0:00:02 > 0:00:03- Start CPR.- Shockable rhythm!
0:00:03 > 0:00:05Charging, everybody stand clear!
0:00:05 > 0:00:06I have an airway emergency.
0:00:06 > 0:00:08Can you open your eyes for me?
0:00:08 > 0:00:10Can you stop doing the drugs, please, and help here?
0:00:10 > 0:00:1230 second adrenaline.
0:00:12 > 0:00:13Seven junior doctors.
0:00:13 > 0:00:15Can I have a stet, please?
0:00:15 > 0:00:17On the front line of medicine.
0:00:17 > 0:00:18Showtime.
0:00:18 > 0:00:20I've got an emergency so I need the crash team here.
0:00:20 > 0:00:21Easy sir, easy.
0:00:21 > 0:00:22With all its blood...
0:00:22 > 0:00:24I love a gory, bloody wound.
0:00:24 > 0:00:25..sweat, and tears.
0:00:25 > 0:00:33This programme contains some scenes which some viewers may find upsetting
0:00:33 > 0:00:34A bit nervous.
0:00:34 > 0:00:35You're not going to die.
0:00:35 > 0:00:38The doctors of your future...
0:00:38 > 0:00:39What the...
0:00:39 > 0:00:41I actually slipped on my wedding dress.
0:00:41 > 0:00:42Everybody stand clear.
0:00:42 > 0:00:43..facing life...
0:00:43 > 0:00:45I'm part of the family now. Lion King moment.
0:00:45 > 0:00:46..and death.
0:00:46 > 0:00:49I think there'd be something wrong with you
0:00:49 > 0:00:50if you weren't upset by it.
0:00:50 > 0:00:51Have they got...
0:00:51 > 0:00:52What have you taken today?
0:00:52 > 0:00:54..what it takes?
0:01:07 > 0:01:09Just 12 miles north of Birmingham
0:01:09 > 0:01:12is New Cross Hospital in Wolverhampton.
0:01:12 > 0:01:16The hospital is home to one of the busiest emergency departments
0:01:16 > 0:01:20in the West Midlands, treating over 130,000 patients a year.
0:01:20 > 0:01:2230-year-old junior doctor Omar
0:01:22 > 0:01:26has just arrived for a ten hour night shift
0:01:26 > 0:01:28in the emergency department.
0:01:28 > 0:01:30It's his second night shift this week
0:01:30 > 0:01:33and he's still getting used to his new sleeping routine.
0:01:33 > 0:01:34Did you oversleep much?
0:01:34 > 0:01:36Yeah, I literally woke up at one, then woke up at two,
0:01:36 > 0:01:38then woke up at three, then woke up at five,
0:01:38 > 0:01:40then thought I'll get up now.
0:01:41 > 0:01:46Newlywed Omar has one other passion in life besides medicine.
0:01:46 > 0:01:49I love cars, I love driving fast, I love driving on tracks.
0:01:49 > 0:01:50And it's something I really enjoy.
0:01:52 > 0:01:55My wife doesn't understand my love for cars and thinks I need help.
0:01:59 > 0:02:00That one's nice.
0:02:00 > 0:02:03Even at his wedding to wife Samira, he couldn't resist
0:02:03 > 0:02:05hiring a white sports car for the day.
0:02:07 > 0:02:08Omar likes these pictures.
0:02:08 > 0:02:10When you thought you were James Bond.
0:02:10 > 0:02:12This is the second time
0:02:12 > 0:02:14that Omar has worked in the emergency department
0:02:14 > 0:02:17and he's considering making it his full-time job.
0:02:17 > 0:02:20The biggest thing for me riding on this rotation is if I enjoy it,
0:02:20 > 0:02:23it would strongly push me to apply for a career in emergency medicine.
0:02:23 > 0:02:25With a full waiting room,
0:02:25 > 0:02:28Omar checks to see who his next patient is.
0:02:28 > 0:02:32It's a 40-year-old lady with a injury to her neck.
0:02:36 > 0:02:38My name is Omar, I'm one of the doctors.
0:02:38 > 0:02:40Can I ask what's brought you in today?
0:02:40 > 0:02:42I actually slipped on my wedding dress.
0:02:42 > 0:02:44I hit my head first, my feet went up in the air.
0:02:45 > 0:02:48Mr and Mrs Fisher have arrived by ambulance
0:02:48 > 0:02:51straight from their wedding reception
0:02:51 > 0:02:53leaving their 70 guests behind.
0:02:53 > 0:02:55You weren't dizzy, light-headed or anything,
0:02:55 > 0:02:57it was just a simple trip over your dress, or...
0:02:57 > 0:03:01- It was, I slipped straight on my dress, no, I wasn't dizzy at all or anything, no.- So it's not... OK.
0:03:01 > 0:03:04The childhood sweethearts have only been married for a matter of hours.
0:03:04 > 0:03:06What's hurting at the moment?
