Out Of Sync

A&E rota

When my colleagues, complained about the A&E rota, I thought it wouldn’t bother me as much. They moaned about how tired they felt etc. I secretly thought I’d be able to weather all of this because of my gift. I can fall asleep anytime, any place.

But now, I feel their pain. Not only am I tired all the time, I’m just out of sync. I was on nights last week, Monday to Thursday. Usually, I’m able to get myself back into day-mode relatively quickly. It’s a week later, and I’m still out of it. I haven’t had a full night’s sleep for 5 days. And I know I need to sort it out sooner rather than later, hold off sleeping too early and not succumb to a few random hours here and there, but I’m just too weak.

And I’m just too tired to do any of the things on my to do list, so I nap, but then I’m up at the early hours of the morning and I can’t sleep. As if I wasn’t already falling behind on my emails. I’m awake when the rest of civilisation is asleep, I’m sat at my screen wondering if 2 o’clock in the morning is a weird time to respond to a work email.

All I can say is, I don’t know how people do this long term. I certainly don’t know how people are doing this and looking after children/household. Any tips on getting me back on track would be highly appreciated.

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Second Impressions of A&E

second impressions

Joseph Greve

I’m half-way through the placement now and I feel more settled, I wrote about my first impressions of A&E here. It just takes time for me to get used to a new place and I remember it being the same for GP as well. In some ways I’ve found GP and A&E quite similar: both general based specialties with loads of opportunity to work independently.

I’ve found A&E more difficult because the level of risk is higher and there’s so much I don’t know. I felt with GP, I regularly managed coughs and colds, UTIs, musculoskeletal pain and other times I could rely on my intuition/common sense. Whereas A&E, I’m suddenly presented with a foot x-ray and I’m supposed to work out whether there’s a fracture or not. It’s a huge learning curve.

As part of the department we have a paediatrics area. And though I love kids, I do get a tremor every time I’m sent around to that side. Fortunately, it always turns out better than I expect and I’m able to get through them quite quickly. It’s usually more pleasant; the parents are more often than not able to give clear histories, the kids are happier, funnier and smell nicer. I’m learning to be more confident on paeds but I still find it difficult. I’m often wondering how I would treat an adult in a similar situation which I know is not an ideal approach, but again there’s always someone around to ask.

There are always seniors around, always. The trick is knowing who to ask. I’ve got a good idea of who to go to and who to avoid. Most are really helpful and will listen and give advice. Some will do it reluctantly and others will snap just having looked in their direction. I do sometimes have an internal conflict I go through every time I want to ask a question. On one hand, I’m a foundation doctor and not an emergency medicine trainee and really I’m there to learn and gain the skills to be a better doctor, but on the other hand I need and want to be an independent clinician. Personally, I feel like my main priority (alongside amazing patient care) is learning and one of the ways to do that is by asking questions. It might just be me projecting my internal issues onto others.

The shifts are long. And I know long shifts are part of the territory in medicine, my body just doesn’t agree. The upside of longer shifts is that we have more off days, but still, my body doesn’t care. In the first half of the shift I’m all ready to go, lots of energy, and towards the end I’m slower, yawning and repeatedly looking at the clock. And this is why a) I don’t book any locum shifts and b) I can’t see myself doing this long term. I’m not really fussed about the effect on my social life. I’m more concerned about not being able to put basic meals together. Or do laundry. Or write.

Plus, there’s a whole lot of running around and being on the ball. It’s like you have to be at least 80% alert at all times, not like on a ward-round where you could twiddle your thumbs whilst you followed the consultant around.

I have liked how social the department is. There are loads of junior doctors plus locum doctors as well. If ever there is a lull it’s really nice to have people around to talk to.

I’m 2 months down, just 2 more to go.

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I’m Glad January Is Over

I’m glad January is over, seemed to last forever.

I know the new year always brings this huge gusto of inspiration and motivation, which I’d admit I was feeling for the first few days. Then I fell sick and all motivation took a dive from there. Whilst I was already feeling rough, it felt like an appropriate time to dwell on personal issues, family issues, media stories, rubbish weather and just be generally miserable. It was no wonder I was feeling even less inspired to do anything.

But whilst I was riding this downward wave, I decided that I might need help to get my ‘mojo’ back, so I wandered into Waterstones and had a look at the self-help section. It’s funny how I wouldn’t even have glanced at a self-help book when I was younger, but I guess those were simpler times. (Take me back…)

The books I bought: F**k It: Do What You Love, The Subtle Art Of Not Giving A F*ck, Rich Dad Poor Dad

                    

 

There’s no theme, these were entirely random purchases. I am not having a quarter life crisis.

I tend to read several books at a time, so whilst I’m halfway through F**k It: Do What You Love, I’m also reading Nocturnal Animals. I’d watched the film during a plane ride back to the UK and I enjoyed the dark and creepy storyline matched with the beautiful cinematography so I thought I’d do what I never do: read the book after watching the film. Unconventional.

So, the year might not have gotten off to a great start, but I’m looking forward to turning it around.  Hope January has been good for all of you.

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Decisions Decisions

Whilst I’m falling down the rabbit hole of Youtube, I stumble on a video that describes a recent realisation I wrote about here. The video gives a much better explanation.  It talks about how we can make decisions either based on growth or fear and when we choose the latter it generally comes from a need we have.

Here’s the video:

If I look at all my past decisions and pick one, let’s say: deciding to live at home during university. I spent a lot of time weighing up the pros and cons,  but in the end I thought I’d save a lot of money by living at home, which I did. However, deep down I was scared. I remember thinking about the horror stories of university halls: roommates from hell, constant fire alarms and so I chose the safe option. And every year after, I had an opportunity to flee the nest but it was never the right time. I guess my fear stemmed from a need to feel secure/safe which makes sense, I find that at the root of most of my decisions is that same need to feel secure.

Let me know if you can relate to this? I sometimes wonder if I’m the only one who likes to over-analyse things…

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6 Months Left

6 months left

Literally 6 months left.

It’s pretty sad that I’m counting down but it’s just how I’m feeling. And at a time when morale is already low, the Bawa Garba situation probably isn’t going to improve confidence. Rachel Clarke writes a piece well worth reading here. This case really is a watershed moment and the effect it’s had on the workforce is palpable.

The widespread sense of shock amongst the medical community truly reiterates how much this case isn’t a one-off occurrence but a reality throughout the NHS. It reflects our daily struggles. We’ve all been in similar situations trying to do the best with little resources. We work shifts time and time again that are understaffed. It’s the norm. But it’s the dawning realisation that not only is our best not good enough, we also run the risk of being punished for matters that are outside of our control.

Maybe as a workforce we are just too agreeable. Our concern for our patients comes first so we do what we can with the little we have. Maybe we need to kick up more of a fuss every time we’re expected to work understaffed shifts. It’s gotten to a stage where we’re expected to just get on with it.

At a time where I’m reconsidering my path in medicine, this just seems to be another heavy nail in the coffin. I just keep thinking about the risks we take as doctors just by turning up to work. I never want to make a mistake, but that’s an impossible standard to try to reach. So far the question I’ve been asking is whether the value I get from being a doctor is worth the physical and emotional toll. But to add to that, I now have to consider the overwhelming reality that I could also be held responsible for the failings of a struggling system.

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