To not want to be on call on my first day back?

[Fivemoreminutesmummy]

1st AIBU- please don't be too harsh but genuinely would like responses.
I have been on maternity leave for 13 months and am due to go back early next month.
I'm a doctor (trainee GP) currently doing the hospital part of my training.
There's an induction day 1st day back as it's changeover for all doctors but I was asked to swap into an oncall that day. I said no as I did not have computer passwords/ ID/ door codes etc. And also mainly because I feel totally unconfident doing so. I'm going back to psychiatry and have only 2 months experience a long time ago in this department.

It's all about seeing and assessing patients and making judgements about complex medications and whether they need admission. I feel unable and terrified about doing this.
Add to this the practical problems of being unable to log on to computers to even check their blood results etc.
There are other trainees starting that day (most actually trainee psychiatrists) who have worked in different hospitals so will at least be able to safely assess and manage the patients.
I guess I'm scared about going back to something so intense when I've spent the last 13 months singing twinkle twinkle and thinking about nothing more than babies.
I also feel it will be quite unfair on the poor patients that see dithering me.
AIBU to insist that it's a NO to the swap or shall I suck it up and get in with it?
Sorry for long post.

[HecateWhoopass]

Are there no procedures in place for a return to work after a long absence?

[QOD]

Yanbu

Madness to drop you in like that!

[Ragwort]

That sounds totally unreasonable in any profession but completely shocking for a doctor - I would ask the HR department (there must be one in the hospital/surgery where you work ) to clarify their return to work policy.

[PessaryPam]

This is the NHS, who brought us Black Wednesday every year.
www.bbc.co.uk/news/health-19080449

[Fivemoreminutesmummy]

Thankyou! They don't care at all as long as rotas are filled. They would honestly put a medical student on call if it were legal.
Maybe there is some return to work thing- I'd not even considered that. I'll have a look.

[HecateWhoopass]

Your life in their hands, eh?

[Fivemoreminutesmummy]

I know! At least I'm the kind of doctor that knows I don't know IYSWIM? There are some that are unaware and I think that's worse. Especially in psychiatry which is pretty unique and separate from other hospital departments.

[Kundry]

Sorry I am a doctor and although YANBU to not want to, YABU to expect it.

If you are able to go back to work, you are able to go back to ALL of the work. There is no phased return from mat leave, it's not like being on long-term sick where you might not be up to the job! Plus you are going to be a junior doctor on the rota - so there will be seniors for you to ask. Everyone expects juniors to ask lots of questions when they are first on call in a new specialty and less as they learn and gain experience. You aren't expected to know everything - that's why you are training.

We try to put the more experienced drs on our rota first and the junior ones later but the bottom line is there needs to be someone on the rota there everyday, we can't accommodate individual variations and we expect you to be professional and ask if you don't know. The patients need to see a doctor and a new doctor with babybrain backed up by a senior dr is a lot better than no doctor at all.

[BeebiesQueen]

kundry, I dont think she is asking for a long term phasing in, rather not her first shift to be on call in a job she hasnt done for a long time (I read it as longer than the 13months mat leave?)

by the sounds she would be happy with her 2nd shift on call when she has done the induction thing and got her passwords etc, surely thats not too much to expect from any employer, even the NHS

[Fivemoreminutesmummy]

Ah but this is a swap that I haven't agreed to. Plus there will be lots if other more competent people available that I think would be better. Also, everyone will be in induction so I will be bleeping the consultant out every 10 minutes (no registrars at this hosp- don't know if that's normal for psych)
I think if I was just on the rota I would have just done it and not said anything but it's more the fact it was a swap request, I said no, and then it appeared on the rota anyway.
I do take your point though (and fully expect to end up doing it.)

[MorganLeFey]

I'm a junior doctor too - although pre Maternity Leave!

I don't think saying no to a swap into an on-call on the first day back is unreasonable - you've been away for more than a year & the Trust will also want you doing all the induction-y things to be uptodate with manadatory training & having all the logins etc.
If you hadn't been there before & weren't on Maternity Leave they wouldn't be asking one of the brand new-also-being-inducted doctors to miss induction to be on call - they'd be sorting it how they always do... a locum, a LAT/non rotating doctor, seniors acting down etc. Quote back some HR spiel about the importance of induction / patient safety issues to them?

But being on a long day after induction has finished is fair game & can happen to any of us at any changeover.

Good luck!

[Shapesorting]

Doctor in training here too. Don't worry about being inexperienced and lacking confidence, the consultant on-call will be there to give you plenty of support and they won't all need to be in induction all day.

You can do ten Keeping In Touch (KIT) days during your maternity leave. You get paid for them and you'll be supernumerary. You could contact the head of the dept and ask to shadow the on-call doctor for a couple of days before you go back, which will give you an idea of the way the department runs. You could probably get all your log-ins sorted too if you give people some notice. Sorry to be harsh, but why are you asking Mumsnet about this 2 weeks before changeover instead of phoning your HR department?

[awaywego1]

It's ridiculous even from a purely practical point of view in that you will need to get I'd card, computer ID etc. if you are on call hopefully it will be possible for you to get these things sorted early on but it will be tricky for you if not.

[Fivemoreminutesmummy]

I'm asking MN because I only received the rota today and was a little surprised to see the change highlighted. Also I genuinely didn't know if I was being unreasonable so rather than shout the odds at work, I thought I'd canvas opinion first (that's what AIBU is, isn't it?)

