My first day on the wards

Dr Rachel Thomas reflects on the memories of her first day as a F1 doctor

I take a deep breath. 

“You can do this,” I repeat to myself. My heart is aflutter, my breathing too fast and too shallow. “Calm down, you can do this.” I take another deep breath.

The neat little boxes on the charts look at me accusingly. However, there is no way I am going to put pen to paper without checking a few more facts.

“Well, who is going to prescribe it if you don’t, doctor?” my Registrar had chuckled, moments earlier, on the phone. He has been making a point of calling me ‘doctor’ all day. The first few times he has said “doctor”, I have looked behind me, eager to see which doctor he is abruptly speaking to mid-way through our conversation. Now, as he again calls me ‘doctor’ on the phone, I realise, with a shock, that he had actually been addressing me all the time. Rather than feeling insulted that he may have no idea of my name, I almost float into the halogen lights overhead thinking of my hard-earned title.

“So you are absolutely sure that you don’t have any allergies, Mr Jones?” I repeat to my first patient I see on my own, smiling as calmly as possible, in spite of nervousness and excitement running riot inside me.

“None, still,” Mr Jones replies. Again. I circle KNDA – no known drug allergies – written on the front of the medication prescription card. I finally feel sufficiently confident of that fact to note it.

“Ok, great, thank you sir.”

I go back into the doctors’ office – that place which, during the period of shadowing the out-going F1s, had appeared so warm and safe. A cosy, yellow haven. ‘Out there’ on the wards had seemed so glaringly bright and sanitised-white, full of alarms and groans.

Now, however, my FYI-shadowing days have finished. Induction is now just a comforting blur. I, myself, have instead become the F1. I now regard the doctors’ office as merely a holding bay, where nurses come to ask us difficult questions, where we answer bleeps, or where we are asked to do seemingly impossible things. The patients ‘out there’ are now my responsibility.

Today, here I am, leafing through my BNF (British National Formulary) yet again, before committing to writing my first prescription. I also repeatedly check the folded and laminated glory of the pocket-sized local anti-microbial guidelines. I check doses, interactions, indications, contra-indications. I check with a colleague or two also.

I deliver my first management plan to a patient under my care, squeezing my signature into the tiny box on the medication card. I become an active cog in the healthcare machinery of the hospital, a contributing part of our surgical team.

My first days continue in a series of time-consuming double and triple checks. I leave late, so that I can catch up with discharge summaries, other prescriptions, reviews and updating the patient ward list. I can then reassure myself that my patients are as safe as I can make them, as we can make them, until tomorrow.

A tomorrow I am looking forward to. I am a doctor!

Find out more

• For continued advice during the foundation programme, read our handbook ‘Supporting you through your foundation years’.
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