Transcript Being a medical reg

Being a medical reg
Avinash Aujayeb
To be, or not to be: that is the
question: Whether 'tis nobler in
the mind to suffer the slings and
arrows of outrageous fortune, Or
to take arms against a sea of
troubles, And by opposing end
them? To die: to sleep…..
William Shakespeare
(Hamlet 3/1)
8pm local DGH
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Handover
Hospital full
Patients in corridors in A and E
12 waiting to be seen in MAU
Ward has 4 critically sick patients
Day reg in middle of an arrest
Night SHO has rung in sick
• Familiar??
What do you do?
• Run away
• Break down, cry and try do your best
• Resign there and then
• Prioritise, you know your strengths and
limitations and rally the team round you?
Role of the med reg
In my own words :
A leader
A manager
A nice person with maybe some extra
knowledge/skills ( some obscure fact about fabry’s
disease in all likelihood) but the confidence to
apply that knowledge and skill
1. Do not re-invent the wheel
2. Do the simple things right
3. Ask for help
My time
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Acted up as ST 1 for 4 months
ST3, ST4 in 2009 with ITU experience
OOPE for 12 months
ST 5 in tertiary care, ST6/7 now
Pleural fellow next year with CCT at some
point
Anecdotes…..Case 1
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St3 SRH
Cardiac arrest
Notes given- bilateral PEs post hip fracture
Thrombolysis
15 min into arrest, realise wrong patient’s
notes in my hand….
• What do you do now?
Case 1
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Speak to family that night
Admit fault
Coroner’s inquest
Press present!
Praise for openness and communication
No harm done
Case 2
• 47 year old with sepsis (background severe
learning difficulties)
• ITU review- to keep on ward
• Speak to family- explain situation
• Get consultant involved
• Patient gets worse, goes to ITU and dies
• 2 weeks later- formal complaint- “Dr Aujayeb did
not listen to us and did not realise X was really
ill”
• What do you do now?
Case 2
• Rationalise
• ?Scapegoat
• Good documentation saved the day ( do
simple things right)
• How would you feel when that comes in
and your supervisor says “ can we have a
quiet chat please?”
All doom and gloom??
You get presents!
• 8 bottles of sherry once…
• Always biscuits/chocolates!
•Great time on OOPE- Oz,
Nz, Asia, Africa
•Lots of spare time
•Publications
•Surveys/Audits
•Protected study timedegree in clinical education
•Good group of friends
•1 year or more in placesform relationships with
other staff- job offers now
•Flexible training
opportunities
•Fingers in many piestraining, teaching, MRCP,
deanery, IMG support,
GMC fitness to practise
•No overall
responsibilities??
Your ideas, concerns and
expectations now
• The buck stops with me overnight. How do
I cope with this?
• What can I take on or delegate? But the
F1 is so busy….
• Inability to do that chest drain or that
pacing line
• Thanks for listening. Questions?