0:00:07 > 0:00:09A typical night in A&E.
0:00:11 > 0:00:12It's like a battlefield.
0:00:12 > 0:00:13Language.
0:00:13 > 0:00:17Full of twentysomethings after a big night out.
0:00:17 > 0:00:22- Lots of vomit, lots of unconscious bodies lying around. - But not everyone's a casualty.
0:00:22 > 0:00:24Squeeze my fingers, please.
0:00:24 > 0:00:28Taking care of them is an army of doctors the same age.
0:00:28 > 0:00:32- They've had five years of training. - Cardiac arrest in A&E.
0:00:32 > 0:00:35And a rigorous induction into hospital life.
0:00:35 > 0:00:38Take full advantage of being in a bloody good city,
0:00:38 > 0:00:40in a bloody good NHS Trust.
0:00:43 > 0:00:44Never done this before.
0:00:46 > 0:00:49Now they face the reality of life on the wards.
0:00:49 > 0:00:50HE GROANS
0:00:50 > 0:00:52Cardiac arrest.
0:00:52 > 0:00:55- And there's no room for error. - You're doing well, sir.
0:00:55 > 0:00:58I guess if I really messed up, I probably could kill someone.
0:00:58 > 0:01:02Seven newly-qualified doctors are sharing this house in Newcastle.
0:01:04 > 0:01:09Second years Keir, Suzi, Jon and Andy, already have some experience.
0:01:09 > 0:01:11First years Lucy,
0:01:11 > 0:01:16Adam and Katherine are newly qualified.
0:01:16 > 0:01:21They've all chosen one of the toughest careers on the planet.
0:01:21 > 0:01:24But have they got what it takes?
0:01:24 > 0:01:29Most people have jobs that are busy some days and not busy other days, and it's swings and roundabouts.
0:01:29 > 0:01:31It's just relentless.
0:01:31 > 0:01:34No, no, no, you've got a needle sticking out of your arm.
0:01:34 > 0:01:37Adam has struggled with the reality of life as a doctor
0:01:37 > 0:01:40so how will he cope on his first night shift?
0:01:40 > 0:01:45Never seen this many patients waiting to be seen on EAU, ever.
0:01:45 > 0:01:50Can Suzi continue to cope with the relentless pressure of accident and emergency?
0:01:50 > 0:01:56I don't want to look as though I can't do my job. You know, how that feels? It makes you feel crap.
0:01:56 > 0:02:01Eight weeks into their new placements, do they still think they're up to the job?
0:02:01 > 0:02:04I don't want to be known as a doctor that does the bare minimum.
0:02:04 > 0:02:07I want to be known as the guy who goes the extra mile.
0:02:07 > 0:02:11You feel like you're at the bottom of a very, very tall ladder, looking up,
0:02:11 > 0:02:15and, like, it's a huge climb.
0:02:30 > 0:02:34It's 8pm and while most people have already done a day's work,
0:02:34 > 0:02:38three of the junior doctors are about to start a 12-hour night shift.
0:02:38 > 0:02:42Second years Suzi and Jon have now clocked up a fair few night shifts.
0:02:42 > 0:02:45But it's the first time for Adam.
0:02:45 > 0:02:47Yes, it's scary, the night shifts.
0:02:47 > 0:02:49You've got a lot less support at night.
0:02:49 > 0:02:53No matter what happens during out-of-hours, it's always more scary
0:02:53 > 0:02:56because you'll always have more responsibility.
0:02:56 > 0:02:58That's why it's so scary...
0:02:59 > 0:03:01..because more than at any other time,
0:03:01 > 0:03:03it's all about how you put your clinical skills
0:03:03 > 0:03:05into assessment and you make your decisions.
0:03:05 > 0:03:10It's kind of you and a few other, like, doctors,
0:03:10 > 0:03:13looking after the whole hospital.
0:03:13 > 0:03:16Tonight is going to be a particular challenge for Adam,
0:03:16 > 0:03:19who's struggled in his first few weeks as a doctor.
0:03:22 > 0:03:26He was frustrated by the amount of admin and lack of patient contact.
0:03:26 > 0:03:27You are the skivvy.
0:03:28 > 0:03:32How can I kind of like base this on what I want to do as a career
0:03:32 > 0:03:36because I'm having very little exposure to the actual job.
