Top tips for new doctors by Jordan Napier

staffdevmeded — 2018-06-29 10:56:31 UTC

Remember that it is better to be curious, than to be right. Your patients have a story, let them tell you. Take a history.

staffdevmeded — 2018-06-29 10:58:09 UTC

If you tell a patient “I’ll be back later”
Make sure you go back later.
That patient will be waiting for you all day.

staffdevmeded — 2018-06-29 11:11:58 UTC

Be kind to yourself

Don't take on too much in the first few months. Focus on being well rested and maintaining a good work-life balance. Put aside time for yourself.

2018-06-29 13:45:15 UTC

There is no such thing as a silly question

2018-06-29 13:52:05 UTC

If you aren't sure just ask! Everyone has been in your shoes before - we would much rather you asked rather than sit and worry!

Make a note of every teaching you attend and write a reflection on each - this makes the portfolio much easier.

2018-06-29 14:09:07 UTC

Take your breaks!

2018-06-29 14:22:39 UTC

Don't feel pressured by a busy 'jobs list' to stop you getting away for your lunch. Nobody works well on an empty stomach, and you'll probably complete tasks quicker if you take 30 minutes to fuel up. You are entitled to breaks - so take them! Lunchtime is also a great opportunity to meet and get to know your other fellow colleagues in the mess, and FY1 is the best time to make new friends before more distancing roles in FY2 (GP, A&E etc).

2018-06-29 15:24:38 UTC

Keep hydrated! Rememeber your own Urine Output matters as much as the patients'!

2018-06-29 18:06:54 UTC

Take a break.. You could go on forever with things to do so make sure to take your break, the jobs will still be waiting for you after!

2018-06-30 04:02:52 UTC

The key to becoming a good FY is to be good at prioritising.
Take things easy, forgive your own mistakes and remember that work is only part of your life.

2018-06-30 18:55:51 UTC

Invest in blackout blinds for your bedroom to survive nightshift in summer months.

The best FY1s are good at task prioritisation; discuss your jobs list with your team after the ward round and decide what needs done quickly and who will do what

2018-07-01 12:46:49 UTC

Take breaks, ask for help often, we've all been there!

2018-07-01 12:48:09 UTC

People who wear green.

2018-07-01 22:39:30 UTC

These are the most powerful (but often lowest paid) people in the hospital. They are our ward clerks, catering staff, secretaries and porters.

They know how things are done, where things are kept and where to get food. Keep them on side.

Discharges

2018-07-02 07:53:54 UTC

Often a senior will tell you “This person can go home today” when on a ward round. Follow up with “What follow up would you like them to have?”.

Otherwise you end up writing the EDD and having to ask the question then when there’s inevitably noone around (especially in surgery).

staffdevmeded — 2018-07-02 08:50:57 UTC

Be kind to yourself (e.g. go to the toilet, get groceries, and seek support during challenging times).

Referral

2018-07-02 12:39:23 UTC

When told by a senior to refer patient to whomever, ask them exactly what clinical question needs answered. Makes your life easier over the phone knowing why you are calling someone

Be nice to each other and everyone you work with, from porters all the way to consultants. Stay humble and remember that we're not working to satisfy our own ego, but to help others.

2018-07-02 12:39:32 UTC

Punctual and reliable.

2018-07-02 13:13:20 UTC

Don't be on time, be early. Come a bit early in the morning to prep for ward rounds, makes your life much easier if you know your patients. Always be reliable. The best FYs are not necessarily the one who knows the most, but it is always the one who is most organised and reliable.

Make friends with the nurses

jthomson485 — 2018-07-02 13:48:38 UTC

Being friends with the nurses will make work so much easier. Go out fo your way to get to know them. Quiet night shifts are an excellent opportunity to get to know people

It's OK not to know everything

jthomson485 — 2018-07-02 13:54:00 UTC

If a patient asks you something that you don't know, tell that that you don't know. But tell them that you'll ask someone who does know. And follow that up by actually finding out and then get back to the patient with the answer

Always, without fail and without guilt...

