Dr Nat 💙🌞 @sugarplumNat Twitter profile

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Dr Nat 💙🌞

2 years

I'm at the end of the foundation programme and here are my thoughts and rambles and ruminations: Firstly, the foundation programme felt like a prison sentence to me. (This is going to long and multiple tweets, potentially many tangents, forgive me)

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Dr Nat 💙🌞

@sugarplumNat

5 months

I'm leaving my current role in a community hospital due to safety concerns that have not been addressed adequately. I'm sharing this because I'm deeply concerned about what is happening in the NHS and I'm worried about the risk our patients are facing.

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Dr Nat 💙🌞

@sugarplumNat

3 years

got told today by my MALE consultant that men don't respect me because I'm too attractive... what the ACTUAL f*** 🙃🙃🙃

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Dr Nat 💙🌞

@sugarplumNat

4 years

Just finished a week where half the doctors on my team are sick bc of COVID, patients are receiving care for COVID - we are under huge amounts of pressure. There are not enough doctors to cope with people believing this is over. Please do your bit and help us. #PandemicIsOverUK

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Dr Nat 💙🌞

@sugarplumNat

5 months

Thanks for reading and apologies for the long tweet. I'm aware of the backlash I may receive from the trust for posting this. We are encouraged to speak up but not when it's something this big. But silence and apathy will not help our patients.

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Dr Nat 💙🌞

@sugarplumNat

7 months

What's the actual point of training to be a doctor now? I look on LinkedIn and find multiple PA jobs which are paid better than I would be as a Dr. I look at doing getting a PA qualification - those with medical degree aren't allowed to apply?!

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Dr Nat 💙🌞

@sugarplumNat

5 months

Or leave? Go to Australia to work. Or leave the profession entirely? What do we do when we are trying to ensure patient safety but no one is listening? This leads to moral injury. I'm really worried for the future of our profession and most of all, the safety of our patients.

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Dr Nat 💙🌞

@sugarplumNat

2 years

do you know what's terrifying? men thinking persistence is cute... went on a couple dates with someone at work last year, wasn't really feeling it, I went on holiday and said maybe we should call it a day... (continued)

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Dr Nat 💙🌞

@sugarplumNat

5 months

Frailty medicine is complex and requires knowledge from all specialities... you can not train someone in frailty without prior training in cardio/resp/gastro/ortho/MH/neuro etc - this is why Drs go to medical school, do post grad training and sit post grad exams

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Dr Nat 💙🌞

@sugarplumNat

2 years

This is someone from my workplace, a healthcare professional who I will most likely work with again in the future. Please, to all, don't be persistent when someone tells you they are not interested, it isn't romantic to ignore a person's boundaries.

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Dr Nat 💙🌞

@sugarplumNat

5 months

We are no longer trying to prevent harm. We are allowing our patients to suffer. This is a nationwide issue - huge funding into replacing Drs with MAPs... especially in community settings and frailty wards - these patients are amongst our most vulnerable

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Dr Nat 💙🌞

@sugarplumNat

5 months

Many pts I would see on a Monday would be inappropriate for a rehab ward. There was a pt diagnosed as sciatica by an ACP in A&E - complete left arm&leg loss of motor function - pt actually had two cerebellar strokes. This is only one example.

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Dr Nat 💙🌞

@sugarplumNat

5 months

I spoke to the senior management about all of this... but of course, I am one doctor trying to fight a government agenda. Doctors are no longer respected - our concerns surrounding the safety of our patients are ignored again and again.

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Dr Nat 💙🌞

@sugarplumNat

5 months

But without a supervisor, how would I be trained? Running an MDT, working independently, diagnosing, managing, discharging, palliating... all for ~£40k/year. Who would take such risk & responsibility to be paid the same as a CHCP you are supervising and are responsible for?

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Dr Nat 💙🌞

@sugarplumNat

5 months

You need to know what you DON'T KNOW to be a senior clinician. How can we expect a "frailty trained" MAP to be confident in acute presentations if they are only training in a community setting?

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Dr Nat 💙🌞

@sugarplumNat

5 months

My concerns raised around patient safety were essentially dismissed as 'no patient harm was caused'. I believe there has not been a significant event because I have been there to recognise an unwell pt and transfer accordingly... my concern was what happens when a Dr ISN'T THERE.

