To help support Foundation Doctors in their first shifts throughout August, we held a live Twitter chat with tips for new doctors from our Trainees and Members' Committee on Thursday 27 July 2017. Below are some useful tips from the Twitter chat.

Working efficiently on a ward round

  • Be organised before the round starts – ensure notes, forms and trolley are at hand.
  • Ask if you have questions – don’t be afraid to ask why a test has been ordered.
  • Involve students, they are keen to learn and help out.
  • Establish a routine so nothing gets missed.
  • Prioritise jobs after a ward round – request investigations and make referrals first, then prepare discharge letters.

Dealing with a sick patient when you don’t know what to do

  • Calmly call for help – remember you are not alone and asking is not a sign of failure.
  • If in doubt go back to the basics – ABCDE, bloods, IV fluids.
  • Ask a nurse to help – they can help you with tasks and provide support.
  • Take a moment to look at the patient from the end of the bed, sometimes this will tell you all you need to know.

Common things you may be asked to do when on call

  • Basic prescriptions – fluids, analgesia, antiemetics, insulin, warfarin.
  • Night sedation – make sure to understand why sedation has been asked for before giving to the patient.
  • Reviewing test results that were not available at handover – at handover ask why the test has been done and what action is required when the results return.
  • Document your actions clearly – it may not be your team who will see the patient next.
  • Remember on call can be fun too – you get to make decisions normally made by seniors during the day.  

Keeping on top of jobs and maintaining a work-life balance

  • Get through routine jobs quickly so more time is free if patients get sick later on.  
  • Prioritise things that only you can do before the end of the shift and handover other tasks, this way you are not worrying about them at home.
  • Prepare meals in advance and bring water and snacks with you.
  • Take breaks – it’s not easy but it’s safer for you and the patient.
  • Plan something to look forward to on your time off and make sure you always take your annual leave.

What skills to brush up on before starting the job

  • Get to know the local policies – referrals, prescribing, door codes.
  • Learn what you can from shadowing and ask lots of questions.
  • Get advice from outgoing FY1s and ask them to step back to let you become involved early on.
  • Sort out your sleep routine early – this will help with shift work.

Thank you to all who participated in our live Twitter chat. Remember that you aren’t alone, always ask and don’t be slow to seek help.

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