How to support your foundation doctors
As you all know, foundation year 1 doctors are at the lowest rung of the career ladder. Their pay is the lowest and their job is the toughest when they are on call - especially on ward cover. They are bleeped constantly to prescribe pain relief, dose warfarins, gentamicin, catheterize, do cannulas, take bloods, see sick patients ( who are not EWSing every minute in one hour.
It is very important that their SHOs support them whenever possible.
This is how SHO's can help:
1. Give your FY1s your mobile number - ask them to message you with any problems they are having. They SHOULD NOT give any patients details. Examples include
- Cannulations
- ABGs
- Catheters
Ask them to message you something along the lines of " ward 34, bed 12 needs a cannula please- on IV Abx and fluids"
No further detail is required. If they bleep you, you may not be able to answer immediately.
Ask them to message you and then they DO NOT need to stick around if they are bleeped to the other wards/see other patients. Having your mobile number will give them a sense of security that there is someone there to immediately escalate to.
2. Ensure they take breaks - Some work constantly and do not realize that they have no eaten. You could text them that you are going to have a snack at a particular time and you would like them to join you ( unless they are exceptionally busy - in that case, you must offer to help). Either way, they must take a break every 2 hours - for at least 10 minutes and have a 30 minute break every 6 hours.
This is only possible if their SHOs help them. If you are not too busy, you can take their bleep from them for 30 minutes and let them take a break in peace.
3. If you are resting in the doctors mess but are not asleep and your FY1s bleep goes off ( when (s)he is asleep), answer it for them. It might be a simple thing like prescribing paracetamo which you can do via electronic prescribing or ask the nurse that you will do it in 10-15 minutes.
4. Pamper them! They are overworked, underpaid and exhausted! Get them pudding or a small snack when you see they are extremely busy. The FY1s of today will be the SHOs of tomorrow and soon they will be registrars and consultants - you or your loved one may be admitted under them one day. So take care of them so that they take care of you. I am sure they will still take care of you regardless of the above but it will help them immensely.
5. Be their friend and support! They may end up crying. They may think they are useless! We have all done this at some time in our careers as well. And we all need a hug, a nice cup of tea and a chocolate. So do this!
6. Listen to their concerns. Ask them if they are worried about anyone. Sometimes they are afraid of escalating. Assure them that the registrar on call is very supportive and friendly however if they are unable to get through, they must contact you immediately.
7. Explain the escalation pathway to them - what the outreach teams numbers are, when to contact the reg. Emphasize that if they are in doubt, they should escalate immediately.
8. Thank them. This is the most important thing! You must appreciate yourself and your team members. We all work very hard! A thank you can make a huge difference in someones life.
9. Know your FY1s limits. If (s)he is working in a different environment ( pysch, less than full time, clinic), you should know that it may be difficult for them to handle acute issues. So keep telling them that you are there for them.
10. Teach them whenever you can - share your cannulation tricks, your personal experiences. Tell them how you started. Keep telling them that they are the best. Because they are - they just do not know it.
11. Ask them to lead consultations when seeing patients on the ward and then give them positive feedback at the end - this way they will gain confidence.
12. Volunteer to do their assessments for their portfolios - help them cover the curriculum they may have missed.
13. Ensure they attend end of life discussions with patients which a consultant may be leading so that they learn.
14. Ask them to learn a new thing everyday - consenting ( if they are allowed to), observing a new procedure, doing something new, discussing a case they may not know how to manage.
15. Bring the best out of them - every person has a weakness and has loads of strengths. Work on their weaknesses together. If they are shy, ask them to present a case to you. Then ensure they present the same case to the registrar. Then to the consultant. They will become very confident this way.
16. Help them do discharge summaries. When they are part of the clerking team, take over their jobs and ask them to clerk. So that they learn how to see patients. If you do it once or twice in every shift, they will eventually gain enough confidence to work as a SHO.
17. You should be their friend rather than senior. Ask them to be open to you about anything they want to discuss. Point them to the right teams if they have concerns.
18. Emphasize that they should come on time and leave on time. Help them become more organized ( by actually giving advice rather than just saying 'you should be more organized' and then walk away). Help them complete jobs on time. Show them how list jobs from the ward round, what is the priority and what can be done later. Help them with the smallest of things to ensure you all leave on time.
19. Guide them on their career pathway. Do not force them to give exams - encourage them to take a year out and see what they want pursue. Guide them about exams IF they want to give them. Show them that they do not have to do a tough specialty and things will get easier with time.
It is very important that their SHOs support them whenever possible.
This is how SHO's can help:
1. Give your FY1s your mobile number - ask them to message you with any problems they are having. They SHOULD NOT give any patients details. Examples include
- Cannulations
- ABGs
- Catheters
Ask them to message you something along the lines of " ward 34, bed 12 needs a cannula please- on IV Abx and fluids"
No further detail is required. If they bleep you, you may not be able to answer immediately.
