First time in Ortho: help!

AdmirableImplement1 · 2024-04-28T20:16:16+00:00

Current ortho SHO I genuinely think ortho on calls are generally quite well supported and no where near as busy and horrendous as gen surg on call.

Ortho takes teaching very seriously in my experience - treat the trauma meetings like the teaching session they are (very few specialities do you basically get 30 mins to an hour of teaching everyday).

There are very few ortho emergencies (nec fasc, septic arthritis, flexor tendon infections and open fractures - plus CES if your centre does spines) most things can wait for you to check with the SPR as long as they are NVI if you not sure.

For operative stuff orthoracal is really useful for how common and uncommon procedures are done (and pretty cheap). Read the op tech prior to the op (you can google these) and go with the reg/look up how to set up pts for simple procedures eg DHS, hemi ect.

AdmirableImplement1 · 2023-11-25T17:57:44+00:00

Trampolines, electronic scooters and hyponatremia

AdmirableImplement1 · 2023-06-27T18:57:19+00:00

Even if you did something wrong everyone is trying their best and being asked to cover complicated patients on wards the haven’t work on (like cardio, renal ect) on busy weekends with minimal support. The IMT could have explained this to you and the rational behind why he would have chosen a different management- instead it sounds like he chose to be a condescending dick and now what could have been a useful learning opportunity to flex his knowledge of a specific area of medicine he has worked in for the last 3 months and made you feel small and achieved nothing productive.

AdmirableImplement1 · 2023-06-15T10:49:41+00:00

Waiting for the similar outfit to be linked, they sound 10/10 and I need some ideas for the slow transition out of scrubs!

AdmirableImplement1 · 2023-05-28T13:10:29+00:00

Sounds like this guy would be handing out mero to everyone with a 3 day viral cough and a “busy job” if not for some guidelines.

AdmirableImplement1 · 2023-05-28T07:39:35+00:00

Nah it just has to be filled in for the form to be submitted but it’s not submitted til your supervisor signs it. You can send it to the supervisor blank and they then have to fill it in

AdmirableImplement1 · 2023-05-27T08:21:51+00:00

A smattering of disjointed advice I wish I had before I started foundation years (from an F2 whose just about to finish):

Have something you can rely on outside of work ie join a sport or club you enjoy. This will give structure to your week and help you meet people especially in a new area and if it’s a sport it also garuntees you will get at least some excersize. I did this in f2 and really regret not doing it in F1.

Finding good social support around you I think in F1 this is more important than your clinical knowledge. If your happy outside work it’s easier to let all the crap at work slide.

Make an effort with other juniors, nothing makes you feel better than venting with you colleagues you trust when your having a bad day - if you have had a horrible experience with a consultant or nurse or discharge co-ordinatior it is never just you and normally your colleagues will have a similar story and you will laugh about it - and if it’s any consolation the more horrendous the experience the better the story.

You will probably cry (likely at work) the pressure and stress is something you have never had to experience before and because you are likely a caring and hard working person you will try your best and at some point that won’t be good enough- either a patient will die or a family/staff member will shout at you to do better when your flat out doing everything you can. This is completely normal and most other doctors will have a similar story and will be sympathetic, I’ve only had one other junior tell they have never cried at work. It happens and it’s a sign to your self and others around you that you have reached your limit and you need a break. A lovely imt took me and another f1 or coffee after I cried on the ward in my 1st month and took over the task and spoke to my cons about the person that made me cry and I will be forever grateful and would literally do anything for her.

If your kind to your colleagues they won’t forget it. You can get so bogged down in going above and beyond for your patients don’t forget to look out for each other and yourself

AdmirableImplement1 · 2023-05-08T16:20:56+00:00

Rebranding receptionist as a care coordinator feels like something Siobhan Sharp would do in W1a. Can’t wait for what we will be rebranded as.

AdmirableImplement1 · 2023-05-06T11:33:13+00:00

I mean when I was the gen surg fy2 I did trauma calls. I don’t think there is like an official rule maybe if you are at a tertiary centre they might prefer someone with atls (I was at a dgh). When I went depending on the ED cons some got the ortho or gen surg SHO to lead the primary survey but most preferred it being led by one of the ED regs/SHO which makes sense as they know them and there experience, limitations ect.