0:03:36 > 0:03:41But when he finally saw patients, he was criticised for being too slow.
0:03:41 > 0:03:45I've been demoted from ward round to discharges whilst ward round's going on.
0:03:45 > 0:03:47- Are you serious?- Yeah.
0:03:47 > 0:03:50He felt like he was never getting anything right.
0:03:50 > 0:03:53Basically, days like today just make me want to quit medicine.
0:03:53 > 0:03:58As he gets ready for his first night shift, how will he cope?
0:03:59 > 0:04:03Fellow first-year Katherine did her first night a few weeks ago
0:04:03 > 0:04:05and gives him some tips.
0:04:05 > 0:04:07I'm a little apprehensive, to be honest.
0:04:07 > 0:04:10Do you have any suggestions on, you know, things I should do,
0:04:10 > 0:04:11or not do?
0:04:11 > 0:04:13Take some chocolate
0:04:13 > 0:04:15because at four o'clock in the morning,
0:04:15 > 0:04:16you'll be, like,
0:04:16 > 0:04:19feeling really rubbish but you won't really know why,
0:04:19 > 0:04:21- and it's because you haven't eaten. - Right, right.
0:04:21 > 0:04:25- You won't feel like pasta, you won't feel like something savoury. - Right, right.
0:04:25 > 0:04:2924-year-old Suzi knows exactly what Adam's about to face.
0:04:29 > 0:04:31I will be honest.
0:04:31 > 0:04:34My first night shift, which was on surgery,
0:04:34 > 0:04:38was my worst day at work of all time.
0:04:38 > 0:04:40On surgery?
0:04:40 > 0:04:42And I came home and cried in the morning,
0:04:42 > 0:04:48and then I couldn't get back to sleep because I was so worried about having to go back in that day.
0:04:48 > 0:04:50I'm sure you'll be fine.
0:04:59 > 0:05:03Adam only left medical school eight weeks ago.
0:05:04 > 0:05:09This is a chance for him to prove he can really do the job.
0:05:11 > 0:05:14But before his shift has even begun,
0:05:14 > 0:05:15Adam has another worry to contend with.
0:05:17 > 0:05:19I'm just going to check that's all right.
0:05:20 > 0:05:22I've totally just broken my...
0:05:22 > 0:05:25I've done the same thing again!
0:05:25 > 0:05:29It's so low that it hits kerbs. The front hits kerbs.
0:05:29 > 0:05:31Urgh!
0:05:31 > 0:05:33- BLEEP- sake.
0:05:33 > 0:05:36He's based on the emergency assessment unit as part of a team
0:05:36 > 0:05:39where he may be called to any number of 170 patients.
0:05:39 > 0:05:41It's really hard here.
0:05:41 > 0:05:42You've got to be quick and get things done,
0:05:42 > 0:05:46you've got to have a good knowledge. It's really, really busy.
0:05:46 > 0:05:51So, tonight he could be stretched to the limit as he covers five wards.
0:05:52 > 0:05:54Although it's eerily quiet,
0:05:54 > 0:05:57it's actually more busy than it is during the day.
0:05:57 > 0:06:01I've never seen this many patients waiting to be seen on EAU.
0:06:01 > 0:06:02Ever.
0:06:03 > 0:06:08Like Adam, Jon's also based on EAU tonight.
0:06:08 > 0:06:09He's primarily ward cover,
0:06:09 > 0:06:14so he goes and sees all the patients on the wards that the nurses think are sick,
0:06:14 > 0:06:15and he sorts them out,
0:06:15 > 0:06:19and I'm solely based on EAU side of leave here.
0:06:19 > 0:06:22Adam's first patient is 70-year-old Paul,
0:06:22 > 0:06:25admitted with breathing difficulties.
0:06:25 > 0:06:28HE COUGHS
0:06:28 > 0:06:30Are you bringing anything up with that cough, sir?
0:06:30 > 0:06:32HE COUGHS
0:06:32 > 0:06:34- Sometimes.- Any blood in there?
0:06:34 > 0:06:36No, no.
0:06:36 > 0:06:38I've tried to put a little bit in there.
0:06:38 > 0:06:42Is it normally just like that, or is there any colour to it?