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Dr Nat 💙🌞

@sugarplumNat

5 months

I was hired as an SHO in a community hospital - I was told the patients were medically fit and receiving rehabilitation and a Dr was needed to do prescriptions, TTOs and reviews if they became unwell with the aim to escalate to acute setting if needed.

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Dr Nat 💙🌞

@sugarplumNat

5 months

I explained that all patients in a hospital should be under a senior clinician and that I didn't think it was safe. I explained that I was not a GP, not a consultant... I was hired as an SHO - the definition of this role is a Dr who works closely with other Drs and a senior Dr

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Dr Nat 💙🌞

@sugarplumNat

5 months

I had worked with a CHCP who was aiming to become a tACP within the trust. She had attended a meeting for the tACPs where they said, "would you rather be looked after by a shit locum Dr or fully trained ACP?" - I started to feel that the trust did not respect Drs at all

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Dr Nat 💙🌞

@sugarplumNat

5 months

The patient referrals were made by 'flow practitioners' or therapy staff in the acute setting. The nurses would accept/decline referral. I noted that many patients arriving were not medically appropriate for a community ward that did not have 24/7 medical cover.

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Dr Nat 💙🌞

@sugarplumNat

5 months

There were no changes for many months. I DATIX'd everything. I documented defensively. I raised concerns via email many times. I was told to contact the ACPs at the other hospitals within the trust as they were 'my seniors' if I had any concerns about a pt.

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Dr Nat 💙🌞

@sugarplumNat

5 months

I raised concerns about the assessments being performed in A&E - this pt had not been seen by a senior clinician prior to being deemed medically fit. I raised concerns around the lack of medical cover over the weekend.

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Dr Nat 💙🌞

@sugarplumNat

5 months

I received an apology from the senior management of this trust in question - after I handed in my resignation due to safety concerns. They are now trying to ensure weekend medical cover - 8 months after I first raised the concern. They did try to offer me a job on contract...

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Dr Nat 💙🌞

@sugarplumNat

5 months

There was no medical cover over the weekend. Patients were arriving on Friday eve and not being clerked until Monday. The nurses were told to contact OOH for any concerns - however, CAS could not access our system or prescribe and would often send the pt to A&E.

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Dr Nat 💙🌞

@sugarplumNat

5 months

I started reviewing the referrals to ensure they were suitable. Many times after refusing a pt, this would be escalated to management by acute who would then overturn this and the patient would arrive anyway.

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Dr Nat 💙🌞

@sugarplumNat

5 months

The ward was meant to be staffed by ACPs but recruitment was low and many had resigned due to concerns with workload/lack of supervision/management/bullying. When I started the job, there was a locum consultant geriatrician overseeing three community wards within the trust.

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Dr Nat 💙🌞

@sugarplumNat

3 months

Any other medics feeling a bit nervous about watching #BREATHTAKING tonight? I think of the patients I treated who died of COVID almost every day...

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Dr Nat 💙🌞

@sugarplumNat

5 months

The 'robust review' took a few days to complete - no one came to the ward, no one spoke to me or the staff to gather information...

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Dr Nat 💙🌞

@sugarplumNat

5 months

Many inappropriate referrals to A&E meant that the paramedics arriving via 999 lost respect for the ward and would question referrals that I would make and that really did need to go to A&E - ie ?sepsis/NOF #/stroke/acute chest pain

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Dr Nat 💙🌞

@sugarplumNat

5 months

I was working independently. There was a GP who came onto the ward twice a week for a few hours. My consultant came once a week to do a ward round. I was able to contact him with any concerns. However, there were issues from the start.

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Dr Nat 💙🌞

@sugarplumNat

5 months

So what do we do as Dr's? Locum and potentially work in unsafe jobs with no progression... go into training (if you're lucky to get a training post)... work as a trust grade and risk no progression and pay that doesn't represent your experience/risk you are handling...

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Dr Nat 💙🌞

@sugarplumNat

5 months

Eventually, a DATIX alerted someone higher up within the trust and a review of the ward was completed. I was told a 'robust review' of the medical model was completed and found that they did not need Drs and could continue with ACPs and no appropriate OOH cover.

