Confessions Of An…A&E Doctor

Illustrated by Anna Sudit.
Most of us dread the thought of ending up in hospital, but there are some people who actually choose to be there.
It’s hard not to respect the work of doctors and nurses, especially the junior ones who earn a fraction of what senior staff make and work long hours under intense pressure. It doesn't get much more serious than looking after the nation's health.
Here, one A&E doctor talks candidly about the hours, upsets and daily tribulations of her hospital job.
What's the best thing about your job?
The variety of patients and activity, and working with an amazing team. Also, post-night-shift brunches are the best.
And the worst?
When things are really hectic, everyone is so stressed we all forget we're on the same team and people become really rude and snappy. It's understandable but rubbish because at the end of the day we're all just here to help the patients.
What are the most challenging and frustrating aspects of your work?
I find it very difficult when I feel that I cannot give the level of care because of the demands on the service and the strain on the department. When it gets overloaded, things grind to a halt and then you can feel like you're running around like a blue-arsed fly and it's not making any difference.
What are your working hours?
I work a 1-in-2 weekend shift pattern with 3-4 nights about every three weeks. Shifts are 10 hours long and can start at all hours.
What's a typical shift like?
Get changed into scrubs, report to the consultant in charge of the "shop floor". Find out which area of A&E you will be working in (minors, majors, paeds, resus) and then head over to see what/who needs seeing. Then it's seeing patients (take their history, examine, order/review tests, initiate treatment if needed and decide if they should come into hospital or can go home). Continue until end of shift!
Do you think you have the work/life balance thing figured out?
It's really difficult to achieve. Our holiday allowance is supposed to be 27 days per year. I have worked every bank holiday this year. You get a day off in lieu but you can only take this on a "normal day", which doesn't come around very often. And who else is free to hang out with on a random Tuesday?

I cried two hours after starting my shift; one of my colleagues spotted the wobbly lip and scooped me up.

How many breaks per day do you get?
Per 10-hour shift, we are allowed two 30-minute breaks. Although taking them can be a whole different issue.
What do you eat at work?
There is a staff canteen in the hospital, but it’s a 10-minute walk away from A&E, so good luck getting there, getting served and getting back in 30 minutes. That’s if it’s even still open when you're looking for food.
Can you remember your worst day?
It involved crying two hours into starting work. Just because of a combination of feeling out of my depth with a difficult consultant, a bad referral to radiology and a colleague snapping at me. Luckily one of my new colleagues spotted the wobbly lip and scooped me up.
What are A&E doctor salaries like?
Compared to the general population we get pretty good pay. Considering the number of hours, the antisocial side of it and the responsibility though...
How much training do you need to do your job?
Five to six years of medical school, two years of foundation training, then you can apply to do A&E training.

I accidentally glued a glove to a patient's head once.

Any embarrassing medical mishaps?
I accidentally glued a glove to a patient's head once. There was a cut on his scalp, and I glued it together wearing gloves. I was holding the cut together while the glue set and unfortunately didn't notice the glue dribbling onto my glove. Because we use superglue I couldn't get the thing off him, so he had to wander around with a stamp-sized patch of bright purple glove on his head.
What is the male to female staff ratio like in your hospital?
Doctors I think are about 50:50, nurses more like 20:80.
Most ridiculous thing someone has come into A&E for?
Generally the ones who come in because they "fancied getting this checked out". I would always encourage anyone who is scared or worried about their health to come to a doctor, because we'd rather tell you you're fine than you sit at home and let the situation become dangerous. But if you knew there was no accidental or emergency aspect to your problem, but you came to A&E – well, you’ve taken time and resources away from people who really needed them.
What's the most extreme case you've seen in A&E?
The trauma calls are often difficult – people who’ve been in car accidents, involved in stabbings, had bad falls down stairs. There's often a lot of blood and a lot of scared family members.
Do you ever think about quitting?
Yes. The workload is never-ending, you are out of sync with your family and friends, you see people going through really sad and bad things every day. And that means that when people (colleagues or patients) make you feel that your best is not enough for them, it's so difficult to face work.
What character traits do you need as an A&E doctor?
Ability to make quick decisions – if you make a decision you can always review it and change it. And a cool head. And you HAVE to like people, because you’re dealing with a lot of them every day.
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