0:06:42 > 0:06:45- It's been coloured, it's been grey, green.- Any other problems?
0:06:45 > 0:06:48Any strokes? I know you've had a heart attack.
0:06:48 > 0:06:51A doctor did mention that I had
0:06:51 > 0:06:57- a stroke of some form, or, you know, I get a flutter in this eye.- Yeah.
0:06:57 > 0:07:01So although it's never bothered me, I feel embarrassed -
0:07:01 > 0:07:04all the boys think I'm winking at them.
0:07:07 > 0:07:10We'll try to find out what's going on, but it's good to have you in,
0:07:10 > 0:07:13give you a bit of an MOT, and check you over, yeah?
0:07:13 > 0:07:15HE COUGHS
0:07:15 > 0:07:18You keep on getting harassed by the wards,
0:07:18 > 0:07:21which is just standard when you're on F1 on nights.
0:07:21 > 0:07:22They just phone you up all the time.
0:07:22 > 0:07:24PHONE RINGS
0:07:24 > 0:07:27- Hello, F1 Claremont. - Still more to see.
0:07:27 > 0:07:28Hiya.
0:07:30 > 0:07:34Yes, you are now literally my next person now.
0:07:34 > 0:07:35All right, bye.
0:07:36 > 0:07:39OK, when I say next, I was lying.
0:07:46 > 0:07:48# Sometimes I go out by myself... #
0:07:48 > 0:07:51While first-year Adam's finding his feet,
0:07:51 > 0:07:55second-year Jon is taking everything in his stride.
0:07:55 > 0:07:56Stress is like a rocking chair.
0:07:56 > 0:08:00It gives you something to do, but doesn't get you anywhere.
0:08:00 > 0:08:02Just get on with it, just deal with it.
0:08:03 > 0:08:07Jon's cool exterior's about to be tested.
0:08:07 > 0:08:12He's called to see a woman who's attempted suicide by overdosing on prescription drugs.
0:08:12 > 0:08:14She's got some ECG changes
0:08:14 > 0:08:16so that means it might be affecting her heart,
0:08:16 > 0:08:22so I just need to see her and see if there's anything else I can do for her.
0:08:22 > 0:08:23The ECG or heart monitor,
0:08:23 > 0:08:27shows the drugs had she's taken have sent her heart rate rocketing,
0:08:27 > 0:08:31which could trigger a cardiac arrest at any moment.
0:08:31 > 0:08:33How are you feeling?
0:08:33 > 0:08:35I can imagine.
0:08:35 > 0:08:39Have you got any palpitations or heart racings? No?
0:08:40 > 0:08:43Just feel a bit drowsy?
0:08:45 > 0:08:49OK, we'll just have to wait and see how it goes, all right?
0:08:49 > 0:08:54I need to do another blood test at the wrist, I'm afraid, is that OK?
0:08:54 > 0:08:57I need to give another blood test at the wrist, all right?
0:08:58 > 0:09:00We have to.
0:09:03 > 0:09:07I'm afraid we have to do it because we need to monitor how...
0:09:07 > 0:09:12how much acid's in your blood cos that could cause you to have problems with your heart,
0:09:12 > 0:09:17and your ECG's already showing your heart's going a little bit faster than we would like,
0:09:17 > 0:09:21and we need to try and find a reason for why that is.
0:09:21 > 0:09:24So I'm really sorry but we have to do it.
0:09:25 > 0:09:28If it's any consolation, I'm quite good.
0:09:28 > 0:09:31I do them quite a lot.
0:09:37 > 0:09:38All right, sharp scratch.
0:09:45 > 0:09:48Sorry, you're doing really well.
0:09:50 > 0:09:53I know you're sore, you're doing really well.
0:09:55 > 0:09:57That's it, done now.
0:09:57 > 0:09:58All right?
0:10:01 > 0:10:04The majority of overdoses we get in here don't have any sort of lasting damage,
0:10:04 > 0:10:07and are more, sort of, cries for help,
0:10:07 > 0:10:10and just people who sort of really regret it after they've done it
0:10:10 > 0:10:12and really don't do themselves any lasting damage.
0:10:12 > 0:10:17We'll just have to see. It'll take days, weeks.
0:10:17 > 0:10:21So, you know, it's a bit of a waiting game now.