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Dr Nat 💙🌞

@sugarplumNat

5 months

I raised concerns again that I felt a senior doctor - preferably a consultant geriatrician - should be overseeing the wards and the medical plans for pts. Was told there was no plan to rehire.

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Dr Nat 💙🌞

@sugarplumNat

5 months

My consultant left the post around this time. I asked who would be my supervisor going forward and was told CAS (?!), the virtual frailty team (of a different trust) and the patients own registered GP would all be options...

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Dr Nat 💙🌞

@sugarplumNat

5 months

This CHCP resigned as felt the ward was unsafe. She had no supervisor apart from myself, a locum SHO. Most of the ACPs were very good but I felt there was no parity amongst them and I had dealt with a few misdiagnoses/errors made by tACPs/ACPs.

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Dr Nat 💙🌞

@sugarplumNat

3 years

he also spent the ward round asking me whether I worked out and whether I had a boyfriend, told me that he is divorcing his wife and I should stay in touch with him so that he can show me "the niceties of life". Also been sending me pictures of his car and watches... thoughts?

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Dr Nat 💙🌞

@sugarplumNat

3 years

just want to clarify that the consultant in question is not part of my parent team 👍 I won't delete the tweet for now as I don't like the thought of silencing other women who have raised their experiences. It's an important topic to discuss and be aware of.

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Dr Nat 💙🌞

@sugarplumNat

3 years

thanks for all the advice so far. It's difficult because I'm fairly certain I will be working with this consultant again next week... he also finds opportunities to make me leave the ward with him alone, to discuss cryptocurrency and explain how he can improve my life...

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Dr Nat 💙🌞

@sugarplumNat

4 years

First week of #FiY1 done eeee, I think being a doctor is SO much better than being a medical student. I've only just realised how stressed and unhappy I was during my studies. To all those who are thinking med isn't work then, see what you think of the job before leaving! 🌸🌷🌞

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Dr Nat 💙🌞

@sugarplumNat

5 months

@probesandjelly I went to the freedom to speak up guardian, I wrote emails and copied in every senior manager including MD and COO. My next steps were to speak to CQC, CCG and then the parliamentary and health service ombudsman if I felt they were not being addressed. Good luck.

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Dr Nat 💙🌞

@sugarplumNat

2 years

And the rest. I start my F3 job tomorrow at a locum rate. I'm gonna save for a house and live a little. I'm not usually a moaning b*stard but I think these issues are important. Felt lime I could speak now without impact. Peace x

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Dr Nat 💙🌞

@sugarplumNat

4 years

today, a patient on my ward told me that I was a great doctor. she said that she was grateful that I had taken time to get to know her and thanked me for being so caring ❤ this is why you do 5 years at med school - it's all worth it in the end! 🌸🌷💕 #MedTwitter #fiy1

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Dr Nat 💙🌞

@sugarplumNat

3 years

he did the classic "show me a scan" trick - any other women experienced this one? Where they stay seated in front of the computer so you have to lean over them to search for a test result. Makes your skin crawl.

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Dr Nat 💙🌞

@sugarplumNat

2 years

today, he has followed me on twitter... I wasn't aware that he had a twitter account and noted that he had liked a few of my retweets from a month or so ago. Feel weirdly violated to think he has been lurking here when I thought I had blocked him everywhere (continued)

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Dr Nat 💙🌞

@sugarplumNat

2 years

We met in a car park as he refused to get a coffee. He sat in my car and told me that he wished me an unhappy life and that I would live to regret the decision I had made. He tried to kiss me, I dodged it and told him to leave my car. Thought that was the end of it (continued)

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Dr Nat 💙🌞

@sugarplumNat

2 years

he sent flowers to the hotel I was staying at (could be cute) but then started saying he was going to get on a flight to join me at the hotel... I was on holiday with my family. I had only been on 3 dates with him (continued)

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Dr Nat 💙🌞

@sugarplumNat

2 years

I explained that it was all a little too intense and that I wanted him not to buy a flight. He begged me to see him when I came back home. I agreed, thinking I would explain face to face which may give him some closure (continued)

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Dr Nat 💙🌞

@sugarplumNat

2 years

that it was my fault because I had 'f***ed with his head' and made him drink and drive. I blocked his number, removed him from social media and hoped nothing else would happen (continued)

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Dr Nat 💙🌞

@sugarplumNat

2 years

I contacted him to ask him to stop messaging, sending gifts etc. I felt slightly unnerved and also was aware that he knew my address so started to feel more anxious. He sent me a message to say that he got caught by the police for drink driving (continued)

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Dr Nat 💙🌞

@sugarplumNat

3 months

We haven't got over any of this. The disdain the government and some of the public feel towards us is very difficult to process when most of us tried really f*cking hard to save as many people as we could. The scandal is only just unfolding.

