Diary Of an FY1: Is this normal?
“Is this normal?”, I ask on my first-ever medical night shift.
Unluckily, I found myself working a week of nights across Christmas and New Year's Eve. A doctor fresh out of medical school, very new to the wards, with no idea of what to expect from the hospital at night. Easy peasy, I thought. I can stay up all night binge-watching tv shows and procrastinating my sleep, this should be a piece of cake.
During those nights, I was either looking after 8 wards with around 20-30 patients each or clerking and examining new patients on the extremely long wait list of A&E. I did this on my own with only one medical registrar* to call for help. Short-staffed, as per usual. They say being a doctor is very stressful, but these nights re-defined stress for me.
I was bleeped constantly over 12 hours, overwhelmed and brought to tears with the number of tasks and deteriorating patients on the ward. I knew how to clinically prioritise tasks, but what do you do when everything is a priority? I was constantly apologising to nursing staff and patients because there was only one of me and 99 problems to solve. I attended cardiac arrests and returned to find 10 missed bleeps, only to call back and be met with very frustrated nurses and pissed-off patients. One minute I’m doing chest compressions, the next I’m verifying death at 3 am. At the stroke of midnight on new years eve I was catheterising a patient into the new year, followed by a quick facetime call to my partner and family, before being bleeped away again.
On New Year’s morning, I sat in the staffroom eating a salad.
The nurse came in, and asked “so, is that breakfast or dinner?”.
I replied, “It’s 4 am”.
There was a never-ending list of patients, with almost every other patient, being very sick, unable to breathe with COVID or the flu. It's as if winter pressures decided to solely pressure me. I saw patients in ambulances, in corridors, and in makeshift rooms, only to find them still there 7 hours later.
One time, a patient approached me, “I’ve been waiting for 8 hours, will I be seen soon?”.
I felt like crying, as I thought about our average waiting time this evening being 12 hours and more, and all I could do was apologise. I tiptoed over patients sleeping on the corridor floors, avoided patients looking for someone to fight and struggled to pull patients in wheelchairs through the packed waiting areas.
And every night didn't seem to get any better.
Shell shock…
This is probably the most appropriate description of my state in the mornings.
So I asked,
“Is this normal?”
Some colleagues dismissed me, claiming they’ve “been there, done that”.
“That's just how it is, it will always be difficult if you're new to it.”
“Other foundation year doctors have done it and they've been fine”.
Others, including my lovely med-reg for those nights, fought back and reported how unsafe the conditions were. However, I can’t help but think about how normalised the stress, trauma and frustration of working as a doctor is.
If you’ve ever watched a zombie movie where there are a group of survivors in a post-apocalyptic world, you’ll know how ugly human nature gets when presented with a lack of resources and desperation. And that is genuinely how it felt like working as a junior doctor in the NHS on these horrible days when the working conditions are unsafe.
And so I write this to reiterate how NOT normal this is.
Although I’m a very new doctor, and I have no personal experience of what the job used to be like, I know this is not normal. Nurses who have been in the profession for as long as I’ve been alive, reminisce about a time when the A&E departments were quiet by 3 pm. When every patient was seen in a timely fashion. When there was time to chat and bond with colleagues. When work was somewhat pleasant. Furthermore, I have done my fair share of slogging in odd part-time jobs, with some even being paid more than I currently am as a doctor; as well as, being part of the furniture attending many placements throughout medical school. I know…
It is not normal to have a lack of support at your workplace.
It is not normal to have to see patients in corridors and cupboards
and it is not normal to have so many helplessly frustrated and pissed-off NHS workers.
It's not normal.
And I hope for change.
* Or Med-reg : a more senior junior doctor training in a medical speciality ( I know the title junior doctor is confusing. Everyone below a consultant, is a junior doctor, even if you have been training for donkey’s years).