The F1 Survival Guide: Week 1

Our guest blogger James Gill is an F1 doctor. In this series, he writes about his personal experiences of that very special time starting out on the wards as an F1.

Well we survived week 1, and (almost) as importantly so did all of our patients! Congratulations, and if you felt that you (almost) didn’t survive that first week – DON’T WORRY TOO HARD. IT WILL GET BETTER

Now I’m not going to tell you that soon life will be grand, consultants will come to love you, and they will invite you to their summer BBQ and introduce you to their eldest daughter – they might, but that would be unlikely (and rather irregular to boot!).

The biggest issue I had when starting as an F1, and I have seen it repeated in the new F1s this week, was a lack of confidence. Let’s all be honest, despite being absolutely no different from 2 weeks ago, you now are, at least to the outside world, a real doctor.

But what does this actually mean? – basically now, when someone, probably a nurse, asks you what drug you would give to a patient for problem x, rather than just being an academic exercise, that person will then ask you to write it on a drug chart AND THEN ACTUALLY GIVE THAT DRUG TO A LIVING, BREATHING PATIENT.

Photo by Carter ComicsI think I must have checked the dose of aspirin at least 10 times in my first week as an F1!! Oh heck I knew it was 75mg once daily, but was I sure, was I completely confident? Thus I kept on checking – what was I expecting I don’t know? It wasn’t as if it would have changed since the morning!

I found that it is was lack of confidence, combined with the realisation that this isn’t just a paper test anymore which made me very tired by the end of my first month – getting it wrong now matters!

When I started on the ward as an F1, I very quickly made friends with our ward pharmacist, largely because of the number of errors I would make on the drug charts. She would come and find me – and putting on her best “stern and disapproving face” would ask if I really meant to give the patient a certain dose, and ask what I thought might be better – she was (and still remains) absolutely fantastic and couldn’t maintain her “stern” face for long, simply because she knew that I was new, and although I wasn’t getting it right as often as a I should – I was TRYING.

REMEMBER AS LONG AS YOU’RE WORKING HARD, THE WHOLE WARD TEAM WILL SUPPORT YOU! You are not alone, despite what it might feel like.

Ok… this week’s top 5 tips

1. Trust the nursing staff. Some have been there longer than the consultants, they will help steer you and guide you when you find yourself alone on the wards – this will be particularly important when you are on nights or on call – remember the nurses control the flow of biscuits and chocolate so be nice, and say PLEASE and THANK YOU.

2. Don’t be frightened of leaving the ward. Sometimes a department (mainly radiology) will be exceptionally busy, and no one can answer the phone – everyone hates a ringing phone, so walk round to the department. You’ll get to know the people on the other end of the line, and I guarantee you that you’re scan requests will be more easily accepted.

3. Call for help often and early. Try not to get stressed when you don’t know what’s going on. You might be a doctor now, but for the first couple of weeks you’ll be barely more than a grunt. Your job is to carry out your seniors instructions. If nursing staff are telling you that a patient as a problem and you don’t know what to do, call for help. No one will expect you to know everything from day one – Ok Dr Satan the Consultant might – but he is in the minority.

4. Accept you WILL make mistakes. You are human, and you will learn through trial and error, but don’t worry, the nurses, and the “stern looking” ward pharmacist are normally exceptionally, and they’ll normally catch things, and show you where you went wrong. Don’t beat yourself up when you do.

5. Start work on your ePortfolio NOW. It’s a pain in the neck, many would describe it as a waste of time. Personally I don’t do well with reflective learning either, BUT IT IS COMPULSORY. In several months you’ll have to think back over the things you have done, and try and remember what was important, if you do it now – i) its easier, ii) you’ll forget less things, iii) life will get more stressful when you are trying to fill in the other parts of the ePortfolio, so start the reflective bit NOW.

Look our for james’s next blog post – the trials of week 2.