Monday, 26 March 2007

Is anybody actually in charge?

I’m employed by a company to do a job and I do it well. Unfortunately, the people who run my company have decided to sack all the people doing the job I am and make us re-apply again for the jobs we are already doing.

They said I can only apply for four positions in four different areas of the country. I’m not happy about it, but I dutifully go through the processes and, because I do my job well, I get shortlisted and interviewed for all four positions I’ve applied for.

I spend a lot of time, effort and mental energy preparing for the series of interviews to try and perform to the best of my ability, after all these interviews are important and I don’t want to be unemployed come the summertime. These interviews are also very stressful but I try my hardest at each of them.

On Friday night my employers email me to let me know that they’ve changed their minds (again) and ask me to guess which interview I’ve done best in (they’re not going to actually tell me which I’ve done best in). Then they say that I can only apply the job in which I believe the interview went well and the rest of the interviews will count for nothing.

My contract is being terminated in the summer and I only have one opportunity to apply for one job to replace it.

Currently, in my company, there are 32,300 people doing my job. These people are competing for about 21,000 positions and come summertime, a third of us will be out of a job.

If anyone told me about a situation like this, I’d advise them to change companies to one that actually valued the hard work of its employees and didn’t treat them in such a slipshod, slapdash, disdainful manner.

Trouble is, my company is the NHS and my job is a junior doctor.

I don’t want to leave the NHS but I’m asking myself, with increasing regularity, “Is it worth it?”

Monday, 19 March 2007

Life Choices

In this life, we must take responsibility for the choices we make.
Tonight I had the choice of

1. Preparing my presentation for my interview for a training position in London tomorrow

2. Messing around on the internet for four hours.

Which do you think I chose?

Looks like I'll have to make up the presentation on the spot

I am such a retard

The St. Patrick's Day March

As a profession, we doctors tend to have the attitude that says "just get on with it" whenever bad things happen. We don't complain (at least not en masse), we don't strike, we just take the endless shit that's heaped on us. Things are changing.

A group of docs called RemedyUK are getting us to take a stand over MTAS and they organised two marches yesterday - one in London and one in Glasgow.

Beforehand, I don't think I grasped the importance of the occassion but this march turned out to be the biggest protest in the history of our profession. It was great to see so many of us speaking out (some very loudly) and uniting against a system that is shafting so many people. It was good to meet up with old friends too. There were great speeches by RemedyUK, by the West Midland surgeons, but I couldn't believe it when David Cameron took to the stage.

I can't stick the Tories or what they stand for and I was fuming that he basically tried hijack the march and turn it into some sort of Tory-party rally. Grrrrr.....
My mood was not improved when the BBC showed their news review and made the march sound like a pro-Conservative demo. In fact, I've got to stop typing now because my blood is about to boil.

I hate fucking politicians.


I've calmed down now. All in all I have to say that it was great to see so many people taking a stand and this is another step towards forcing the powers that be to sort out this mess they've created. I feel proud.

Monday, 12 March 2007

The joy of spring and the MTAS fiasco

I’m feeling very happy at the moment. I don’t really know why, maybe it’s because spring has its foot firmly in the door. Maybe it’s because England beat France on Saturday. Maybe it’s because I’ve just had a free weekend (a very rare thing for me at the moment) and the sun shone and I spent it drinking beer with friends. Maybe it’s because I spent a lot of time this weekend having sex with a beautiful woman. Whatever the reason, I think that, in general, life is going pretty well at the moment and not even the ongoing MTAS fiasco is dampening my mood.

You may or may not know about the way the government has tried to fuck up junior doctor’s training but in a nutshell, here’s what’s happening.

The government is sacking every junior doctor in the country on 31st July this year.

They are making us re-apply for the jobs we are already doing through the Medical Training Application Scheme (MTAS).

If you do not secure a job starting 1st August via MTAS, the system PREVENTS you from re-applying EVER again.

Due to a number of wholly predictable cock-ups, including lost documents, computer crashes and leaked marking schemes, MTAS has not worked. There are thousands of doctors who are not even being interviewed for the jobs they are already doing and doing well. This means they are staring down the barrel of unemployment and will either have to change careers (after between 7 and 10 years of medical training) or leave the NHS to practice medicine abroad.

It’s crazy.

Aphra Behn has put a more detailed guide to this debacle on her blog.

Unsurprisingly, this is causing a huge amount of stress, panic and misery among my colleagues; you can read about just how upset and angry some doctors are here, here, here, and here.

Fortunatley for me, I’ve managed to secure an interview for every position for which I’ve applied and the second of my interviews is tomorrow.

I have to say, I’m feeling very relaxed about it, which is sort of strange given the potential importance of tomorrow’s interview but, to be honest, I have no faith in this system and honestly do not believe that whether or not I get offered a job will have anything to do with how good a doctor I am.

It’s with these thoughts in mind that I’ll walk towards the interview panel tomorrow… and smile.

Wish me luck!

The reason why doctors work late...

Friday, 4pm and a patients arrives on the ward from the Medical Assessment Unit. This man is as sick as a dog. Jaundice has turned his eyes and skin bright yellow and we look at his blood test results and his bilirubin level is about 500. This is very bad news indeed. He’s a homeless man and you didn't need to be a doctor to tell that he was seriously unwell. He was all skin and bones and he had the haunted look about him of someone who knew his time was at hand. He wasn’t fighting it.

This man wasn’t well enough to even speak to us anymore. For us to know why he was so jaundiced and unwell, we needed to scan his liver by ultrasound.

