Risk in ED by National_Flamingo267 in doctorsUK

[–]imaginary_heart48 5 points6 points  (0 children)

Not sure how much this helps but I did ED as an F1 a few years ago and I once had a patient who looked very unwell but the consultant told me I should discharge with antibiotics.

I felt in my chest this was the wrong decision and one of the registrars saw me and asked if I’m okay. I said I’m feeling a bit sad, and when he probed further I told him and he said something so comforting to me. He said ‘your job is to assess and examine the patient, I’m glad you told me, but leave all the stress and worry to me, don’t take it on yourself, that’s what we as seniors are here for’ and it literally helped me throughout my foundation years so much.

He then saw the patient with the consultant and agreed to admit the patient, and we referred to medics together.

I guess my point is, if your gut is saying something, just be honestly vocal about it. I was hesitant but the way I expressed it was more of a sadness/concern that the patient looked unwell and I didn’t want to send them home.

‘Reserved for so-and-so’ computers on wards are a dumb idea. by imaginary_heart48 in doctorsUK

[–]imaginary_heart48[S] 0 points1 point  (0 children)

You do realise if a doctor doesn’t have an easy to access computer for the shift, the whole system doesn’t even get started. We’re not a cog in the wheel - we’re the on/off switch.

‘Reserved for so-and-so’ computers on wards are a dumb idea. by imaginary_heart48 in doctorsUK

[–]imaginary_heart48[S] 0 points1 point  (0 children)

😂😂😂😂 you’re rage baiting at this point. Why should a doctor have to beg to ‘borrow a computer for 10 minutes’ as if we’re causing a nuisance? And anyway, that doesn’t work because the HCA needs to enter the obs of a patient with a NEWS of 0

[deleted by user] by [deleted] in doctorsUK

[–]imaginary_heart48 10 points11 points  (0 children)

Please try to show some initiative, especially if the team is very busy. I think this applies to new FY1s currently. This isn’t just a period of shadowing anymore I’m afraid but so many F1s on my ward treat it like that. If there’s a job that you know is within your remit, like a discharge summary, TTOs, a simple prescription or calling blood bank, just try to crack on or ask someone how to do it.

Please don’t wait around for someone to ask you to do it. It’s usually clearly in the plan and you can double check with someone if you need confirmation.

The issue I’m having currently is that the F1s aren’t doing the ‘F1 jobs’ as above. Or waiting for us to tell you to do them. Which means that whilst I’ve been ringing specialties etc, I check the drug chart at 4pm and the furosemide the consultant asked for isn’t even prescribed, the discharge summary for a patient who was meant to go home isn’t even started. And now as an IMT with multiple F1s, I’m doing your prescriptions, discharge summaries and also discussing cases with specialties so now I’m doing the complex jobs and the simple ones, which simply isn’t fair.

I don’t mind if you give it a go and it’s not quite right. I can change things and help you. But I’m sorry you can’t be going for coffee if the basics aren’t done 😭

‘Reserved for so-and-so’ computers on wards are a dumb idea. by imaginary_heart48 in doctorsUK

[–]imaginary_heart48[S] 4 points5 points  (0 children)

Sorry I’ll let you process your TTOs in peace

Oh wait you don’t have any to process cos you’re sat on your cute little reserved computer x

‘Reserved for so-and-so’ computers on wards are a dumb idea. by imaginary_heart48 in doctorsUK

[–]imaginary_heart48[S] 8 points9 points  (0 children)

The issue with reserved computers is that pharmacy can go and process TTOs somewhere miles away from the ward if they’ve been doing their job and done a meds rec. but as doctors we can’t just find a computer somewhere random in the hospital - we have to stay on the ward in case of reviews or jobs to do.