0:03:06 > 0:03:10My head, where I hit it, of course, and my neck.
0:03:10 > 0:03:12If you have a traumatic fall,
0:03:12 > 0:03:14there's a risk that you may have broken a bone
0:03:14 > 0:03:17or fractured a bone, and if you don't diagnose and treat it
0:03:17 > 0:03:20and manage it appropriately, it can have serious complications.
0:03:20 > 0:03:23What I need to do, I need to get some of the staff members
0:03:23 > 0:03:26and we need to do something called a log roll.
0:03:26 > 0:03:28It's a procedure where we sort of roll you to one side
0:03:28 > 0:03:31whilst keeping your neck completely straight.
0:03:33 > 0:03:35I need to log roll a patient in three.
0:03:35 > 0:03:38Can't find your legs.
0:03:38 > 0:03:40To prevent any further injury,
0:03:40 > 0:03:43Ms Fisher's neck must be kept perfectly straight.
0:03:43 > 0:03:44One, two, three.
0:03:44 > 0:03:47If there's a problem, Omar needs to find it quickly,
0:03:47 > 0:03:50otherwise she could be at risk of paralysis.
0:03:51 > 0:03:54I'm tapping you on the back of your head, is that painful?
0:03:54 > 0:03:55No, that's fine.
0:03:55 > 0:03:57Yeah? Normally, we may need to cut your clothes off,
0:03:57 > 0:04:00- but I think...- No, no, don't.
0:04:01 > 0:04:04OK, we're going to roll you back, one, two, three.
0:04:06 > 0:04:09The neck's fine, which is the thing we were concerned about.
0:04:09 > 0:04:12We'll pop the bed up, light-headed, a bit dizzy.
0:04:12 > 0:04:14So we will give you some pain killers,
0:04:14 > 0:04:15and we'll let you go in a short while, OK?
0:04:15 > 0:04:17Any questions, anything you want to ask?
0:04:17 > 0:04:19- No, that's fine, thank you. - All right, excellent.
0:04:19 > 0:04:21Thank you.
0:04:22 > 0:04:24Oh! Now I'm so tired.
0:04:25 > 0:04:28Because I've got a long train, I don't know what happened.
0:04:28 > 0:04:30I just slipped on it
0:04:30 > 0:04:32and my feet just went from underneath me
0:04:32 > 0:04:35and my head just hit the ground first.
0:04:35 > 0:04:37So I was just walking.
0:04:39 > 0:04:40Long day.
0:04:41 > 0:04:44- Eventful.- Yeah, very eventful.
0:05:02 > 0:05:06This morning, 24-year-old Anna is working on the respiratory ward.
0:05:10 > 0:05:14She's one of the youngest junior doctors at New Cross.
0:05:14 > 0:05:16Have we got 1-2's dru chart?
0:05:16 > 0:05:17Yes.
0:05:17 > 0:05:22Away from the hospital, Anna has a favourite way to unwind.
0:05:22 > 0:05:26I actually have one quite unusual hobby and that is ballroom dancing.
0:05:26 > 0:05:27I absolutely love it.
0:05:27 > 0:05:29And rock back out.
0:05:29 > 0:05:31It's a bit of glam time in the week.
0:05:31 > 0:05:35I think it's important to have interests and other things to do
0:05:35 > 0:05:38outside of work, because you completely switch off from medicine.
0:05:41 > 0:05:43Anna is working with consultant doctor Ejiofor.
0:05:43 > 0:05:46Think her obs have been stable.
0:05:46 > 0:05:48They're going to see Mrs David
0:05:48 > 0:05:51whose CT scan results have shown some abnormalities.
0:05:51 > 0:05:54Despite her six years' medical training,
0:05:54 > 0:05:56there's one thing that Anna still has to learn...
0:05:56 > 0:05:58- Morning.- Morning.
0:05:58 > 0:05:59..how to break bad news.
0:05:59 > 0:06:03My name is Dr Stan Ejiofor, this is Dr Anna Burns.
0:06:03 > 0:06:06Such a hard task, breaking bad news.
0:06:06 > 0:06:09We are lucky as juniors that it's usually the consultants
0:06:09 > 0:06:11and registrars that take it on.
0:06:11 > 0:06:14You've had some tests whilst you've been in hospital.
0:06:14 > 0:06:17You had a more detailed CT scan, you went through the tunnel.
0:06:17 > 0:06:20- Yeah.- OK, and that scan was to do a scan of the head?
0:06:20 > 0:06:23- Yeah?- Not like there's nothing there!
0:06:23 > 0:06:25Well, we know there's something there now,
0:06:25 > 0:06:28cos the scan suggested there was something there,
0:06:28 > 0:06:29so you're OK with that part.
0:06:29 > 0:06:31We also did the scan of your chest and your tummy.