In hospitals, half past four on a Friday is the worst time to try and organise things. Departments are shutting up for the weekend and the staff are trying to finish up their workload so they can get to home/to the pub.
Luckily for us, our consultant (effectively our boss), was on site and he came straight to the ward and, after speaking to four different radiologists, found someone who was willing and able to scan this poor man’s liver. The radiologist pages me 16:40 and says “I’m in the ultrasound department, I need to leave at 5pm. If you can get the patient here in the next five minutes, we can do the scan for you.”

So I grab one of the nursing assistants and we wheel this patient on his bed, through the corridors of the hospital to the Ultrasound Department.
I have to say, this was all very dramatic and one of the few times I actually felt as though I was in an episode of E.R. or House or Holby City or any of those medical dramas where people are always running through corridors yelling “Emergency! Emergency!”

The radiologist is there waiting for us and the scan shows that this man’s liver is chock-full of cancer. This is why he was so jaundiced and this is why he was so unwell and this is why he was going to die. As doctors, there is nothing we can do to save this man’s life, but, because we managed to get a scan done, we’ve spared him from having further blood test, needles, catheters and all the other unpleasant things that we do to our patients in order to diagnose and treat their condition. What we can do for him is make sure his last hours are peaceful and painless, and from that we can take solace.

I’m typing this on Sunday evening and I will be very surptised indeed if he’s alive when I get to work tomorrow morning.

Sunday, 4 March 2007

The ward night out

Last night, I went out on a night out in the Town with the nurses from the ward. I must confess that I was a bit wary about going out drinking because, in my experience, I’ve found that when nurses get drunk together they get totally wasted and crazy stuff happens.

I got the train from The City (where I live) to The Town (where I work and where we were going out) and got in just before 10. A couple of phone calls later and I manage to track them down. It turns out that they’d been drinking since 4 o’clock and were totally off their faces. It was pretty obvious that there was going to be very little in the way of meaningful conversation going on, so I had little choice but to get pissed. It actually ended up being a really fun night withoads of banter with random bods and lots of laughing and dancing.

At about midnight, James, one of the other doctors from the ward, pulls me to one side and tells me that Anna, one of the nurses, was coming on to him. Problem was that she was in a long-term relationship and he asked me what I thought he should do.

I know the whole “doctors and nurses” thing is such a cliché, but seriously, it’s so true. Just about every male doctor I know has shagged at least one nurse, you could call it a perk of the job. For me personally, it’s been two – one as a house officer and one as a medical student. It would have been more but for my views about sleeping with people you work with, I’ll explain my opinion in a later entry.

Anna’s pretty cute and I definitely would, so after giving James that caveat that I’m a bit of a badboy I said:

“Look, she obviously really likes you and from what I hear, she’s liked you for a while. I don’t think the fact that she has a boyfriend is really relevant here, she’s a grown woman and she’s capable of making her own decisions. Personally, I think it takes a lot of guts to say what she just said to you, and personally I don’t think that I’d EVER say that to someone, no matter how much I liked them. I think what’s important is that you decide what YOU want to do. I think if you’re honest with yourself about whether or not you want to go out with her, or shag her or kiss her, then you can be honest with her about it. And I think she deserves that honesty whatever happens”

Surprise, surprise, half an hour later, James and Anna are swapping spit on the couch in the corner of the club. I think things would have gone further if Anna’s boyfriend hadn’t arrived to pick her up about an hour later. I wonder what she’ll say about the whole thing on Monday. Stuff like this makes work so much more interesting!

All in all, I had a surprisingly fun, if a tad cheesy night out, and I’ll definitely go along to the next one – and next time, I’ll start at 4 o’clock!

Saturday, 3 March 2007

Mind on the job!

I took Tina out to dinner last night to celebrate both the fact that I’d been paid and that I’d finished my nights and am now officially back in the land of the living. Tina is a girl I’m seeing at the moment. I met her in a club a few weeks ago and since then, we’ve become sex-buddies. She’s very pretty, very tall, brunette with big blue eyes, big breasts and a sense of fun – just the type I go for, in fact. She’s a total party girl and her antics make me laugh loads. Maybe part of the reason I like her is that she provides a flip-side to my job which is often really depressing.

For example, one night, me and the registrar saw this 59 year old woman in A&E with breathing difficulties. We saw her at 23:30 and she looked awful. She was a long-term smoker and this had destroyed her lungs, leaving her with COPD. In addition to that, her heart was failing, meaning fluid was building up in her lungs, slowly drowning her and making it even harder. On top of that, she also had pneumonia, so there were three very good reasons why she was sick and couldn’t breathe properly. When we saw her in A&E, it wasn’t so much a question of IF she was going to die, but WHEN. I was determined that it was not going to be on my shift and we gave her all the appropriate treatment but, as we expected, she continued deteriorate and ended up dying about noon the next day.

I was lying in bed thinking about this woman this morning when my internal “voice of reason” kicked in and said:

Voice of Reason: What are you doing?
Me: Nothing much, just thinking about that patient
Voice of Reason: Why on earth are you thinking about that NOW?!?! You are an idiot. You are lying in bed on the first day off you’ve had in ages, you’ve got a dead sexy woman lying next to you, she’s stroking your stomach and rubbing her breasts against your side and you are thinking about that woman gasping in hospital. Come on son, mind on the job!

And I guess this the age-old problem of not being able to leave work at work. In the time since I qualified as a doctor, I’ve got better at not dwelling on things, but sometimes, still, work gets to me…

Thursday, 1 March 2007

Steady hands

Try this:
I got 26.113 secs on my fifth go! Maybe I should become a brain surgeon.