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Wilkommen to my blog - my name is Karin Purshouse, and I'm a doctor in the UK. If you're looking for ramblings on life as a junior doctor, my attempts to dual-moonlight as a scientist and balancing all that madness with a life, you've come to the right place. I'm currently a doctor/research trainee in oncology after spending a year doing research in the USA. All original content is licensed under a Creative Commons Attribution 4.0 International License.

Thursday, 13 December 2012

Doctors cry (especially junior ones)

Ok, so I am really bored of crying at work.

Since I started working back in August, I have probably had a cry-per-month ratio higher than I have ever had in my life.  The thing is, I don't cry.  Normally.  So by way of learning to 'Man Up', here's my cry diary from the last few months.

Cry number 1 - Day 1 of work.  Ward that normally has quite a few doctors on it - find myself completely on my own for a chunk of the afternoon.  Feel overwhelmed by number of jobs to do and no idea how to do them, along with being asked questions I don't know the answers to.  New SHO arrives and makes the fatal mistake of asking me if I'm ok.  Cue tears.

Cry number 2 (and 3, 4, 5) - First set of nights.  At the end of a busy, horrible first ever medical night shift, I realise in front of the entire team that I made a small mistake - an error based on lack of knowledge of a particular routine.  A non-dangerous mistake that breaks me at the end of a long 13 hours.  Two nights later, and I'm similarly being dragged all over the hospital.  At 3am, I have a choice between the patient who is desaturating down to 50%, a blood pressure of 65 or chest pain.  That means the patient with the minor-sounding problem is unfortunately not a priority.  Said patient lets it known she is not very happy about this when I finally reach her at 7am.  For me, it's the final straw.  Didn't feel I'd been very supported in this  decision making process by the nursing staff, and once I've calmed down a bit, I have a chat about supporting each other during the night shift.  I think the patient realised I was upset and once I'd sat down going through her problems for half an hour, seemed to be more content with the situation and that I hadn't apologised for my tardiness without meaning it.  A few people subsequently asking 'if I'm OK' triggers Cry 4 and 5.

Cry number 6 - having had no deaths on my clinical team, we have three deaths in one week.  One patient who I'd seen over a weekend on call, and happened to see during an on call later the subsequent week, dies literally in front of me.  Then we had a couple of admissions that week of patients with dementia who had stopped eating and drinking.  Taking a history was impossible.  Persuading them to have bloods taken was tricky.  The underlying feeling of 'I can't actually make this situation any better' and 'What am I actually doing? What can I bring to this situation?' proves a little more than I can bear.  In fairness, I don't actually cry, but the only place I can find to hide to take a few deep breaths is the patients' bathroom.

Cry number 7 - there's a long pause before cry number 7.  Another weekend on call.  It's been a very busy Saturday and once the day registrar has left at 5pm, I'm on my own to sort everyone out til 9.30pm handover.  The bleep is out of control with non-urgent jobs.  Then at quarter to 9, someone is spiking a temperature.  I decide this is the most urgent job, and the others on my list will need to be handed over. I speedily do an assessment (my bleep obviously continuing to go off), take some bloods, take some cultures, get a new drip up.... and as I'm getting these things sorted in the office, I'm still being called - 'Doctor, can you just....'.  I don't know how I can say it differently - that unless the problem is more urgent than the one I'm dealing with right now, it will have to wait 5 minutes.  I head to handover, and I'm not angry, just tired and frustrated with myself for not being able to do 3 things at once.  The SHO reminds me that I can't expect to be able to do everything.  My night counterpart brings some water and tissues, and I get it together.  What a wimp.

Cry number 8 (8???? This is ridiculous) - new job, working late.  My senior and I assess a patient.  Once her blood tests are back, my senior decides she needs an urgent scan.  The person who would do the scan disagrees.  He does not communicate these feelings in a very sensitive way.  Some poor documentation on my part confuses the situation (which I apologise for) and overall I feel quite stupid and like my professionalism is being questioned a little unfairly.  It's the last of these which sets me off.  This has all happened over the phone, and I'm with my senior seeing another patient on another ward by this point, so a whole set of healthcare staff and patients alike are completely mystified by this sobbing doctor.  When I see said person later (scan finally done and entirely justified), I apologise for my part in any confusion.  I receive no apology.

You see?  I totally need to man up.

The thing that frustrates me more is, I am coming to believe now that actually, I am an alright doctor.  This is quite a big deal for self-depricating little me.  I had my end/start of rotation appraisals recently, and yesterday saw my feedback from the doctors, nurses, ward clerks, pharmacists from my previous rotation.  Their feedback was really nice! Of course, I am now sort of back to square one in a new job and the amount still to learn is overwhelming.  I am still just a junior doctor.  But I'm ok with that, because I know that, despite all of the above events, I learn from my mistakes and that I'm not terrible.

So really there is nothing to cry about.  I just need to learn to back myself, and cope better when things get a bit stressful.  And perhaps carry some Kleenex around in my on-call bag.  

Monday, 10 December 2012

Hello job, goodbye life

I finished my first rotation this week and it was with a degree of sadness and trepidation that I left the hospital and job I was only vaguely starting to feel on top of, in exchange for a new job in a much bigger hospital.

I now work in surgery, and my hours are, as one might say, 'plus plus antisocial'.  There is literally no regular evening hobby I can do any day of the week, because all my shifts either start, finish or occupy the evening time.  

Means of coping with this?

Go home and find your mama and give her a big hug.  Go for a stroll and contemplate life.  Generally escape the bubble that is 'work'.  

Buy yourself a truly excellent Christmas jumper.  And stop getting too bah humbug everytime they play 'Driving Home for Christmas' on the radio.  Because I will not be driving home for Christmas.  Even if I did, only the cat will be there because my family are (rightly) taking the opportunity to visit our extended family.  

Go to the pub and have a snuggly mulled wine with good friends.

I am determined not to be a whiner!  It's been quite an intense time, but my new musical and literary flavours of the month are helping plenty - I've just bought Lucy Rose (old favourite for complex reasons) and Alex Clare (@alexanderclare for all you twitter fans)'s albums, and can highly recommend both.  Book wise, a charity shop trawl proved fruitful.... 10pm finishes for me for the next 7 days, so I'm spending my early mornings with my nose in a (non-medical) book to keep my sanity and a smile on my face.