0:06:31 > 0:06:34- Yeah.- And looking at it from the CT scan,
0:06:34 > 0:06:37there's been spread of cancer to the liver.
0:06:42 > 0:06:45Is there any treatment for that?
0:06:45 > 0:06:50Well, the difficulty is trying to find out what sort of cancer it is.
0:06:50 > 0:06:52- Yeah?- Yeah.
0:06:54 > 0:06:58And there are ways to try and find out, that out.
0:06:59 > 0:07:01OK?
0:07:01 > 0:07:03I'd like to talk to my family first.
0:07:03 > 0:07:07- Yeah.- And see what they've got to say about the matter.
0:07:07 > 0:07:08Yeah.
0:07:16 > 0:07:17All right?
0:07:17 > 0:07:20I can come back a bit later on to have a chat with you.
0:07:24 > 0:07:26And we can take things from there.
0:07:26 > 0:07:31- yes, OK, Dr.- If you've got any questions at all in the meantime,
0:07:31 > 0:07:33- just let us know.- OK.
0:07:33 > 0:07:37It was awful to watch cos she's a really cheerful lady
0:07:37 > 0:07:42and I could just tell, you know, what was going on under the surface.
0:07:42 > 0:07:43It was really heartbreaking to see.
0:07:45 > 0:07:48Breaking bad news to someone is something that all junior doctors
0:07:48 > 0:07:50have to learn via the training that you've done,
0:07:50 > 0:07:53and also by seeing it being done on various ward rounds.
0:07:53 > 0:07:58But trying to do it and do it properly is sometimes quite hard.
0:07:58 > 0:08:01I'm going to try and come back just after clinic to have another chat...
0:08:01 > 0:08:05It's really kind of shown me the time pressures that the NHS have
0:08:05 > 0:08:08because Dr Ejiofor is actually in clinic this morning
0:08:08 > 0:08:10and he's already an hour late,
0:08:10 > 0:08:14so it's like how do you rush something like that
0:08:14 > 0:08:16and telling someone they have cancer?
0:08:16 > 0:08:20There's just absolutely no time to kind of do it properly
0:08:20 > 0:08:24and take her outside and it's really difficult, I think.
0:08:25 > 0:08:27Thank you.
0:08:34 > 0:08:37Junior doctor Jo is preparing for a big day.
0:08:37 > 0:08:40I think that's normal, to have a coffee machine in your room.
0:08:41 > 0:08:45She is going to be assisting in surgery for the first time in a year.
0:08:45 > 0:08:49So today I'm going to theatre, yay!
0:08:49 > 0:08:51I'm really excited.
0:08:51 > 0:08:5327-year-old Jo is currently working
0:08:53 > 0:08:56in the trauma and orthopaedics department.
0:08:57 > 0:08:59As part of her placement,
0:08:59 > 0:09:01she's spending a day working with a surgeon.
0:09:01 > 0:09:02It's going to be an intense day.
0:09:02 > 0:09:05Got to have my game face with me today.
0:09:05 > 0:09:07After coffee, this will be my game face.
0:09:10 > 0:09:13I'm really easy to look after, I'm basically like a dog. Just feed me,
0:09:13 > 0:09:16run me, and then every now and again tell me I'm a good girl
0:09:16 > 0:09:18and I'm sorted.
0:09:19 > 0:09:20Like all junior doctors,
0:09:20 > 0:09:24Jo needs to choose what type of medicine she wants to specialise in
0:09:24 > 0:09:26but she's still undecided.
0:09:27 > 0:09:31I love surgery, and it's, you know, here's a problem, let's fix it.
0:09:31 > 0:09:35But I have really, really enjoyed my job in A&E so I'm a bit torn.
0:09:56 > 0:09:59Second-year junior doctor Jin is starting his shift
0:09:59 > 0:10:01in the emergency department.
0:10:01 > 0:10:05Really don't want to be working, I'm shattered right now.
0:10:05 > 0:10:07Struggled to get up this morning.
0:10:10 > 0:10:12For my first weekend,
0:10:12 > 0:10:15I'm hoping it will be really quiet, cos I'm tired, man.
0:10:15 > 0:10:19It's his sixth shift this week and it's taking its toll on his body.
0:10:19 > 0:10:20Oh man, I've got tummy pain.
0:10:23 > 0:10:24Oh, man.
0:10:26 > 0:10:30My bowels are just, I think it's just impacted, you know?
0:10:30 > 0:10:34I'm sure you've been constipated before, you know, not nice.
0:10:34 > 0:10:37Takes ages to open... Let's just stop, man.
0:10:41 > 0:10:46South Korean born Jin has always had very high standards.
0:10:46 > 0:10:49When I make mistakes, I think I take it harder on myself
0:10:49 > 0:10:50than other people do.
0:10:50 > 0:10:53I try my best not to make mistakes because emotionally it upsets me,
0:10:53 > 0:10:56it makes me feel rubbish about myself.
