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Hello again

What a surreal day. The goody two shoes kids from medschool who never did left wing politics are finding themselves having to organize a picket. Expect not my year- it's been ten years since I graduated now and my year are nearly call consultants or GPs by now. I'm still a registrar, but that's because I am training part time in order to do research in the rest of my time.

We aren't striking in Scotland. And I'm glad of that. I hope they find a compromise.

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Latest reply: Nov 30, 2015

Sticking my trunk back around the door..

I've been away from h2g2 for a while. But I thought I'd pop back. When we first 'saved the site' there was a time when all we did was live and breath h2g2 for a while. Then when I stepped down and left it in Pastey's capable hands I guess I needed a break.

There's things I miss about h2g2 though, so I'm going to pop back.

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Latest reply: Feb 7, 2015

Day 8 Onwards - the rest of the month

Well I missed a couple of days, I'm going to carry on keeping a diary in a single thread, because it could be interesting.

Where was I?

This week is 'hours monitoring week'. There are legal maximum hours that junior doctors can work in each week. Every so often we have to submit a form with our exact start and finish times on it for a whole week. If we go over the maximum number of hours the hospital pay have to pay you more. At some hospitals there's a pressure to finish on time in hours monitoring week, 'can't you leave your paper work this week'. But not so here.

Yes I have stayed late, though that's at times because I've been gossiping with my colleagues instead of working during the day, because I've wanted to update families who work during the day and can only visit during the evening, and because I'm inefficient at times. I don't mind being inefficient, all it means is that I have to stay until the job is done. Which I do, and I don't mind doing it. Anyway this exercise is taking place got me thinking about what is work and what is fun.

Oh yes, Just recently it's occurred to me that most of my time is taken up with stuff that most people could call work. But is it really work?

Obvious being in a hospital taking care of patients is work, and that's what goes down on the form. Is sitting in the coffee room chatting to my colleague work? probably not. Sitting down and drinking coffee and chatting to a junior about their personal problems - again probably not work. Then there's things I do in the evenings, proof reading a paper, helping with other papers, and writing my thesis. Well that's not officially work according to the hours monitoring people. What about going to an evening seminar at the Royal College of Physicians? Well that's officially not work either.

I'm working this weekend, having next weekend off, and then after that I'm working two weekends in a row. I get a good hourly overtime rate for the second one so I don't mind. But that counts as work, and it's illegal to take more than 12 days in a row without a day off. So I have to use up my annual leave in the middle of the week to make it legal. Oh well. never mind. And I'm going to spend that time working on my thesis.

I always knew that writing up would be a difficult time, and fortunately I'm nowhere near burnout. The clinical work is sufficiently different from the academic work that it feels like two separate things. A few years ago I was talking to Prof D, my PhD supervisor and he said 'to make it as a clinical academic it only works if the research is a bit of a hobby, because it's basically all done in your spare time'

smiley - mammoth

So the seminar. The Royal College of Physicians of Edinburgh is one of the hallowed halls of medicine, it it is in a big Georgian house with interiors by Robert Adam. The first time I went there it was for the membership ceremony, the graduation from the MRCP exam. I was so excited to be actually in this amazing place. Now living in Edinburgh I seem to find I go their quite a lot. For physicians in Edinburgh it's a cheap place to have meetings, it's fairly central and most people can walk home. Not so glamorous any more.
The last meeting I went to was about improving patient safety, it was meant to be for trainees and consultants, I went along because I thought it looked interesting. And because I'm aware that I might end up in a hospital that isn't such a great place for patients, and the choice is either to leave, continue to give substandard care, or to make things better. I need to learn how to make things better.

We had a talk about the general principles of improvement and the aftermath of the Francis report, then about the medicolegal side of what to do if you have to become a whistleblower, and finally a talk from an ITU nurse who had talked about giving the care that people wand and need, not what we've always done. The Q&A ended up being mainly about visiting times!

Tomorrow I'm on call, and I'm going to have to try and write down what I did, in a way that doesn't breach anyone's confidentiality. I may end up talking about biscuits a lot.

