Liking GP?

Photo by Ben Neale on Unsplash

Since the beginning of F2, I’ve felt tired. Not the kind of tiredness that goes away with sleep, the kind of tiredness that requires two weeks in the sunshine. That’s the issue with being in a training programme, you just keep ploughing on and on and savour the few days that you get off.

I appreciate being on GP right now and I’m liking the slower pace. But it’s still really hard to get up in the morning. I feel like I have to emotionally psyche myself up and then drag myself to work.

But weirdly, as I start settling into afternoon clinic and I’m between patients, I start thinking that it’s actually not that bad. And it’s happened more than once that I’ve caught myself thinking that.

No one is more shocked than I am. As a student, I found GP placements boring. Sitting in the corner and staring, as people come in and out. Not fun. Now, I see my own patients. I have to think on my feet, but at the same time I feel supported and I feel like I’m learning. And I feel like I’m helping. I have time to talk things through with people.

Before we get carried away, I’m still only a few weeks in. Even though it wasn’t my plan, I’m happy I had this placement first. I’m looking at my A&E rota for my next placement and it looks dire to say the least. 10 hour days, 8 in a row. Eugh.

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A Really Bad Week

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Last week was a series of lows.

I can’t even describe it. It was a case of the proverbial faeces hitting the proverbial fan. Multiple times.

I started the week feeling incredibly tired from the weekend. Nothing unusual, just a tad more Monday blues than normal. But I didn’t think anything of it.

I ran a few errands on Monday and Tuesday: sorted a few things out on eBay, put off writing a blog post, some running. I was slowly beginning to feel a bit overwhelmed with all the things I was juggling. And to top it all off, it felt like I was coming down with something. And instead of really tackling those issues, I found solace in lying in bed watching Youtube videos, just something to take my mind off everything.

Then came Wednesday. I had my morning clinic and then went on a home visit to review an elderly man with back pain. The symptoms had resolved by the time I got there so I made my way to the hospital for the weekly afternoon teaching. I grabbed a Subway on the way, even though I’d been avoiding buying lunches because I am trying to save. But I’d been so tired, I hadn’t prepared anything to bring in to work and eat, I must.

My supervisor grabbed me as soon as I arrived, so that we could have our mandatory introductory session (which we have for the start of each placement). She asked me how I was and all of a sudden I just offload a tsunami of emotions, mostly about how deflated I felt etc, etc. She gave me a funny look: concern/surprise/worry and told me she wanted to see me again in two weeks. I caught her off guard but to be honest, she caught me off guard as well. Saying it out loud made it all seem a bit more real. I’m not sure why it all came spilling out like that and I kept thinking about it, all the way through teaching.  I had some idea in my head that the medical postgraduate team were going to put me on red alert or something and start watching my every move.

By 8, I was fast asleep, I was just too tired and achy to fight it any longer.

I got to work Thursday morning. Settled into my clinic. First patient didn’t arrive and I’d left my GP bag in the car (the one I use on house visits and that I had taken home with me the day before). I quickly went out to get it before the next patient arrived. I couldn’t find it. Weird. I called home and asked if someone had taken it out of the car. No one had.

I looked all around the car, panic rising. Where could it have gone? Eventually, I ran out of places to look and I had to walk back to my supervisor and let her know. I felt so responsible and stupid. I’d only been there (at the GP practice) for 2 weeks, and this really wasn’t the way I wanted to form an impression. I felt like I let them all down.

I went to the police station later on that day. My expectations were low; I knew it’d be unlikely they would find an unmarked generic black bag, but I needed to report it. The policewoman I met made me feel 10 times worse. She had a really accusing tone. One of the questions she asked me: “how do you know the bag was stolen” left me dumbfounded. I stared at her confused, I looked at my mum, and then back at her. I didn’t understand what she wanted me to say. There were other things she said that again made me feel like she was judging me or making assumptions about me. The whole experience was uncomfortable and unnecessarily so.

So, all in all, not a great week.

 

 

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General Practice

Photo by Brigitte Tohm on Unsplash

We had a lot of exposure to general practice (GP) during medical school. Usually, I’d have one day a week based at a practice and sometimes a couple of four week blocks would be allocated for general practice alone. So I’ve seen a fair share of different practices, some were better than others. But overall, I felt like I had a better appreciation of what it would be like to be a GP.

Throughout medical school we were told that at least half of us would be GPs. On its own, the statement doesn’t sound bad, but in context, a lot of the time it felt like we didn’t have much choice in the matter. 50% of us would be GPs regardless of whether or not we wanted to. Some people took offense, I didn’t particularly, even though at the time I thought wanted to be a paediatrician.

