My First Day As A Doctor! | UK Junior Doctor Vlog

hi guys my name is ollie i'm a junior doctor living and working in england and welcome back to my youtube channel now in this video i'm gonna take you through my first ever day working as a doctor within the nhs although it'll actually be the first few days and i'm recording this video on friday night i started work on wednesday the 4th of august 2021 that's the start of my career as a junior doctor as ever you know that i think it's really important to capture the real lived experience as i'm going through on this channel and keep you up to date with what is actually going on for myself and many junior doctors that are starting work at the moment before we launch into the video however i do just want to remind you to subscribe if you can and make sure to hit the little notification bell to make sure you don't miss any videos and to go and check out my social media channels particularly my instagram where i post photos virtually every day of my life as it unfolds as i'm sure you'll notice i look absolutely shattered and very drained and there are several reasons for that but let's just jump in on day one so remembering that i have spent the last two weeks in induction training for this job so although it's my first day of work officially on wednesday i have been working for the previous two weeks on the hpb unit hepatobiliary surgery and we started work just like any other day i arrived around 7 30 in the morning so i can leave my flat just after 7 00 a.m can get a hopper bus from the rvi which is three minutes walk away from here and about 20 minute bus journey to the freeman get there for around 7 30 get changed into scrubs and then try and be on the wards or at least in the office for around 7 45 a.m after we've said good morning to everyone in the office so we work out who the junior doctors are going to be during the day and the registrars they're going to be leading the wardround one of us will go to handover and this is where the night team the team of doctors and nurse practitioners that have been looking after all the surgical patients during the night will hand over from their 12-hour shift and tell us what's happened through the night and tell us any other jobs that we need to chase up during the day we'll then go back to the ward office and we'll spend the next kind of three quarters of an hour maybe even an hour if we get time preparing for the ward round you'll have heard the phrase perhaps prepping the notes before and what this involves is looking down the entire list of patients so my team will look after between 50 and 60 patients probably between the team and we're split into two teams each of which has doctors and pa so we have a red or more acute team and a green more chronic or elective team so each team is looking after around 25 to 30 patients and each team will prep the notes for their set of patients so that involves things like checking over the background of why are they in hospital so someone might be post whipple's procedure or post liver transplant or something like that and they've had several laprotomies or a gallbladder removal or something like that so just getting a condensed very quick history of who they are why they're there we then want to know the results of any recent tests so their most recent blood test results how was their liver function how are their electrolytes what are their blood cells doing their inflammatory markers and so on we want to know how well their kidneys are doing we might want the results of any recent imaging or scans they may have had a ct scan which is very common or an abdominal x-ray taken we will also want to know about their observations that is things like their heart rate their blood pressure their respiratory rate their temperature and this will generate something called a new score or an early warning score so ideally we want that number to be as close to zero as possible but as people's parameters become more deranged so as their heart rate either goes very high or very low or their respiratory rate gets too high or too low that early warning score will increase and a higher warning score means that we need to pay more attention to that patient it is an early warning that they may be about to deteriorate and then lastly we simply want the plan for this patient what are we doing for them are they nil by mouth can they eat and drink should we be encouraging them to mobilize are they on antibiotics or any other treatment essentially what are we doing for them and once we've got all of that information put together and summarized for each patient we can then begin the ward round and the ward round will either be led by a registrar or a consultant these are the senior doctors and we will go with them as the junior doctors to document what they say using a computer on wheels or a cal as we call them essentially typing all of the notes as we go and see a patient so the registrar consultant will ask them how they're doing maybe perform a quick examination and we'll be documenting as the juniors everything that goes on including the plan as the consultant comes to it so they might just say continue current antibiotics until they're finished outpatient ct scan and once the blood tests come back or normal they can maybe go home tomorrow that might be a very typical plan so then we'll go around see all of the patients that we need to see on a particular ward and rinse and repeat until we've been across all of the wards that we need to go across that might then take us until about 11 o'clock or half past 11 at which point my team usually breaks for coffee which is a really really nice reprieve a chance to just come back together as a team get all of our thoughts together just chat for 10 or 15 minutes and unwind from the very busy and often stressful ward round because consultants will be firing plans at you this this this and there's a lot of