So ends my first week as officially not-a-doctor.
It’s been a challenging start; I’ve had to start at the beginning with most aspects of the job, but thankfully I’ve just been shadowing the current marketing manager here. She’s breaking me in slowly – a stark contrast to my first week in Paediatrics, where we had one day of child and baby resuscitation training, a quick summary of all the serious health problems that we might see and some guidelines on how to treat them, before being thrown into a row of night shifts where I was suddenly responsible for a ward full of babies.
The pressure I feel now is of a different kind. I’ve entered a world where under-performance will get you fired. In the NHS, sheer desperation and bureaucratic inadequacy means that incompetent staff can easily hide their flaws. I’m glad to say I’ve only ever met a handful of doctors like this – some of whom would have been OK with a bit more support and training, and some of whom made me wonder how the hell they ever got through medical school.
Despite the threat of dismissal however, there are many pleasant things about this new job, and some of them I find downright bizarre…
1. Coat hooks
In my first rotation as a newly qualified doctor, I worked in the busy acute medical unit at Queen’s hospital. The unit looked very new and flashy (PFI, of course) but there was very little space for the staff. The nurses had a small room away from the unit, and the consultants were crammed into offices the size of cupboards. As for the junior doctors, we had the hallway between the unit and a storage hall. There was a handful of lockers there, but not enough for everyone, and a filing cabinet upon which, if you got there early enough, you could grab a space for your bag and coat. If not, then you had to put your stuff on the floor. There was no lock on the door and several people had things stolen. As a fresh-faced F1, I just accepted this, but as time went by, I became aware that other people had a different opinion.
My friends would ask me where I kept my money and phone. It shocked them when I said that I kept a small amount of cash in my handbag for emergencies or lunches. When we were told not to carry handbags any more as they were ‘unhygienic’, I kept them in the pockets of my scrubs or wedged into my bra.
As I hung my coat up on a hook in the office this week, I suddenly realised I’d never have to scrape its trampled form off a hospital floor again to brush off the muddy shoe prints. Luxury!
2. Lunch breaks
On my first day, I was taken out for lunch by my new boss. Some of the team came along as well – they told me it was a company tradition. We ate at a nice Thai restaurant and the IT team even had some beers. All in all, we were out of the office for nearly one and half hours! I thought back to one lunchtime in orthopaedics, when my bleep went off so many time that it took my all afternoon to finish one sandwich, and wondered how these people ever got anything done.
3. Everyone really respects the fact that I’m a doctor
When I met one of my new colleagues, she actually exclaimed, “Oh my goodness, so you’re an actual doctor?” I guess you would expect to find a doctor in a hospital, so it’s not a big deal. It’s even less significant when you’re surrounded by brilliant senior doctors who are much more qualified and cleverer than you. As a result, I’ve never really thought of my degree as being anything special, but here in the real world, having a junior doctor on the team is almost revolutionary. The head of PR is excited because he’ll no longer have to waste time getting medical articles proof-read by busy consultant partners, and my partner in marketing is relieved she’ll no longer have to struggle to translate medical language into lay terms. I kind of wish other doctors like me had the chance to see their skills in this context, because you suddenly realise you are an exceptionally trained and rather useful individual.
4. My appearance
I’m wary about saying this, given the recent allegations in the media that us poor, pathetic, baby-making females are responsible for the downfall of the NHS. I merely note this as a difference in my life now.
As a junior doctor, my focus wasn’t on the way I looked. I admit, I started out as well groomed and image-conscious, but that was quickly knocked out of me by the strict rules that exist in hospitals. I looked my worst during nightshifts, as I was just too tired to bother. After my shower, I’d pull my hair back into a quick ponytail, and wouldn’t bother with make-up. In the changing rooms at work, I’d change my sweatpants and T-shirt for oversized scrubs and my indoor trainers. If I went to the loo, I’d avoid looking at myself in the mirror.
When I did clinics, I could dress a little better, but the bare-below-the-elbow rule still stood, so no bangles, watches, false nails, nail polish or rings (except a wedding band) were allowed. This is all for the sake of hygiene, though interestingly, there isn’t any solid evidence behind it. So much for our “evidence-based NHS”. I didn’t mind it that much however, until I got engaged. I loved my engagement ring and all it stood for, and taking it off every morning was a bitter reminder that this profession would eat into my personal life as long as I remained in it.
5. Individual adjustments
I guess this ties in with the respect thing. My colleague suffers from back pain, so she sits on one of those exercise balls while she works. She must have exceptional balance because she never rolls off.
