Any doctor, no matter how qualified they are, will always remember their first day as a doctor. Ideally, your first day will be on your new firm where you may be with other foundation year one doctors and more senior doctors who will have the time to support you throughout the day. Unfortunately, some new doctors will start on a night shift.
My first day as a doctor was on the night shift working from 8 pm to 8.30 am. I was the surgical house officer on call covering the wards and any GP OOH (out of hours) referrals. I attended handover where the day team informed us of any patient admitted that day or any patients waiting to be seen in A&E or the surgical assessment unit. They also informed us of any patients who were very unwell on the wards or needed to be reviewed later in the night.
I was handed the bleep - it went off straight away
I was handed over the bleep and a list of jobs by the day team that they hadn’t had the time to complete. This included reviewing patients, blood and x-rays, taking blood and rewriting drug charts and fluid charts. My bleep started to go off straight away. There was a patient who had been in day surgery that day and was waiting to go home but his heart rate had risen so he needed to be reviewed by a doctor before he was discharged. There were patients in pain who needed their painkillers to be reviewed as well as many other ward jobs. My registrar and senior house officer had taken a patient to theatre so I was on the wards alone.
I slowly started working my way through some of the jobs feeling very uncertain and scared of the decisions I was making. I then received a bleep from A&E informing me there was a patient with severe abdominal pain who needed to be reviewed by a member of the surgical team. This would normally be referred to the senior house officer but as they were scrubbed and operating I was the only member of the team who could attend. On examining the patient, they had a query leaking abdominal aortic aneurysm which is a life-threatening emergency. I was then bleeped by the vascular ward who informed me a patient who had had an operation on his leg earlier that day to restore blood flow now had the same symptoms in the other leg. This, again, is an emergency, as without re-establishing blood flow the person would lose their leg.
Out of my depth, I realised I needed help...
At this stage, I’m not embarrassed to say I had to go and find a quiet area and take a big breath and fight the temptation to run away and hide. Realising I was out of my depth and, needing help, I bleeped my registrar in the theatre and explained the situation. He then came to A&E and, working as a team, we reviewed and treated the patients.
After completing the 12-and-a-half-hour shift, I was exhausted but also had a sense of euphoria that I had helped others and worked as a doctor. The experience comes as a shock to almost every new-starter.
"A uniquely rewarding experience..."
This kind of pressure and intensity will only increase with the increased demand and strain on our health system, so when considering whether life as a doctor is for you, it’s important to consider how you feel you’d cope with this kind of environment. Though stressful and intense, it is a uniquely rewarding experience to have such a direct impact on the well-being and survival of your patients.
Surgeon Nicola Comer reflects on her 18 year career in clinical medicine and how she came to work in paediatrics.Read more
Work experience in your local GP surgery is an excellent addition to any application. The medical professions are hands on and so securing relevant work experience is important.
During your hospital work experience, you should try to get as much variety as possible. A placement is a opportunity to learn what a ward round is like and to shadow a doctor.