u/sumpra3

TLDR: made a mistake prescribing, feel terrible

New FY1. The consultant on Ward round told me to prescribe a medication, I misunderstood what he meant and the patient was receiving what I prescribed for like 6 hours.

One of his routine bloods came back and they were very deranged (trying to be vague a bit here), as soon as I heard I panicked, went into to A-E him and had to call my consultant who was not impressed at all, but gave me advice how to correct things.

I don’t think there was any major patient harm that came from this (we’ll see OOH though I guess) but right now I’m feeling like I just want the world to swallow me up and disappear forever. I feeling so stupid and incompetent, so much more than my colleagues at my level, and I’m feeling really crap about going in Tommorow and explaining to everyone what happened at board round, since I know that pt won’t be going home tonight.

I feel so stupid rn in F1 tbh, I really don’t feel like I’m putting my best foot forward at all. I get so flustered during ward rounds and disorganised, I’ve tried strategies to be more organised but everything just seems to move so fast, and when I stop people to clarify what they’ve said or the plan they get progressively more pissed off at me. I’m always scared about reaching the end of the day and missing tasks, I look at my patients WR entry 3/4/5 times each day just to make sure I haven’t missed a job, and even still things will fall through the cracks with me. I don’t feel like I’m engaging my brain properly when I’m at work, like all the things I can wax lyrical about when I’m
Just sitting down and thinking about it, I find so hard to actually do in the moment. And to top off it I get flustered talking to patients and NOK too, I’m sure they think I have no idea what I’m talking about even when I’m told to just inform of a relatively simple thing.

Maybe this is all normal but I feel like I’m sinking into just a pit today with that experience. I just wanna be so much better than I am 😞

Rant over

New to the area, any recommendations for a good local GP? Had a few bad experiences and just looking for one that is at least intuitive to book an appointment at.

Could a couple, theoretically ofcourse😂, share their monthly bus pass, assuming they don’t travel at the same time with it. Say for FirstBus.

Would you be able to log out on one phone before the other logs in or send a screenshot of the bus pass to them before they travel?

This first week I’ve felt so disorganised during WR.

Everyday we round with a consultant, and I feel like such a disorganised clutz. I have to clarify the plan each time because I feel like I don’t understand it properly after we leave the pt bedside, I end up confusing who’s going home today and who’s meant to go home Tommorow so my jobs list later creates loads of confusion among the nurses and rest of team. And on top of that the consultant expects me to present each patient before we talk about them, I try to SBAR them but I feel like the background I give is missing loads of details the consultant wants like certain scans and referrals.

Is it worth coming in earlier to pre round on everyone first? Or do I just need to git gud.

I’ve tried reviewing the notes for 30 mins or so before I go in but I feel like there’s too much to get through and I only end up reviewing 4/5 pts before I run out of time and have to run to handover.

Edit: oh and another I get super nervous during WR, whenever I’m asked a question be that about the patient or just medicine in general I completely freeze up and look like a total idiot. Before I even hear the answer I think ofcourse it’s that but I’m so nervous during WR to the point I’m physically sweating lol (it is hot too rn tbf)

7:50: Arrived off bus
It’s too early in the morning

8-8:45: Made a Coffee, Studied in Mess
Glad I remembered a mug after shadowing, and that’s not even counting the one I’m drinking coffee from.

8:50: Made it to the Ward
Oh shit, what do I say to the night team, what do I say to the people already there, do I introduce myself, oh shit.

9:00: Board Round Starts
Frantically skimming through handover notes, dropping them every time I go to pickup my note, not really keeping up with the board round. Reg asks me to do a job after WR, not at all aware what they have just asked but nod confidently anyway.

9:30: Ward Round Commences
Consultant speaks at lightning speed, extremely nice person but my god I was lost. We see 4 pts in 3 hours. Thank God for the regs.

12:30: WR Finishes
Go to sit down to edit the absolute drivel I’ve written during WR, nurse asks me to prescribe some meds. Can’t figure out the system so I text the reg.

12:45: Enter Irate Reg
Very nice person (at least when we first met in shadowing) but looks like they’re about to strangle us any second for the stuff we’re asking.

13:00: My FY2 Saviour
FY2 shows us how to do every single job on the list and even how to write the damn job list. Cue massive embarrassment from me looking like I have egg on my face having not cracked on with anything aside from a few prescribing requests. FY2 cracks all the jobs out basically with us FY1s just running around like headless chickens and looking terrified every other second.

13:30: Will I survive until 5?
Jobs well underway, consultant asked me to do some things specifically, how the hell do I them. I start umming and ahhing around the FY2 who has the patience of a saint.

