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Welcome to the unique position of being a doctor. Now the only difference between you and me is age and experience! Medicine is exciting and frightening often both in equal measure. It has always been tough, hard work and both physically and mentally challenging, but that is why you have been selected and trained in the way you have been.
Your first year as a doctor changes you fundamentally. Forever. The responsibility is daunting so share it. Most senior colleagues will have no difficulty remembering the fear, trepidation and elation of starting 'doctoring' for real. Know when to ask for help (especially if someone else is suggesting this to you). Never EVER be afraid to phone for help if you have a sick deteriorating patient in front of you. You can't know everything and it's okay to say what you can't recall immediately or safely - take some comfort that you know how to access information far better than most. You have a duty of care to that patient that trumps all else, and if you sense that raising a problem isn't being received quite as you expected, talk to a colleague or someone locally in the BMA!
Welsh Council represents medical students, current and retired doctors in Wales through members directly elected to Council and through the chairs of the committees that represent each branch of practice. In many ways, we are the professional side of the BMA as your trade union. We are old and new, and here are some of the top tips that we hope you may find useful as a new doctor in Wales. Let us know how you are getting on!
My top tips:
In the acute setting, when approaching ANY patient, fleeting consider your 'A,B,C's as you approach. This way you are prepared for the worst (as you have practised and trained for) and you can relax when they are sitting up and clearly talking sensibly to you. If they are unexpectedly sicker than you thought, you are then not taken by surprise and you have reflexly resorted to a structured approach. This may look and sound as if you know where to start rather than a rabbit in headlights!
Think about what you would do if the patient in front of you did deteriorate - what actions would you take and who would you call? This way you are prepared with a plan of action in your head, but when the patient gets better (as most may do) you have planned, rehearsed and controlled the panic for when they do not.
Value EVERYONE involved in patient care around you - domestics, cleaners, porters and all those who help you care about patients and the NHS you have started work in. Get to know them if you can, for you are in the 'people' business and understanding the need for everyone will just help a little to keep your feet on the ground.
Despite the plethora of evidenced based guidelines, protocols and pathways and myriad standards setting aims and targets, your primary duty is to your patient(s). Most complaints are to do with communication and altered expectations. The basic tenet remains to treat patients and relatives as you would want a member of your own family to be treated; if YOU would complain or be offended, then do not be surprised when a patient or relative is.
Treat patients as people not diseases and relatives as a help not a hindrance; it is your task to get the best out of both to help deal with the situation in front of you.
Learn how to give feedback and to communicate concerns or frustrations effectively. Many doctors have high 'EQ', but some are woefully lacking (and of course, medicine is practised by widely diverse groups of doctors with different strengths and weaknesses that hopefully match the role they find themselves in)! Dealing with problems - perceived or actual - early may prevent escalation of concerns or even whistleblowing. This is about valuing those around us.
What are your top tips for new doctors?
You Will Survive is BMJ's e-guide for newly qualified doctors. Here are some of the tips:
“When asked to a see a patient during the night, ask the nurse to do a fresh set of observations and any other relevant tests (ECG, BM, bladder scan etc) while you make your way down to the ward.”
“Different wards have different layouts, so you won’t know where all the equipment is. Save time by carrying some equipment (ABG syringes, cannulas etc) in an on call bag, along with a small reference book (Oxford Handbook) and a chocolate bar.”
“Most consultants would prefer you to call them rather than for a patient to suffer.”
See more here http://bit.ly/1SW8Xmy