0:10:21 > 0:10:23The team have stabilised her,
0:10:23 > 0:10:27but her heart rate will have to be closely monitored over the next few days.
0:10:41 > 0:10:45Whilst Jon's coping under pressure, Adam's being pulled in every direction
0:10:45 > 0:10:48and trying to juggle all the demands thrown at him.
0:10:48 > 0:10:50Hello.
0:10:51 > 0:10:53It's not you.
0:10:53 > 0:10:57My name's Adam Beaini, I'm one of the doctors.
0:10:57 > 0:10:58Can you hear me?
0:10:59 > 0:11:02OK, can we pop a needle in your arm?
0:11:02 > 0:11:06I think the night's always going to be tricky.
0:11:06 > 0:11:09You know, it's a cross between patients needing stuff on the wards,
0:11:09 > 0:11:12and people needing to kept on the EAU.
0:11:12 > 0:11:15It's just a matter of what needs prioritising.
0:11:17 > 0:11:20Adam is called to see another patient.
0:11:20 > 0:11:23Can we pop a needle in your arm?
0:11:23 > 0:11:27- Just so that we can give you your medications?- No.
0:11:27 > 0:11:31But even the simplest jobs can be difficult when a patient's half-asleep.
0:11:31 > 0:11:33OK, sharp scratch.
0:11:33 > 0:11:36- Ooh, you're hurting me! - All right, all right.
0:11:36 > 0:11:40- Ow!- No, no, no, you've got a needle sticking out of your arm!
0:11:40 > 0:11:43I put the needle in her arm, and she just goes, takes her hand away,
0:11:43 > 0:11:48and then blood starts pouring out everywhere because the thing started coming off.
0:11:48 > 0:11:52Right, let's do the other one quickly and then get out of here
0:11:52 > 0:11:56because otherwise, like, someone's...someone's going to have my arse for lunch.
0:11:59 > 0:12:04Adam is trying to keep up with his jobs but his patients are beginning to back up.
0:12:04 > 0:12:07PHONE RINGS
0:12:09 > 0:12:11Hello, F1 Claremont.
0:12:11 > 0:12:14I'm just seeing someone with chest pain at the moment in EAU.
0:12:14 > 0:12:16Could you call me back in a bit
0:12:16 > 0:12:17and just let me know how she's doing?
0:12:17 > 0:12:19All right, thanks, bye.
0:12:20 > 0:12:25Most people have jobs that are busy some days and not busy other days,
0:12:25 > 0:12:28and it's swings and roundabouts, and peaks and troughs.
0:12:28 > 0:12:29EAU's just not.
0:12:29 > 0:12:32It's just relentless.
0:12:32 > 0:12:34Like, you never win.
0:12:34 > 0:12:36You're never on top.
0:12:36 > 0:12:37Pulled in every direction,
0:12:37 > 0:12:42Adam constantly has to decide which patient takes priority.
0:12:43 > 0:12:45I have a bit of a dilemma -
0:12:45 > 0:12:48should I go and see somebody with a spiked temperature,
0:12:48 > 0:12:51or this lady who had a stroke in A&E,
0:12:51 > 0:12:53and she doesn't look very well.
0:12:53 > 0:12:54Let's have a look at her notes.
0:12:54 > 0:12:56There's more pressure on the junior doctors.
0:12:56 > 0:13:00They've got requirement, they need to be here with us,
0:13:00 > 0:13:03but they also need to be on the wards seeing patients.
0:13:03 > 0:13:06I think sometimes the doctors get quite pressured by us.
0:13:06 > 0:13:08They'll have to get used to it!
0:13:12 > 0:13:15The nurse has just given me stick for being too slow.
0:13:15 > 0:13:17PHONE RINGS
0:13:19 > 0:13:21PHONE RINGS
0:13:22 > 0:13:24Hello, F1 Claremont.
0:13:24 > 0:13:27Adam's called away again,
0:13:27 > 0:13:29as another patient needs a doctor.
0:13:36 > 0:13:39Housemate Suzi is working her night shift in A&E.
0:13:39 > 0:13:41Even with experience, nights are challenging.
0:13:41 > 0:13:47Her confidence was recently knocked when a patient threatened to make a formal complaint about her.
