Junior Doctors

Junior Doctors are being discussed a lot at the moment, partly because of the strikes about conditions but also because of the general election coming up. I’ve seen a lot of junior doctors in the last few years, mostly because I’m a good teaching/learning case with my Adrenal Insufficiency, so they often get directed to me to practise, along with med students. However, they also lack years of experience (because they’re juniors) and often feel they have a lot to prove, so some make rash judgements (e.g. I have a high attendance at a&e=most likely time waster, in their book), which means I’ve had my fair share of horrible encounters. I get it, they’re overworked, underpaid and have to do a ridiculous amount alongside studying and CPD. But that doesn’t mean they have the right to punch/kick a door closed in frustration, call me a ‘bitch’ to their colleagues (and I wasn’t by the way!) or stand outside in a corridor shouting at me into the treatment room, to use 3 examples. I’m a good patient, but even if I wasn’t, they’re the doctor and should work professionally. 
             Anyway, rather than make this post a rant about the junior doctors who have caused me grief, I thought I’d acknowledge the good ones who do exist and tell you about a junior doctor who was brilliant. I’ll call him Josh, and he was working in a&e. The triage nurse also happened to be the nurse in charge. I had sepsis markers along with the fact that I’m a red flag patient, so she walked into resus shouting instructions to staff, bumped me to the top of the list over everyone except cardiac arrest, kicked another patient out of the space and produced Josh and a nurse (who was also brilliant). Josh was a bit flummoxed because he’d been in the middle of something else when she’d pulled him off the case and hadn’t been given my chart yet because it hadn’t been printed. He wasn’t the most knowledgable junior doctor I’ve had, but here’s why I thought he was great: 
He told me his name. Not all junior doctors do this. It’s really, really basic but he made sure I knew his name despite the chaos that was going on, which made me feel more at ease.
He treated me like a human. I’m pretty calm in hospitals but this was my first time in resus and I’d worked out by the level of activity that I was seriously ill. Let me tell you, being critically ill with an illness that most people are unfamiliar with is bloody terrifying. Some junior doctors see you as an illness rather than a patient and do things to you without really saying anything or interacting- they’ve got a limited amount of time so they sometimes forget the whole patient interaction thing. But actually, it’s really important. He joked back when I tried to laugh about it as a way of coping. 
He didn’t pretend to know anything/everything. This is so important for chronic patients like me who go to hospital a lot. The nurse in charge had told me to get my injection ready in case I passed out before they could get hydrocortisone into me IV. He clocked this and my medical ID and said ‘you must come here a lot. I’ve only dealt with one case of Addison’s but your BP tells me you’re not a textbook case. And you’ll know more than me anyway. Anything you think you should get that I don’t do, let me know’. So I handed over my emergency protocol saying the drugs and investigations required and he read it thoroughly and asked some questions. Lots of doctors hate that kind of thing.
He didn’t have a God complex. He helped me get changed into the gown. That’s not really his job, a nurse or healthcare could do it, but my nurse was finding the drugs and fluids he’d just ordered and it would take longer for him to wait or find another one. So he did it. He also worked well with the nurses. Some junior doctors are so rude to them! 
He wanted to learn. He even said that he wanted to learn so that he could help the next patient with AI better. But not just from his books, from me as a patient and what it felt like to have the illness. I thought that was pretty cool. 

He came back to check on me and brought me my new doctor when he went off shift.
You tend to see the nurses a lot but doctors don’t spend a lot of time with patients. It made me feel looked after that he stuck his head in the treatment space when he walked past, even if it was just to say hi. 

He didn’t make me feel like an inconvenience
. Sometimes when things are busy, doctors cut you off mid sentence because you’re not answering the question with the reply they need. For someone like me, I can’t concentrate on what you’re saying if you do that, and the process actually takes longer in the long run. He didn’t make me feel hassled or stressed. In fact, he saw it as his problem for having not phrased the questions properly. 

He asked for help when he needed it
. He had issues getting a cannula in (my veins move a lot) so he got the nurse to do it. Then made a joke about it since that was our ‘thing’ by that point. Lots of junior doctors continue to stab you beyond the 3 strikes, which isn’t great. 

He worked fast but was calm
. I’ve had a fair few doctors panic around me because I’m unusual. They do a good job covering it up, but I’m also quite good at seeing through it from having been a teacher. He had a calm air about him which was reassuring. 

I asked him to double check some of his treatment plan with the consultant and he did
. I needed IV antibiotics fast but I have allergies and I’ve had a seizure in the past due to doctor error. It’s made me wary of drugs I haven’t heard of. So I was grateful that he went and checked when he wasn’t sure about interactions rather than telling me he knew best, particularly as I was still in ‘the danger zone’ so he needed to move fast. It’s not uncommon for doctors to pretend to ask the consultant and give advice which is completely wrong- they tend to look quite sheepish when challenged. 

I was informed about my care and felt involved
. I like to know what’s happening because I’ve had a few doctors get it really wrong and almost kill me, so I feel the need to ‘check’ some things. When there was a delay with the antibiotics, he came back to explain what was going on and why. Again, this might seem basic, but you’d be surprised how often people ‘forget to tell the patient’ and wonder why we haven’t moved/been to x-ray.
         I can remember his name and face even though it was a long time ago and I was pretty out of it. He had that big an impact on the way I felt about my care. 
        I only really remember the excellent doctors or the terrible ones, because I’ve seen so many. Sadly there are probably an equal number of terrible ones on my list as excellent ones. But not Josh. It might seem like common sense but it’s usually the common sense stuff that gets put to one side when doctors are under pressure. I haven’t had a junior doctor like him since, partially because I mostly see consultants now, but I’d love to have more Josh-like junior doctors treating me. 


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