To think my NHS department is toxic?

[Thecolourandtheshape]

I work in the NHS as a doctor. I graduated last year. This is my third job and at the moment I'm stressed up to my eyeballs by the disrespect shown by my seniors.

Firstly, there is no fixed morning ward round. My registrars come to the office one by one and very quickly run round all the patients without giving us time to write down the plans or ask any questions. Then they'll text us throughout the day, giving us jobs they've just thought of, or asking for results they're perfectly capable of looking up on a computer themselves. Later in the day, various consultants appear totally at random and expect us to drop everything and do their ward rounds. They change the patient plans and suddenly give us a whole new set of jobs, usually including urgent scans that we then have to argue with Radiology to do. Then they go to theatre and are unavailable unless they want something from us.

Then the registrars and lower grade surgical trainees appear throughout the day, demand we stop whatever we are doing and come to "catch up" and go over what jobs we've already done, further interrupting us. I once had four "catch ups" with different seniors in the space of 2 hours, which wasted an insane amount of time and was immensely frustrating.

I have no control over my work or the structure of my day at all, and I'm constantly being dragged from pillar to post, e.g. sent to take bloods at 4pm on the other side of the hospital because my senior has changed their mind and suddenly wants them, and now I've got to hand over chasing the result to the pissed off night team.

The nurses in our team have their own office. We don't. But if we don't sit in the nurses' office and go to find a PC to use, they spread rumours we are shirking our duties. So the only alternative is to sit there and infantalise ourselves by asking to please borrow "their" computers.

Meanwhile the nurses in our team gossip viciously about everyone. I've been told incredibly unprofessional things, including some racist comments, and personal issues e.g. comments on X staff member being off with stress and how they're "milking it", comments that the consultants don't like a certain registrar, and comments that one of my colleagues is weak and doesn't appear to understand English (which is utterly baseless).

The consultants don't even know my name. I've worked here for nearly 4 months and the other day I was mistaken for a student, then asked what my name is. Another consultant thought I only started this week. They don't ask me about myself or even say "good morning" to me. They say "good morning" to the registrar and look through me. One of them has only ever spoken to me to shout at me.

I'm running around for 10 hr shifts being treated like shit on everyone's shoes. Today I didn't have lunch until I'd been working for 7 hours, and only because I absolutely insisted on taking my break.

I'm just so tired of the disrespect and chaos of my day. If they cared about me even slightly, they wouldn't treat me like this. Sometimes I wonder if I didn't turn up at work one day, would they even notice? Or would they just be pissed off that there's no one to drop their shit jobs on?

Spent all day mentally taking deep breaths and trying to focus on making my patients happy. But the more tired I am, the less I have to give, the more I go into myself. A patient cried today as I took blood from her, and I felt like the worst person in the world for upsetting her, but if I hadn't taken the blood I'd get it in the neck from everyone above me. I don't even really know my patients beyond what operation they've had.

Sorry. I'm so tired

I used to work in a Deanery and it's so depressing that the same issues are still being raised by junior doctors all these years later. I remember consultants saying they couldn't spare fifteen minutes to do a review with their juniors - that was only once every three months and they only had two FY1 maximum. There was also the issue of radiology holding things up. Hasn't it occurred to anyone that we need more radiologists or radiographers or whatever is holding up junior doctor time and patient treatment?

When I was in hospital with pancreatitis caused by gallstones, they actually had to keep me in hospital for several extra days because that was the only way to get an early ultrasound. What a waste of a bed!! The consultants also said I was nil by mouth but obviously didn't communicate this effectively as I was offered meals every day...

I agree with PPs that the consultants have too much influence on their timetables. Other consultants actually told me that. The really conscientious ones are brilliant, but it's also easy for some consultants to not work efficiently and effectively because they're not really accountable to anyone.

All I can say is I hope you won't be like that when you've finally got to the top of the tree. I also remember consultants saying that they used to be on their own overnight with loads of patients;; but as more enlightened consultants said, in those days people spent longer in hospital so there weren't as many really sick patients as there were more hospitals, and people stayed for longer, so there were more surgical patients just convalescing, rather than seriously ill.

@Thecolourandtheshape people will continue to treat them the way you allow. You must have an educational supervisor? Talk to them. Take your lunch etc

You are a valued member of the team and deserve to be treated as such but others will continue to take the piss if you let them . I have stood up for many things as a junior doc but was glad to leave hospital medicine and become a GP where you have more autonomy and there is less of hierarchical issues

As an F1, all the jobs you’ve described are your responsibility. You’re the most junior member of the medical team so unfortunately you have to dance to someone else’s tune until you are at a more senior level. However annoying it is, there will be a reason that the senior ‘suddenly decided’ they wanted bloods, and unfortunately someone has to do them. Don’t be afraid to push the job back on them though, or they will continue to take the piss. When I worked in acute medicine, I got into trouble a few times with my nurse in charge for suggesting a registrar (and at least once, a consultant 😁) did the bloods they were asking me, a nurse juggling 10 poorlies, to do while they sat in the office clerking. They did them though because they couldn’t produce a valid reason as to why they were unable to do it themselves when met with my 🤨 face!

I understand that you’re exhausted but this is the job you signed up for and it’s been a shit year. It’ll get better, but you just need to suck it up for now.

Whatever you do though, stay humble! You sound like a fab doctor 🙂

This is such bad state of affairs. This is what happens when you keeping feeding a beast that is accountable to no one. NHS really is not fit for purpose on so many fronts.