0:13:47 > 0:13:51The family are just basically not happy with my figuring out of things.
0:13:51 > 0:13:54- Where's Camilla? - Let me speak to him.
0:13:54 > 0:13:58Feels like he was looking at my badge as if to say, who are you?
0:13:58 > 0:14:00You know. What do you know?
0:14:00 > 0:14:02I just don't want to talk about it, seriously.
0:14:06 > 0:14:10Back on the ward, Suzi must put this episode behind her.
0:14:11 > 0:14:17She's called to see an elderly patient, an ex-smoker, admitted with dangerously low oxygen levels.
0:14:17 > 0:14:24Jean... Jean. So, she had a stroke last year, she's been in with her chest quite a bit.
0:14:24 > 0:14:28- She was in four weeks ago with a chest infection.- It's always been chest related in hospital.
0:14:28 > 0:14:33Is this how she is normally when her chest gets bad, or is this different?
0:14:33 > 0:14:36No, the last couple of times, she hasn't been as bad as this.
0:14:36 > 0:14:42Suzi must assess whether 86-year-old Jean is unconscious, or asleep.
0:14:42 > 0:14:43Jean?
0:14:43 > 0:14:47Jean? Jean? JEAN SNORES
0:14:49 > 0:14:51How are you feeling?
0:14:51 > 0:14:53Uh-huh.
0:14:53 > 0:14:55- Do you have any pain anywhere?- Ahh.
0:14:55 > 0:14:56No.
0:14:56 > 0:14:59James?
0:14:59 > 0:15:02Suzi asks her senior doctor for advice.
0:15:02 > 0:15:06James, this is this lady here, she's 80 something.
0:15:06 > 0:15:10- The daughter saw her yesterday and she had a bit of a cough.- Mm.
0:15:10 > 0:15:15She's come in this evening more lethargic and quite drowsy and things.
0:15:15 > 0:15:19She could be drowsy because she's got a UTI, or she's got a chest infection.
0:15:19 > 0:15:24- She mobilises herself, does she, or does she need help with that? - I don't know. I need to find out.
0:15:24 > 0:15:27I think we just need to try to find a bit more collateral out about her,
0:15:27 > 0:15:30what she's normally like, does she feed herself, that sort of thing.
0:15:30 > 0:15:33- Yeah.- Is that all right?- Yes.- OK.
0:15:33 > 0:15:35Brilliant. Thank you.
0:15:35 > 0:15:41Suzi's sent back to ask more questions to make an accurate diagnosis.
0:15:41 > 0:15:44So she's normally in bed, or...?
0:15:44 > 0:15:47No, she normally sits in her wheelchair in the lounge, you know.
0:15:47 > 0:15:53- She's quite sociable?- Yes. - And does she...feed herself?
0:15:53 > 0:15:55- Does she get help with that? - No, she's got...
0:15:55 > 0:15:59- Well, she can feed herself. - She can feed herself, but she's got a very, very shaky hand.- Right.
0:15:59 > 0:16:03- So she does need help, but she does feed herself. - I'll just go and put this
0:16:03 > 0:16:06through the machine, I'll be back in a second.
0:16:08 > 0:16:11I asked some of it, I just didn't ask all of it.
0:16:11 > 0:16:13I'm not bloody perfect.
0:16:15 > 0:16:21Suzi's ordered a chest X-ray to get to the bottom of Jean's breathing difficulties.
0:16:21 > 0:16:27She's got some changes in her chest X-ray. She's got a bit of an infection there.
0:16:27 > 0:16:32She diagnoses a chest infection and decides on a course of antibiotics.
0:16:32 > 0:16:34Jean?
0:16:34 > 0:16:38- Haaa.- How are you feeling?- Uh-huh.
0:16:38 > 0:16:43- We're giving you some antibiotics for your chest, because you've got a bit of an infection there. OK?- Aaah.
0:16:43 > 0:16:45OK.
0:16:47 > 0:16:51Suzi asks James to double check Jean's X-ray.
0:16:51 > 0:16:56It's looking serious, and he asks Suzi to order stronger antibiotics.
0:16:59 > 0:17:00Can we give Cefuroxime instead of...?
0:17:03 > 0:17:05- Am I just in time?- Yeah.
0:17:05 > 0:17:09Good. How can I change it on the order?
