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I could tell that we had had changeover day; the referral that last week would probably have read, “Funny turns—?seizures,” now gave a full, detailed history, the space allowed filled completely with tiny but scrupulously neat handwriting.
As a medical student working in the neurophysiology department of a busy hospital to earn some money, I took a telephone call from a young doctor making her first referral. She'd filled in the form but had a question about the process, could she come and see us? I said yes—we have a policy of encouraging all doctors to come and see us if they want to talk something over. In fact, she asked her question immediately, and I was able to answer her. Should she still come to visit us? I gave her the option of coming over whenever she had a minute or of putting the referral form into the internal post. The next day she dropped into our main office, introduced herself, handed in the referral form, waited while I made the appointment for her patient, and went cheerfully on her way.
In the meantime, I had taken a call from another foundation year 1 doctor in a hospital about 30 miles away. It was late afternoon, and I could hear the note of panic in his voice. He needed to speak to the consultant neurophysiologist urgently. I explained that neither she nor her secretary were available—could I help? Obviously on the verge of tears, he told me that he had been given a list of tests to arrange and given the consultant's name, but beyond that had no idea how to go about doing this. I reassured him that he was talking to the right person, guided him through finding and then filling in the referral form, and stopped another panic attack when he interpreted something I'd said to mean that he needed to specify individual nerves for testing. Finally, I told him how to address the envelope so that it would get to us speedily through the internal mail system. It was only his second day at work in the hospital, and he was already so stressed that he was nearly overwhelmed.
I am uneasy that he thought he needed to talk to the consultant herself to arrange the tests rather than her secretary or someone else in the office. Had he just got the wrong end of the stick or had he been deliberately misled? Are there still some people who think that getting the F1 doctor into trouble with a consultant is fun? Many consultants would not be pleased to be interrupted with trivia like booking appointments.
In a few years time it will be me struggling to learn how to be an effective member of a team. Will I be lucky, like the first young doctor, busy but given sufficient support that I can cope with the new environment and its pressures—or will I end up like the second doctor, in a situation where I am not supported and guided appropriately, exhausted and demoralised by the second day?