Authors: Gavin Tunard, Charlotte Davies / Codes: CC1, CC12, CC14, CC15, CC24, CC4, CC6, CC8 / Published: 01/09/2014
How to be a good registrar
Theres a lot of tips out there for surviving as a new doctor, or as an old doctor. The transition from SHO to SpR is something that many are ready for, and many have picked up their own tips for. Some people are a little bit more apprehensive, and would appreciate some more tips. Here are a few suggestions from the @slemfoam team with special thanks to @240minDoc.
This is written much better here:
1 – Get a good handover
When you start a shift, make sure you know the plans for patients, and follow the plans up. Check for results, and when theyre back, prompt the doctor.
Walk round the department so that every member of staff, porters, nurses and doctors know who is in-charge for the shift, and who to get in touch with.
Have a look in all hidden cubicles and corridors and find the sick patient that no-one knows about.
2 – Encourage discussions with the juniors
Make sure they know they can, and should, ask you about patients. Chase them up if they dont. Talk through your logic, so they can learn for next time. Signpost them to appropriate learning resources and protocols – and make sure they know about @slemfoam!
3 – Review patients
You get told to always see patients that are discussed with you, and its difficult to. See the first patient every junior discusses with you, and then you get a better gut feeling of the juniors capability. If something doesnt sound right, the junior asks you to, youre not sure or it just doesnt make sense, be more likely to see the patient. Be extra careful with children – even if youre just asked to review an x-ray, check the right body part has been imaged.
4 – Encourage Breaks
Even when you dont feel the department can handle it, remind your juniors to have breaks. Remember HALT – youre more likely to make mistakes when you are hungry, angry, late or tired. This applies to you as well as your team!
5 – Solve problems
If someone tells you about a problem, solve it there and then, and dont try and brush it under the carpet. If you hear about an angry patient, or a patient that doesnt want to leave, go and see them – you can often nip problems in the bud.
6 – Know who you can ask for help
The medics, surgeons, orthopods etc., are there to help. If they refuse a referral go and see the patient, then speak to them. You can then identify whether your junior needs some help with referrals or whether the specialty registrar needs some guidance.
7 – Err on the side of caution
If youre not sure whether a patient should go home or should come in, always admit the patient. Theres no prizes for sending people home, but a lot to be lost by sending them home too soon. If your junior thinks youre being overcautious, and youre still not sure – admit the patient anyway – theyve asked for your advice because theyre not really 100% sure.
8 – Maintain your portfolio
This is a pain, but really needs doing. Get an app on your phone to log all your FOAM, and procedures. Make sure you know what assessments need doing by the end of the year – I get google to pop up with the list once a week to remind me. It doesnt work, but anything is worth a try.
Theres lots to try and get done. Think about having a learning month, an assessment month, and an ultrasound month – and rotating them all around.
9 – Party
Organise the departmental parties. Theres nothing like a party to break down barriers. Make sure youre not too friendly with the juniors – once crossed, the line between friend and senior can be difficult to cross again – and respect is difficult to re-earn.
Its also a good time to make friends with the rota coordinator…
10 – Lead By Example
Pick up the patient nobody wants to see at 07:30 after a busy night – it gives you kudos with juniors & nursing staff. If they see you with your game face on they will follow.