printing out radiology reports to stick in notes etc.

Secondly, food:

Being able to survive without food during working hours is a skill worth mastering. You may be lucky if you took lunch with you, and get to eat it over your PC whilst on hold to switchboard, accessing results etc on the PC and signing off filing. This however doesn't help digestion, and you may not want to read this report or this report about the cleanliness of NHS keyboards if you do eat lunch this way.

Thirdly, support:

If you are lucky then your ward SHO won;t have too many patients to see on other wards; clinics to attend to, or be on nights / receiving. under these circumstances they will help you with some of your tasks. if not, the prioritisation of what needs to be done now, today, or even this week is essential. achieving the list of jobs requiring doing between successive wardrounds is a skill, especially if there are only 2 days between ward rounds.

Fourthly, referring:

A skill not taught in medical school. How to present you patient in 3 paragraphs and explain to another specialist why you want them to come and see your patient and what you want them to do when they do so. This is often followed by a phone call from them wanting 200 bits of info - 50 of which you don't have and half of those are such that you cannot bluff them. this may necessitate ordering more blood tests, radiology etc, prior to the specialist coming to see your patient. This is especially difficult if the specialist is based at a different hospital as you need to obtain a phone number for the person, and then maybe a fax number to send the letter, and they always page you back when you are not near the notes for the patient concerned.

Finally, ward cover:

After 5pm, and at weekends, you may suddenly go from looking after one ward to looking after 7 or 8. Each nurse assumes you have an encyclopaedic knowledge of their patient, and as such may not use names when referring to 'my wee man in room 3'. You may also start to hate your colleagues who have left 'the venflon no one has managed to do all day' or 'they need some fluids writing up but they have a special regime which isn't written down'. But you are fully aware that you may have done the same on nights when you just wanted to get away...

But in your first month all these can be forgiven on the day you pop into the medical business centre and find in your pigeon hole, a small self sealed perforated envelope with your name on it. Upon opening you see that the NHS has decided to reward this work, which is much like an onward progression of your final year med student shadowing role with a sum of money.