What is it like to work in paediatrics? Felicity Taylor is a ST7 trainee in paediatric emergency medicine in London. Here she gives us a glimpse into the highs and lows of working in the specialty, dealing with a 56 hour week, and having the accolade of becoming an HSJ Rising Star.
I’m Felicity, a ST7 specialist trainee in Paediatric Emergency Medicine in London. I have a special interest in NHS leadership and management, and the role of mentoring and development in quality improvement initiatives.
My colleagues. Emergency medicine attracts “can-do” clinicians who thrive under pressure, but who also know how to have fun (and have a sometimes wicked sense of humour). Combine this with paediatricians and paediatric nurses who are dedicated, inspiring and goofy in equal measures, and you have a recipe for a job which truly makes me jump out of bed in the morning although of course there are always days where you don’t quite feel like that!
I learn something new every single day and seeing my patients and their families feeling a little better and smiling after an intervention I have made makes every second worth it - it’s the ultimate loyalty reward scheme!
At medical school I originally planned to work in general medicine, but I quickly realised that generalism in the adult world wasn’t quite what I had envisaged. Paediatrics offered the chance to be a true generalist, covering everything from the care of a 23 week gestation neonate to a 17 year old young person.
Role modelling and mentoring is really important to me. We’ve all had that “I want to be like you when I grow up” moment and paediatrics has more than its due share of inspiring colleagues. Joining paediatrics in London really felt like joining an extended and slightly off-the-wall family and the supportive and friendly nature of training clinched it for me.
Paediatric emergency medicine, although technically a specialty, is my attempt to make my work area even more general; I love the fact that you can expect absolutely anything to walk through the door.
I find the child safeguarding work really very hard. I am a naturally open person who was brought up, and medically trained, to take people at face value. I still haven’t found the ideal coping mechanism for when you realise you have been lied to.
It is a daily challenge to consider non-accidental injury as a differential of an acutely ill or injured child. Through supportive supervision I am getting better at it, but it still depresses me that we have to.
Maybe you should ask my friends and family that question! I haven’t quite learned to say no to work encroachment enough, but I have a small and hard-core network of friends who look out for me and remind me to look after myself.
My family are my biggest cheerleaders and always pick me up if that 56 hour week has left me feeling a bit flat. As a typical ESFJ personality type (Extraverted Sensing Feeling Judging) I’m never happier than when throwing some sort of get-together, and I am a sporadic novelty exercise class taker and bad baker.
It was such a stimulating and humbling year. I went into the year rather frustrated at how impossible it was to drive through change at ground level, with the belief that if only I could get to the top I could "sort it all out”. How wrong I was! Amongst many other skills such as people and time management, strategy and policy development, I learned that if you want change to happen it needs to be owned and delivered by those closest to the issue.
It also inspired me to believe that clinicians with management expertise can play a vital role in the future of the NHS. I describe the year as humbling as I realised how many non-clinicians are working 60 hour+ weeks to deliver a better NHS, without the same respect and job security that we have as clinicians.
Generally due to shift work I get to leave my clinical work at the door when I go home; during my year at NHS England I sometimes worked 19 hour days and was on call through my phone 24/7. It really helped me to understand the pressures that non-clinicians in the NHS are under.
"Stop considering and start applying" would be my immediate response! However being pragmatic, it is a wonderful career with options for research, flexible working and specialisation, but it is hard in terms of hours and shift working. You will still be called at 3am to put in a cannula in your mid 30s!
If you look to the long term, you need to choose a career working with people who are inspiring, friendly and fun, and I don’t think you’ll find another specialty to beat paediatrics in that regard. If you are someone who would like work to be second to life - and that’s no bad thing - then you need to consider your specialty carefully so that you don’t burn out by middle grade. Speak to middle grades and new consultants to get a real view of what day-to-day life is like.
I was slightly overwhelmed when I received that accolade, which aims to spot future NHS change-makers. I suddenly felt that I had better do something to earn it and felt like a total imposter, which is a feeling that I know many wonderful colleagues relate to, so I’m in good company.
Many people think that leadership is a ‘thing' that needs to be learnt on a course, or that only a few chosen people can do: after all, we do like to put our leaders on a pedestal and attempt to chop them down. For me, leadership is imagining a better future and, through actions and personal behaviours, encouraging and enabling others to achieve it.
Look around you and try to quantify the niggles, the less than perfect, and the things that can be done better. Work with others to improve it, and resist the temptation to accept the status quo and contribute to negative energy. And always smile.
This article was first published on the Royal Society of Medicine website on 6 March 2017.