There's not a lot to read this week! This year students are qualifying in unprecidentedly difficult times. Many students are joining the COVID19 temporary register and some students may be coming to terms with the fact registration may not be all that far away.

Starting life with the responsibility and pressure that comes with registration is always nerve wracking and we remember it well. So we've compiled some of the bits of advice we wish we could have given ourselves before we registered.

Below are some of our points, but this is something thats really better off heard. Plus at the end of the podcast, hear some of the advice our fantastic colleagues have to share. Thanks so much to @samdharrison, @HosznyakRachael, @edtindall, @J_L_T_M, @LukeAndreou and our colleagues Ellie, Simon and Steve for kindly sending us their advice and featuring in the podcast.

1. Don't Panic!

It's really not that bad!

2. Listen to others

People you work with may have been in this situation before. Experience and useful tips can come from the most unlikely of places.

3 . Follow up your patients from day one.

Every time we don't find out what was wrong with a patient is a vital learning opportunity. Use feedback systems where they exist, and where they don't be a force for change and help create them.

4 . Guidelines guide, clinicians decide.

Guidelines can't account for every situation. Part of having that registration means using the latest evidence to advocate what is right for your patient, even if that isn't expressly written down.

5 . Make your decisions in the best interests of the patient, not through fear of personal concequence.

If you do what you genuinely beleive is the right thing for the patient, then you are doing your job.

6 . Keep a shift diary and record the peaks and troughs of your confidence.

It can be helpful to look back and see what you were struggling with and the thoughts you had in the early days. It helps to clarrify how you're feeling in the present and put into perspective just how far you've come.

7 . Take on board Ideas, Concerns and Expecations to help make your decisions.

Understanding what the patient hopes to gain from the consultation will help shape your plan.

8. Think about what your plan offers the patient.

Are they going to hospital because its what they need? or what you need?

9 . Share your decisions, there is always help available.

Whether it is from Senior clinicians at hospital; GP's, Clinical suppervisors, The mother of the patient who knows more about their childs condition than their consultant, or that CFR you didn't know was an Ex-Emergency department and cardiology nurse (real situation I had). There is help all around you, don't be afraid to share your decision and discuss them with others if needed. But remember, the decision is yours as the attending clinician, so don't feel you have to enact a plan you are not comfortable with.

10. Clearly document your safety net in your plan

This is the most important part of your paperwork, treat it as such. Detail what you think the problem is, how long it should last, what will happen if it gets worse or you are wrong and crucially WHEN you want the patient to seek out further help.


Finally, enjoy yourself! This is a fantastic career you're embarking on so try to enjoy every part of it.

As always clinicians are responsible for their own practice. These podcasts are produced for informative purposes and should not be considered sufficient to adjust practice. See "The Legal Bit" for more info.

If you’ve got any comments or questions on the article please email generalbroadcastpodcast@outlook.com or post in the comments section.

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