After a brief
health and safety meeting where we're told what different-coloured fire
extinguishers do (will I ever remember?), I'm assigned a ward with 30 patients
and four nurses. I'm in charge for the afternoon. I'm 25, I still can't cook
properly, but I'm responsible for 30 lives. It's pretty terrifying.
STRESSED:-
Many junior Doctors have to make life-saving decision based on little
experience. My bleep goes off 20 seconds after I start. I ring the ward where
the nurses are frantically searching for a doctor.
A surge of
adrenaline rushes through me. The harassed voice on the other end of the phone
says: 'We've got a patient here with a brain tumor and we think she's septic
(suffering from a life-threatening infection). Which antibiotics should she be
on?'
I think an
unspeakable word. Not only has this patient got one of the most serious
conditions you can get, it's at a life-threatening stage. And I certainly
haven't got a clue what medication she's due.
Should you not
ask someone more senior, I croak? There is no one else. I make my way to the
ward and introduce myself to the patient. As I discover will often happen, the
minute I get there, someone says: 'It's OK, the doctor's here now', as if I
will offer some miracle cure.
I can't tell
them I haven't the faintest idea what to do. The patient is already on a
complex array of medication, and if I start prescribing more I could make the
situation worse.
So I decide to
not give her anything. She doesn't look too ill at this stage and should make
it through until someone more senior comes around. I later discover, to my huge
relief, that the more senior doctor didn't prescribe any antibiotics
either.
But I'm angry
at myself for not knowing what to do. What if that lady had gone rapidly
downhill and died? I shudder to think what would have happened if this had been
a night shift when it's likely there would just be me and another junior doctor
on duty.
I've already
heard that night shifts are horrific. Before my time, junior doctors worked
more day shifts and were often on call at night - in nearby hospital
accommodation - if their patients got sick.
But because of
new EU rules which state no one is allowed to work more than 48 hours a week,
everyone works shifts – either day or night. As a result the one or two junior
doctors working at night in a specialism can end up having to look after
between 100 and 400 patients on their own, with no back-up.
And because we
have to work either day or night, the number of day shifts we'll work has
fallen.
That means we
won't work as often with senior staff such as consultants and registrars - the
people who train us.
So when we're
alone at night and having to make decisions about patient care, I won't have as
much knowledge. I'm terrified I'm going to make a mistake.
Can anyone
keep suicidal thoughts away?
The first year after medical college called
internship, means round the clock hours, low rank, constant demand from
patients and seniors, learning complex new skill and constant fear of a making
mistake that could harm a patient.
The Result: - A year of stress and self doubt
that drives up thoughts of suicide to nearly four times the normal rate.
