Make your life as a resident doctor easier. Follow these 5 simple C’s when you take your first steps onto the ward floor.
Confidence in yourself is essential if you want to instil confidence in your patients. While you might still be training towards vocational registration, don’t let that stop you from being confident in your decisions.
Build this confidence by not shying away from opportunities to practise your skills, especially with the guidance or supervision of a more senior doctor.
However, one addendum to consider: being confident isn’t about knowing everything, it’s also about being able to admit when you aren’t sure about something—even to a patient.
Always follow up an “I don’t know…” with a “…but I will find out from our hematologist/cardiologist/specialist and get back to you”. Have confidence in your team as well as yourself.
Confidence is great. Competence is better. Competence will come with time and practice, but there are ways to speed up the process.
Firstly, always consult protocols, policies and guidelines if you aren’t sure about something—and double check even if you are. For example, performing an ECG test for atypical chest pain might seem like an unnecessary drain on resources, but in reality it ensures that potentially fatal problems aren’t missed. The rules are there for a reason, and following them is an easy way to develop competence.
Secondly, remember that competence is infectious. Spend time around the doctors you admire; learn from the way that they work. Imitation is the sincerest form of flattery, but it’s also a fast-track to developing competence of your own.
Lastly, remember that competence isn’t just about having medical knowledge—sometimes it can be as simple as always carrying a spare pen for taking patient notes when you inevitably lose the one you had in your pocket just this morning. It can be as simple as a quick but insightful chat with a senior nurse about a patient’s behaviour since you were away. It can even be simply taking some time to reflect at the end of a shift on your successes and challenges.
Anything that makes your colleague’s work (and your own) easier and your patients’ stay less uncomfortable can help you develop competence.
It’s essential to work in a culture where it’s encouraged to voice concerns and ask questions, regardless of who the question or concern is targeted to—whether that’s a senior specialist, a nurse, or a resident doctor like yourself.
This means you get the opportunity to learn from any and all comers. Don’t make the mistake of thinking that a senior nurse’s advice isn’t necessarily valuable —and don’t be afraid to ask “stupid questions” either. The answer might save someone’s life.
This culture of communication also ensures that people are willing and able to share up-to-date information about patient circumstances without feeling they are wasting someone “more senior’s” time.
One last thing to note, however: there are no stupid questions, but there are good ways to ask questions. The key is specificity.
Asking a haematologist for assistance with an anaemic patient, for example, isn’t particularly specific and may result in the haematologist spending more time than necessary with your patient.
Asking about the merit of a bone marrow biopsy under specific patient circumstances, on the other hand, gets to the point far more quickly and ensures the culture of communication operates on relevant communications.
Always come to the table with the knowledge you have, and what you think the best course of action is—and be ready to adjust that course with guidance from those more senior.
The sheer volume of what you need to learn as a resident doctor can be intimidating, but don’t back away from it. Curiosity means not rushing through learning opportunities—now is the time to learn, so take your time. You will get faster.
Read the notes, ask questions, listen to your patients and their families—it could reveal a missed diagnosis. Make the most of your clinical rotation and attachments—each has it own unique learning opportunities.
Ultimately, curiosity will keep you hungry for learning, and satisfying that hunger will make you a better doctor.
One last tip: if you are feeling lost and don’t know how to deal with a particular issue, “What do you normally do in these situations?” is a good question to ask another doctor to get some pointers on next steps.
Consistency in a hospital is ensuring that patient care is your number one priority, regardless of what other factors may interfere with you, your team or your DHB.
Commercial pressures and resource constraints do not override expected standards of care. It’s a bitter pill to swallow, but ultimately these are challenges that every doctor will have to learn to deal with. Regardless of what is going on outside of those walls, your patients need to feel safe, secure and cared for—consistently.
One quick tip for ensuring consistent levels of care for your patients: communication. This might as well be the sixth C on this list, but it’s particularly important for consistency.
Keep communication open with both the patient and their family. Sometimes, all that’s needed is reassurance that an ongoing complaint is being resolved, or is running its expected course.
5 minutes of time spent explaining something can save your patient hours of stress later down the line and ensure a consistent level of care both inside and outside of the hospital.
Want to learn more tips and tricks for surviving as a training doctor? Download the RMO handbook!