0:10:58 > 0:11:01I would be a doctor even if the pay wasn't as good.
0:11:01 > 0:11:03The core of being a doctor is about who you are,
0:11:03 > 0:11:06it's about the profession, it's about treating patients,
0:11:06 > 0:11:08caring for people. That's what I believe.
0:11:10 > 0:11:12Even though Jin isn't feeling at his best,
0:11:12 > 0:11:14his first patient of the day is waiting.
0:11:14 > 0:11:1780-year-old Kenneth has come into the emergency department
0:11:17 > 0:11:20for the second time after a series of falls.
0:11:20 > 0:11:22OK, sir, how can I help you, what's happened?
0:11:22 > 0:11:25In my last week, I've had three falls.
0:11:25 > 0:11:28The fall that brought you in today, you didn't hit your head or anything?
0:11:28 > 0:11:32No, I just slid. I just slid down onto the carpet.
0:11:34 > 0:11:37- OK, sir.- I'm quite heavy and I can't get up.
0:11:37 > 0:11:39- Why couldn't you get up? - Too much weight.
0:11:39 > 0:11:42- Too much weight.- Too fat. - So that sort of...
0:11:42 > 0:11:45Oh, come on sir. That's, that's usual for you though,
0:11:45 > 0:11:47- I mean as in like...- Usual?!
0:11:47 > 0:11:50Oh, God, oh, God, Oh, God.
0:11:50 > 0:11:53I don't mean it in that way, sir, I don't mean it in that way, sir.
0:11:55 > 0:11:57OK, sir, sorry, I've just got a stomach....
0:11:59 > 0:12:01Rumbling stomach, rumbling stomach.
0:12:01 > 0:12:02Do you want me to get a doctor?
0:12:02 > 0:12:04Hey-hey!
0:12:04 > 0:12:06With a medical complaint of his own,
0:12:06 > 0:12:09Jin needs to quickly finish seeing the patient.
0:12:09 > 0:12:13I'll discuss with the consultant whether we need to do another CT
0:12:13 > 0:12:16of your head because we've already done one in the last couple of days
0:12:16 > 0:12:18and this sounds like a mechanical fall.
0:12:18 > 0:12:20It's just because you're on warfarin,
0:12:20 > 0:12:22it could increase the risk of bleed in your brain with falls.
0:12:22 > 0:12:23- I'll see you again sir.- Yes.
0:12:23 > 0:12:26When the blood test results are back. I'll come back in again.
0:12:26 > 0:12:27All right, Yep, I will do.
0:12:27 > 0:12:30- All right.- All right.- Take care, sir.- Thank you very much.
0:12:30 > 0:12:31OK, no worries.
0:12:35 > 0:12:37I need to go toilet.
0:12:37 > 0:12:41Even the busiest junior doctor can't ignore the call of nature.
0:12:52 > 0:12:56In surgery, Jo is preparing to help orthopaedic surgeon Ms Mahroof
0:12:56 > 0:12:59to remove a ten-year-old growth the size of a tennis ball
0:12:59 > 0:13:01from a patient's elbow.
0:13:01 > 0:13:03I'm excited.
0:13:03 > 0:13:05I'm a bit nervous as well, yeah, cos I haven't...
0:13:05 > 0:13:08I haven't done surgery in so long, I'm a bit like...
0:13:09 > 0:13:13The patient has been given a local anaesthetic in her arm
0:13:13 > 0:13:16and will be awake during the whole operation.
0:13:16 > 0:13:17This is really cool.
0:13:17 > 0:13:21Jo is one of the six people in theatre and has been given
0:13:21 > 0:13:25the important job of spreading the patient's skin as Ms Mahroof
0:13:25 > 0:13:26makes careful incisions.
0:13:28 > 0:13:31The skin around the growth needs to be fully removed
0:13:31 > 0:13:34before it can be safely taken out.
0:13:34 > 0:13:37This is definitely a two-man job, isn't it?
0:13:37 > 0:13:39Or a two woman job.
0:13:39 > 0:13:40Don't need no man.
0:13:44 > 0:13:46- Excellent.- It's nearly there, isn't it?
0:13:48 > 0:13:50See? Clean's coming nicely.
0:13:50 > 0:13:51Yeah.
0:13:53 > 0:13:54- Look at that.- It's a girl!
0:13:55 > 0:13:57With the growth removed,
0:13:57 > 0:13:59gore-loving Jo gets to have a closer look
0:13:59 > 0:14:03before it's sent off to the lab to confirm what it is.
0:14:03 > 0:14:06- Look at that. - It's like a chocolate cyst.
0:14:06 > 0:14:08- Yeah!- That's so satisfying.
0:14:09 > 0:14:11For the last stage of the procedure,
0:14:11 > 0:14:13Ms Mahroof gives Jo the opportunity
0:14:13 > 0:14:15to help suture the elbow incision.