It reminded me of one manager I had as a doctor, who treated the doctors like we were his minions. He also had back pain, for which he was given a specially-made chair which must have cost the NHS thousands. Meanwhile, we doctors would spend any free time we had on night shifts trying to put our heads down on a desk or the floor. I once thought myself very clever and pushed two wheely chairs together to make a bed. I curled up between the hard plastic arms, and I did fall asleep for a few minutes, but as I lost consciousness, the wheely chairs slowly wheeled apart and I fell straight down the middle. As I rubbed the bump on my head, I looked at the clock: 3 am. Still 7 hours to go. Brilliant.
6. Being able to do other stuff
I haven’t really tried this yet, but looking at my colleagues in the office, it’s definitely possible. I always wondered how my fiancé seemed to get so much done – buying things online, organising appointments, sorting out holidays and payments… I thought he was just better at life than me.
The problem was, having a bleep on me meant I couldn’t just pop to the bank or the post office in my (usually non-existent) lunch break. The terrible phone signal that many hospitals seem to suffer from made sorting my life out pretty difficult. I remember leaning off a stairwell towards a window during my last placement, trying to speak to the letting agency about our broken extractor fan. The irony if I’d broken my neck in process! Frankly, I was often just so busy, that the thought of doing anything else overwhelmed me.
7. Sitting at a desk
As my role now mostly involves the internet, I spend a lot of time sitting at a computer. I suppose I did so as a doctor as well, but my screen sessions were always interspersed with exercise. I could walk literally miles seeing patients, going to the lab or the imaging department, or following seniors around. Then there was heavy lifting: after hunting endlessly for a patient’s notes you discover them in another patient’s slot and realise they are absolutely massive. While struggling to pick them up, about 20 bits of paper fly out, littering the floor. You sigh and bend down to pick them up, wondering what on earth they did with the £10 million that was promised to make a ‘paperless’ system.
Then of course, there was running to crash calls. I used to sprint at school, so I quite enjoyed this bit, especially once I’d worked out what to do when I got there. I tracked my footsteps one day with an app on my phone and it came to 12000 steps. I don’t think I’ll ever get anywhere near that in this job.
8. Access to the boss
I appreciate that this is unusual, and it’s one of the perks of working for a small startup. I see the CEO every day and have access to the medical lead by phone if I need her. She came in on Friday and we sat down to go through the way the website’s content is written. I told her that I thought the language was a bit too medical in places, and that simplifying it might be more comprehensible for potential customers. She took my opinions on board and we made a plan for going forward within a few minutes. In the NHS, to change anything takes weeks of planning, getting permissions, consulting, battling through red tape and reviewing – and that’s as a consultant.
I once tried to change things as a junior and ultimately it got me trouble with the Deanery. I’ll tell you about it some other time. For now, it’s nice to have a voice.
Before I started my orthopaedic job, I was sent an email with a request to send documents such as my GMC certificate, my proof of no criminal record certificate, my immunisation records for Hep B and other infections, my proof of identity, proof of address, medical degree, etc. etc.
Also attached were about 15 different forms to fill in – IT access, smartcard appliation, parking permit, library access, mess subscription and more. I did everything about 2 months before starting and sent it all in. On my first day at the hospital, we were informed that the paperwork for several of us had been ‘lost’ and that we’d have to fill in all the forms again and bring in all our documents. We weren’t allowed to start work until everything had been done and approved.
I started this job with my passport and a couple of references.
Fridays in hospitals feel like a mass panic. Everyone knows that for the next 2 days, there will be only emergency cover available, so you do everything in your power to get things done in advance. If you think your patient might go home on Sunday, you prepare all their paperwork so that some poor soul on call doesn’t have to waste time writing a discharge summary. You fight your colleagues for access to the handover systems to give the on call team a summary of your patients and make any requests for blood tests, scans or reviews over the weekend, and as everybody is doing this at the same time, the system inevitably crashes at 4pm, leaving you banging your head on the keyboard for the next couple of hours. And if you happen to be the one on call on a Friday, good luck to you. Freed from the demands of work and school, the people come flooding into A+E, followed later by the drunk party goers who’ve fallen down staircases or decided that jumping off that roof was a good idea.
So there I was on Friday, trying to get things finished off quickly before the weekend, when my colleague tapped my shoulder and offered me a glass of wine. I turned around, and on the table was a selection of cheese and biscuits, some chocolate cake and a bottle of red. I must have looked dumbfounded, as my colleague, who is an ex-doctor as well, just smiled and said, “Well, it is Friday, after all.”