A day in the Life of an FY1 - The Chronicles of a Foundation Year 1 Doctor

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I want to first clarify that actually no day is ever the same. When you think you’re going to have a quiet day, you’ll have a crazy one. The days you go in thinking it will be manic, often turn out alright.

The three cardinal rules of any working day:

NEVER say the ‘Q’ word! Eg. In a sentence, it would be: ‘it’s a quiet day isn’t it!’ Just don’t do it! The Gods of misfortune are listening…
Never turn up un-caffeinated. You don’t know when you’ll get your coffee break.
Eat lunch as close to lunchtime as possible. Again. See above for why.

My day as an F1 typically started at 8 am and finished at 5pm. There are exceptions of course, but barring on-call shifts and crazy days, that was the regular pattern. Luckily for me, I had a short commute of 1 minute from my room to the wards and so I would regularly wake up and turn up (as it were.)

The most important tasks of the morning (in that order) were as follows:

Greet and know the senior nurse in charge of the ward for the day.
Check the Early Warning Score (aka NEWS) for all the patients and check to see if there are any acutely unwell patients known as ‘sickies’. These need attention first and if sick but stable, need to be seen by a senior medical colleague sooner rather than later.
Check the board/ screen or wherever it is written on the ward for any new patients overnight – typically these need a detailed look through notes and the consultant will normally see them on their ward round so as juniors we need to be aware of them!
PREP THE HANDOVER LIST. Now. For those of you have never been on a ward or somehow have been on one but have missed seeing this lifeline of a sheet, the handover sheet is a junior doctor’s most prized possession of the day. On this list are the names, identification numbers, problem list, current management and any other specific detail relevant of every single patient on the ward. On this list is where the new jobs generated from the ward round go. This is the list you will refer to when you need to quickly remind yourself of a patient. If you find yourself in possession of one that doesn’t belong to you, either discard of it or find its rightful owner. And never never never leave it hanging around where non- medical people can get to it. Right, rant over!
Prep the notes of all the old patients.

Now by the time you’ve done all the above, it probably feels like the end of the day (LOL) But in reality, this only takes about 30-50 minutes to do. And you normally have a team of juniors to help with all of it.

It’s around 9 am and it’s time to start seeing patients. Most wards have dedicated days for consultant rounds and junior-led rounds. This was great because the consultant was always there to help out with difficult or complex patients and the sickies as well as the new, but you also got a go at doing your own ward rounds. The advantage of this was that you saw a patient’s journey from beginning to end and started making your own management plans.

Either way, every patient on the ward gets seen by a doctor every day.

At some point, either in the morning before the ward round or ½ way through it, we will have a multi-disciplinary meeting. This is where every morning, the nurses, doctors, discharge coordinators, therapists and anyone else relevant discusses each of the patients on the ward. The purpose of this being to see why they are still in the hospital and what the barriers to discharge are.

By the time the ward round finishes it is around 12 pm.

It’s time for lunch! But here is what I always do before lunch:

Check in with the rest of my team and go through the patients and the jobs we generated during the ward round
Do any urgent bloods/ ordering scans/ calls – basically anything that will delay patient care and potentially cause harm needs to be done first!
Check results that are back. Often blood tests are taken by the phlebotomists in the morning would be back in the afternoon so I always would check them.

Happy that the ward is okay, the team would go for lunch around 1 pm

On a less busy day, lunch would end around 2pm. Earlier, if we knew the ward was busy. Typically during lunch, there would be teaching and seminars we could attend or else just chill in the mess or hospital canteen with the doctors from other wards.

The afternoon would then be spent basically doing the jobs from the morning. This would include things like:

Reviewing a patient again who was unwell earlier.
Having conversations with family members.
Chasing results and scans that you asked for in the morning.
Asking other specialists for input for your patient.
Preparing discharge letters and medication summaries for patients likely to be discharged.

This would normally take me right up to home time at 5 pm, but I did always manage to squeeze in a small coffee break- even if it was for two minutes whilst I chatted to a nurse about a patient.

Before I leave I would always make sure to:

Check in with the team again and help out with any tasks they might not have gotten to yet.
Update the list! (so It’s accurate for tomorrow morning.)
Make sure that any urgent jobs that haven’t been done, get passed onto the on-call team to do.