16:00: Afternoon WR
Try to engage, 99.5% of things go over my head, I’m terrified of being asked a question about something I was meant to do and didn’t do. Wondering if they’ll even let me go home and will I be mobbed if I try to exception report

16:50: All Jobs are Finished, by some Miracle!
What??? Am I about to actually finish the day

17:00: Home
I actually finished my first day, is no one gonna come chasing after me saying I didn’t do about 50 different things I was meant? No? Really? Sure? Let me check my email and WhatsApp on the bus

17:01: Dreading Tommorow, Relieved I got through one Day
Time for some coke, the drink I mean

If you’re getting a single fare somewhere, are you expected to tell the bus driver ‘single to xyz’ or do you just tap the card machine. I’ve seen some bus drivers go and select your stop on their little screen and some just tell you to tap straight away with your card. My stop is normally 2.50 so when you tap are you always just getting charged 2.50?

If so how? struggling to find the button

Like just ways of referring to stuff that just sort of feel weird to hear out loud. Maybe this is just me and my weird brain but here are mine:

-‘GPland’ - reminds me of Neverland from Peter Pan, like a magical place all these doctors are getting flown to🧚
-‘Matty Leave’ - Just sounds so strange to me when I hear it, like is Matt some fella approving all this leave, it also makes me think of Yoga Mats. 🧘‍♀️
-‘NEWS’ - I get what it stands for but when I hear it out loud I can’t stop thinking of newspapers🗞️
-‘MEWS’ - No❌
-‘Reggies’ - I get shortening registrars to regs, but where’s the extra I coming from, makes me think of cereal🥣
-‘Cons’ - A lot less egregious to my ears as short hand for consultant since they also spell it on the rota like this, but still makes me think of a constable 👮‍♂️
-‘Trust Grades’ - I know this is universally understood term but I don’t understand how this is an intuitive name for that term, like it’s a non-training job employed by the trust, but why not call it a non-training grade vs training grade, like it doesn’t add up to me why we add the trust as a prefix here and no else I can think of🥴

That’s all I can think of for now but there are others. This is just a bit of fun, no shade

Edit: also just remembered, RESPECT form and calling Geris COTE instead of geris. Both feel like putting a sausage in vanilla ice cream.

Edit 2: Cloppy Dogs🐶

I’m guessing probably not but isn’t having med students pulled a major loss of income? do you guys think it’ll at least make some
Hospitals appear more to care about teaching?

Also does anyone have any tea on what actually caused them to pull out, aside from the usual universal issues with placement? Were there some scandals?

I had two kinda moments during shadowing week that I’m feeling really crappy about the more I think about and I don’t want to happen again, at least not with me being so aware as they happen.

The first thing is I saw someone crying outside A&E today near the ambulance bays (I’m not rotating into A&E was just walking past) as I was heading home, I’m guessing they probably got some tough news. Maybe it would’ve been annoying anyway but I wanted to ask the fella if he was alright, give him some tissues and just see if he wanted to talk for a few minutes or wait somewhere more comfortable. But I wussed out, I walked past him first then turned around and saw him around the corner again but just couldn’t get over the social anxiety of saying anything and in the end I just went home. Feel crappy about it now because I’m sure we’ve all had a tough moment in public before and someone noticing you, and actually stopping to talk, for me personally anyway, I’ve remembered all those times.

Other time I wussed out this week was when we had a med student on the ward. They were very early on not final years or anything, and we’re shadowing the current fy1s ourselves. But I could see that familiar position they were in of sitting behind the doctors or trodging behind the WR not getting any teaching or learning out of the day. I had some moments spare and I tried to explain to them what I remembered about interpreting certain ECG patterns and the pathophys behind them, sprinkling some stuff I learnt in step1 too, but after a bit of time I stopped trying. It was nothing to do with their attitude or knowledge base but I just felt really self conscious teaching a med student as the (incoming) FY1.

I know it’s probably overthinking but I felt so self conscious about saying or teaching something wrong or sounding dumb infront of my seniors/regs. I know they were busy doing tasks themselves but I was worried of them overhearing me teaching what basic stuff I knew and thinking what I was saying was so stupid or I was so far out the dunning Kruger curve thinking what I was saying was worth trying to ‘teach’.

At the same time, I also felt just weird in general about teaching and talking to the med student normally, I’m sure it was probably in my head but like when I turned to talk to the med student it’s like everyone just cracked on with doing stuff but then later on when I stopped talking to the med student my seniors would turn and make casual conversation with me without acknowledging the student I was just talking to, despite them being right next to us. It makes me so guilty thinking about it but it made me feel weird about talking to the med student, like I was talking to an outsider too much and my colleagues either found it weird or like I was wasting too much time (even though they were making casual conversation with me at the time a lot so I knew the ward/jobs wasn’t swamped at that moment - and also it was only a few minutes here and there).

Anyway I’m sure loads of this is not anyone’s fault but my own overthinking and social anxiety/awkwardness. Does anyone else get me and any tips how I can nip this shit in the bud? I hated the last part so much as a med student and I know a lot of the times ppl do it without even realising but I really don’t wanna be the type that just ignores students on the wards.

