Boy Critically Underweight and Doctors Don't Know Why | Confessions of a Junior Doctor | Only Human

we can put her into one hello lady my name's Morgan I'm one of the doctors there are over 63,000 junior doctors working in Britain's hospitals as young as 23 they are the foot soldiers of the NHS how are your bowels and water works yeah it's not glamorous hey they'll welcome us into the world they will be there at the end but they're working in hospitals that are treating more patients than ever before no beds no space everything is stretched we haven't got a lot to give and something needs to change these doctors have become a symbol of the state of the NHS we are doing our vats that we are working our hardest but it's just not enough filmed in one regional hospital at the height of the junior doctor crisis this series is about the young doctors who are the future of our health service to survive as a junior doctor you must have courage courage to cope with what we see day-in day-out encouraged to deal with people at the very worst moments of their lives and courage to work in a system that can't cope with the pressure it's under [Music] there is one date that sticks in the mind of every Gimli adoption and that's the first Wednesday in August that date is when they begin to work in hospital for the very first time you can ask any doctor in the NHS and they will tell you that that is the most important day in their professional lives in August 2016 around 6000 medical graduates are beginning their careers across the country so I just have butterflies in my stomach because it's just it's just the unknown isn't it obviously it goes without saying I'm I'm petrified of letting my patients down 30 are registered to Northampton general their induction is led by dr. Philip Pearson it's my job to welcome them but also to warn them what's ahead the NHS at the moment is running very very close to the edge and the junior doctors other ones very much in the frontline my fear is it will be harder for them than any other generation previously welcome to Northampton and for that matter welcome to medicine doctors it will be hard work it will be stressful you will be taxed physically emotionally mentally in the next 12 months more than you ever thought possible you will have patients dying in front of you there will be times when all you want to do is just burst into tears there will be times when you go home dancing punching the air because of things that have happened there are plenty of good times and there are always people to help you thank you for your time it's been a long day but welcome to medicine there are hundreds of general hospitals like Northampton across the UK they are the backbone of the NHS providing care to millions every day this is of haptens hospital most people who work here live here most people we treat our neighbours there's a lot of pride in the place it does a fabulous job with limited resource but we're not much different from anywhere else we've got ever-increasing number of patients coming through the front door but we haven't got an increase the number of staff to provide that care we haven't got an increase in the number of vets to provide that care and we haven't got any more money each new doctor has been assigned to a hospital ward working in a full medical team for the first time ok sharp scratch I'll ask one of the other doctors to help me you're right you're sharing it is terrifying you don't want to come across as the nervous doctor who doesn't know what they're doing and who makes loads of mistakes and nobody trusts them they look like they're don't what's that saying rabbits caught in the headlights is it that's that's exactly what it is I think thank you for 28 year old Holly it's been a long journey to get to this day when I found out that I had qualified I was just shocked I was shocked because when I was 15 one of my teachers told me that would never be a doctor because I wasn't clever enough and I had no Drive left me with no confidence I feel I have I've had a quite a lot of jobs to get here I've been a health care system but a pub manager for a while did a bit of security work it hasn't been straightforward it hasn't been easy on Holly's first day she's working with a consultant and nurses on the emergency assessment unit where acutely ill patients are sent from a and B [Music] at midday the consultant is briefly called away and Holly is left as the only doctor covering the ward I think everybody's biggest fail on their Thursday is causing serious harm or killing a patient which is very difficult to do empowerment hopefully but within minutes one patient has started to deteriorate what was it Marty had he's had one gram oh babe but he won't beat you anymore now until before there is gentleman with a pneumonia and despite being given treatment in antibiotics they haven't been successful so at the moment we're trying to explore different treatment programs for him but he is acutely unwell I'm quite worried about him at the moment three hours into her career holly has a patient's life hanging in the balance my name is Holly I'm one of the doctors on the ward at the moment and the consultant that came to see you earlier this morning would like you to have a tube put down it's one that we popped through your nose down into your stomach so that we can help with things like your pain you squeeze my hand if you understand what I've said when you first see somebody very sick all of a sudden you realize the pressure of the position that you're in you know it sounds rather dramatic but you held there like in your hands and all of a sudden that hits you and you realize that all that training all that you were taught this is what it's for this