#im just ranting. but i get it! im not sitting here with a clipboard scoring internet users on the retweet/reblog olympics

[xannerz]

snark ahead

idk its just bonkers to witness how often ive seen tunglr users easily 'spread this like wildfire!!11' w/ like the most commonplace/preaching-to-the-choir stuff on here and at a certain point it feels wildly performative and self-congratulatory like there's a psa quota we have to reach-- but when it comes to AZE and TUR violence on ARM ppl suddenly start muttering awkwardly and hem and haw with this very quiet but very transparent ohhh-jeez-i-dunno-maybe-it's-both-sides-isms and i think i know exactly where it's coming from, but i also kind of dont care b/c it's not an excuse lol.

and ik this sounds more vaguely accusatory than intended so ill just idk. clarify?? that im not coming from that annoying and pervasive 'x people should and can rb this/you're bad if you don't rb every post about This Thing' angle i see all the time on this site, either. it's condescending and creates this weird artificial pressure on people and makes individuals feel like their Social Justice Quotas are being unmet in the panopticon of the internet --- and i can go on and on and on about why i think that messaging does more harm than good, but im rambling now and that's besides the point.

idk im just tired? like that disconnect btwn western ppl/journalism and the rest of the world. it takes 2 seconds to google shit and if you have any basic media/news literacy you could easily reach the conclusion that: "oh ok what's happening to ARM is fucked up actually and it's literally another genocidal land grab by AZE on behalf of big brother TUR." but you see enough hand wringing and noncommittal language across soc media just enough, banging your head against a wall is preferable to sifting through all that noise.

[dxmedstudent]

Hi dxmedstudent :) i LOVE your tumblr and appreciate all info and advive you give js, as well as your stories 🤗. Im a final year med student. Can you please give me any tips on how to best prepare for F1? And also any advice you'd give your current F1's? Thank youuuu x

Aww thank you! I’m really humbled! I’ll do my best in the future :D Soon I’m sure you’ll have stories of your own to share.

I give too much advice to my FY1s, sometimes my time with juniors feels like a stream of consciousness conversation in which I’m just trying to make their lives less horrible by giving them all the tips I can as much as possible. But I can’t remember it all off the top of my head XDPrioritising is so important. Deal with urgent or time sensitive jobs first, then order the rest in order of how much it will change what you do today. So, bloods and imaging are important, as are reviews by other speialties, and collateral histories. But if you are swamped, always remember what is likely to change my management plan here and now? What is the most clinically urgent?

First do the most urgent jobs; this may even be during ward round. Reviewing anyone who is sick goes into this category. Requesting urgent opinions, doing urgent bloods or urgent investigations, goes here.

Then jobs that you want to get back ASAP (requesting imaging, doing bloods).  If your nurses can’t do a blood sample, and your phlebs won’t, then you’ll have to do it, but remember it will take 2 hours to come back, at a minimum, so prepare accordingly.

I request things before sitting down to do the other jobs like phoning different specialties for routine referrals, speaking to relatives, getting information from the GP etc go here. Therse are the kinds of things

EDS/TTO/TTAs should be left til the end of the list, as should reboarding drug charts, updating relatives that nothing new is happening. However sometimes non-clinical urgency (bed managers hassling yout to send  people home, relatives telling you ‘I want an update but I am leaving in 5 minutes’) may push it up your priority list so you have to deal with it sooner.

some things can wait til tomorrow, if you can’t get everything done today.

Aim to keep people safe. That is the most important thing.

Don’t be afraid to hand over to the oncall. It is what they are there for.

Don’t stay later than you have to. We all get crises sometimes but we shouldn’t make it a habit.

it is really hard to organise yourself at the beginning, so if you end up staying late or feeling like there are too many jobs, please remember it is hell for everyone at first, and it will get better. You will become so organised!

General tips:

be nice to everyone. befriend the staff as soon as you start FY1. Everyone is a teammate and deserves to be treated as such. And if you treat people nicely, they are much more likely to help you, too.

If you want something to happen, send a request. If you want it to happen faster, phone them up and have a chat. If you want them to bend space-time and make it happen right now, walk down and see them personally.

If something doesn’t happen when you expect it to, call them up and ask why.

If something was requested by someone else, assume it may have gotten lost in the void, and call up/have a chat to ‘chase’ where it is up to. Unfortunately, for some reason, half our job is chasing things that other people are meant to have done. You requested it, but that’s not enough. Your seniors will expect you to chase to make it happen.

be a team player with your other FY1s. Some people will be snakes, you can only let them do their thing. But try to make friends and support each other.

Mental health is important, and you are too. If you are struggling, it is very common, and not a reflection on your own worth as a doctor. Look after each other and reach out; you are each others’ support network.

Tea and Empathy and the Junior doctor contract forum are two groups for UK doctors on facebook, and honestly two of the most useful sources of doctor information and support that I’ve seen.

Bad jobs and mean seniors will happen, but they will end. They are not forever.

Carry a clipboard full of any request forms/paperwork (like DNACPR, drug charts, continuation sheets) that you will need in your daily work. I don’t carry one now because you get ribbed for carrying one as an SHO and an SHO shouldn’t be having to do as many ward jobs, but it was honestly so, so useful that I held onto mine for like 3 years. Your consultants will think you are the most organised person ever, because whenever they need a form, you will spirit one up out of nowhere.

You can also print out the most commonly used protocols in your hospital; for example ACS, falls, head injury. So you can keep them in your folder and refer to them at a glance. If not, they will always be on your hospital intranet but make sure you familiarise yourself with how to find them easily. There’s a guideline for almost anything.

I keep an acute medicine handbook on me for oncalls, but a general pocket guide can be useful.

download any apps that your hospital uses (e.g  microguide for antibiotic guidelines). Download the induction app; people upload the internal numbers and bleeps for your hospital.  They are a godsend. The MDcalc app is wonderful for remembering how to calculate Wells scores and CHADSVASC etc so you don’t have to at 3am. The BNF app is amazingly useful; I used to carry a pocket prescriber book, but not any more.

I have a tag called #tips for new docs which might be useful for you. I try to lump my ‘how to survive night shifts’ style posts over there. And if you have any questions about FY1 life, or if you just need to rant, , I’ll always be happy to help.

Hope this helps :)