2018-07-02 15:09:20 UTC

> eat on time (you will make mistakes if not fed, everything (!!) except an arrest/peri-arrest can wait 30 min)
> drink lots of water through your shift -this will help with fatigue
> escalate if unsure, we are all here to help you!
> if sick, stay at home. You will get better quicker and won't make your colleagues sick. You are human!
> book your annual leave by week 2 of each placement
> make a timeline to spread out when you need to get CBDs etc done by, don't leave it all to the end!

2018-07-02 15:16:58 UTC

If making a referral or request, make sure you know about the patient and why you want the review or scan

Prepare for phone referrals

2018-07-02 15:29:30 UTC

No matter how scary phone referrals mights be initially always bleep for help if you need it...as long as you have prepared the patient's background, their list of medications and a fresh set of observations

Thinking about whether or not to call your senior for advice?

2018-07-02 15:38:32 UTC

I would rather be the idiot that called unnecessarily, than the idiot who didn't call when they should have

Help each other

2018-07-02 15:45:17 UTC

Make the time to check if your fellow F1's are okay. If you check on them, they will check on you. Get this culture engrained in your cohort!

Imaging

2018-07-02 15:50:44 UTC

When requesting a scan, always know what the clinical question is you want answered. If your seniors don’t tell you, ask them, as the radiologist won’t agree unless you know!

Invest in comfy shoes, trousers with pockets and light t-shirts.... the hospital can be a sweat box in summer!

2018-07-02 17:21:27 UTC

Have a system for your ward team and stick to it, divide up patients or jobs but know what's going on and keep organised. You'll feel calmer and cope better with unexpected developments

2018-07-02 17:22:53 UTC

Doing a bit of portfolio often makes the pain of getting ready for ARCP easier, if you get a certificate put it in immediately rather than faffing at the last minute! Keep track and plan when you can get bits and pieces signed off ahead of time. MiniCEX/DOPS/CBD can be done on your mobile with a reg standing next to you!

2018-07-02 17:23:31 UTC

2018-07-02 17:45:09 UTC

Just show up.
Keep showing up (unless you have annual leave, are unwell, sick leave etc) ... just keep showing up day in, day out. You'll get the hang of it and you'll figure it out.

If you ordered a test make sure you follow the result ,,

2018-07-02 18:02:04 UTC

Make "Cake Fridays" a regular thing

jthomson485 — 2018-07-02 18:56:11 UTC

Take the opportunity whilst you’re new to ask lots of questions and get to know the role of the whole MDT. Us AHPs will be happy to help you out and we often have more time than the nurses!

2018-07-02 19:36:33 UTC

Be kind.... especially to yourself ❤️

2018-07-02 19:44:27 UTC

Light blue tunics

2018-07-02 20:11:10 UTC

Remember that although many staff members wear light blue, they are not always healthcare assistants. Please ask us if we are a HCA before just assuming so.

Food

2018-07-02 20:21:27 UTC

Eat, regularly. Buy ready meals and freeze them and always eat after a night/late shift.

Nurses often know

2018-07-02 20:32:15 UTC

Don’t be scared to ask the nursing staff questions. Many of the nurses have worked on the ward for a while and will often know plenty about pathways, referrals, treatments etc. Use them to your advantage.

Be sociable

2018-07-02 20:46:27 UTC

NHS Tayside has an excellent doctors’ mess. Join it and make use of it. Similarly, post-nights team brunch and the occasional night out are worth arranging if no-one else is doing it. Having a social circle of other FYs in place is invaluable during the occasional tough times.

2018-07-02 20:54:40 UTC

Listen

2018-07-02 20:55:34 UTC

Listen and talk to your patient including at ward rounds. The patient knows their own body

Looking ahead

2018-07-02 21:19:50 UTC

Remember that you are allowed a taster week in FY2. If there's something you're interested in, look into it now.