moment Holly needs to insert a nasal tube that can supply life-saving antibiotics when you measure an NG is just dancing an on-call team is there to provide support are you thinking with the engine your self yeah yeah I've had training well you can have the training it shouldn't be a problem okay when it's your first few days as a doctor and in expect it happens that's when the self-doubt creeps in someone once said I couldn't do this am I about to prove them right if it'll this is uncomfortable just squeeze my hands and hollywoo stop okay Polly inserts that you perfectly but won't know until tomorrow if the antibiotics have worked you do feel like you're on edge either this patient will pick up and improve and then go home or they'll take a turn for the worse and it's it's a waiting game there are 210 junior doctors in North Hampton you want to tell me what's brought you into hospital today just sort out this head of mine alongside caring for patients there's a continuous program of training when you're the person that makes that diagnosis and starts the treatment when you've saved someone's life it stays with you forever and as their careers progress they take on ever more responsibilities [Music] my name is Emily I'm one of the oncology doctors I understand that you've been diagnosed with breast cancer so do you want to tell me what's brought you into hospital at the moment 26 year old emily has just started on the cancer ward as a third year this is her first chance to specialize her training can I have a little look at you if that's all right I really don't know why I wanted to be a doctor I just know that I always wanted to be one and I think it was because my mom was one and she was such an amazing role model and I think I just saw the difference that she made a couple of years ago she went for a normal mammogram and she was diagnosed with breast cancer three days before my medical finals white cell count is she did have to have a big operation she did retire early from work but it really made me realize that being a doctor as much as it's about the medicine and the medical decisions actually in situations like that it's about the person as a whole but also about their family as well Emily's mum made a full recovery but the experiences led her to choose end-of-life care as a speciality people just seem to wonder why I want to work in palliative care I think a lot of people just don't see the benefit in it and maybe those people haven't had family members died or had bad experience it's a maybe they think that every death is the same but I would argue that it's definitely not and there is a huge amount that you can do Emily's Ward treats people with complicated or terminal cancers one patient Tracy used to work in the hospital chest x-rays a little bit worse so it's a little bit of a knife edge that you're balancing on I know Tracy's got lung cancer but unfortunately now it's spread to other parts of her body I am very slightly aware as well that the liver lesions will probably be getting bigger whilst you're off your chemotherapy yeah she has got a lovely family who really involved the kids have been telling weigh-in her husband that he needs to go home and have some rest as well but yeah the next few days are quite important like Emily's mum Tracy's cancer came completely out of the blue she meant when he told us we kind of started laughing because it was a bit of disbelief wasn't he yeah I didn't really cuz I've never smoked so I didn't really believe it at the time I'm going into my third year and I'm happy and I've had a fantastic two and a half years doing stuff I wouldn't have done if this didn't happen something lucky yeah but I still give that all up I know you not to be going for all of this to be a good doctor you have to care because I think when you stop caring then that's when you become a bad doctor but I think the worries for me are just that it's quite emotionally demanding and emotionally draining and it is well recognized that people do burnout I think working in oncology will definitely help me see whether it is something that I can do every day or whether I think it would be too much for me back on the assessment unit Holly's patient has continued to deteriorate I think the most difficult thing when you start as a new doctor is understanding or realizing that you're not going to be able to help everybody there are some patients there whatever you do they're not going to improve and as a junior that's very difficult to get your hand around we've been giving him a lot of antibiotics and we're still struggling to keep him comfortable this is my second day and I already feel like I know him so well later that week the man dies from his infection [Music] he's Holly's first-ever patient you just for that moment think was there anything I could have done you're there to relieve pain suffering make patients better but death is a consequence of life it is a privilege to be a doctor it really is you get invited into these patients lives and you see them there absolute worse I just hope for that patient that he was as comfortable as possible [Music] Northampton general is serving a growing population but they've had no increase in doctors in training for the last 15 years like many NHS hospitals it operates at near full capacity most of the time at the moment we are dealing with the problems of increasing patients coming into hospital who would generally sicker they're often older there are more complex problems and therefore they going to stay in hospital longer can you take some deep breaths in and out for me so all staff whether they're junior or senior are under significant pressure to see 20 25 percent more patients than they would a couple of years