0:14:15 > 0:14:18Do I want it coming out deep down here as well?
0:14:18 > 0:14:21No, just similar to where you are, that's it, yep.
0:14:23 > 0:14:26It's crucial that Jo gets the stitches exactly right
0:14:26 > 0:14:29so that the elbow heals properly
0:14:29 > 0:14:31and the patient is left with a tidy scar.
0:14:31 > 0:14:33That's not quite big enough, is it?
0:14:33 > 0:14:36No, and go closer to where you've entered the skin on that side.
0:14:36 > 0:14:39So see, the clenching is starting.
0:14:39 > 0:14:42Yeah, is that all right? Yeah, is that too much?
0:14:42 > 0:14:45No, no. Well done.
0:14:48 > 0:14:50Oh, Ms Mahroof is just fantastic.
0:14:50 > 0:14:53She's so inspirational and so encouraging,
0:14:53 > 0:14:56she's definitely a role model.
0:14:56 > 0:14:57I want to be like her!
0:14:57 > 0:15:00She actually sutured better than I do!
0:15:00 > 0:15:02No, she sutured extremely well.
0:15:02 > 0:15:04I was really pleased with it, actually.
0:15:04 > 0:15:07I just found myself completely zoned into it.
0:15:07 > 0:15:13And I don't really get that feeling with anything else that I've found.
0:15:13 > 0:15:16Do you know if you want to do trauma orthopaedics then?
0:15:16 > 0:15:19I'm 99.999% sure, yes.
0:15:19 > 0:15:22I'm not going to apply for a job if I don't love it.
0:15:22 > 0:15:24Yes, I think that's the right thing, cos working within
0:15:24 > 0:15:27the health service is not easy with everything else
0:15:27 > 0:15:29that's going on at the moment.
0:15:29 > 0:15:33You need to be able to find a core of peace within your job
0:15:33 > 0:15:35and if you don't enjoy that job at hand
0:15:35 > 0:15:38as well as all the other rubbish, it's unbearable.
0:15:38 > 0:15:40Yeah. I'll go home and think about it all now.
0:15:40 > 0:15:41Yeah, exactly.
0:15:47 > 0:15:51In the emergency department, Jin is back from an unscheduled break.
0:15:51 > 0:15:55I was on the toilet. I'm just relieved, you don't need to know.
0:15:58 > 0:16:01I just went toilet and had a big...motion myself.
0:16:01 > 0:16:03- Oh, lovely!- Not that you needed to know.- TMI?
0:16:03 > 0:16:06But, yeah spent 20 minutes in there, man.
0:16:06 > 0:16:09I was in the toilet for 20 minutes, it was slowing you down.
0:16:09 > 0:16:10Him or you? He was in toilet?
0:16:10 > 0:16:12I was in toilet 20 minutes.
0:16:12 > 0:16:14Impacted.
0:16:14 > 0:16:15- Anyway, anyway.- All right.
0:16:15 > 0:16:17So I'm not being deliberately slow.
0:16:17 > 0:16:19I'm telling everyone!
0:16:22 > 0:16:24Junior doctors struggle when they start.
0:16:24 > 0:16:27Number one is a longer shift, number two is a changing shift pattern.
0:16:27 > 0:16:31You start with the morning, come lunchtime, then evening, nights.
0:16:31 > 0:16:33Their digestive system is upset and their sleep.
0:16:33 > 0:16:37I'm just, like, letting people know where I was for the last 20 minutes.
0:16:44 > 0:16:48Last year, the government brought in a controversial new contract
0:16:48 > 0:16:50for junior doctors in England,
0:16:50 > 0:16:54that they believed would be fairer for doctors and safer for patients
0:16:54 > 0:16:57and would help provide better NHS services.
0:16:59 > 0:17:01For many doctors at New Cross,
0:17:01 > 0:17:05today is the first payday since the new contract came into effect.
0:17:05 > 0:17:07I woke up, the first thing I did today
0:17:07 > 0:17:08was look at my bank statement.
0:17:08 > 0:17:10I can eat for another month!
0:17:10 > 0:17:13The junior doctors are getting together for a payday tradition
0:17:13 > 0:17:15of pizza in the doctors' mess
0:17:15 > 0:17:18and the new contract is on everyone's mind.
0:17:18 > 0:17:21I don't think anyone really wins with a junior doctors contract.
0:17:21 > 0:17:23People just lose slightly less.
0:17:23 > 0:17:24Yeah.
0:17:24 > 0:17:29Is what I'd say. It's a grade of how... How much you're losing, yeah.
0:17:29 > 0:17:31Anyone with any job that has a contentious topic
0:17:31 > 0:17:34such as your contract and your work, your hours and your pay,
0:17:34 > 0:17:36everyone's going to have an opinion, aren't they?
0:17:36 > 0:17:38It's been such a hot topic, recently.