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Dr Nat 💙🌞

@sugarplumNat

2 years

A couple of weeks later, a gift arrived at my home with a handwritten letter apologising and explaining why we would be perfect together, saying that he wanted to have children with me (continued)

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Dr Nat 💙🌞

@sugarplumNat

4 years

To all prospective medical students from state schools- please don't lose hope, we need doctors like you🌞your stories,history,culture and experiences of prejudice will make you a GREAT doctor🌞 the way you're being discriminated against now is all the more reason to not give up!

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Dr Nat 💙🌞

@sugarplumNat

3 years

@iowmillie thank you ❤ I'm just angry to be honest, I pride myself on being the person to tell creeps to f*ck off but in this situation I felt helpless... completely different when they're your boss.

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Dr Nat 💙🌞

@sugarplumNat

2 years

She asked me how I could treat people in this way. I felt sad that the public perceives us as part of the problem. We are the ones holding the system up and ensuring patients receive treatment.

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Dr Nat 💙🌞

@sugarplumNat

4 years

intrigued by responses to me saying I'm interested in child psychiatry - eye rolling & "you're one of those" &"why would you even want to do psych?" & "psychiatrists are weirdos"- why is there stigma associated with a career in psych? esp. from doctors? @Choose_Psych @rcpsych

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Dr Nat 💙🌞

@sugarplumNat

3 months

The 'flow matron' who moved a COVID pt to my acute oncology ward which resulted in 6 of our patients dying in the space of 2 days. I made the phone calls to devastated families. They were never held responsible.

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Dr Nat 💙🌞

@sugarplumNat

2 years

This has been a bit of a rambling thread, I have so many thoughts on being an NHS doctor, being an ex- 'council houser' who is a doctor, sexism and harassment at work, infantilisation of juniors, patient safety and more. Thanks for reading.

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Dr Nat 💙🌞

@sugarplumNat

2 years

But I do have £90,000 of student debt. I don't have many savings and I'm a long way off getting a house. I'd like my pay to reflect the 6 years of university and the responsibility I hold.

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Dr Nat 💙🌞

@sugarplumNat

2 years

Is it any wonder that junior doctors are leaving? I do not blame them. I don't want to leave. My job is a privilege, I'm good at it, I make a difference and I can make someone smile in the darkest moments.

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Dr Nat 💙🌞

@sugarplumNat

4 years

I'm graduating virtually today! Dr Natalie Miles BMBS #bleedgreen #exeteruni #medstudentcovid #fiy1 #exeterforever

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Dr Nat 💙🌞

@sugarplumNat

4 years

First night shift as a doctor complete 🌞✅ #medtwitter #FY1

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Dr Nat 💙🌞

@sugarplumNat

4 years

just been offered an #FiY1 job at @nottmhospitals 🌞🎉🌷 looking forward to starting and getting my @TheBMA rainbow lanyard hehe! (thanks again @BMAJamesP @BMALouiseC - I'm never gonna stop going on about it) 🌈🌈🌈

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Dr Nat 💙🌞

@sugarplumNat

7 months

@apprenticesurg How do you fight back? This is a government working to erode the NHS. The management are extension of Tory government - same tactics, same underqualified individuals making huge decisions that impact patient safety and care.

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Dr Nat 💙🌞

@sugarplumNat

2 years

*MEGA THREAD PART 3, forgive me* So then it was F2, I was an S H O. Yikes. First day on call, was in theatre, didn't have access to computers the standard. But, at least I was getting ~£16/hr now.

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Dr Nat 💙🌞

@sugarplumNat

3 years

First placement in surgery complete - love this piece of feedback! 🌞🌻

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Dr Nat 💙🌞

@sugarplumNat

3 years

@fosterjaf but I'm not flattered. I'm angry.