0:17:12 > 0:17:16Jean needs to be transferred to a specialist unit in another hospital.
0:17:16 > 0:17:21Hello, I'm calling from A&E at the General, I wondered if I could just...
0:17:21 > 0:17:25let you know that one of our patients is coming over later on this evening.
0:17:25 > 0:17:32But Suzi can't wake Jean up, and it's too risky to transfer an unconscious patient.
0:17:32 > 0:17:34Right then, OK. Thanks, bye.
0:17:36 > 0:17:40I need to speak to James about it.
0:17:40 > 0:17:44James, the Med Reg says that she can't go in the back of an ambulance.
0:17:44 > 0:17:45She's in Resus 4.
0:17:45 > 0:17:49Jean? Hiya! Can you open your eyes for me?
0:17:49 > 0:17:52Hi, Jean? How are you feeling?
0:17:52 > 0:17:54You're all right. All right. All right.
0:17:54 > 0:17:58Sorry. I'm sorry. How are you feeling, Jean?
0:17:58 > 0:18:01I'm sorry to wake you up like that. That's horrible, isn't it?
0:18:02 > 0:18:06Sometimes with people that are quite drowsy, you've got to be
0:18:06 > 0:18:09a bit firmer to try and wake them up
0:18:09 > 0:18:12and actually elicit how drowsy they are.
0:18:12 > 0:18:15She's a bit more alert than I think Suzi thought.
0:18:17 > 0:18:21I don't want to call the Med Reg back, she's going to laugh at me!
0:18:21 > 0:18:26Jean was just asleep. Suzi needs to phone the other hospital to explain her mistake.
0:18:26 > 0:18:31Fully conscious, the patient can be transferred after all.
0:18:31 > 0:18:35My registrar has since been in to see her, and he's been able to rouse her and, after that,
0:18:35 > 0:18:41she was fine, and able to speak and do things, move around.
0:18:41 > 0:18:43Thanks again. Bye.
0:18:44 > 0:18:47I was crying earlier, because I was just really stressed.
0:18:47 > 0:18:49I feel like that all the time, actually!
0:18:51 > 0:18:55It gets worse. It's worse when you're on nights, I think. You feel a lot more...
0:18:55 > 0:19:00- It is. You're more sensitive. - Yeah. You feel there's not as much staff around and things.
0:19:00 > 0:19:04I think you feel more like you're making decisions on your own, don't you?
0:19:04 > 0:19:07You feel more like a burden on the registrars, too,
0:19:07 > 0:19:10because they have to answer all of your silly questions!
0:19:10 > 0:19:13'Junior doctors working in a new department, it's really tricky.'
0:19:13 > 0:19:17They come in with what we think is very little experience.
0:19:17 > 0:19:20They've done House Officer jobs where they're really quite led
0:19:20 > 0:19:22by the more senior doctors.
0:19:22 > 0:19:25When they come to us, we expect them really to be making decisions
0:19:25 > 0:19:31on the hoof, admitting and discharging patients off their own back and off their own knowledge.
0:19:31 > 0:19:36And it seems that they're asking more and more questions of the more senior doctors, the registrars.
0:19:36 > 0:19:40Which is a good thing to start with, but then they need to progress on.
0:19:40 > 0:19:43Sometimes it seems like that's not happening as quickly as it used to.
0:19:46 > 0:19:48- Don't worry about that.- I know, but I just feel kind of like...
0:19:48 > 0:19:52- Yeah, well...- But it's so basic.- You didn't do anything wrong.
0:19:52 > 0:19:56Oh, I know, I know. I think I was just feeling down earlier.
0:19:56 > 0:20:02- The senior doctors on A&E know how hard it can be.- 'I think a junior doctor's confidence'
0:20:02 > 0:20:05can be knocked by the whole situation in A&E.
0:20:05 > 0:20:07It's a very fast-paced environment.
0:20:07 > 0:20:09Some patients can be very demanding.
0:20:09 > 0:20:13'Other patients can present with very complicated problems and often
0:20:13 > 0:20:17'a young F2 has got the problem of dealing with that.
0:20:17 > 0:20:19'I think you must have a very sensible head on your shoulders'
0:20:19 > 0:20:22and a good way of dealing with that when you struggle.
