Saying No

I feel uncomfortable saying no to people. Blame it on the people pleasing child in me. The one that wants to keep other people happy whatever the cost. The one who hasn’t grown enough self-esteem to just say no, simply and plainly.

My consultant wants me to do an audit. She mentioned it and in a roundabout way, I let her know that I didn’t think I would be able to. I hadn’t even completed the audit from my previous placement. She mentioned it again 5 minutes later and explained the project a bit more. At this point I could feel the pressure. Now my consultant is super nice and it’s the niceness that makes it even harder to say no.

Who am I kidding? I just don’t like saying no, particularly to someone above me, like my supervisor. I feel like by saying no, I might rile them and turn them against me.

I’ve been learning a few tough lessons over the course of the last few months. I thought I was a smart individual, but it seems like I have to go through the same type of situation over and over again before I learn my lesson. And each time I fail to learn, the lessons become harder and the consequences harsher.

I can see it now: I’ll take on this project, I’ll end up staying late multiple times after my shift to complete it, it’ll end up being subpar, I’ll be grumpy and unhappy and subconsciously take it out on everyone else.

I just need to be honest with myself and clearly let her know that I cannot. Already, I feel like I’ve got a lot on my plate, I honestly don’t think I could cope with the additional pressure of something else. Any spare energy I have, I want to spend it on me. I already give a lot of my energy to this job. And I don’t even like doing audits. GP audits are easier to do because everything is computerised, there won’t be any wading through pages and pages of notes trying to decipher handwriting. I just don’t want to.

Obviously, she doesn’t need to know all of that. But I should just be honest.

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Rota Gap

My surgical team consists of consultants, a registrar, a core trainee (CT) and a couple of foundation doctors. Because of the varying on call rotas, we aren’t all on at the same time. Like any rota, if there’s bad coordination then it may cause a rota gap, where there isn’t a sufficient number to cover the ward. This was Week 4 and it was already happening. To make matters worse, it felt like it was my responsibility to fix it.

Why was it my responsibility? I didn’t understand it either. It seems it was on me to find someone else to fill the gap. Which I’d tried to do. I’d asked other F1s, multiple times, whether they would be willing to cross cover for at least one of those days: and I got subpar responses. How hard should I have pushed? If someone said no, what else could I say? I didn’t feel it was my place to coerce people. It wasn’t an easy position to be in. I ended up feeling really sorry for me, in dramatic fashion silently screaming ‘why is it always me?’

What made it worse was getting flack from the core trainee and then by the registrar which I didn’t appreciate. (At this point it was just me as the other foundation doctor was now on zero days, so I was the only visible one if that makes sense). The rotas are online. You can see your own rota and everyone else’s on the surgical firm. So, I really didn’t appreciate the CT making it my fault that he wasn’t enlightened earlier. Excuse me?

Where else in this country would it be the employee’s responsibility to make up for the rota co-ordinators mistake? Where else would the responsibility lie on the most junior member of the team to sort out. It’s the kind of additional stress that I don’t need. And it’s the kind of thing that makes me feel resentful.

I think I just assumed that the rota that had been provided would be right. I appreciate I could have escalated earlier, but in that time, I was trying to get cover. Anyway, the issue was resolved by me offering to come in and cover those couple of days even though I was supposed to be off (but I can take those at a later date).

Please comment below, I’m really interested to know what everyone’s opinion is.

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Driving Home

I open my eyes and sit up in my car seat a little. A minute later, I start the engine and continue my drive home.

I’d just finished a busy night shift. Non-stop, constant running from ward to ward for most of the 12 hours. I’d come on the shift with more than 10 jobs already waiting for me. The F1 on call was apologetic as she handed over a few more. What can you do? Some days are just busier than others. Add that to the patient that was deteriorating before our eyes and it’s easy to see why there was a back log.

I spent a lot of my time on this patient, his blood pressure kept dropping despite giving him 4 L of fluid. By the end of the shift he was taken to HDU for more support.

When the day team arrived, I was relieved to shrug off all responsibility and head home. I couldn’t be happier to get into my car and hit the pedal.

The tiredness never hits me in the beginning. I’m usually fully awake and smiling as I head towards home. It’s towards the end when the monotony of driving in a straight line without having to change lanes or stop or think plus the steady soothing hum of the engine starts to gently carry me away. I’m on autopilot. Ever so slowly the road markings start to blur, it feels like I’m drifting a little bit to the left, my lids feel really heavy…

This doesn’t always happen; I can often make it home without stopping. But there have been times I’ve come off the motorway, stopped at the side of the road or once at a local Tesco, switched off the engine and just closed my eyes.

Time passes, I open my eyes, turn the key and away I go.

It’s scary what tiredness can do. I had a colleague tell me that she thought she’d nodded off on her way home and was jolted awake by a horn from the car whose lane she’d started to drift into. The fear and the adrenaline spike kept her awake all the way home.

It’s hard work that we do. It’s just scary to think about what the consequences could be.

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5th May 2017

lunch

At 1 o’clock, I went to the fridge to get my lunch. If there’s one thing I look forward to during a shift, it’s lunch time. Half an hour of (supposedly) uninterrupted break time. So when I found a good point between jobs to get lunch, I dropped everything and headed straight to the staffroom, smug  in the knowledge that I wouldn’t need to line up for the same carb-loaded meal I had yesterday (pizza and chips). I opened the fridge, nothing immediately jumped out to me, so I had another look. No lunch. Stay calm, there is probably a reasonable explanation.

Turns out the reasonable explanation was that one of the health care assistants had thrown it away. What, with the container? No, the container was safe. The contents, not so safe. She apologised profusely but said she was just doing her job.

I didn’t have anything to say. I was not happy. Just one more reason why I resent the system.

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Getting A Medical Opinion

I had a really sick patient over the weekend. Everything I gave him seemed to have a temporary effect. The surgical registrar reviewed him, then asked me to get a medical opinion.

The way the bleeping system works is you press a single number, the bleep you’re trying to reach and the number of the extension you’re calling from. (The handheld phone didn’t have the sticker which tells you what the extension number is, but I knew the number off by heart anyway). I bleeped the med reg (medical registrar). No answer. I bleeped the assisting med reg. No answer. I waited. They’re probably really busy. I should just be a little patient. So I waited a little more. I might have bleeped a couple more times. Then I bleeped the critical care team because I was really worried about the patient. No answer. (In hindsight, I can see why this should have been a clue)

A little later I finally got the med reg to see my patient.

I left the med reg to it and tried to get on with the growing list of jobs. It was fast becoming a sea of green, amber and red requests. I was on a different surgical ward when I picked up the phone. I can’t remember who I was going to call or bleep but I flipped the phone over to check the extension number and I froze. Like actually stopped in my tracks and didn’t move. These were the four same numbers I’d dialled in earlier when I was trying to get the med reg. I cover these wards so often I’d mixed up extension numbers in my head. So every time I’d bleeped, they had probably been ringing this phone on this ward, whilst I waited on a different phone on a different ward.

What a stupid, embarrassing mistake to make. Obviously, I didn’t own up to it. This particular med reg wasn’t the kind you would have even a slightly humorous conversation with. I imagine he would first stare me down  until I disintegrated, then later make me the butt of every joke, till the end of time.

*embarrassed face emoji*

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