again I think it's almost thinking right everything is stretched that this is the worst I've ever seen it in 36 years a morale is not great because it's so difficult deliver the standard care that Cleveland off hi my name's Sam Pollan I'm a second year doctor and at the moment I'm thinking about leaving the NHS for good Sam is 24 and working on the gastro ward dealing with bowel and stomach problems and a lot of elderly patients you know which hospital were in at the moment hello it's Sam one of the doctors how are you getting on today Joyce you feel okay yes okay and how we our bowels and water works yeah it's not glamorous it's not glamorous I leave work most days covered in either poo blood vomit or a combination of the three hello miss Harrison all right now this is just a little bit of local anaesthetic I worked my ass off in school to get into med school I worked my ass off in med school to get where I am now sorry it's quite uncomfortable I know and then you come out into the real world and you're trying to put all of that knowledge and idealism to use in the system that is slowly breaking down in a system that's over stretched and underfunded and it is kind of demoralizing it kind of sours a lot of what you've worked so hard for all these years Sam's Ward has a staff shortage and today he's looking after double the number of beds he should be 20 year old Ryan has had numerous hospital visits and lost half his body weight but no doctor has been able to diagnose his condition I may have been in and out of here 17 times this year I was originally eight stone and now I'm down to four stone to you know just look like a malnourished perennial and it's horrible hi nice to meet ya nice to meet you can I um examine you okay you just relax so we see patients like Ryan a lot and he'll come into hospital very frequently what they need from us as doctors is our time it's a bit of a mystery at the moment but bear with us and we'll figure out what's wrong okay Cheers all right I'll see you shortly but you physically don't have the time to sit with a patient for 20 minutes and listen to them because I've got 50 other patients I have to see by lunchtime and that's what frustrates me about medicine today is that we physically don't have the opportunity to give the level of care that I have been trained to offer and then I want to offer and then I should be giving to my patient and you feel guilty about it you feel guilty a lot of the time a lot of the time the number of junior doctors leaving the NHS is rising in some hospitals it's now a daily challenge to have enough juniors on the wards Lindsay Barone is responsible for Northampton's medical rotor at the moment out of 65 junior doctors we have 10 gaps as of today next week that's gonna be more because somebody's two people are leaving that's will be 12 hi I'm just going around wards but I know you're one down to see how it's going on there are days where you don't know how you're going to ensure that each one has sufficient doctors providing safe enough care and that is a very knife-edge situation last year almost a third of junior doctors left the NHS after only two years this is your first day on this ward the gap was largely filled by foreign doctors it yeah always quite helpful quite give me where to go so yeah there's no way the NHS would survive it without overseas doctors there's no way good how are you getting on most of the adverts that we put out for doctors that we need will be overseas and hence a lot of the interviews will be Skype interviews sometimes we have people that have not done very much and it's a bit of a gamble but you have to assess that at interview as to whether you feel they are experienced enough for you to supervise here each year it gets more difficult and it feels as though we are on the edge of things cracking up a doubt about that it's Holly's third week at the hospital one morning with a knee already busy two of her team failed to turn up we should have thought it would round by now but I've just been told it's been a bit of confusion with the consultants writer so the actually no consultant around at the moment and it just means that we can't really get the ball rolling with our day and here we get a consultant to come in and review people without a consultant review nobody can be admitted or discharged from Holly's ward the department grinds to a halt as people continue to arrive into a indeed I Nene currently has approximately 70 patients in it this is quite a few in A&E at the moment but I don't know what else I can do because that's a state they've got nobody a minute go in mind this Ward is full and we've been told that the hospital is full to capacity no it says no beds on any wards at the moment the emergency admission system is running at its absolute limit it's stretched the point where if one person one key person doesn't turn up for whatever reason then the whole thing can just fall apart it's like a don't grow dominoes in just one person comes out the whole thing just collapses because the flow stops you get a blockage and it backs right the way up to the front door it just becomes impossible within two hours the hospitals on red alert as numbers in A&E have doubled so dots Milanovic can I just checked you're happy with the plan so we need to chase the CT heads whenever a hospital is on alert all wards are under pressure to discharge patients for Emily this happens on a day her team is down three nurses do you have any problem knowledge this morning okay maybe a check from your pink EULA do you hear me any other question for us it's just a little bit stressful cuz I'm the consultant wants the ward round to speed up see you bye however the problem is when you try to see them