0:20:27 > 0:20:28MOBILE RINGS
0:20:31 > 0:20:36- Hello.- Back in EAU, Adam and Jon are coming to the end of their 12 hour night shift.
0:20:36 > 0:20:39It's 5:40 in the morning on...
0:20:41 > 0:20:45..Saturday 3rd October now.
0:20:45 > 0:20:47Or is it the 4th? It's the 3rd.
0:20:47 > 0:20:49I have no idea.
0:20:49 > 0:20:50Sunday the...
0:20:50 > 0:20:54Oh, God. Anyway, I'm up-to-date on my jobs, and that's a good thing.
0:20:54 > 0:20:57Yeah, I'm quite tired tonight.
0:20:57 > 0:21:01Tomorrow night I'll be more sprightly after I go home and sleep.
0:21:03 > 0:21:08Adam has nearly made it through, but there are still patients to be seen.
0:21:08 > 0:21:10Hiya, pet.
0:21:10 > 0:21:13My name's Adam Beaini, I'm one of the doctors.
0:21:15 > 0:21:19All right, pet. Try and keep some oxygen back on, OK?
0:21:19 > 0:21:22I'll take your pulse and listen to your heart first. Then I'll listen to your back.
0:21:22 > 0:21:25- Sure.- And I'll have a quick feel of the tummy.
0:21:25 > 0:21:27And then we'll have a chat about what I think's going on, OK?
0:21:27 > 0:21:30So, do you want to just rest back on to the pillow for me?
0:21:30 > 0:21:32Righto.
0:21:32 > 0:21:36I hope you're not going to poke, poke, poke, like they were doing the other day.
0:21:39 > 0:21:41Let's hope not, eh?
0:21:41 > 0:21:46You've maybe got more experience than some of these young lads.
0:21:46 > 0:21:49Right. D'you reckon you'll be able to keep that in?
0:21:49 > 0:21:54- Yeah.- All right, pet. I'll see you later.- In my eighties now.
0:21:54 > 0:21:58- Well, you don't look it. - SHE GIGGLES - Thank you!
0:21:58 > 0:22:00See you.
0:22:00 > 0:22:03Is he married?!
0:22:03 > 0:22:09It may have been tiring, but working nights has given Adam the patient experience he was desperate for.
0:22:09 > 0:22:12It is nice, learning to do things myself
0:22:12 > 0:22:15and I am becoming a bit more independent,
0:22:15 > 0:22:18without feeling like I'm putting patients at risk
0:22:18 > 0:22:20or being, you know, a rubbish doctor.
0:22:20 > 0:22:25I feel like I'm being OK, so I don't feel too bad about anything.
0:22:25 > 0:22:29'I feel like I'm doing an OK job. I think it's really important that I've had to experience nights.'
0:22:29 > 0:22:36I think it's kind of encompassed what it is to be a junior doctor, being on nights and doing like,
0:22:36 > 0:22:41- you know, the- BLEEP- jobs, the good jobs, and everything in-between.
0:22:41 > 0:22:44I think it's just been a really crazy experience.
0:22:46 > 0:22:52As Adam heads home, housemate Keir is starting his shift on the Plastics Ward.
0:22:52 > 0:22:54Hello. How are you doing, Sir?
0:22:54 > 0:22:58- I really like it here.- It is, it's great. You know,
0:22:58 > 0:23:04you are buzzing! Two weeks ago, you would have walked down this corridor going, "I hate my job!"
0:23:04 > 0:23:10Now, you're walking down this corridor, just jumping and buzzing and being happy.
0:23:10 > 0:23:15You're constantly doing something, you feel like you're part of something that's working towards...
0:23:15 > 0:23:18But you will find that medical consultants and registrars on the ward
0:23:18 > 0:23:24will start involving you a lot more in treatment plans and will start asking you to assess patients
0:23:24 > 0:23:27and just going with your findings. And you will be trusted a lot more.
0:23:27 > 0:23:30So you might not just be as much of a paperwork monkey as you were.
0:23:30 > 0:23:32OK, dude. Well, I'll see you back at the house.
0:23:32 > 0:23:33Cool. I'll catch you later.
0:23:33 > 0:23:35Bye-bye.
0:23:39 > 0:23:46While Adam's buzzing from his first night shift, at home, Suzi's confidence is low.