Sorry you’re having a shit time. It’s insanely busy. My advice is to make friends with the nurses, they can help you. Seriously.
Have you eaten? Down a pint of water and watch some shit on your iPad. Big hug.

Gosh OP just reflect a little about how the F1s speakntonthe patients. Last time Inmet one they were unspeakably rude. "I'll assume you are retired as you are over 60". Er no. And there was no need to speak to me as though I was semi literate as they did a wholly inappropriate frailty review. There was also no reason to question my concerns about having a broken back. Even though they were given a clear history re osteoporosis, similarity of pain, etc. There was no reason to tell me they thought I was wrong. There was no reason to ask me to carefully consider the risks of radiation when I requested an XRay. (Partocularly when their consultant said that despite their behaviour the senior reg who had to manipulate another bone would have ensured my back was XRayed in any event). Despite being told only the L1 had been fractured previously failing to tell me the T12 looked as though it had been fractured as well (clearly didn't think they shoukd share enough info to prove they had been wrong). They most certainly didn't need to tell me they had been to medical school and I needed to trust them.

In shirt op, you are newly qualified, very inexperienced, have very little humility and need to learn a great deal more. Be pleasing, nod and smile, realise your limitations and if you think your seniors are being rude to you, have a little think about your potential attitude to patients. the same patients who may be old enough to be your mother, professionally qualified, able to see through your inexperience and deserving of, frankly, rather better than an inexperienced and deeply arrogant F1 has to offer

From what you have written I can understand why some colleagues have been a little pointed and been very clear that they expect you to jump when they click. Grow up and start to own what you still have yet to learn.

Apologies for typos. But yes I had a broken back. Concerns entirely dismissed by an arrogant and inexperienced F1 who was also excruciatingly reductive and rude.

Keep your head up OP.

This is unfortunately pretty standard for surgical FY1. As others have said, feed back via your Foundation Programme director - in reality though this won’t change anything (certainly not for you anyway).

A few things that helped me during rotations that I hated:

1. Literally ticking off the shifts left on a calendar
2. Did an audit with my last department that I loved, portfolio fodder plus a reminder than not everyone is an arse(!)
3. Having dates in the diary/social events to look forward to every free weekend. Breaks up the months ahead nicely.

And ignore the poster above, who seems to pop up on any NHS-related thread with the same large chip on shoulder. At least it’s not the usual “call me Mrs” rant, mixes it up a bit!

I voted YABU not because I don't empathise, I do, and I would feel exactly like you in this situation. I hate petty gossip and having to run around like a headless chicken because others people are disorganised.

YABU because it's like this in the vast majority of workplaces at the moment, it's not unique to the NHS, sadly.

Any workplace in education, schools, FE and HE, the civil service, NHS, local councils, supermarkets, and e-commerce giants like Amazon has its fair share of bullies, politics and idiotic policies.

There is so much shit going on everywhere, so much pent up frustration and ludicrous management cultures. Most managers are not worth their salt, unable to actually manage. The worsening economic inequality in the UK plus all of us becoming zombies who are attached to our devices 24/7, fear on tap e.g. Covid, Russia, North Korea, global warming, lack of freedom of speech, it's insane.

Your workplace does sound shit but people gossip, it's incredible just how much they gossip, if you tell one person at work, you may as well tell the all place.

Hang in there dear OP. You are a wonderful doctor, keep going, look after yourself and try and find a niche where you can be happy. At least you are saving lives and really making a difference, you will always have a certain status as a doctor and you can help give medical advice to your nearest and dearest. Go part-time when possible and look at the long game. Many alternatives are equally shit or even shittier. You can do this.

It’s shit to have worked so hard to get to where you are to feel like you do. You are not alone and I can guarantee there are a lot of people within healthcare that feel the same. Like you said you have 3 more months left for the placement, keep your head down, do what needs to be done and then get out of there!

I remember after I finished my pharmacy pre-reg, I was wondering why the hell I studied to become a pharmacist for 5 years…still wondering that now haha.

But yes I had a broken back. Concerns entirely dismissed by an arrogant and inexperienced F1 who was also excruciatingly reductive and rude.

What does that have to do with the OP though?

Seems to have a similar, self important attitude and yet so much still to learn.

wow you are very bitter, again it's not the OPs fault.

It sounds very shit and frustrating, OP. And I don't think you sound arrogant, or like you're "above" taking bloods etc, just fed up with a chaotic system which you are at the bottom of. It's just shit. And not easy to change jobs either, for those suggesting that - if you quit an F1 post you'd have very few options for going elsewhere or making any progress.

There are probably things you can do to try to improve it, either your ES or the FTPD for starters, or the Freedom to Speak Up Guardian. Or escalate to the Foundation School. It will all take time though, so also try to work out ways of making the daily grind more bearable.

This won't be forever, and while life as an NHS doctor still has many flaws, it does get more bearable as you get more senior.

Your name pops up all over the place with the same disparaging attitude towards every HCP you’ve ever met, and always with the air that you feel they are beneath you. Perhaps you ought to look for a common denominator?

Doctors in Distress offers support for medics. It's anonymous.

doctors-in-distress.org.uk/

Offers peer to peer group support.

I wonder how much of it is misogyny? In our Trust its always the older male consultants who are the rudest.
There is no excuse for racism, I've told other staff and patients that racism isn't tolerated here and given them a hard stare, they have always denied that they meant any harm and apologised. Racism (and homophobia) I will always challenge.
Hopefully you'll be out of there soon.