unspoken information that you need to pick up on and kind of interpret what exactly is the consultant wants you to do and try and formulate it into a reasonable plan it's like i say we break for coffee or maybe have 15 20 minutes downstairs in the hospital canteen having coffee and then come back to the office and the next kind of half an hour 40 minutes will be spent preparing the jobs list for the day and this is all of the jobs that have become apparent on the ward round that need doing so patients might need bloods they may need blood cultures if they've been spiking a temperature because we need to look for any bugs in their blood that are a sign of an infection we may need to prepare someone for surgery they may need consenting for particular procedures and so on and so forth people might need reviewing uh just go lay eyes on that person and check that they are receiving enough fluid alter this person's prescription so we're creating an itemized checklist basically and then prioritizing all of these different tasks which can maybe be a sheet of a4 long at the start of the day doing any really quick easy ones such as prescribing new meds or altering prescriptions going down doing the easy ones first and then we'll go out on the wards as a team and start doing the jobs that need doing so most commonly for me as a junior this will be assessing unwell patients altering medications such as people's antibiotics or their insulin or their fluid therapies lots of patients need bloods so that's something that as junior doctors will do a lot and perhaps one of the most frequent jobs is cannulas that is inserting a needle into the arm the hand or anywhere where you can find a vein really which allows someone to receive intravenous therapy because without a cannula or a line going into one of their veins they are basically restricted to oral medicines and if someone is being very sick for example and they're unable to keep medication down we can give them all the tablets we want but if they vomit them back up they're not absorbing those medications their bioavailability of those drugs is very very low and the other element to this is that we all carry these decked phones um around our necks at all times and each of us has a dedicated phone number and all of the staff on all of the wards know how to get in contact with us so very often we are receiving phone calls from nurses and other staff members such as dietitians pharmacists and so on throughout the day asking us for advice for particular patients or are you looking after mr smith their blood glucose is very high do you want me to give them their insulin now do you want to adjust the dose you're kind of constantly being bombarded with phone calls with small tasks or perhaps a patient looks particularly unwell to the nurses and they might say i'm one of the nurses on this particular ward i've got this sick patient and they're under your department's care would you mind coming and assessing them please and so if that happens you might just have to stop whatever you're doing and go and lay eyes on that patient because they're obviously at risk of becoming very unwell and you're the doctor who was meant to go and look at them and my first day to be honest was great this is basically how it progressed all day until about five o'clock when i'm due to finish work and what we will do is prepare jobs to hand over to the doctors that are on call until 8 pm who will then hand over to the night team who comes in and starts work at 8. so we try and do as many jobs as we can during the day to minimize what we have to hand over to the doctors on call who are very busy update the main list of ward jobs so that the whole team and the whole department knows roughly what's going on with each patient and then i ended up going home about half past five on day one very tired because jobs are coming all the time but i did manage to get on with most of my jobs i was very well supported we had a great team all of my junior doctor colleagues are amazing super competent and we get on really well so i absolutely love my hpb team i love working with them and shout out to the pas as well the physician associates who have been keeping us as brand new f1s on the straight and narrow answering all of our stupid questions because we don't really know how to do anything and basically yeah keeping as well so thank you both then day two unfortunately was a bit of a disaster it was just an awful day actually for a brand new doctor for some reason in my router i was placed on a completely different unit in a completely different specialty with a completely different set of patients that i know nothing about and crucially i've not had any induction in right so if you imagine that i've had my two weeks of induction in one specialty to prepare me for how things work there for some reason i was covering this completely different ward on the second day so i roll up a little bit uncertain around the same time half a seven and essentially just being completely frank about it i had very little support uh available in place and i was basically left to just get on with things by myself for most of the morning i can't fault the doctors in particular who were my seniors but they were extremely busy the surgical workload is picking up a lot um at the moment because of covid and how restrictions have been on all types of procedures so they're really cranking up trying to get all their jobs and operations done as quickly as they can but for me that basically left me abandoned on a unit virtually all day not really knowing what i was supposed to be doing or how any of the systems worked or anything about the patients and there are quite a lot of sick patients and i just felt that i was left handling some situations that were really quite scary for a new junior doctor and and the pace was also really really hectic so jobs were coming in thick and fast much faster