0:17:38 > 0:17:42I'm 25, and compared to my peers who did a normal degree in a normal job,
0:17:42 > 0:17:45at 25, in my life I am nowhere near where they are.
0:17:45 > 0:17:46They are closer to getting a mortgage,
0:17:46 > 0:17:48they are closer to getting married,
0:17:48 > 0:17:50having a life, settling down, having kids.
0:17:50 > 0:17:52- I am nowhere there. - I do feel, I agree,
0:17:52 > 0:17:55I feel like I'm about three or four years behind my peers
0:17:55 > 0:17:57of the same age from medical school.
0:17:57 > 0:17:59You look at every corner of the NHS and everything, you know,
0:17:59 > 0:18:02there is problems that the pay is not as glorious
0:18:02 > 0:18:03as maybe some people think.
0:18:03 > 0:18:06Everyone moans about their job and it's more just frustrations
0:18:06 > 0:18:09that, you know, oh, I want to be able to do more and help more people.
0:18:09 > 0:18:12At the end of the day, I... I love my job and think I'm really lucky.
0:18:18 > 0:18:20Away from the respiratory ward,
0:18:20 > 0:18:22Anna is enjoying some well-deserved time off
0:18:22 > 0:18:24with pilot boyfriend Fraser.
0:18:28 > 0:18:30How are we doing, then?
0:18:30 > 0:18:34For her birthday, Fraser has bought Anna her first ever skiing lessons.
0:18:34 > 0:18:36- It looks horrendous! - No, you'll be all right.
0:18:42 > 0:18:43Oh, God!
0:18:43 > 0:18:45Really hard.
0:18:47 > 0:18:51With Anna working more evening and weekend shifts at the hospital
0:18:51 > 0:18:55and Fraser doing long hours as a pilot, their schedules often clash.
0:18:55 > 0:18:57I've been on nights and Anna has been working long days
0:18:57 > 0:19:00so as I'm going out to work, she's been getting in,
0:19:00 > 0:19:04so having some time together is really, really nice, actually.
0:19:04 > 0:19:05Yeah!
0:19:05 > 0:19:07Was it harder than you expected?
0:19:07 > 0:19:08I think so, yeah.
0:19:08 > 0:19:11I think it's just made me really want to go on a skiing holiday.
0:19:11 > 0:19:13We'll have to do some saving.
0:19:13 > 0:19:16With the new contract, it means I can't afford anything.
0:19:16 > 0:19:20- I know.- You'd think now, I'm working so many more hours, weekends,
0:19:20 > 0:19:23doing 14-hour days, and it's, like,
0:19:23 > 0:19:27I should really see a big boost in my pay from what I had before.
0:19:27 > 0:19:29- But it isn't there.- It's not there.
0:19:47 > 0:19:5126-year-old junior doctor Jin is halfway through his shift.
0:19:53 > 0:19:55ED.
0:19:56 > 0:19:59You go in half an hour and you fix it.
0:19:59 > 0:20:01I'm going here because it's busy there.
0:20:01 > 0:20:04The emergency department at New Cross Hospital
0:20:04 > 0:20:07treats over 350 people a day.
0:20:07 > 0:20:10I need to just do these treatment charts.
0:20:10 > 0:20:12Like all the doctors in the department,
0:20:12 > 0:20:14Jin is under pressure to see his patients
0:20:14 > 0:20:16within the hospital's target time-limit.
0:20:16 > 0:20:2090% of patients either have to be sent from the ED Department
0:20:20 > 0:20:23up to the ward or sent out, discharged, within four hours,
0:20:23 > 0:20:25so if the patient is still here and it's four hours,
0:20:25 > 0:20:28then that means that we've gone over the limit.
0:20:28 > 0:20:30Jin, Jo needs a plan on that man with the arm.
0:20:30 > 0:20:33Oh, is he back from the X-ray?
0:20:33 > 0:20:34- OK.- She just wants a plan.
0:20:34 > 0:20:37OK, no worries. It's going to breeze, isn't it?
0:20:37 > 0:20:38Could you give me just five minutes?
0:20:38 > 0:20:40I'll be back.
0:20:40 > 0:20:42I just need a quick...
0:20:42 > 0:20:44A quick discharge. Yep.
0:20:44 > 0:20:47We're trying our best to keep to that four hours,
0:20:47 > 0:20:50which is chaotic and hard because how can you expect us to do that
0:20:50 > 0:20:52when it's understaffed, there's a lack of junior doctors,
0:20:52 > 0:20:54lack of staff resources?
0:20:54 > 0:20:56Behind it all, we're always stressed out.
0:20:56 > 0:20:58We're all working hard for our patients.
0:20:58 > 0:21:01We're trying our best and it's not falling apart, it's still going,
0:21:01 > 0:21:04but a lot can be done to change the system, I think.
0:21:05 > 0:21:09Having avoided breaching the four-hour time limit with one patient,
0:21:09 > 0:21:13Jin returns to Mrs Choo, who's suffering from severe dizziness.
