Viewpoint: A taste of my own medicine

Rachel Brettell

doi:10.3399/bjgp18X699569

I was recently asked to speak at our local trust induction for the new Foundation Year 1 doctors. The thrilling subject matter I was entrusted to cover was discharge summaries.

When I arrived, there was an action-packed schedule essentially telling the new doctors what not to do, how not to get in trouble, and one talk (I wish I could have stayed) aptly entitled ‘how not to kill people’. The new recruits looked pale and clammy, and there was a definite sense of impending doom. Perhaps they were hungover, but, sadly, I’m pretty sure they weren’t.

I was tasked with imparting the importance of timely, concise discharge summaries, ensuring they avoid the dreaded phrase ‘GP to chase’ and know how to write a fit note. I’m not sure how helpful it all was — talk of dosette boxes as their minds swum with more pressing matters, like crash bleeps and, well, lunch. Maybe they took some of it on board, or maybe it all passed them by in a blur — either way I left feeling a bit deflated. As I walked away I realised why. All I really wanted to do was point them in the direction of the League of Friends, give them a big cuddle, and tell them they were going to be OK. I wanted to suggest they swap numbers with the colleague next to them — explaining they’ll probably be your friend for life and they’ll definitely get you through some rubbish shifts, emotional turmoil, and tricky cannulas over the next year.

So, when I got home I indulgently made a list of what I think actually matters. The advice I wish I’d known. The things I could have said that might have made those new doctors sit up and actually listen. It read as follows.

Be kind.
Always eat your lunch.
Ask when you’re unsure.
Introduce yourself by name.
Take your parents out with your first pay cheque.
Just as the needs of your patients matter, so do your own.
Find time for the things that make you happy.
Tea with colleagues is rarely time wasted.
Don’t leave your portfolio to the last minute.
Stop when you stop caring.
You are finally getting your chance to make a difference so enjoy the moments when you do.

It transpired that I wasn’t the only one thinking about our junior colleagues, with #tipsfornewdocs trending on Twitter. Online, plenty more sage advice was offered than mine — which comfy shoes to buy, how to avoid getting your pen stolen (keep the lid — what a revelation!), and why we should all make tea for each other. Haikus, videos, lists, and gifs abounded, as many reminisced about the early days of a career that, despite it all, they’ve stuck with. Alongside the black humour, something important was being said. The fact that making the world a better place is a feeling you can’t buy. Reminding us that whatever happens, however bad, depressing, or annoying, and however broken the system, the patient you’re seeing is still holding the short end of the stick.

And then it hit me, the advice I wished I’d given those shiny new doctors is the same advice I should be listening to myself, and the advice that we as busy GPs perhaps need to remember now, more than ever. I’m a little less anxious and a little more jaded than when I started, but the basics of kindness, compassion, and self-care never change. These online words of wisdom will be useful to our new doctors, but don’t all the rest of us need to remember them too?

So, if they ask me back to induction next year, I’ll probably still have to talk about structuring a decent discharge summary. But I’ll try to make time for a few extras too — why we do this, the difference we make, and what really matters. I’ll tell them about #tipsfornewdocs and all the wise words, fond memories, and insight being shared. And, in the meantime, I’ll be printing my own list out too, to stick up above my desk in surgery. Hopefully I’ll glance up when I’m next having a tough day in the hope that it might prompt me to go and make a cup of tea for myself and a colleague. Maybe we need a new hashtag too? #tipsforalldocs

View Abstract