than i could keep up with them by myself i was the only doctor for maybe 30 odd patients again i don't know anything about we had teaching in the afternoon so teaching for us fy1s is compulsory we have that on a thursday but i was too busy to attend so obviously now i'm stressed about missing the compulsory teaching and they take note if you're missing teaching um because if i'd left to go to teaching it would have left the ward without a doctor so i couldn't go i didn't manage to eat anything on the thursday because again jobs were coming in very quickly but i don't know anything about the patients so it's taking the extra time to get to grips with what's going on with each of them then actually execute them and i finished just very late absolutely demoralized and it was only due to the the very kind intervention of some senior doctors from different departments that i was able to really achieve much of anything and that was really hard and there's a there's a picture of me you can see here at the end of the second day i was just absolutely exhausted um beyond measure it was really hard but then on to day three i'm back on my original unit back working with my same team that i'm used to but the pace on the friday was even more ridiculous than uh the previous two days and me and and my colleague um who will remain nameless for now but you might meet her at some point here on the channel we were just working flat out all day uh trying to execute jobs go and see patients clark knew patients as they came in which again generates more jobs they all need bloods cannulas ecg's assessments referrals to different specialties and so on and neither me or my colleague i don't think we managed to sit down all day we certainly didn't get a chance to eat anything neither of us had lunch and i think we both left about six half past six again just having eaten nothing not been to the toilet not had a break all day and it was just so so intense and that's basically how the first three days have been so that's a quick summary of of what we actually do day to day and how it has been and i'm just gonna spend the next few minutes kind of reflecting on how it's gone so far how it's going very early on and some of the advice i was given and whether or not we've been able to do anything with that advice and just how i'm feeling about medicine at this very early stressful stage so i think the first question that i asked myself is is this what i thought the role of a doctor was um it isn't it isn't i did an assistantship and i really enjoyed it which is after finals for us at warwick you spend a couple of months shadowing an f1 doctor in their role and while that was really helpful and insightful it's very different when you have the responsibility for what's going on when it's your name on the decisions when it's your name on the prescriptions and so on and you're called to deal with an acutely unwell patient it feels very different it hits different as they say but the thing that has really surprised me and i can imagine many doctors hearing this and just cringing at how obvious it is so much more of the job at least for an f1 is not medical i think it more than i expected it's very clerical in its nature at least so far i'm doing on calls next week which are going to be quite different but your jobs are mostly admin really but admin that it takes someone with medical understanding to be able to do you know in order to adjust prescriptions and prescribe new things and assess patients you have to obviously have an understanding of what's going on but it's very low level medicine at least on my unit virtually all of the decision making is led by the senior doctors as it should be obviously these are very sick and vulnerable patients but what makes it difficult is two things is the speed at which the jobs come in during our busiest periods we were probably getting wrong every two to three minutes by different people and obviously everyone would add a new job to your jobs list and very few of the jobs can be executed that quickly so you just end up with a really really long and unfilled jobs list and the bulk actually of the difficulty is completely non-medical it is communication between different departments it is waiting for things to be done in other departments like waiting for bloods to come back for scans to be done for scans to be reported and most of it is simply figuring out the system like i know what i need to do i need to order a blood gas for this acutely unwell patient how do i do that do i type in blood gas here nope that doesn't seem to work or how do i prescribe this particular medication that doesn't appear on the system or do i need to fill out a form to get this endoscopy can that be done online does it have to be done on paper why does the lab keep rejecting my results we're very slowly figuring out all these weird systems of just navigating how our department works and you just need someone senior to tell you but you really don't want to ring your registrar as a new doctor with something that's like so far below their pay grade like how do i order this test on the electronic system it's got nothing to do with any of your patients but i need to know or how do i order this ecg and make it happen now or how do i make this ct scan happen in four weeks and not right now and not have an angry radiologist shout at me it's it's all of this kind of thing i think as doctors we are very much problem solvers at this level it doesn't matter what the nature of a problem is it may be medical it may be completely non-medical but it's a problem and you've got to fix it so this is where i think the lateral thinking and communication skills come in for junior doctors and the other major thing i'm sure you've noticed is the lack of breaks or time to eat or time for self-care this is something that i think nurses do much much better than doctors and because they actually have a