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Latest reply: Nov 9, 2013

Day 5: Social media through the ages.

Another day that consisted of work and of doing my thesis in the evenings. I really am struggling here, so going to talk about work, and twitter. As I mentioned previously I currently have two followers on twitter who are consultants at the current place where I work, and because of GMC guidelines I have to be on twitter with my real name. So I'm online and everything I say is traceable back to me. If I post 'well works rubbish, we don't have enough beds' then a reporter from the Evening News could do a story on it.

One of the reasons I changed my h2g2 account from my old one, that I've had for some time, to my new bland one is that I have said things as a student that I'm not entirely comfortable with being publicly associated with. At first I was not entirely comfortable with this, because, well I thought I might have to censor my posts if they were traceable back to me. Turns out I wasn't planning on posting anything interesting.

Those of us that were on h2g2 in the early days (I joined in 2001) remember the early days of social media. When it was something odd, that only a few people did. When you mentioned that you interacted with people online they assumed you were some sort of geek. Why would you want to do that? You can interact with people in real life? When you mentioned that you were going to a meet people assumed you were some sort of axe murderer, or you were going to be murdered.

I could compartmentalize my life back then. I had h2g2 friends, medical school friends, elsewhere in Uni friends and home friends. And they never, ever met. I once when into a computer on the library and found that someone else had logged into h2g2 before me. That was surreal, very very surreal. I remember saying to Ben 'How odd would it be if it turned out that someone at work would know you on h2g2?'

Actually come to think of it I wouldn't tell people I met Ben on h2g2 back then, though I would now. Now meeting people online is normal. But now I am online as me, i'm online as me on facebook,and my h2g2 friends interact with my skeptical and medical friends. h2g2ers get on very well with skeptics for some reason.

smiley - mammoth

Anyway, getting back to the point. I was talking to Dr C today and we got talking about why she's so busy on twitter. Partly because it is instant interaction with people who aren't doctors. If you post something about an illness on twitter you get a lot of patients commenting on it, which really helps you seen things from their point of view. You see as a doctor you can never really see things from a patients point of view, because you are never really a patient, or a relative. And that's one of the things I've always liked about h2g2 - the opinions of all sorts of people, not just doctors.

In the good/bad old days, doctors said what happened and it happened. If you decided someone needed an operation, they generally did what you said. Now it's all about making decisions together. We're treating a generation that consists of a lot of people who are the used to the old kind of doctor. A few days ago I asked someone if he wanted a test doing and he said 'Do I get to say no?'
I know some patients find partnership decision making fairly irritating. (I expect my accountant to tell me about my tax affairs, my mechanic to tell me about my car, and you to tell me about my body), but I think most of the time it works.

Discuss this Journal entry [6]

Latest reply: Nov 6, 2013

Day 4: Mammoth struggling to find something to say.

I did lots of interesting things today, but I can't tell you about any of them because of patient confidentiality. First I went to work. I'm working for a new team, which consists of two consultants who job share. Except they don't job share - they see half the patients each. I remember when consultants seem to be god-like creatures, now they are my facebook friends, people I follow on twitter, and people I share coffee with. Gradually my peers who didn't do PhDs (or have babies) are becoming consultants. Susie and Trisha are Dr S and Dr C when on the ward, but definitely Susie and Trisha when not on the ward. And @Trish on twitter. It's a bit surreal to be chatting about patient care at 5.40, and then commenting on one of her tweets at 6pm. Susie doesn't do social media.

So yes, I did some stuff I can't talk about. Then I had lunch, then I did more stuff I can't talk about. Then I came home, and forced myself to do some academic work. I'm currently editing Chapter 2.2 of my Thesis - a systematic review on renal function and cerebral small vessel disease. It's just about ready to submit to a journal, but we're in the final polishing stage. Both my supervisors have added comments to it so I'm going through it making their edits. Today, because I was tired, all I could do was to correct the typos they'd pointed out. Tomorrow I need to reformat two of the figures, then do a final proof read, and then hopeful (hoping beyond hope!) it will be ready to submit to a journal.

Discuss this Journal entry [8]

Latest reply: Nov 4, 2013


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