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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.

Saturday, 26 September 2015

The Truth about being a Junior Doctor

I haven't really said very much about the Junior Doctors' Contract furore that is currently dominating every thread of social media I participate in.

You know why? Ironically, because I'm either at work, or exhausted from being at work.

I have always maintained that doctors are not special cases when it comes to the argument of 'we work hard, we deserve to be rewarded for that'.  I also hate whining or all-round negative vibes.  So instead I will stick with my realities and let you decide.

I am twenty seven years old.  I qualified as a doctor when I was twenty four (pretty much on the dot!).  In that time I have been bled on, urinated on, nearly hit by confused patients, shouted at by other stressed colleagues, performed CPR on dozens of chests, stuck needles in hundreds of arms, tried to make life-saving decisions at every hour of the day and night, kept patients comfortable in their final days and hours, been present at or confirmed more deaths than I care to think of, and looked into the eyes of the confused, weary, sick, dying and hurting and tried to find the right words and actions to ease their pain.  I have missed weddings, birthdays and Christmas.  I have cried out of pure tiredness, in frustration and in absorbed grief from the clinical situation in front of me. I have done quality improvement projects, audits, presentations, research papers, teaching (bedside, lectures, tutorials, ward rounds... you name it), exams (yes, postgraduate exams continue) and further training courses around all of that, often at my own expense both financially and time-wise.  A Consultant asked me recently what other work activities I was doing outside my clinical job - these extra things are not for 'bonus points' - they are seen as essential and the norm.

Time away from this has made me see that that's all not very normal, and I think the reason junior doctors are so angry about the new Junior Doctors' Contract is the same reason why teachers get so frustrated by the latest change in their curricula or contracts.  I heavily resent being told by someone who has never faced the situations I have outlined above (often at 3am, or at the end of a 13-hour shift) what my job is 'like' or what it's 'about'.  I *think* I am good at it; I try very hard to be, and to get better.  I don't choose my hours to earn more money, or pick which of the 1-in-4 weekends I'm at work, or which of the evenings each week I stay at work til 10pm (plus any additionals that just sort of 'happen' if people are sick).  I go to my job because I love it, but you don't experience the challenge of treating very sick people and looking death in the face and the distress of peoples' families without giving something that government ministers cannot convince me they understand.
I reiterate, this is not a moan, more a reality check from the perspective of one junior doctor.  The negativity in hospitals amongst junior doctors is tangible, and yet they still give 100% to their patients because it is good and right to do so.

When I was working over a weekend recently, I found myself with a cluster of other junior doctors on the same ward all dealing with separate but sick patients.  It was 9.30pm on the Sunday evening, and we had all been working all of the previous week (plus an additional evening), 13 hours on the Saturday and were reaching the end of another 13 hours on the Sunday.  We all had a full week plus at least one additional evening on call ahead of us.  And there we were, a bunch of twenty-somethings, giving it 150% to make these patients better - organising blood tests and X-rays, talking to families, calling other specialties for advice, giving drugs and waiting to see if they worked before making the next intervention - working with passion and pushing past the fatigue.  In between phone calls and writing in the notes, we would share a little of our current clinical dilemma and the day we had had, and try and find a few smiles and giggles to keep us going.  I felt so, so proud at that moment to be a junior doctor.

And I am proud, not just of me but of the NHS.  I am twenty seven years old.  I am a junior doctor.  I love my job and all the things it makes me feel and see.  It is an absolute privilege.  But I also have a brain, and I'm not afraid to use it.