One of our GPs spoke with an older man who has a terminal diagnosis, and his friend. When the GP asked if they were partners, the patient said, โSee, I told you theyโd be ok with us. Theyโve got them Rainbow badges.โ This is why
#NHSRainbowBadge
training is so important. 1/2
Yesterday a patient with ?meningitis, who had been accepted onto a ward with a sideroom by senior sister and consultant, was instead sent to the middle of a bay on a different ward. These decisions are being made every single day in the NHS, against clinician's advice.
The NHS sees more pressure than usual over Easter and the 4 day junior doctors' strike threatens to cause significant disruption.
I urgeย
@BMA_JuniorDocs
to call off strikes and get back around the table to find a fair offer. Read moreย
@Telegraph
ย ๐
Fully support all my consultant colleagues stepping in for us, but I've seen more thanks and goodwill for consultants for one night than I ever have for juniors. Moved to cover a shift gap? No thanks. Gaps uncovered meaning you're doing the work of 3? No thanks.
As an F4 I was leading arrests in resus. As an IMT1 I'm reviewing falls and warfarin doses on the ward. This is why people don't want to go into training.
Just witnessed another junior being bullied into consenting a patient for a procedure they won't be doing and have never done. Had to step in. Explained legal issues. Still trying to push junior. Why do we put up with this? (I say we, I don't ๐)
Night two. Remembering my hate hate relationship with this antique bit of plastic.
Grateful for the sandwich delivery but struggling with the idea that consultants get fed and watered whilst โjuniorsโ donโt.
#PayRestoration
first. Working conditions next.
#DoctorsStrike
#bma
Medical students - let us know what teaching you need. Am willing to do zoom/online sessions to help you with finals content and F1 prep.
(PS, don't worry too much about practical skills - you will get better at these on the job anyway.)
We are horrified, but not surprised at what transpired in the Lucy Letby case. We work in a culture where datixes and GMC referrals are thrown around as threats, yet people with less clinical experience and responsibility are making decisions that impact patient safety.
Only doctor on the ward on Monday, staffing are escalating to agency if they've had no response from the bank by 2pm.
Why has it even been left this late? What do they hope to achieve in 3 hours when this should have been eacalated a week ago?
The work isn't fairly distributed though is it? As an IMT I've mostly been used for ward cover with limited take time (unless I argue for it), no scheduled clinics, no scheduled procedural experience, deanery teaching I can't attend >50% of the time due to on calls.
Please stop with this mis informed, short sighted, and dangerous rhetoric.
There is enough work for every member of the healthcare team. All of whom are valued.
Oh you have the trainees - they're just stuck on the ward chasing the bloods, ordering the scans, doing the TTOs or on call/on nights, never rosteres for the training opportunities that they actually want and need.
@parthaskar
Agree. The problem many of us have is not enough trainees for clinics/theatre!
I rarely have a trainee in clinic- so am training up an ACP.
As an IMT on a gastro placement, I had no opportunity to go to clinic, let alone endoscopy or experience anything that might push me into the specialty. We need to actually teach and train our medical trainees.
@veggieequallife
We donโt have enough gastroenterologists so why not let an experienced PA do their low risk OGD lists? Leaving you for the more complicated cases? Particularly as we all need to work on reducing our incredibly long OPD waiting lists.
Can we stop with meaningless gestures please? Resilience isn't about mindset or choices. The word resilience shouldn't even be used. It should be about the trust recognising ways to improve staff wellbeing other than webinars they have to do in their own time.
Abi is a relatively senior medical registrar, which if you knew anything about roles in the NHS, you would understand is one of THE most vital roles in the hospital. She has said that she works 38 hours a week - those are full time equivalent hours in any other profession.
I did a one handed cannula, first time, after someone else had already failed and I don't recognise myself, what are these newfound skills ๐ (I'm not a great cannulator and get weird mental blocks with procedures so this is A Win for me)
This is why I rage when non medics say the doctor's mess is "elitist".
Imagine taking over a doctor's work space then doing this.
That hospital at night team needs to be fired straight into the sun.
I think I wrote "able to tolerate oral" in someone's notes whilst on call, referring to consciousness level in management of hypoglycaemia but christ, I'm not showing my face on that ward again now.
When you take into account LTFT, maternity leave etc, training can be a VERY long time and takes up our 20s and 30s. We have to get away from this idea that training is temporary and we just have to get it over and done with. Also, not everybody will be a consultant.
As a Consultant, the remuneration compared to PAs is much better. As I tell my trainees - training is finite. For most, training time is much shorter than time served as a Consultant or GP. Overall earnings will be higher across a career than a PA, the journey is tougher though.
"We've definitely got enough medics" said no hospital ever. Consistently 2 wards worth of patients bedded down in ED, waiting to be seen, rota gaps and sickness gaps all over the shop but still no increase in training numbers. Joke.
Thank you Prime Minister for becoming an ally to LGBT people.
Thank you in particular for your personal commitments to same-sex marriage, the GRA, and LGBT-inclusive SRE.
CH
Nobody should have to sacrifice their fertility for a job. Medical careers were always designed for men and we should be moving away from archaic attitudes.
@AliJaneMoore
In the past having a family and children was something that was delayed until you approached your consultant post as a doctor. By doing that you got your consultant post in your early 30s. No one said being a doctor would be easy. Have to move around to get trained properly.