quickly it means that the patient's become dissatisfied which is understandable and you can miss things that you would have picked up if you'd have spent that time all right we'll see you tomorrow morning okay he is the sort of patient if we just walk in and walk out he will kick off for the rest of the day if we don't explain that to him his anxiety his depression and he'll be suicidal again and I'll have to phone the acute I don't normally have long conversations unless I need to have them what is the next mission Tracey Simpson room six I've not checked her Bloods yet to have another chance it's really do you mind helping me Sayid grabbing the notes and things because dr. mallanna [ __ ] wants to speed up but I can't do it all by myself okay and you're feeling short of breath up there now so we'll carry on with the nebulizers I'm gonna ask for a chest x-ray just to make sure there's nothing new going on is that Alright okay we'll see you later it sounds like she's not floated today and I want to look into that a little bit more but now it is difficult to feel like you're doing your best when you're so busy hello can I help by the afternoon the staff shortage catches up with the ward 25 year old Rachel has been waiting for hours to see a specialist nurse I have a patient sitting here for a pump change and I can't do everything it's too much I mean we were supposed to be here for half an hour today rachel has stifled throat cancer they've told you that she has averted 40% chance of survival and how how can this happen how can this be [Music] it's just really stressful because we've just not had enough doctors or nurses you can part with anything when it's a few hours or a few days but when it's a permanent thing that there's never enough staff and you're always running at 110 percent and you can't keep it up this ward has broken me it has broken me this job's broken me [Music] on the assessment unit Lindsay Braun has stepped in to do the consultant ward round see if we can but Holly's day is about to get even busier find no not really so had a cardiac arrest wouldn't the ward and I'm part of the arrest team today so we seem to get there and find out what's happened in the next-door Ward an elderly patients heart has stopped Polly and her team have only minutes to save a life went into cardiac arrest we started treatment and then it got to the point where I we'd dealt with everything and she was still developing rhythm so there are untreatable really so the Medway just made the decision and then check with the team I'll have to stop the decision was late but in the brief time she's off her ward another patient has died okay when things get really hectic and the wards are very busy you have to become almost like a machine emotion just doesn't come into it if you've got time to sit and worry about how you feel you've got more time any hands than you thought by the end of her shift holly is just beginning the discharge paperwork it's 25 past or not had love I met to finish in five minutes I actually feel at the moment like I look really incompetent so like this discharge is probably take me about an hour well actually if I just sat down with no distractions it would have been less than ten minutes it's just that fear of I don't wanna let anyone down I don't want people to think I am incompetent because I'm not at times the NHS is on its knees and it is becoming more more evident to me exactly how stretches all of our senses out [Music] one of the big things for me was that I didn't want to get to the point where I forgot the patient and today I couldn't tell you a single thing about any of my patients if you line them all up in front of me now I couldn't tell you any of their names because I've been too rushed today I was expecting it just not on the level of today today's been hectic at the beginning of September the hospital is quiet today we've got a full complement of doctors on the ward which means we're each looking after one bay which means I have actual time to spend with my patients so yeah today should be a good day Sam's team have spent the last week trying to solve the problem of Ryan's weight loss but with little success the Ryan conundrum continues it's quite a complex case and all of the things I would have tested for we've tested for and they've come back normal so I'm lost at the moment he's no guy it's got life to live it must be difficult for him all right okay and we've got an office for you down there if you want it on there for me we can set up a chat for a bit I've got a bit of time now solution yeah I know you struck for time yes so go ahead you wanted to have a child yeah being on that ward is making me really upset no wait I don't want to leave here and tell him okay I don't think we're planning on kicking you out rapidly any time soon yeah not only laughing because just because they will drawl from the cannabis that's the main thing I was gonna speak to you about today mmm-hmm oh why not you I am hi cannabis user which I'm trying to cow and I know for a fact if I go about next week I'll end up smoking they come amiss again or I can already see how often would you say you smoke cannabis every day okay it's good you've brought that up because that means I can speak to the team and we can make sure everybody's in the loop and that can be sorted from our side I'll just relate it to other word all right cheers Cheers so I've got Ryan's old notes here lifestyle factors are often important and what causes people's symptoms and no wasted drug use is one that is often very important but doctors very shy to ask about and cannabis which a lot of people consider an appetite stimulant in long-term use is actually an appetite suppressant so if all this