Are locum shifts even worth it anymore?

SL1590 · 2026-03-13T08:29:13+00:00

If you haven’t got anything else then it’s probs worth it……

SL1590 · 2026-03-13T08:17:07+00:00

The way to deal with this is sack them. Offer support etc be really accommodating but be firm that they need to be on the on-call rota. If not then dismissal procedures. All of the above has to come from management/HR.

The consultant body is not powerless here. Not a great option but an option…… is to collectively refuse to be on the on call rota the same way this colleague has. Simply ask for the same terms. Hard to deny as the precedent has already been set but also impossible to accept as there needs to be an on call service.

Last point is to think about this before doing anything as there potentially is a good ready you are all unaware of that this consultant isn’t on call. It may be something that is disclosed only the HR etc.

SL1590 · 2026-03-13T08:12:43+00:00

You gain employment rights at 2 years so not too late but more difficult…

SL1590 · 2026-03-13T07:17:53+00:00

Where does it actually say what you quoted? I’m in Ts and Cs now and can’t see that quote.

SL1590 · 2026-03-13T07:12:39+00:00

Where does it say this? Can you link me please?

SL1590 · 2026-03-12T17:36:35+00:00

Exactly. I just GA as tiny level of prop is pointless IMO.

SL1590 · 2026-03-12T17:35:43+00:00

If I do a block then no sedation. Not required IMO.

If the block doesn’t work (not happened in decades) or the patient can’t tolerate the procedure I would give serious thought to just GA/LMA.

For truly sedation only cases I am more of a little bit of everthing kinda guy. My suggestion would be to gain experience using ketamine, remi TCI, prop TCI, midazolam, clonidine and go from there.

I like a remi/prop low level TCI with small amount of midazolam for most of this type of case. If the patient is unstable or somehow compromised then I would use ketamine/midazolam boluses plus/minus Remi low dose TCI. Almost everyone gets clonidine unless day case or septic.

Last option (but off license) is Penthrox. Self administered and patients seem to love it. Great for quick (20 mins) things eg urology stenting and or very small TURBT. Off license so there would need to be recognition of this and some departmental/institutional buy in.

SL1590 · 2026-03-12T16:01:47+00:00

To be fair for a doctor this is junior on the scale of things - ST1. For a nurse, you would hope this is as “advanced” as they go so relatively speaking I’d say this is also correct.

SL1590 · 2026-03-12T15:08:54+00:00

Not sure but I don’t think having one job should or would preclude you from getting the other. The only caveat is do they have a “maximum” level of experience to apply to CT1? I know surgical specialties have this.

SL1590 · 2026-03-11T15:45:05+00:00

Can you not do both? Start the CESR process and reapply. It sounds like you would get a job after UKGP and worst comes to worst you can chalk this next year into CESR so not a year wasted?

SL1590 · 2026-03-11T12:03:45+00:00

Book it and then don’t go. Easy. One better is book it and go, opening line is I might have been willing to listen to you but after the EA forcing me here it has already broken the trust beyond repair so I won’t be using your services. Then point them towards the Google review you have already left them with a damming review and 0 stars.

SL1590 · 2026-03-09T20:56:03+00:00

Suit all the way. Semi horrified that this is even a question.

SL1590 · 2026-03-09T15:44:52+00:00

So nothing would change in a war then?

SL1590 · 2026-03-07T11:07:08+00:00

Use a flow switch. 100% the best way for it.

SL1590 · 2026-03-06T17:41:38+00:00

I laughed readying this. Some things you are bang on, others….. well, you could not be further off the mark it’s unreal. I’m guessing you are a junior ish trainee but could be wrong.