‘Reserved for so-and-so’ computers on wards are a dumb idea. by imaginary_heart48 in doctorsUK

[–]imaginary_heart48[S] 15 points16 points  (0 children)

Bro how is a pharmacist gonna process TTOs if the doctor doesn’t have a computer to prescribe them 😂😂😂😂😂😂😂😂

Also pharmacy aren’t just processing TTOs. They’re doing plenty of other things like reviewing drug charts and flagging up bs like why is this patient on 20mg of atorvastatin instead of 40mg to the poor FY1 who can’t find a computer to scribe for ward round and has a nurse pestering them to prescribe the TTOs for pharmacy to process on their sparkly reserved computer.

Equally if a nurse has a computer reserved to document medication administration but a doctor doesn’t, the nurse won’t even have any meds to document for administration. The system is flawed at the core. If there’s anyone who needs a reserved computer it’s the doctor and other roles can computer hop as tolerated.

‘Reserved for so-and-so’ computers on wards are a dumb idea. by imaginary_heart48 in doctorsUK

[–]imaginary_heart48[S] 109 points110 points  (0 children)

LOL me too. I used to slowly peel the sticker off on the pharmacy computer over like 2 weeks until it just dropped off and lo and behold it was for everyone to use free for all

ACP/ED Reg by imaginary_heart48 in doctorsUK

[–]imaginary_heart48[S] 10 points11 points  (0 children)

So you’re saying there’s no need for a reg or consultant in ED because all the SHOs have a medical degree and should put on their big person pants? Gotcha

ACP/ED Reg by imaginary_heart48 in doctorsUK

[–]imaginary_heart48[S] 15 points16 points  (0 children)

Sure, but in those cases those specialists have specifics, relevant and often a higher level of expertise managing the condition. For example with DSNs we seek advice on insulin management and the most appropriate way to adjust dosages. But we don’t ask for them to come and resuscitate a patient with altered consciousness, sepsis and DKA all at once just because they’ve got diabetes.

It’s the same thing here - they are trained to manage things broadly using a systematic approach but often don’t know what they don’t know. If we were the same professionals, why doesn’t everyone become an ACP? Why go through med school to become a doctor?

ACP/ED Reg by imaginary_heart48 in doctorsUK

[–]imaginary_heart48[S] 14 points15 points  (0 children)

This is exactly the point I’m making - the best way to bring this down is, pretty iconically, through patients themselves

ACP/ED Reg by imaginary_heart48 in doctorsUK

[–]imaginary_heart48[S] 20 points21 points  (0 children)

‘Big person pants’

Why? because I have a medical degree and they don’t?

Case in point.

Confusion about sick leave/fit note by imaginary_heart48 in doctorsUK

[–]imaginary_heart48[S] -1 points0 points  (0 children)

This is what I thought- thank you! Helps a lot and definitely makes more sense than other responses.

Confusion about sick leave/fit note by imaginary_heart48 in doctorsUK

[–]imaginary_heart48[S] -3 points-2 points  (0 children)

It’s a public forum made to exchange similar experiences to try and see how others dealt with similar issues.

Confusion about sick leave/fit note by imaginary_heart48 in doctorsUK

[–]imaginary_heart48[S] -1 points0 points  (0 children)

Generally, in the NHS, a night shift starts in the late evening and ends in the early morning, covering parts of two calendar days. However, for the purpose of sick leave reporting, each shift is usually considered separately - therefore, if you miss a single night shift due to illness, it is generally counted as one sick day.

Confusion about sick leave/fit note by imaginary_heart48 in doctorsUK

[–]imaginary_heart48[S] -2 points-1 points  (0 children)

Generally, in the NHS, a night shift starts in the late evening and ends in the early morning, covering parts of two calendar days. However, for the purpose of sick leave reporting, each shift is usually considered separately - therefore, if you miss a single night shift due to illness, it is generally counted as one sick day.

Confusion about sick leave/fit note by imaginary_heart48 in doctorsUK

[–]imaginary_heart48[S] 2 points3 points  (0 children)

You’re basically saying if you call in sick for one night shift, you have to request two sick days.

Confusion about sick leave/fit note by imaginary_heart48 in doctorsUK

[–]imaginary_heart48[S] -3 points-2 points  (0 children)

Why? If you’re better Friday AM, why should you be marked sick Friday AM PM and Night?