A few years later, now a F2 on my GP placement, I can see the appeal. 9 to 5 every day plus one afternoon off every week. I don’t have any night shifts or weekend shifts. There’s 30 minutes to see each patient, all the while sat down in a room with plenty of opportunities for tea/coffee breaks. I know this isn’t fully representative of an actual GP but it’s generally a much better working environment than what I’ve experienced so far working in hospital.

So part of me wants this to be it for me. Do GP, have a great work life balance and be financially stable. I really wish I could fall in love with it. At the moment, it just doesn’t excite me. Some of it does. I hear a lot about GPs who have more unusual working patterns, that go beyond seeing patients in a clinic. But if I go for general practice, I want to be really for it, not just the good bits. It’s like buying a cake but only being excited for the icing. And then throwing the cake away when all the icing has been eaten.

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6th August 2017

unprepared

I worked a locum shift during the weekend. Nothing stressful, just an admin shift. I pretty much sat around all day, flicking through paper and typing entries onto a computer. I expected it to be a chilled shift, so I didn’t even bother wearing my stethoscope. This particular shift meant that I was sort of spread across different wards, but I didn’t have any clinical duties, so I wasn’t seeing patients anything like that.

That all changed one minute to the end of my shift. I was called over by a nurse to review an unresponsive lady. I felt so unprepared. Like I said, I wasn’t expecting to do anything clinical, I’d left my stethoscope in my bag. And I know the training that we get gives us what we need to do when a person becomes acutely unwell. I don’t know why, but in that moment I felt really unprepared. I went over and kind of went through the steps of assessing this elderly lady. To me, she wasn’t unresponsive but it’s hard for me to know how well she’d been an hour before. I don’t know how she’s like normally. I try to examine her, whilst giving some instructions to the nurses and dodge around 3 family members. It all felt very haphazard.

The medical registrar came and took over, and he must have thought I was slow or something because he just did everything himself.

Driving out an hour later then I should have been, I just felt deflated. I felt like I could have done so much better. And I use the excuse that I’ve feel like I’m out of the loop after having done surgery for so long but really, is that a reason?

I was thinking about it all the way home. Just picking over the situation again and again.

It’s hard to remember exactly what happened because my mind was somewhere else. So this is was what I think happened: I’m trying to join a dual carriageway with three lanes. I can see two cars, one blue car in the middle lane and another in the furthest lane (right lane). I look right, then left and then start to pull out. Then I break suddenly, to stop myself crashing into the blue car speeding past in front of me. I’m sure it wasn’t there before so I wonder whether it swapped lanes when I looked away.

And I mention this because, it made me think. I was so concerned about how stupid I looked and how I did a bad job. I took that issue which was self contained (the patient was ok, the registrar had reviewed her) and I made it affect my driving to the point where I could have been in an accident. That would have been a much bigger problem and I’m really glad I narrowly avoided that.

So, this really is a lesson for me, more than anything else. Be more careful and don’t make a bigger mess of things.

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The Last Day of F1

The last day was a mix of emotions. Overwhelming gratitude and relief that I’d finished a difficult placement but also a slight melancholy that I was leaving. I was happy, don’t get me wrong, I’d started a countdown midway through the four months. But while I was working through the final jobs, I kept thinking of how everything was coming to an end. Not only was this the end of a placement but it was also the end of the academic year, the majority of doctors would be moving on to new hospitals. The people I’d worked with over the last months, the relationships I’d built, the comradery, it all felt like it was coming to an end.

We had a small get together at lunch with cakes and drinks and it felt like the end of an era.
The hospital can be really sociable. Just walking down the corridor, I’m bound to run into someone I used to work with. I enjoy that aspect of working in hospital.

My next placement is in GP which will be a massive change of environment. It’s always been the one thing that’s bugged me about general practice: the fact that there isn’t that community of peers around you. But I’m still looking forward to the change of scenery. I’m hoping GP will give me some of the learning experiences I’ve felt like I’ve been missing. Plus, surrendering my bleep for the next four months feels like a huge bonus. Not having the constant paranoia/palpitations every time I hear that beep anywhere around me. Immediately looking down at my bleep to see if it’s me that’s being summoned to some unknown problem. I just want to actually learn and do some medicine. Listen to a problem, take my time, explore the issues and be guided and taught as well. All whilst being sat down. I’m really hopeful.

I had the new foundation doctors shadow me on Tuesday and I honestly tried to be as positive as possible. I tried to give them all the necessary information they needed but I know they’ll learn it all as they go along. Luckily, the consultants are lovely so they should be fine.

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