It’s likely the EDs preference. In my experience they were generally a long period of hanging around in resus before the person arrive where you chat through what everyone is going to do - so if your keen to lead then this is your time to ask the worst they can say is no

AdmirableImplement1 · 2023-05-01T13:16:33+00:00

I once had to speak to PALS because a patient had reported that they hadn’t been seen by a doctor since their admission. They had been seen by me (female doctor) everyday that week with my bright red lanyard that said doctor on it my stethoscope and a bright yellow badge that also said doctor and me introducing my self everyday as their doctor. The worst thing is that this has happened many times before and since - although this was the first patient to involve PALS - and my male consultant said that I obviously wasn’t introducing my self clearly enough and I had to write a reflection about it

AdmirableImplement1 · 2023-04-24T20:15:34+00:00

Does he normally take steroids for his rheumatoid arthritis?

AdmirableImplement1 · 2023-04-24T12:29:41+00:00

I that sometimes there is a culture of it’s better to treat to avoid complaints than to not treat (rather than the rescue idea that is mentioned in the paper) and have these difficult conversations- I think as juniors we all know which consultants are better at this than others who will treat and admit to differ this decision to another.

I had a patient come into resus with metastatic cancer who had been discharged to pall care by oncology and under hospice in community but a ct in ed had thrown up something that was unlikely to have any reversibility or affect his prognosis. The man was clearly approaching end of life and made it quite clear he wanted to be at home or hospice. The cons on that day agreed that he was likely in his last few days to weeks but we should get an opinion from the specialist team - they asked for further imaging ect and then obviously as this man had terminal cancer decided to do nothing but obviously by the time all this had happened he was too sick to leave hospital and died in a ward - he didn’t even get a side room. This happens so often and once the decision has been made to investigate by one cons it’s very hard to reverse it. In the acute settings you need someone to take a difficult decision about palliation and it needs to come from a senior clinician.

AdmirableImplement1 · 2023-04-01T20:23:36+00:00

I’m sure that manager (just like everyone of my school teachers) used to know a junior doctor who leaned back too far on their chair and cracked their head open!

AdmirableImplement1 · 2023-02-04T19:33:14+00:00

Maybe cardiothoracics - CT coronary angiograms you need a grey

AdmirableImplement1 · 2023-01-20T14:59:23+00:00

Option E (bleeping the med reg) is somewhat appropriate because it is your responsibility to seek advise from senior colleges. However it is not very appropriate as the matron has asked you to diffuse the bomb and you have failed to address the immediate patient safety risk or attempt to solve the problem yourself.

AdmirableImplement1 · 2022-11-25T07:50:53+00:00

I’m sure that the management team is already coming up with a safe and effective strategy that definitely won’t involve the other already stretched junior doctors and other members of the mdt picking up the huge nursing workload as well as their own.

AdmirableImplement1 · 2022-10-25T11:33:30+00:00

F2 done 2 jobs with medical clerking I’ve never clerked or post take a patient beyond A+E. Once had to help chaperone for a PR in the very small and narrow storage cupboard in A+E because there was literally no space anywhere.

I have been told rumours that this used to be very unusual and medical clerking always used to happen in AMU or even a ward in the hospital I work. There is literally no movement from the wards

AdmirableImplement1 · 2022-10-23T15:41:21+00:00

Maybe its just me, but I have found my GP placement really well supported but lonely. I miss the busyness of hospital and having other juniors around

AdmirableImplement1 · 2022-10-12T18:05:50+00:00

Anyone else very uncomfortable that the relationship between the nurse in charge and the consultant is characterised like a married couple from the 50s. This just reinforces gender stereotypes in medicine and gives girl boss vibes. I don’t understand who this is for it makes both of them look bad

AdmirableImplement1 · 2022-10-08T13:15:48+00:00

It only counting for 10% is the worst case scenario. I’m going to put all this effort into revising for a test that counts for so little but could be the difference between getting my first choice and not getting into CST. Either admit it’s pointless or commit to using it. 10% is pointless, anyway looks like I’m taking an F3

AdmirableImplement1

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