I've been looking for a while for some youtube channels that talk about current issues but everytime I search i come up pretty sparse with results.

Dr Ollie Burton has made some good videos over the years. Also I can find videos peppered across various medfluencer channels talking about strikes and current conditions, also some organisations/charities too but im wondering if theres some channels that talk more in depth about issues and are dedicated towards that.

I know this subreddit does a good job but I'd also like some information in video format and just wondering if there's much out there.

Edit: also big fan of Medlife crisis and Dr Hope's Sick Notes, looking for more channels

Other than marriage counselling which isn’t feasible rn but maybe will be in the future. The issues im describing can revolve around her feeling ignore, me previously watching adult films (gave it up), financial things. We’ve had discussions and I’ve tried to come up with systems that work for us. Some successful some need more work.

when she argues or complains to me, beyond anything I just feel tired. I feel like the wind is taken out of me. I try to ignore and just take it, see the message she’s trying to tell me and ignore the feelings that come up, at first I get it right, I’m calm I make changes based on her words, tell her I’m sorry give her reassurance and try to solve the issue. When that doesn’t work after 3/4 days and it seems like the issue is spiralling into a much bigger argument, I get agitated, we argue, she cries, I feel depressed, we eventually make up. I try to avoid this point like the plague, but when the argument gets worse, I feel backed into a corner, I feel like nothing improves until we actually start arguing, it doesn’t matter what I’m saying, it only changes when my emotions are also visible and a bit not controlled.

All of this makes me apathetic about our marriage sometimes. I wanted and talked extensively about a marriage where we had clear expectations, boundaries and things we did and expected from each other. We talked about a lot before marriage. But now, I feel like that was all just a pipe dream. We have arguments over multiple different, quite distinct and sometimes unrelated issues (still big issues at times), but I feel we don’t learn lessons from those arguments and discussions, I don’t feel heard by the end and neither does she.

Honestly, I feel like I just try to actively avoid saying or doing the wrong things at this point. I’m scared, I walk on eggshells, I try to just keep our relationship together. Whenever we have a conflict, I try to get us to communicate the issue and come up with a plan to work on it, I feel like she doesn’t and talks in a not logical and more emotional way, not just for a few hours when everything’s raw but a few days or a week at times.

This is probably the crux of the issues, I think I have some sort of neurodivergence that requires me to get emotionally attached to routine expectations lines and things like the feeling of my clothes on my skin or the rain. And when I see her not trying to come back to logic and expectations, not having clear plans and scores or let’s say expectations written out that don’t particularly change with each situation, that can be progressed with and regressed with like goals you’re heading to, it kinda shatters my heart. I don’t feel safe.

I don’t know what to do with these feelings either. Normally they come out when we argue, and that’s a billion percent the wrong time to bring it up. Sometimes I bring it up when there’s no argument (and I ask previously if it’s okay) and it triggers an emotional response in her and we argue. And sometimes I feel that she doesn’t take it seriously and the discussion goes nowhere. I just feel like I’m dying on the inside with these feelings I try to put them away and just focus on solving what’s in front of me with our relationship, from my side anyway, but each time we argue and the discussion becomes complex and not clear (despite me asking us to write things down, have a weekly meeting where we discuss issues etc) I feel like I die a bit on the inside.

I always see name and shame threads and a lot of stuff that happens in departments are pretty messed up. Just to pick my mood up a bit can you guys name and praise some departments that have really been nice for teaching/training either in Med School, FY Years or Reg training.

Obviously no one dox themselves, can be praise from a while ago.

Edit: Or certain Individuals/Seniors if comfortable

Shower thought I had today is why loads of doctors are bad at communication despite loads of sessions being timetabled in the modern medical degree centred around communication, showing empathy and breaking bad news etc.

We get zero real life practice. It’s all well and good explaining to an actor they have cancer in a 30 minute clinical skills session or Osce station where the responses are basically scripted anyway.

But the level of difficulty there is nothing like trying to explain simple dyspepsia to someone who’s first language is not English or with a relative translating, with a time crunch of 10 mins per appointment or running behind in clinic and whilst also to get through the whole appointment. Similar thing with SBAR like it’s all well and good doing an elegant handover in a scripted station but what about when the notes and information from others is all gobbledygoop and you need to piece things together first. Or what about when you inherit a patient or their family who claims they’ve had zilch explained to them and you need to breakdown what’s currently happening whilst stopping them getting more agitated.

I understand that a large majority of patient complaints can probably be traced back to communication so I understand somewhat the push for this aspect to be strengthened nowadays. But is it me or are medical schools not even preparing us soft skills wise for practice? If we get no practice in clinic taking histories or communication that actually matters in realistic scenarios, then all these actor scenarios are kinda just…useless? Because it doesn’t simulate reality at all or prepare you.