Life and loathes of a new doctor: Carry on nursing

When you eventually start working, forget about trying to impress your senior colleagues. On the surgical wards, especially, you never actually work with them. They appear for 10 minutes each morning and evening and spin round the ward, glancing over each patient. As long as the patients still look pink and responsive, the surgeons are happy. The people you work with and rely on all day every day are the nurses. These are the people whom you dont necessarily need to impress--after all they cant write you a reference--but they are the people who can make your life very difficult if they want. After a few shifts you start to realise which nurses are superb and know more about basic patient management than you ever will; the ones who do everything by protocols regardless of the harm it does; and, more annoyingly, the ones who take no responsibility or who are generally unhelpful.

The average surgical ward day is timed like a military operation. Patients are continually coming and going for investigations and operations. If it doesnt run smoothly then operation time is wasted and consultants lose valuable golfing time. When you first start work, many practical issues concern managing this continual stream of people, which they dont teach you in medical school. However, the nurses hopefully will have been on the ward for a while and can guide you through and keep the boss down in his theatre happy.

Never ever lose your temper with the nurses, despite the ridiculous things they may ask you to do. It seems to be worse at nights: Ive been paged to come urgently and see a patient with a fever of 37.2C. I thought they were winding me up the night they called me to come and take an Augmentin trough level. Most frustratingly was being woken at 4 am on one of the few nights I got to sleep, to prescribe gastrograffin for a patient going for a computed tomography scan the following morning at 10 am. Remember: no matter how daft the thing they ask you is--you asked even stupider questions during your first few days.

Stephen Goldie, medical preregistration house officer, Royal Alexandra Hospital, Paisley
Email: stephen_goldie@hotmail.com


studentBMJ 2005;13:89-132 March ISSN 0966-6494