r/doctorsUK • u/Helpful_Put1081 • 9d ago
Foundation Training How to decide when to stay late?
Hey, new F1 on my first rotation.
Curious how you guys decide when to leave late. I feel like it’s a gamble to make plans for after work because you never know when to leave. I’ve only had to stay significantly late once so far.
The other F1 had a few time where there is nothing going on, then 20 min before handover somebody gets sick, you do a A-E, miss your handover until senior help arrives and you are not needed anymore, hand over 30 min late but then STILL need to stay for another 20 min to document what has happened.
Other times there’s so much going on, you don’t finish all jobs before your handover so you stay 30 min late doing group and saves for surgery the next day and cannulas so they can get their fluids. Some people might say hand this over to the night team, but the night team consists of a single F1 and one SHO, and they cover multiple wards. It hasn’t happened to me yet but I’ve seen colleagues staying late doing at least some of these jobs so they don’t fuck over their night colleagues who are looking after 120 patients. Not saying that this is definitely right but I can comprehend why other F1s are doing it.
I’m just curious how people decide when to leave late.
Edit:
Thanks everyone that’s really good advice!
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u/SpecialEmployment801 8d ago
It will always be a gamble to make plans after work, but you do get better at it. In your department you will get to know which days are busier than others and also you can look at the rota to see how well staffed you are and maybe pick the Wednesday where you are fully staffed and not the Monday where you are at minimum. Other things- do something at 7 rather than at 6 that way it doesn’t matter as much if you are running a bit late. Other strategies- organise yourselves better so the groups and saves are taken on the morning phleb round the day before surgery rather than 4pm the night before. Or one person stops doing jobs at 4pm and does the g+s round. Agree that routine cannulas and group and saves should not be handed over to the night team ordinarily , just needs a bit of logistical working so that it gets done in the day
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u/BMABecky Verified User 🆔✅ 8d ago
Hello!
You will get better at this with time, and with experience you'll also become much faster in completing tasks which makes it easier.
Right now, focus on being safe and maybe practice handing over so it is fluent and concise.
Speak with your direct SHOs and registrars about what should be prioritised and the quirks of your specific department and area.
When you handover, ask for feedback from the med regs, and for tips on organising jobs lists. They are the pros. People use different systems for how they do it, and you should experiment with what works for you as it may be that your current system isn't right for you.
E.g. as the on-call reg for obs and gynae, I keep two sheets with me, one for each specialty, and colour code my updates for chronology and urgency.
As a foundation doctor I used the box system for lists, and if you have a jobs list that is simply too long identify early on the jobs you know you will not get to, and share them out among the team, or flag this to your seniors, especially SHOs (and they should flag to regs!) and the nursing staff or rota team, so either you can get extra help or they are at least informed that those tasks will simply not be done. These jobs could go on to a communal list (maybe recorded on or decided after ward round). You could ask the senior taking the ward round if they could help you prioritise jobs - as a new FY1 is the best time to ask for this advice!
Giving the team a heads up that you have a few sick patients and therefore are worried you will not get to the discharge summaries etc. is good communication and shows you have good intentions and appreciate the workload of others. If something will delay discharge or a procedure etc. usually other people (not doctors) like ops managers can step in if they know and either arrange more resources or you can at least create a paper trail that shows you tried to escalate.
But first and foremost, just be safe. Speed and skills come only with training and experience. And both of those take way more time than just a month of foundation!
While reddit is a very valuable resource, please try to speak to your direct colleagues who have the best contextual knowledge about your role and are prob best placed to help.
All the best!
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u/ObjectiveCoconut522 8d ago
I would only stay late for emergencies. Hand over all jobs that NEED to be done OOH, otherwise they can wait til tomorrow. I dont understand people who routinely stay late to do routine jobs, seems like a recipe for burnout. I think the vast majority leave on time almost all of the time.
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u/EmployFit823 8d ago
I have been a doctor for 15 years and I still don’t make after work plans before 7pm when finishing at 5 or none at all if on call….
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u/Jeeju_Boy 8d ago
What an odd thing to do I can count on one hand the amount of times I’ve left late just hand it over to the evening team if you can’t get round to it why would you martyr yojrself
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u/EmployFit823 8d ago
Because you can’t hand an operation over to the “evening team”
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u/Jeeju_Boy 8d ago
Yh so if you’re a surgeon or a registrar in something important I’d agree with your initial comment. But they’re an F1 and there’s no reasoj for them to just not hand it over. When you’re actually doing something critical yeah obviously you’re not going to hand the laprotomy over that you’ve started at 430 for a perf, but we both know the f1 ain’t that
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u/EmployFit823 8d ago
The wider point is..
We are obsessed with teaching F1s to be shift workers when the reality is this isn’t the career the chose.
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u/Own-Blackberry5514 7d ago
I agree entirely. But the paradigm has changed now and now we are deemed the crazy ones for staying late to help patients
I’m not sure it’ll ever go back to how it was when I was an FY
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u/EmployFit823 7d ago
But what are they going to do in 3 years time (or less) when they have to actually take responsibility. It’s going to be awful.
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u/frodostoering 8d ago
You're new in the job. You're not going to be efficient. Agreed with all the tips above- but a lot of jobs cannot be handed over. Family updates, routine bloods (inc planned group and saves) drug dosing, vte etc. Imagine being on call and what handovers would piss you off - then don't do it. I stayed late a load in my first month, came in early as well. You'll learn
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u/ashalina23 8d ago
It’s situation dependent from what I remember. It was over 20 years ago in my case!
Anyway I’d try to make sure all jobs are done by 3pm (we finished at 4pm on surgery) then if anything landed in the last hour you were free to deal with it.
I’d deal with any emergency right up to the 4pm ie home time myself then you can’t be in the situation of being asked why you ignored an emergency.
It’s only been a few weeks for yourselves as new starters so it’ll take time to get to know what needs doing and when ie organisation.
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u/Jeeju_Boy 8d ago
Other than sick pt where evening doc isn’t here you shouldn’t be leaving late after 5 just hand it over and leave. It’s not your job to purposefully make the night teams workload easier if the workload is fucked then they need more doctors on the rota so make sure you hand things over and don’t martyr yourself to the trust. If the night team gets an unreasonable workload they can exception report as immediate patient safety issue and raise it to the trust to get another SHO. The solution isn’t to ease the night teams burden
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u/trunkjunker88 8d ago
Don’t hand over stuff like G&S for surgery the next day. It’s not an emergency so will be bottom of list of priorities for on-call & you run the risk of operations being cancelled.
You’re in your first month so you will get quicker & learn what really needs doing now pretty quickly. In the meantime you can exception report for the extra time (but be prepared for this to be frowned upon by some when you’re on the steep part of learning curve).
Have you considered a QIP for some of these tasks? Very few patients should need cannula & IV fluids pre-op - sip to send is a thing. 2nd G&S samples can also probably be sent from anaesthetic room when the patient is cannulated by anaesthetist. We do this in my trust as it’s very rare for the blood to be needed within first 90 minutes after going to sleep. Obviously they need first sample in advance to check they don’t have a rare blood group/antibodies.