Keep some scan request cards handy

2018-07-02 22:04:26 UTC

Depending on your Trust, many use paper requests for scans su
ch as MRI, CT, Doppler etc., with CTs and MRI's needing a Registrar or Consultant signature so keep a few of these handy with you in a clipboard so don't have to chase seniors in the afternoon to get it signed. It also makes the round go smoother and investigations to be ordered in a timely fashion.

Make the best of Oncalls for Work based assessments

2018-07-02 22:11:59 UTC

Keep a note of interesting cases you clerk while on call, as these can make great CBDs if you get the chance to present the case when the Consultant comes for the ward round.

Don't be afraid to ask for help

2018-07-02 22:15:21 UTC

If a patient is very sick, don't be afraid to ask for help early. Always remember A to E assessment

2018-07-02 23:34:45 UTC

Nurses!

2018-07-03 03:26:15 UTC

Ask the nurses for help/advice/opinions. Some nurses may have been on that ward for donkey’s years and will know the specialty inside out

Enjoy:)

2018-07-03 07:37:41 UTC

Your job is to know the patients on the ward and make the ward round as smooth as possible for the registrar and consultant. You are their eyes and ears. Therefore, have your list ready, bloods book, scan results and any other queries/clinical questions ready.

Keep the nursing staff up to date with plans for the patient too and prepare discharge letters as soon as you can. Do this and you will be loved. Finally, enjoy the journey as you only are a FY for 2 years:)

Make time for the things you enjoy!

2018-07-03 08:35:24 UTC

When you are working long shifts, it is difficult to find time (or have the energy) to do the things you enjoy. Try and set a side an hour each week to do something just for you. Go for a walk, read a non medical text book, watch the latest episode of your favourite show, anything that makes you feel good :)

No matter how baffling the situation...

2018-07-03 11:07:58 UTC

A-E assessment,
repeat OBS,
blood gas,
discuss with senior.

From a patient/relative's perspective, take the time to get to know patients names, introduce yourself and to explain procedures in simple and honest terminology. This goes a long way in building confidence with patients and families.

2018-07-03 12:57:11 UTC

Bloods

2018-07-03 21:27:40 UTC

If struggling to get blood from a patient, you can resort to using paediatric bottles even if they're not a child. Also, there is just about enough blood to run a blood gas in the tubing of a butterfly needle.

Don't ever forget that your patients are more than a bed number or a disease. They are someones Mum, Dad, Brother, Sister, Son, Daughter or friend. They are trusting you to help them, respect them and support them. Be kind, be humble, be human

2018-07-03 22:42:18 UTC

Introduce yourself. Ward staff like to know who you are. Always ask for help, never ever be scared to.

2018-07-04 07:46:41 UTC

If a ward has COWS (computers on wheels) please use them instead of "hogging" the computers at the nurses station. It drives ward staff crazy

2018-07-04 08:27:54 UTC

Discharges

2018-07-04 12:52:02 UTC

Please work with the team to ensure a patient is sorted for discharge (not just medically stable), if an AHP has concerns it will be for a valid reason - we are all aiming for discharge!

Make sure you have a whatsapp group for all your colleagues on the rota - this allows for easy coordination of lunch breaks, shift swaps, and most importantly team nights out.

2018-07-04 16:29:45 UTC

2018-07-05 11:37:34 UTC

Relax. This is one of the most exciting times of your life. All those years of hard work and study have brought you here.
Enjoy. Make the most of the experience. Relish the challenges that each day brings.
Prioritise. Look after yourself first and foremost. A happy Doctor will make their patients happy.
Don’t worry. There will be some tough days but you will work as part of a team. Share your worries. Talk to people if you are struggling (p.s Doctors are not very good at this so you are the generation to change it).
Stop. If you find yourself doing something that doesn’t feel right. Stop. Ask someone. Check.
Good luck. You are going to love it.

2018-07-05 11:37:48 UTC

Communication!