coincides with his use of cannabis and we may be on to something on Ward round the next day Sam can test his theory with Ryan's consultant so I had a chat with Ryan yesterday just trying to figure out a bit more about him and his lifestyle and he said that he just smoked quite a large amount of cannabis and has been for a while I'm really surprised hello how are you today great so why do you think you've got better here when you weren't getting better at home any idea cuz cannabis suppresses appetite did you yeah yeah I go to carry on with the cannabis No so are you worried that when you go home to start using cannabis again she only bring now gets me through day really and have you been very depressed at home I was before come in or all or dude wake up go get smoked up some probably [ __ ] Chris I left me for about two three days and now I'll just sleep all day that's not much of a life no no no it's a vicious circle isn't it you take the cannabis you don't eat you get more tired you end up skin and bones sometimes it's not the advice that you give someone that solves the problem it's the opportunity to be listened to that solves the problem and I think nobody's really had the time to have these discussions with him I'm sorry that you took us a while to get to this well I should have said about this sooner that day Brian's medication has changed and the drugs counselor called in and I'm calling as I have a patient I'd like to refer to yourselves for a review as an inpatient if possible you go through so much of the job feeling like you haven't lived up to what's expected of you that when you actually do something that's spot-on it's just really satisfying here's dr. Dee it reminds you of why you're here and why you put all the work in and why you sacrifice so much to carry on being a doctor because of those moments on the cancer ward Emily's team has just received Tracy's latest test results Tracy is really poorly at the moment so seeing that the x-rays worse I suppose isn't surprising but it just confirms that perhaps things aren't going in the right direction after years of treatment Tracy's body has finally given up their final so for me this is one of the things that it's all about because the way that this whole situation is handled now will massively massively affect that family for the rest of their lives I mean if Tracy's in pain or distressed and there's more trauma heaped on top then that will stay with the family forever as well as the grief and I think it makes the grief much more difficult to process it really shows whether you have a good doctor or not as to how you handle those situations [Music] how are you feeling Tracy I just wanted to catch up with you and see how you're doing you shattered how does your breathing feel do you think the armoire has helped a bit you think it's just knocked you out a bit okay and I've had a look at some of the Bloods that have come back so unfortunately despite the antibiotic some of the Bloods are looking a little bit worse we are possibly entering that zone if the platelets drop any lower tomorrow that we might not be able to carry on with the blood thinner but I think it is just a little bit concerning that things don't seem to be going quite in the direction we wanted - did you have any questions for me no okay all right okay all right I'm new here in please Tracy okay yes it's very difficult to get the balance right when you're having that sort of conversation to give people the information you need to give but I think I managed to broach the subject and plant the seed but it's just a very sad situation you can really clearly see the love between them and so I think it's obviously going to be incredibly difficult for them [Music] for all juniors life as a doctor is 24/7 okay baby you want to open your eyes to me hospitals never close and day shifts are mixed with nights I'm convinced I did the wrong thing hey you didn't because she was expecting us to check consultants are there for juniors when things get too much and you did it in the balanced way which I think was very good but in the emergency department Holly's team is still battling staff shortages so I am Tony on day 9 of a 10 day straight at the moment I know that there's a lot of gaps on the rotor and I don't mind helping out where I can and filling in those gaps but there's only so much that we can work in the tire do you get the more challenging it becomes in her first month Polly has treated over 300 patients certified almost a dozen deaths and like many NHS staff hasn't once left work on time my partner makes a big joke because then Jeremy Hunt said there's no reason why doctor shouldn't be leaving at 5 o'clock and so when I rock in at 8:30 my partner wants to know what my excuse is because my boss Jeremy Hunt says I should leave at 5 o'clock if we work too wrong and we started at the time we supposed to start and finish what I was supposed to finish the NHS just would be non-existent I would say a large proportion of it runs on goodwill the goodwill of the staff so sharp squirt coming up the reason that we don't stop is because we care about patients we put them first ok fine why would you be a doctor or nurse or work anywhere in the NHS if you didn't care about people for all of the stress and pressure that I have felt under and enjoying being a doctor but there have been days where I have thought twice being a physician is the best and most brilliant job in the world that's just far too much it you know we can't just keep expanding the number of hours we work and keep a smile on our face and keep doing it perfectly you can't do that we are reaching our capacity we haven't got a lot more to give and something needs to change by the end of September