Ask them to message you and then they DO NOT need to stick around if they are bleeped to the other wards/see other patients. Having your mobile number will give them a sense of security that there is someone there to immediately escalate to.
2. Ensure they take breaks - Some work constantly and do not realize that they have no eaten. You could text them that you are going to have a snack at a particular time and you would like them to join you ( unless they are exceptionally busy - in that case, you must offer to help). Either way, they must take a break every 2 hours - for at least 10 minutes and have a 30 minute break every 6 hours.
This is only possible if their SHOs help them. If you are not too busy, you can take their bleep from them for 30 minutes and let them take a break in peace.
3. If you are resting in the doctors mess but are not asleep and your FY1s bleep goes off ( when (s)he is asleep), answer it for them. It might be a simple thing like prescribing paracetamo which you can do via electronic prescribing or ask the nurse that you will do it in 10-15 minutes.
4. Pamper them! They are overworked, underpaid and exhausted! Get them pudding or a small snack when you see they are extremely busy. The FY1s of today will be the SHOs of tomorrow and soon they will be registrars and consultants - you or your loved one may be admitted under them one day. So take care of them so that they take care of you. I am sure they will still take care of you regardless of the above but it will help them immensely.
5. Be their friend and support! They may end up crying. They may think they are useless! We have all done this at some time in our careers as well. And we all need a hug, a nice cup of tea and a chocolate. So do this!
6. Listen to their concerns. Ask them if they are worried about anyone. Sometimes they are afraid of escalating. Assure them that the registrar on call is very supportive and friendly however if they are unable to get through, they must contact you immediately.
7. Explain the escalation pathway to them - what the outreach teams numbers are, when to contact the reg. Emphasize that if they are in doubt, they should escalate immediately.
8. Thank them. This is the most important thing! You must appreciate yourself and your team members. We all work very hard! A thank you can make a huge difference in someones life.
9. Know your FY1s limits. If (s)he is working in a different environment ( pysch, less than full time, clinic), you should know that it may be difficult for them to handle acute issues. So keep telling them that you are there for them.
10. Teach them whenever you can - share your cannulation tricks, your personal experiences. Tell them how you started. Keep telling them that they are the best. Because they are - they just do not know it.
11. Ask them to lead consultations when seeing patients on the ward and then give them positive feedback at the end - this way they will gain confidence.
12. Volunteer to do their assessments for their portfolios - help them cover the curriculum they may have missed.
13. Ensure they attend end of life discussions with patients which a consultant may be leading so that they learn.
14. Ask them to learn a new thing everyday - consenting ( if they are allowed to), observing a new procedure, doing something new, discussing a case they may not know how to manage.
15. Bring the best out of them - every person has a weakness and has loads of strengths. Work on their weaknesses together. If they are shy, ask them to present a case to you. Then ensure they present the same case to the registrar. Then to the consultant. They will become very confident this way.
16. Help them do discharge summaries. When they are part of the clerking team, take over their jobs and ask them to clerk. So that they learn how to see patients. If you do it once or twice in every shift, they will eventually gain enough confidence to work as a SHO.
17. You should be their friend rather than senior. Ask them to be open to you about anything they want to discuss. Point them to the right teams if they have concerns.
18. Emphasize that they should come on time and leave on time. Help them become more organized ( by actually giving advice rather than just saying 'you should be more organized' and then walk away). Help them complete jobs on time. Show them how list jobs from the ward round, what is the priority and what can be done later. Help them with the smallest of things to ensure you all leave on time.
19. Guide them on their career pathway. Do not force them to give exams - encourage them to take a year out and see what they want pursue. Guide them about exams IF they want to give them. Show them that they do not have to do a tough specialty and things will get easier with time.
20. FY1s are NOT the donkeys of the ward. They are here to learn. Make sure you give them plenty of opportunities. Ask them to assist you in lumbar punctures, chest drains, etc. Ask them to observe bronchoscopies, OGDs, etc when you are well staffed on the ward. Ask them to sit in clinics with consultants when there is nothing much to do.
21. Make sure you arrange ward get togethers and ensure the FY1s attend. They will open up even more you and will feel that they are well supported.
At the end of the day, treat them like your family - like you would want to be treated by your senior colleagues.
FY1s are the worker bees of the NHS - without them, it would all fall apart. Take care of them so that they can take care of the whole trust and do not break down - They have a long way to go but with your support and kindness, they can be amazing doctors.
FY1s are the worker bees of the NHS - without them, it would all fall apart. Take care of them so that they can take care of the whole trust and do not break down - They have a long way to go but with your support and kindness, they can be amazing doctors.
Comments
Post a Comment