MRCP be like "here's a guy with lung disease, he's been exposed to BIRDS, BATS, MINES, PIGEONS, FARMS, HAY, PARROTS, have fun deciding which is to blame!"
Every set of nights I've done for the past month has involved an "escalation plan" from medical staffing that one doctor cover the work of two. That isn't an escalation plan, that's make do and mend.
The BMA should negotiate that whenever a shift goes unfilled - the pay for that missing person is split between the understaffed doctors that are working that shift.
Theyโre essentially doing somebodies job for free.
I medicated my anxiety. I also graduated with a 1st class BSc, distinction in my medical degree and am now a fully functioning successful doctor. This is ableist crap.
@kristinhamill
@DoohanRachel
Iโve noticed it indeed!
Hence my concern that if someone is unable to withstand the relatively pedestrian pressures of the undergraduate course without medicating their anxiety, theyโre unlikely to sustain a career as a doctor.
Itโs tough out here!!
Incredible contempt for junior doctors from
@royalhospital
CEO Dr. Hal Spencer.
โUltimately we need to make it not too comfortable for themโ.
To fund it from the educational pot?
These are doctors FOR FUCK SAKE.
Context from OP provided in the last pic. Doctor is now in NZ.
Just done my first ever couch to 5k run. If you had told me when I had crippling depression and suicidal thoughts that not only would I now be hench from the gym, I would also choose to go for a run on a Sunday afternoon I would have laughed in your face.
Officially on mat leave now and hanging up my steth for a year ๐ (the thought of being a mum is more scary than the fact I would have been med reg next year tho!)
I, as IMT2, have patients where I may often have to speak to e.g. tertiary liver centre. My reg is clerking in resus, I've seen the patient. Unless the reg on the other end is unhappy with my assessment or referral, why?
Almost always, the person holding the referral bleep is also seeing referrals. It takes more than 5 minutes to see a patient. I would always answer after seeing the patient but it wouldn't be safe to keep leaving to answer calls.
@Parody_RCGP
This is my usual approach too. Happy to wait on hold 5 minutes while I write my letter. If I've been waiting more than 7-10 minutes then I'd usually send to A&E.
I've just had to move from a computer where the email didn't work to another where the mouse barely worked, all whilst sat under an air con unit that can't be turned off in the doctor's "office" that is actually an old treatment room.
This is a great example of tech investment helping our NHS teams cut waiting times.
By making greater use of new technology in the NHS, we're working to ensure people are getting diagnoses and treatment quicker.
โ ๐ Improving patient experience
โ โฑ๏ธ Improving waiting times
๐
The thing I'm most surprised at, is that people were actually planning a normal Christmas despite everything. It may have been allowed by the government initially, but it was never a good idea.
@Dr_BellaR
4 drains to be done on the ward the other day. F1 stuck doing discharge summaries literally all day. I was stuck on ward round. CNS' came and did the drains before ward round was even finished so I got to do 0.
Cannot fault my GP. Submitted online request for fit note at 10pm last night, sent to me before 9am this morning. I've had a lot of contact with them over the past few weeks and it's been fab service each time.
@Beccajfish
@feleciadsouza
@gnwren
Omg this is what annoys me most. I'm 5ft and look quite young and want to look professional at work but instead just look like a child in their parent's clothes.
Consecutive understaffed, unsafe night shifts without escalation rates or step down policies fill juniors with dread but trust leaders don't step in then.
The junior doctors' strikes planned for this month and January will fill trust leaders with dread. This is the toughest time of the year for the NHS and patients will be hit hard. It isnโt too late for the government and unions to resolve the dispute and prevent more strikes.
Really productive day
@barnshospital
for our 'Pharmacy Discharge Team' (formed to help facilitate patient flow during the
#JuniorDoctorsStrike
). 17 TTO's written by our Pharmacist Prescribers... 29 in total over the last 3 days. Equivalent to a full ward worth of beds! ๐
Katy works for me. She is single & earns less than 30k, rents a room for ยฃ775pcm in Central London, has student debt, ยฃ120 a month on travelling to work saves money every month, goes on foreign holidays & does not need to use a foodbank.
Katy makes my point really well.
When consultants are doing these important ward jobs (discharge letters, seeing referrals, answering ward queries, arranging investigations, reviewing patients overnight), we canโt also do our normal busy jobs.
When a consultant leaves you this feedback:
"More than competent at managing an acute take at registrar level independently." ๐ญ๐ญ
Thanks
@StephCrudden
โค๏ธ
@ollieburtonmed
@Xeon4f145d96s1
To see someone having set clinics and theatre time 2 years post graduation when doctors much further down the line have to fight for these opportunities is just disappointing
This is a busy time of the year for colleagues at Timpson to get married, so itโs great to be able to give them an extra weeks holiday (fully paid), ยฃ100 towards the flowers, and provide a nice car and driver to be used on the special day.
So when we see people with half of our experience scheduled for clinics/theatres/procedures, showing it can be done, then yes it's frustrating but nothing ever changes despite these issues being raised.
The work isn't fairly distributed though is it? As an IMT I've mostly been used for ward cover with limited take time (unless I argue for it), no scheduled clinics, no scheduled procedural experience, deanery teaching I can't attend >50% of the time due to on calls.