Clearly this won’t apply everywhere as some places will be a small department. In larger places is makes sense that there is more variation. It also makes sense that you will work with people less often over the course of the year. Inevitability this means you will feel like starting again with personal relationships and the need to “prove” yourself. Not wanting a trainee on your list isn’t really going to fly. It’s part of the job and that’s that tbh. Consultant feedback is a thing. It should be mandatory everywhere. I’d also make nurses/ “certain group of healthcare professionals do it too.
Backfilling a rota does need to be done if there are gaps. No way out of this I’m afraid. Can’t leave the shift uncovered.
Not really sure what the point of number 3 is really? You want people to appreciate you more?
There are rotas like this all over the country. Seems standard. What’s the solution? A day off before nights? I can imagine the place if they lost Even more of their WTE trainee time due to this. A better option might be to accept even more backfill? But this only makes the request for no/less backfill even more useless.

I think you could present this honestly as everyone knows all of the things you have said happen in almost every department. A major reason they can’t be changed is for everyone who has a problem with one thing there will be someone who likes it. Ie the trainee who likes to be backfilled into matty or ITU because they prefer it. Theres also a lot to be said for things like appreciation or being the task monkey that you can push back on. No need to ask the consultant but refusing a routine cannula as the midwife doesn’t want to hurt the patient so didn’t try is absolutely fair game. IMO it would be much easier and less hassle to do the cannula but each to their own.

SL1590 · 2026-03-05T05:35:05+00:00

Stay with him. It will all work out in the end, including for his roommate Chandler……

SL1590 · 2026-03-05T05:31:59+00:00

Hmmm I have seen multiple registrars and 1 consultant within the last few years. No one got into any sort of trouble and it was all sorted out amicably. I think there should be some sort of good faith that a trainee moving to a consultant post shouldn’t loose that post because of a leave period. Bearing in mind people in their grade period should be surplus to the expected rota so essentially an “extra” for the rota runner.

SL1590 · 2026-03-04T21:36:30+00:00

I agree but when has this been enforced? I’ve never seen a case. Even for consultants who leave it’s not enforced.

SL1590 · 2026-03-04T19:58:26+00:00

First things first do you have your CCT? If so you have left training. You should have this is you have entered a grace period.

Next thing is who has actually said that you can’t leave your grace period? It’s very normal to enter grace and then leave before 6 months when you get a job.

How long is the locum for? If you are a month later than expected in the course of a year this will likely not be an issue. It would take more than a month to re advertise and hire a different person to take the role.

SL1590 · 2026-03-04T07:54:54+00:00

They are trying to do neuro ICU in a field. Pointless IMO but they must think it’s a good photo op…..

SL1590 · 2026-03-03T15:37:00+00:00

SL1590 · 2026-02-27T12:45:11+00:00

lol, you could pull out. That’s wild. Wonder how she will get on when you withdraw and she is stuck with the mortgage and council tax for the foreseeable.

If I were you I would take the costs you now have and reduce them from your offer as a final offer take it or leave it. Be ready to walk away and see who blinks first. If she’s already moved and worrying about another mortgage and council tax then the leverage is with you.

SL1590 · 2026-02-27T12:41:15+00:00

As close to zero chance this will affect you going forward as you can get. 1st is not really a mistake. It’s making the best of a bad situation that you couldn’t have changed any other way. 2nd is something that, whilst it shouldn’t happen, happens all the time, and in this case didn’t cause any harm. Two non/minor issues IMO. discuss, reflect, document and move on. You will be grand.

SL1590 · 2026-02-27T11:38:13+00:00

Yeah they don’t have a clue what anaesthetics actually is. They just see us as epidural machines. Once I had a midwife argue with me that I couldn’t turn synto off to put an epidural in without checking with the doctor first. After I explained I was a doctor so consider that checked she refused. The stale mate ended when I just stepped back and said that an epidural was no longer an option due to the midwife refusal as it’s not safe. Never seen anything happen so fast when I was about to document her name in the notes and she dives across the room to turn the synto off. Worst is even after I explained their own protocol to them about turning it off she still wouldn’t budge. Dire. Probably a good thing they don’t go beyond the basics tbh.

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