0:21:13 > 0:21:17Sorry, sorry, just had to quickly discharge a patient.
0:21:17 > 0:21:19Can you give us a water sample?
0:21:19 > 0:21:21- Mm-hm.- If you can provide us with a water sample,
0:21:21 > 0:21:24get one of the nurses to do a line and standing blood pressure.
0:21:24 > 0:21:27If that's all normal, then we can discharge you.
0:21:27 > 0:21:29- OK.- We'll try to get you out as soon as possible.
0:21:29 > 0:21:31- Thank you.- No worries.
0:21:31 > 0:21:34Jin wants to measure her blood pressure when she's standing
0:21:34 > 0:21:36and sitting to see if it's causing her dizziness.
0:21:36 > 0:21:39If the blood pressure is dropping from when you're lying
0:21:39 > 0:21:42and then standing up, you're going to get dizzy and faint
0:21:42 > 0:21:44because your blood pressure is dropping.
0:21:44 > 0:21:47That's her sitting and that her standing blood pressure,
0:21:47 > 0:21:48only she's going to leave.
0:21:48 > 0:21:51Whoa, whoa, that's quite high, here, isn't it?
0:21:51 > 0:21:53There's a greater than 20 difference as well, isn't there?
0:21:53 > 0:21:56There's a bit of a possible drop in blood pressure.
0:21:56 > 0:21:59Jin is concerned about his patient's blood pressure results
0:21:59 > 0:22:02and checks with senior consultant Dr Galani.
0:22:02 > 0:22:03Standing is a bit high.
0:22:03 > 0:22:05It's 198. It's a greater than 20 drop.
0:22:05 > 0:22:08- But she basically... - No, sorry, standing goes up.
0:22:08 > 0:22:09Yeah, it goes up.
0:22:09 > 0:22:11- So that...- Oh, it's not a drop, is it?
0:22:11 > 0:22:14Oh, God. I'm not thinking straight right now.
0:22:14 > 0:22:16I'm not thinking straight. Sorry, sorry.
0:22:16 > 0:22:18- Oh, God.- That's fine.
0:22:18 > 0:22:20Sorry about that.
0:22:20 > 0:22:21Clearly I'm tired.
0:22:24 > 0:22:25I can't do simple maths.
0:22:25 > 0:22:29It's not a drop, it's actually increased. Just...
0:22:35 > 0:22:36Can I go on a quick break?
0:22:36 > 0:22:39- Go on a...?- Quick break.- Break?
0:22:39 > 0:22:42- Yes. Break.- What's break, guys? You know anything called break?
0:22:42 > 0:22:45He's, like, "A quick break? What's a quick break?"
0:22:45 > 0:22:47Break? Why haven't you gone earlier?
0:22:47 > 0:22:50We asked the EU and the working time directive...
0:22:50 > 0:22:52Off you go. You should have gone earlier, man.
0:22:54 > 0:22:58Jin finally gets to eat his lunch seven hours into his shift.
0:22:58 > 0:23:00I'm going to get a little political.
0:23:00 > 0:23:03When I say this, I mean no offence to the politicians
0:23:03 > 0:23:04at the top, right?
0:23:04 > 0:23:07Unless you work on the front line as a junior doctor and as a nurse
0:23:07 > 0:23:10and as all the staff, you don't know what it's like.
0:23:10 > 0:23:12Unless you experience it.
0:23:12 > 0:23:14So they're only counting statistics and numbers
0:23:14 > 0:23:18and looking at the budget and determining, and it's all good,
0:23:18 > 0:23:20that's what you need as well,
0:23:20 > 0:23:22but I think we need more doctors,
0:23:22 > 0:23:25more senior doctors and more junior doctors who represent us
0:23:25 > 0:23:27to sit on the table to advise the politicians.
0:23:27 > 0:23:30To keep the NHS alive, they need to keep us alive.
0:23:30 > 0:23:33They need to keep us moralised. They need to keep the staffing levels
0:23:33 > 0:23:35alive and at the moment I don't see it happening.
0:23:47 > 0:23:48Away from the hospital,
0:23:48 > 0:23:52newlywed Omar is catching up with two other junior doctors,
0:23:52 > 0:23:54Anthony and Raul.
0:23:54 > 0:23:56How long have you been married?
0:23:56 > 0:23:59Just trying to figure it out!
0:23:59 > 0:24:01That's not a good sign!
0:24:01 > 0:24:03You should have your first anniversary present
0:24:03 > 0:24:04planned out already, man.
0:24:04 > 0:24:07Yeah, it's fine, it's all in here.
0:24:07 > 0:24:09Everything's up here, everything's in here.
0:24:09 > 0:24:11Have you got anything big planned out?
0:24:11 > 0:24:13- Taking her anywhere?- Going abroad.
0:24:13 > 0:24:15It's just a case of planning it now.