[Kundry]

Swaps are different - and you would be entitled to say you can't swap due to eg childcare. however I'd always be wary as you'll want a swap or a favour yourself at some point and you don't want to be known as the person who doesn't swap IYSWIM. Especially if most of your colleagues don't have children so will never need to take carer's leave. 4 months can be a long time if you and your colleagues don't get on (been there, bought the T-shirt)

Plus have you ever to an induction day that wasn't mind-numbingly boring and largely pointless? And I speak as someone who teaches on induction

[Shapesorting]

Sorry, that came out harsher than I meant it to.

YANBU to expect them to put the person with most experience on call on the first day. YANBU to phone up and say, sorry, you're not doing the swap, you've already made childcare arrangements based on the original rota (assume you'd be on-call past 5pm). However, KIT days would have sorted a lot of the problems you've highlighted, so YABU to not have found out about them already, sorry.

[Fivemoreminutesmummy]

I'm pretty good with swaps (largely because I don't have a life post children so don't have any exciting weekends away/ nights out booked etc.)
I've emailed the rota secretary asking for the consultant's email who is on that day- at least I can explain that I don't feel very confident and might need a bit more support.
As for passwords and ID and door codes, I'll stumble through somehow. I wasn't exactly looking forward to going back but I'm dreading it now.

[scottishmummy]

do your reading,brush up your psych practice,bnf stuff
why do to think you'll be dithering?significant part of rotation is prep and thinking I can do this
you're not completely novice,you are qualified you've taken history,you know how to assess and ask criteria for admission. you need to nor expect to rock up thinking you'll be dithering wreck.and no baby brain excuses either.you'll be fine

[scottishmummy]

you need to lose the dread, it will be apparent and do you no favours
read up,do courtesy call to consultant briefly introduce self,say you're looking forward to it
seriously though all the dread is not right way to approach this at all.sorry but no one wants to see a trainee the I'm dreading it,rather be someplace see vibe.get a grip on yourself.can you network ask other trainees for tips etc

[wreckedone]

It's a pain, but someone has to do the on call I guess. Hubby is in a&e and moves to new hospital at beginning of February, he's on nights finishing job at old one, so will work 20-08 monday and tuesday, then have to drive straight over to new hospital for induction 09-17 wednesday, then he's on long days thursday-monday (07-21).

[thebitchdoctor]

GP trainee here too (although out of hospital thank fook).

YANBU to say no but YABU (a bit) to be surprised you've been asked. The rota coordinator probably doesnt know you're coming back off mat leave and I assume you're a reasonably experienced SHO they probably expect you to be more confident than an F2. Espesh in psych in my experience where there are constantly gaps in the rota that they constantly bully ask us to fill.

Are you on call for wards or A&E?

If you're on for wards the psych nurses will help you out, they're very experienced and helpful. Just explain your situation. It'll be mainly clerking in, so revise your psych histories and get up to speed on prescribing rapid induction meds.

If you're on for wards I would hope you will have an RMN from the crisis team to come and do the A&E assessments with you.

In my experience yes it is typical for there to be no physical psych Reg cover on call but they are always contactable by phone. To be honest they will probably expect you to call after every patient you assess initially to go through your plan and the crisis nurses are excellent at guiding you with your plans.

You will be fine, I think Psych's actually a decent one to come back from off mat leave because you can ease into the working lifestyle without having to worry to much about medicine stuffs. Also, what will your day job be? Most GP trainees in my region get community psych posts with a lot of downtime so lots of AKT revision opportunity if you haven't done it yet. (I did mine on Mat leave).

Good luck, you'll be fine :)

[Awingandaprayer]

YANBU I'm a consultant psychiatrist and where I work we would not expect you to be on-call in your first few weeks. GP trainees or new trainees would normally get a few weeks to complete their induction and learn about the essentials before being on-call. It might be a mistake. I'd call medical staffing/hr and if no joy approach your consultant to see if there's a way around it.
Having said that, if you don't have any luck, don't feel afraid to call the consultant for anything, even at 4am. We expect to be called in psychiatry much more than in other branches of medicine where the junior trainee would rarely call the consultant direct. If there are no registrars in the place you're working they'll just be glad its you rather than a social worker calling them out for a MHA in the community somewhere! I'd expect a new trainee to talk through all patients for several months before having to make even a simple on-call decision alone. Also most places will operate with a crisis team as first line so you'd have them to talk to too.

Hope it gets sorted out and you enjoy your placement.

[divegirl77]

I read the title and thought I bet it's a junior Dr. Sadly I see HR/rota masters haven't changed their game since my time in the hospital rotas. If this a swap they have then done without asking YANBU to say no but I agree if all juniors are changing over I stunned it didn't occur to you that they would ask. Keep in touch days really would have been appropriate (and negated the password etc issues) and I would consider this a learning point - you have plenty to reflect upon in the eportfolio (I know I know, but even though I am far from a natural "reflector" I do think it has in some ways made me a more rounded GP).

[Fivemoreminutesmummy]

Thanks everyone for your input, I think I've got my head around it more now. I was just a bit surprised on Friday when, despite saying no to the swap, my name was on the rota.

I've rooted out my psych books and am going to do some catch up over the next week. It's only a 12 hour shift at the end of the day so it can't be that bad!

Thanks again