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Dr Nat 💙🌞

@sugarplumNat

4 years

mental health tip - get a dog 🌞🐶🌞🐶🌞 #MedTwitter

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Dr Nat 💙🌞

@sugarplumNat

2 years

I look back over the last 2 years and can not count how many times senior doctors, patients and nurses have been rude and disrespectful. From seniors, the majority preach this 'back in my day' rhetoric and think it's ok for us to have terrible working conditions.

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Dr Nat 💙🌞

@sugarplumNat

2 years

PS. I was asked to write a report to my university regarding the bursary I received. This was during my F1. I sent a very long report - have a look if it interests you. My university ignored it, never responded. If that doesn't prove my point then... 🙃

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Dr Nat 💙🌞

@sugarplumNat

3 years

TW: homophobia. Just found out that a guy I'm dating (no longer I assure you) is homophobic. "it's just wrong" - was the phrase he used. I am saddened that someone so young (32) has this view. In the words of Florence Given:

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Dr Nat 💙🌞

@sugarplumNat

4 years

got my start date today for #FiY1 at @nottmhospitals - 1st of June 🌞🙏🎉 gives me a lil time to settle into a new house & some time to read! any book suggestions for me? 📖 #BookRecommendations #medstudentcovid #covidcohort

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Dr Nat 💙🌞

@sugarplumNat

2 years

I have a lot of colleagues who make daft comments about 'poor people' or 'council housers'. Nurses who 'bitch' about other doctors being 'rubbish' because they were unable to do a job whilst covering over 100 patients out of hours - ON THEIR OWN.

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Dr Nat 💙🌞

@sugarplumNat

4 years

official first day of F1... and I'm on nights 🥴 yikes #medtwitter #fy1

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Dr Nat 💙🌞

@sugarplumNat

2 years

Received a phone call from the bursary department. Had -£396 in my account. They said I have been awarded a scholarship. £25,000!!!! Over the next 5 years. Felt like a millionaire. Was told my first payment of £5000 would be given ASAP.

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Dr Nat 💙🌞

@sugarplumNat

2 years

THREAD PART 2 (rambles on training in the NHS etc): So I moved out. Became pretty isolated as my non-medic friends had graduated. Would walk into the hospital and my heart would be pounding. Saw my doctor, started propranolol.

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Dr Nat 💙🌞

@sugarplumNat

3 years

just finished my 13 hour Christmas day shift - really sad day today, families saying goodbye to relatives & COVID making people extremely unwell. Merry Christmas and a big thank you to those that have sacrificed time with family today to protect the vulnerable. #christmas #NHS

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Dr Nat 💙🌞

@sugarplumNat

4 years

#PandemicIsNOTOverUK

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Dr Nat 💙🌞

@sugarplumNat

4 years

#FY1induction today 🌞🌞🌞

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Dr Nat 💙🌞

@sugarplumNat

3 years

Update - thank you all for your support and advice - it is greatly appreciated. I wanted to let you all know that I have reported the incident and have been completely supported by my trust in doing so. This is being investigated and dealt with.

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Dr Nat 💙🌞

@sugarplumNat

4 years

Just wanted to say that if anyone needs peer support right now, I am more than happy to be PMd - our wellbeing is so important right now. #MedStudentCovid

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Dr Nat 💙🌞

@sugarplumNat

2 years

My mate (another medical student) at the time was saying how broke he was. I told him that I was struggling. He said I should dip into my savings. What savings? He said he had 16k in his bank, "how do you not have savings?"

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Dr Nat 💙🌞

@sugarplumNat

7 months

@mancunianmedic But not all Dr's want to progress to consultant anymore... SAS/middle grade/portfolio medicine looks more appealing but the opportunities aren't there. Not without £££ on exams and competitions ratios that quite frankly, put many of us off

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Dr Nat 💙🌞

@sugarplumNat

2 years

*continued on a new thread* - if you've read so far then wow lol, you must be bored x

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Dr Nat 💙🌞

@sugarplumNat

3 months

The night shift where instead of 15 doctors, we only had 6 due to staff sickness with COVID. There was an entire ward of patients who weren't suitable for ITU and were dying..there was nothing to do. A pt asked me if she was dying and I said no and held her hand whilst she died.