culture of taking breaks and ensuring that they try and get their breaks on time obviously it doesn't always happen but certainly when i was working as a healthcare assistant on a nurse-led unit it was very much when do you want your break and breaks are as much as they can be protected time and i'm not in any way trying to insinuate that that makes nurses lazy or anything like that it's a really good thing that they have it baked into their professional identity and their mentality that allows them this structure with the doctors and especially for us as junior doctors at the moment there is a culture of one more job one more job one more job i'll i'll take 15 minutes to try and have some lunch when it quietens down but the problem is is that it never quietens down you will never get 20 25 minutes uninterrupted to sit down and eat it just doesn't happen um in reality and because we have to carry our phones with us everywhere there is no way of kind of walling off your time and saying i'm just taking 20 minutes to have my lunch can you just call me back in 15 minutes when people ring you they usually want something doing now and that's why they're ringing you and the other thing that i'm finding especially difficult at the moment is often we are required to hand over to other specialties so we might need to discuss someone's antibiotics with microbiology for example or their new ecg with cardiology and it takes time to get through to these departments so if i ring microbiology for example they're all lovely people but they'll say you know i'm busy right now dealing with something else i'll ring you back in 20 minutes but you can't just sit there for 20 minutes and wait for them to call you back you'll start executing other tasks so i'll start thinking about another patient and managing their discharge letter or their treatment summary and i'll then get this sudden call from another department who wants a specialist handover of the original patient that i rung them about and i can't be like i'm having my lunch right now can you bring me back in 20 minutes because they'll say well no you called me um give talk to me about this patient that you want to speak to me about i'm free now and these are you know consultants they're experts these are the people that you're vying for their time and seeking their advice so you then whatever you're doing drop it go back to a computer pull up all the relevant details and been trying to compartmentalize these specialist level handovers and formulations of these different patient cases i think this is the thing that i'm finding most difficult at the moment mechanical tasks i can just knock out one after another go and do bloods here go and do a cannula here adjust this prescription here but if i midway through one of these things and i suddenly get a specialist calling me about something that takes a lot more mental energy to deal with and say you know i've got this patient here they came in with this they've had this very specific treatment plan and i need your advice with with what to do next that takes a lot more understanding and certainly that's what i'm finding hard at the moment but all of these things you know i'm confident that i will get better at and my colleagues will get better at but we're not there yet we've been staying late every night virtually still not getting the jobs done as quickly as we need to not very good at looking after ourselves eating sleeping properly like i just woke up bolt awake at like one o'clock last night because i'd forgotten to log something on the systems so i rang the night doctors and like can you do this for this patient i forgot to do it so it's you know it's leeching back home and interrupting other things and all of these things are i think just a symptom of us being very new inexperienced and the massive cognitive load that comes with trying to learn all of these new systems in a very short space of time because you don't want to look useless you want to look like a competent young doctor so that's where we're at guys um i'm just beyond tired but i've got the weekend off i'm just gonna try and relax unwind not really do much of anything try and meal prep for the week coming but like i say i'm just tired out of my mind it's it's very very stressful at least it has been for me on a very intense job with high expectations and very sick patients but thankfully a lovely team and the last thing i want to end with is that i know the tone of this video may come off as quite negative but i'm loving what i'm doing i actually despite all the challenges and despite the lack of sleep and the tiredness and the lack of breaks and all the rest of it i i feel absolutely vindicated that i've made the right choice i'm very stimulated by it although it is exhausting i'm confident i'm in the right place and doing the right thing and that being a doctor was the right thing for me so that's something at least despite all of that um i am weirdly still very happy so that's where i'm gonna wrap this video thanks for watching sorry it's been a long ramble as they always are but take care please be sure to hit that like button for me leave a comment subscribe and don't forget to go and check out my website and blog at hollyburton.com take care and i'll see you next time [Music] you

Channel: Ollie Burton

Views: 7,882

Rating: 4.9773369 out of 5

Keywords: Doctor, warwick medical school, postgradmedic, medicine, medical school, med school, education, graduate medicine, grad medicine, grad entry medicine, junior doctor, surgery, vlog, med school acceptance, med school motivation, med school graduation, med school application, med school interview, med school personal statement, med school vlog, med school day in the life, doctor day in the life, postgrad medicine uk, medicine meme, postgrad medicine, warwick medical school asmr

Id: 5sLt2WDYHPg

Length: 23min 0sec (1380 seconds)

Published: Sun Aug 15 2021