Top Tips for FY1s – Acute Care Guide

Top Tips for FY1s by Fergus Taylor

Congratulations on starting work as a doctor. We can’t cover everything, but Medical School will have prepared you for most. As you put this into real practice, whenever you encounter a new real scenario, (e.g new AF), a good bit of advice is to look at the guidelines at the time, check you’re not missing anything, and then to look back on it a while afterwards to help cement your learning for next time.

It’s good to be aware of the Tayside Guidelines for this reason and you should save them somewhere you can access, like the Staffnet homepage. It also saves you a lot of time over 2 years if you save your clinical system links too..

Some clinical system links..

Each department will have its own induction focused on the things they think are important, and this is summarised in the Junior Doctor’s Handbook.

Basic clinical procedures are described here, but are perfected through the sheer volume you’ll perform as a junior doctor. There’s no shame in involving other more experienced team members if you’re struggling with a cannula, there will always be another one, and your team members should remember this.

The theme running through the Acute Care Guide is this – If you’re not sure, get help. You should remember this throughout your first year. It might be embarrassing to do frequently in practice, but the most important thing for you to learn is what your personal competencies are. Patient safety is the overriding principle, and if that means you need to ask a lot of questions early on, then do so. As you experience more, your confidence and competency will grow, but every doctor has been through this learning curve – multiple times throughout their training.

Find a support network for yourself. The job can be both physically and emotionally taxing, hours may be much longer then you are used to, and you will be highly focused on everything you are getting wrong, far more so then the hundreds of things you are getting right each day. You will need to find ways to process and deal with the stress of this. A group of people, (family, friends, colleagues), you can talk to is crucial. NHS Tayside has a number of support programs, including an FY2 Buddy system, confidential staff wellbeing service, and an occupational health counselling service. You should make use of these if you need to.

Enjoy your time off. For many of you this will be the first time you’ve had a significant salary after years of financial stress. Use your annual leave to do something you’ll enjoy, be that a holiday abroad, cooking classes, evenings out.. You’ll be working hard and should reward yourself for getting through the new job.

The vast majority of what you need to learn, you’ll learn as you go along. Pay attention to what’s going on around you, and what people are trying to teach you. (This patient has a new fast HR. Do you know where to find the ECG machine?) Have a look at the Acute Care Guide topics as you need them, talk to your colleagues in the mess whenever you can, and ultimately try to enjoy this time during Foundation. It will go quickly, everyone is in the same boat and you’ll learn a lot just by turning up. Good luck.