In life, I’m a firm fan of diving in headlong, leaving my comfort zone behind and either sinking or swimming; usually managing to stay afloat and actually discover I really like it. Whether that’s in sport, diving into running a marathon and ultra within a couple of years of starting, diving headfirst into medical school when I’d only been 18 for a fortnight, or entering a triathlon when I’d yet to learn to swim.
On July 22nd, two momentous things happened. The first one was that after 5 years of a mix of hard work, great fun and new experiences, I graduated as a doctor, and finally got to update my name to Dr Sarah Marsden eeeeeverywhere (you so would too). The second was that I received my work rota for my first 4 months as a doctor.
The majority of my new FY1 doctor friends starting work on August 5th were either starting in some of Yorkshire’s smaller district general hospitals like Harrogate, or starting on jobs on general medicine or elderly medicine, with supportive teams ready to gently nurture them through their first weeks, with no on-call responsibilities to put them out of their depth. The first short straw I drew by comparison was a surgical job at the biggest teaching hospital in Europe; a job spoken of in hushed whispers and given looks of respect as the hardest job a junior can start on. The second short straw? I was starting on a pair of night shifts for my first two shifts as a doctor.
Despite Jeremy Hunt’s delusion that doctors don’t work nights or weekends, they very much do, and as a junior doctor working overnight, you have senior doctor support, but it’s very much down to you to decide when you need it, contact them and explain the situation appropriately, and woe betide you if you ring them without having started to manage the patient yourself- no ringing and saying ‘HELP!’ before you’ve seen the patient! You work largely alone for 12 hours, covering several hospital wards (I had 5, which equates to 150 patients), carrying the crash bleep so you’re first on the scene should anyone have a cardiac arrest, and a bleep so the wards can get hold of you. You answer the bleep every damn time it goes off, even when it’s 5am and you’re fighting heavy eyelids, a foggy brain and a body that desperately wants to be asleep. You work your way through whatever happens, deciding yourself what is most urgent and what can wait.
I was downright terrified starting on night shifts, not helped by all the consultants’ comments of ‘God help those of you starting on nights!’. I nervously clipped the two bleeps to my belt and left handover, equipped with a piece of paper full of patients’ names who had the potential to become unwell overnight, a list of jobs to do, and 12 hours later on Thursday and then Friday morning, I returned to hand the bleep back over, tired, a little shell-shocked and jittery whenever anything bleeped near me. Wednesday night was steady; a sensibly-paced stream of jobs to do, with a couple of poorly patients who responded well to basic management, and aside from a man who could not stop hiccuping and I had no idea what to do, I managed with minimal phone calls to my senior doctor.
Thursday night was a different beast entirely. During the course of the night, I never stopped, apart from when I forced myself to sit down for 15 minutes for ‘lunch’ at 2am. I filled in 53 drug charts, took 7 blood samples, made 1 very long trip to hand deliver said blood samples to the Pathology department on the other side of the hospital, received 6 new patients who needed to be sorted for their operations at 8am, and stabilised 4 particularly poorly patients who needed my help. I’d wager I probably walked, and sometimes ran, at least 8 miles during the course of the evening, and I was utterly worn out, surviving the last hour on adrenaline and Percy Pigs alone.
I used to think fear was a negative thing that I should never show, but endurance sport taught me it’s something I should harness and use to my advantage. When I said to Eleanor, my lovely senior doctor for the nights, that I was terrified, she looked me in the eye and said ‘Of course you are. Anyone would be. You’re 22 and suddenly responsible for lives. Fear shows that you care. Now go on, don’t forget to breathe and see what you can do’. Sage advice for doctoring, and for life as well.
In case you’re wondering, I survived and so did the patients 😉