2018-07-06 07:49:51 UTC

Communication- listening, asking, explaining is the key. Whether you’re communicating with patients and their families or with colleagues and other health professionals. Ask yourself “what do I need to know” and if I was in the other persons shoes “what would I like to know”
At the end of the day interest, kindness, manners and a smile go a hell of a long way 😃

GP are your friends

k_mcconville — 2018-07-07 15:33:27 UTC

In the advice about discharges here remember we are happy to liaise with you and the the patient about the d/c plan but we are not here to do the the arranging for you. If you are unsure about meds / info for the patient we are always happy to accept a query call at the practice although we might have to get back to you as soon as we can if in the middle of a surgery.

tips

roderick_mcleod1 — 2018-07-09 10:57:23 UTC

my personal words of wisdom would suggest you buy /wear sensible, comfortable pairs of shoes, essential – depending on the size of your hospital you may walk several miles a day. Also get good at drawing on your own success stories in your mind. You need to remember these little jolts of optimism and positive energy.

“Smile more and take a reality check now and again!”

Discharges and pharmacy

2018-07-09 11:20:58 UTC

When pharmacists ask whether discharges have been done we are not nagging - we also need time to process them, amend any errors (errors don't annoy us we know you are still learning) and counsel the patients, we understand you are busy but we are too and we are trying to help you.
Also please ask us questions regarding medication don't feel you have to know it all, we are happy to help

Communication!!!

2018-07-09 11:41:32 UTC

Communicate with the whole team and don't hesitate to ask for help. Remember oxygen is very important for these sick patients..

2018-07-10 10:09:09 UTC

you get back what you give........be kind, offer help when you can, support your team and communicate well.

2018-07-11 09:02:25 UTC

That way when you need it, they'll have your back too!

good luck. you will love it.

Use the referral finder to work out how to contact other specialities. The diabetes website also gives a wide range of helpful info.

2018-07-11 15:06:09 UTC

Enjoy your time!

Don't be scared of the neurosurgery clerk in! Patients have interesting signs and just follow the form. If in doubt, ask for help

2018-07-17 08:14:02 UTC

Exercise

2018-07-24 10:52:55 UTC

Morale

2018-07-24 10:56:15 UTC

Lots of doctors enjoy 'pork pie Tuesday. Don't be left out .

2018-07-24 13:31:55 UTC

Soft soled shoes for night shifts!
As well as black out curtains, eye mask and ear plugs. Turn your phone onto silent and get to sleep!
You're part of a team - get to know them and be nice! Porters, domestics, catering staff, nurses, HCAs, consultants...a smile and a hello go a long way.
Enjoy!

Portfolio

2018-07-24 14:00:50 UTC

You will get regular, weekly F1 teaching. Start a word document on your computer tonight with a table on it. Include date, attended (y/n) plus reason for absence, content and learning points columns (these last two can be filled with bullet points). Content can be a general topic covered plus a bit about it, and you only need one or two learning points. Anything that you miss, just include a paragraph at the end reflecting on why (unless annual leave or sickness, in which case it's fairly obvious!).

You should get regular departmental teaching. For each rotation, do the same. Bedside teaching can go in, formal teaching can go in.

These 4 documents will make ARCP much easier, and if done contemporaneously will make it much less of a chore!

Chase results as soon as you can

2018-07-24 21:00:22 UTC

Try to chase bloods as early as you can instead of leaving to late in afternoon, just in case there’s a few abnormal results to deal with and to help avoid staying late dealing with things like AKI and hyperkalaemia. I always order tests early morning and chase after lunch

Tricky bloods

2018-07-26 21:31:51 UTC

If you're absolutely desperate for some blood and having no joy in the normal places then a syringe and an orange needle to those little veins on the inside of the wrist will usually yield enough for an FBC and U+E

Also buy one of those camping head torches. They look incredibly naff, but worth it for that cannula at 3 in the morning when the bedside light doesn't work

2018-07-26 21:58:33 UTC

Learn to recognise the small wins!

lxmccabe1 — 2026-06-01 13:46:38 UTC

There's so much to learn (for everyone) that some days will be better than others. Learn to recognise your own personal growth in yourself and in your colleagues and let them know - either face-to-face or through positive event reporting like Learning from Excellence (in NICU, A&E, CAHMS and GenSurg)