junior doctors have been imposed for two months every day has seen new patients arrive and apart from their care so unfortunately Tracy passed away on Friday I last saw her on Thursday night or the early hours of Friday morning as I was doing the night shift and it was becoming more obvious that she was becoming much more than well in it and that she was dying and Tracy said that her last wish really was that she wanted to pass away at home and I'm just so glad that she managed to get there even if it was just for a few hours on the 23rd of September Emily's colleagues were able to fast-track Tracy home where she passed away surrounded by her family patients like Tracy it completely reinforces what I want to do palliative care she died where she wanted to die her pain was under control I think she died with dignity so as far as I know I would say that she had a good day of course it affects me and I've cried at work I've cried a few times but you do just have to learn to be able to deal with that and pick yourself up and go back out there because as sad as it is there's always another patient that you need to go and see and so we just have to carry on here and they came here to see you asking for what could be better that could be worse no I couldn't do this job for the rest of my life it's too much but I do want to stay in the NHS and hopefully climb the ladder and become a consultant there's no other job that I can see myself doing because for me it's about making a difference in caring for patients and there's no other job where I think I could use the skills that I've got and make that difference in patients lives I'll see you later on okay across on the gastro ward Sam success with Ryan has made him reflect on his own career I feel like this is what I came here to do and I am doing it well it's a confidence that oh actually I am a good doctor since coming under Sam's care Ryan's gained six kilos and is now ready to go home hi Ryan so you're off today how are you feeling it's been really nice meeting you but I hope we never see you again Wow I don't see you again but it's not in a professional capacity all right behave yourself I want to stay as a doctor in the NHS this is my whole life this is everything I have trained for since I did my GCSEs this is I pour all of my effort and all of my time and all of my energy into caring for the people that are in this hospital you keep your head still for me look forward they go but I have no idea what my future holds because I have no idea what's happening with the NHS no degree of efficiency savings or strategic cuts is going to solve the problem that there are too many patients and not enough people treating four weeks after discharging Ryan Sam chooses not to apply for further NHS training I want what anybody wants I want to be able to do the job that I'm trying to do I want to be respected and I want to I wanna be happy so I've decided to take a year out to decide whether I want to stay in the UK and pursue my training here or do I want to go to Australia and New Zealand somewhere abroad to pursue my training out there Sam is one of 6,000 junior doctors who applied to work overseas in 2016 we have a whole generation of the most dedicated and compassionate people I've met doctors nurses everyone who works in the NHS who are completely disillusioned by a career that they've worked so hard for I think we're seeing a slow painful collapse of an institution that we should all be grateful for and it's a shame that's the most accurate word for it is that it is a crying shame on the emergency assessment unit Hollies now been a doctor for two months from day one till now I think my contents is increased and continues to increase exponentially on the acute wards there's no time to stop and look things up check a textbook wait for a consultant to arrive the patients are so sick that you need to make the decisions quickly and in a confident way thirteen years after her teacher said it would never happen Hollies firmly established as a hospital doctor if you want something badly enough it doesn't matter what background you've got what money you've got it is your drive and ambition and determination that will get you there and I still have as much passion now as I did when I was 15 just take some deep breaths for me but there are times when we feel that we can't do any more than we already are and there's still patients waiting [Music] I'm right at the start of my career and I'm worried about what the future holds I think if nothing changes that just won't be an NHS I can't see its current functioning level that it can continue but I still love my job I love everything that I do and I couldn't imagine being anything else it's for you you're going home next time the onset of winter creates a surge of patients in a and B we're in a very difficult position here and new recruits must adjust to life in the hospital's busiest department I begin to question why the hell I'm doing this I need for me even good enough [Music] [Music] click on-screen for more videos of extraordinary humans you

Channel: Only Human

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Rating: 4.841732 out of 5

Keywords: junior doctors, junior doctors on the front line, junior doctors season 1, confessions of a junior doctor documentary, confessions of a junior doctor full episodes, confessions of a junior doctor, junior doctors bbc, confessions of a junior doctor episode 1, junior doctors your life in their hands, junior doctor uk, Only Human channel, Only Human, only human documentary, medical documentary, day in the life of a doctor, day in the life of an emergency room doctor

Id: r4WlZ_9n7Pc

Length: 47min 31sec (2851 seconds)

Published: Mon Nov 04 2019