0:24:16 > 0:24:17Time's flown by.
0:24:17 > 0:24:21How is actually, like, balancing married life and...?
0:24:21 > 0:24:24I think just now, with this A&E rota, everything is a bit manic.
0:24:24 > 0:24:26Our rota changes every week.
0:24:26 > 0:24:30I think you need to look ahead and sort of see, you know,
0:24:30 > 0:24:31what big gaps I've got.
0:24:31 > 0:24:33It just takes more planning.
0:24:33 > 0:24:35It's been fine so far, thankfully.
0:24:35 > 0:24:37We'll see how it goes.
0:24:37 > 0:24:39But I think that's the one thing about A&E,
0:24:39 > 0:24:40it's a lot of shift patterns.
0:24:40 > 0:24:42Yeah, that's true.
0:24:51 > 0:24:53It's nearing the end of Jin's shift.
0:25:00 > 0:25:01Tired, man.
0:25:01 > 0:25:05And the emergency department is reaching its busiest time of day.
0:25:05 > 0:25:07Does it always get this busy at night?
0:25:07 > 0:25:10- Of course.- Is it because there's less doctors on at night?
0:25:10 > 0:25:12- Is that why, or...?- Yeah.- Oh. And more patients.
0:25:12 > 0:25:14Is it your left side?
0:25:14 > 0:25:15- Your left hip?- My right.
0:25:15 > 0:25:17On your right hip?
0:25:17 > 0:25:20ALARM SOUNDS Suddenly, the emergency alarm goes off.
0:25:20 > 0:25:22- What's going on?- I don't know.
0:25:22 > 0:25:24A patient has gone into cardiac arrest.
0:25:24 > 0:25:27Jin needs to get to them, and fast.
0:25:29 > 0:25:30Every second counts
0:25:30 > 0:25:32and he must quickly assess what needs to be done.
0:25:32 > 0:25:33Oxygen...
0:25:33 > 0:25:35The ambulance crew are pumping the chest
0:25:35 > 0:25:39to keep the blood flowing around the body whilst the heart has stopped.
0:25:39 > 0:25:41Can I grab a stent, please?
0:25:41 > 0:25:44Jin carefully monitors the patient's pulse for two minutes...
0:25:44 > 0:25:45Has that been the time, two minutes?
0:25:45 > 0:25:48..to check for a sign that they can try and restart the heart
0:25:48 > 0:25:50by shocking it with an electric current.
0:25:50 > 0:25:52- Shockable rhythm.- Carry on.
0:25:52 > 0:25:54- Press charge, yeah?- Wait.
0:25:54 > 0:25:56Charging. Everybody stand clear.
0:25:58 > 0:25:59Check pulses, please.
0:26:00 > 0:26:02Shockable rhythm? Will I press charge?
0:26:02 > 0:26:03Charge, please.
0:26:03 > 0:26:05Stand back, stand back.
0:26:05 > 0:26:07Shocking.
0:26:07 > 0:26:08Continue.
0:26:08 > 0:26:10Rhythm's back, rhythm's back.
0:26:10 > 0:26:11Check for pulse.
0:26:14 > 0:26:18At last, a pulse has been detected in the patient
0:26:18 > 0:26:21and she has come round, disorientated but alive.
0:26:27 > 0:26:33It's 11pm and Jin has finally finished his shift,
0:26:33 > 0:26:3512 hours after it started.
0:26:48 > 0:26:51I've worked long hours every day.
0:26:51 > 0:26:53I feel shattered, I feel tired.
0:26:53 > 0:26:56When you experience things like this, it keeps you going
0:26:56 > 0:26:59and it reminds you that you are making a difference
0:26:59 > 0:27:02and you feel gratified in the sense that the patient survived
0:27:02 > 0:27:05and you were there, doing your little part, and that's...
0:27:06 > 0:27:08..that's a rewarding feeling.
0:27:08 > 0:27:11It makes everything else worthwhile,
0:27:11 > 0:27:15all the other emotions and the crap and all the politics
0:27:15 > 0:27:19about the NHS and the demoralisation and, you know,
0:27:19 > 0:27:23all the staff shortage, all that becomes secondary, in a sense,
0:27:23 > 0:27:25after events like this.
0:27:25 > 0:27:27I feel a little emotional now.
0:27:28 > 0:27:33Cardiac arrest is the ultimate life-and-death situation in medicine.
0:27:33 > 0:27:36It doesn't get any more life and death than this.
0:27:43 > 0:27:45I think that's part of being a doctor.
0:27:45 > 0:27:48You just act. You have responsibility for everyone.
0:27:48 > 0:27:50You can try it.
0:27:50 > 0:27:52Have you ever...
0:27:52 > 0:27:54parts down below?
0:27:54 > 0:27:55Yeah.
0:27:55 > 0:27:58It's quite scary. For a second, I thought he was going to die.