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Dr Nat 💙🌞

@sugarplumNat

2 years

I have loved being a doctor. Its a lot easier than being a medical student. I found studying made you inherently selfish as you are forced to concentrate on 'sign-offs'. As soon as I was on the wards, everything fell into place. I was glad I stuck it out.

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Dr Nat 💙🌞

@sugarplumNat

2 years

Another time, I was told by a senior to ignore a patient who was asking for help as we saw admissions. I ignored him, helped the patient. He told me I was a 'rubbish junior'and needed to prioritise 🙃🙃 I told him where to stick it

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Dr Nat 💙🌞

@sugarplumNat

4 years

@saynotoa2ndwave This is awful. That's why we need to do our bit so that the NHS has capacity to help those in need and protect them from COVID-19

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Dr Nat 💙🌞

@sugarplumNat

4 years

I'm registered with the @gmcuk ! One thing ticked off the list ✅ Now let's just wait for a job... #medstudentcovid #fiy1 #MedTwitter #covidcohort

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Dr Nat 💙🌞

@sugarplumNat

2 years

There was no Christmas lunch for us. I ordered a wagamamas after three 12 hour shifts over Christmas, it was 10pm, the deliveroo driver said he couldn't find me and put it in the bin. I cried my eyes out in my car. Final straw and all that.

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Dr Nat 💙🌞

@sugarplumNat

2 years

Didn't want to give this tweet any attention but I genuinely feel concerned for the GP in question. I understand the frustration being on the other end but I worry about the vitriol and hate this GP is facing.

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Dr Nat 💙🌞

@sugarplumNat

2 years

Had to do a lot of locum work. Thankfully, I had this option. However, I only had 6 days off in 2 months. This was the only way to make ends meet. One of my colleagues said, "why don't you just buy a house?" 🙃🙃🙃🙃

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Dr Nat 💙🌞

@sugarplumNat

3 years

any other COVID-graduates just feeling absolutely exhausted and disappointed? spent all of foundation (& interim) essentially as a rota filler, with minimal educational opportunities, minimal supervision and training

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Dr Nat 💙🌞

@sugarplumNat

5 months

@lyndseyhamilton I'm so sorry - it's exhausting. I know I've tweeted saying I wasn't supported but please so raise your concerns via freedom to speak up guardian at your trust - not every trust is like this and I'd like to think they'd support you. DM me if you need any support.

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Dr Nat 💙🌞

@sugarplumNat

2 years

So I had a year out. My brother underwent brain surgery, I was relieved to not be at university and be around family. I got a job as a Nanny and cleaner, looking after 4 kids. It was £5/hr. Felt minted earning £130/week. Spent this on driving lessons and went on holiday to Spain.

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Dr Nat 💙🌞

@sugarplumNat

2 years

People took the piss out of my accent - they seemed to think I was northern despite growing up in Devon. I was nicknamed POV by a few medics. I laughed it off. Felt like class and money didn't matter, we were all here now, right?

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2

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Dr Nat 💙🌞

@sugarplumNat

3 months

Not hugging my family for a few months - socially distancing within our own home. Worrying again and again about the risk to them. Worried about telling them how bad it really was in the hospital.

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6

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Dr Nat 💙🌞

@sugarplumNat

4 years

Night shift complete - 7 patients arrived and clerked, new onset fast AF, one fall, one cardiac arrest call and numerous drug cards to write 🥴🥴 time to sleep! 🌞😴😴😴 #MedTwitter #FY1

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42

Dr Nat 💙🌞

@sugarplumNat

3 months

Working in a COVID ward, where we ran out of PPE. No FFP2 or FFP3 masks left. No gloves, no aprons. Staff didn't hesitate to walk into that ward and still treat. I scrubbed myself clean before heading home, fearing that my family would get COVID.

4

8

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Dr Nat 💙🌞

@sugarplumNat

2 years

"If I get through the year, I don't have to kill myself." I said this so often to myself, it became normal. I met with my tutor, she said I was a great student, that there were no concerns with my study skills, that it was just bad luck and medical exams "don't suit everyone".

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0

41

Dr Nat 💙🌞

@sugarplumNat

2 years

Had to admit a patient, she was elderly, had been waiting in A&E for 5 hours to be seen by me - I had 6 patients to see before her. I apologised. Her daughter said I should be ashamed of myself. It was 3am, I was the only doctor covering an entire specialty.

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2

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