0:23:46 > 0:23:52'I hate it when I do anything wrong or I think, "Oh, I could have done that better." You know?'
0:23:52 > 0:23:59And if we do anything wrong in our job, the worst thing that can happen is that someone dies.
0:23:59 > 0:24:01And that's like a massive thing.
0:24:01 > 0:24:05Like, someone's life in our hands.
0:24:05 > 0:24:09Like, I'm 24, and that's such a kind of burden and stress and things.
0:24:09 > 0:24:15Despite coping well on the wards, Jon's also thinking about his performance as a doctor.
0:24:15 > 0:24:19I kind of scraped through this last year,
0:24:19 > 0:24:22just doing the kind of bare minimum.
0:24:22 > 0:24:29And I guess, you know, I don't want to be known as a doctor or whatever that does the bare minimum.
0:24:29 > 0:24:33I want to be known as the guy who goes that extra mile and, you know,
0:24:33 > 0:24:36would do anything to make sure that patients are OK and stuff like that.
0:24:36 > 0:24:39So I guess I've got a few challenges this year.
0:24:40 > 0:24:42In fact, he's got a lot to prove.
0:24:42 > 0:24:47He just scraped through his first year after failing to keep up with his assessments.
0:24:47 > 0:24:49There's a lot of red here.
0:24:49 > 0:24:55I just put it off till the last minute, really. It's the kind of stuff I do, that's how I work.
0:24:55 > 0:25:01He wants to be a surgeon, and has just taken an exam to get into that field.
0:25:01 > 0:25:05But it was squashed into a hectic week of night shifts and rugby training.
0:25:06 > 0:25:11The book's about this thick, and I've read about this much, so we'll have to see.
0:25:11 > 0:25:12We'll have to wing it.
0:25:17 > 0:25:23While he's waiting for his exam results, Jon goes home to Oxfordshire, to see Mum and Dad.
0:25:25 > 0:25:27Hey, Dad, how's it going?
0:25:27 > 0:25:29Hello, sunshine, how are you? Nice to see you.
0:25:29 > 0:25:32'We are quite a close family. We like spending time with each other.
0:25:32 > 0:25:34'I try and get home when I can,'
0:25:34 > 0:25:37even if it's just for a couple of days, just to see Mum and Dad.
0:25:37 > 0:25:40I think Jonathan expressed an interest in being a doctor
0:25:40 > 0:25:43when he was about six or seven. I mean,
0:25:43 > 0:25:44like all boys, "I want to be a fireman,"
0:25:44 > 0:25:47"I want to be a policeman," "I want to be a truck-driver."
0:25:47 > 0:25:52But when he got his A-level results, he gave me a big hug and he said, "Mum, I'm going to be a doctor."
0:25:52 > 0:25:56And I mean, I was in tears, and I think he was almost in tears as well.
0:25:56 > 0:26:03His mum knows that he can be very laid-back, and is anxious to find out how the exam went.
0:26:03 > 0:26:07The first paper was really hard, the second paper was pretty easy.
0:26:07 > 0:26:10Well, not easy, but nicer questions.
0:26:10 > 0:26:13- I think I've probably passed the second paper. - But you've got to have...
0:26:13 > 0:26:17But you have to pass both, it's not like a cumulative thing. So...
0:26:17 > 0:26:18'He does try hard,'
0:26:18 > 0:26:22but he doesn't give you the impression that he has tried hard.
0:26:22 > 0:26:26He'd always, you know, if he had homework to do, he would be
0:26:26 > 0:26:30the one that would stay up all night the day before it was due in.
0:26:30 > 0:26:32You know, I might have been brilliant and passed it.
0:26:32 > 0:26:34Yeah. Pigs might fly!
0:26:34 > 0:26:36- It's happened in the past! - Well, it has, yes.
0:26:36 > 0:26:39'He nearly failed a couple of his exams'
0:26:39 > 0:26:44in his first year, and I think that really brought him up short.
0:26:44 > 0:26:48And he thought, "Yeah, I do need to maybe put a little bit more effort in."
0:26:55 > 0:26:59Back in Newcastle, Jon's housemates, first year Katherine
0:26:59 > 0:27:03and second year Keir are working on the Plastics Ward.
0:27:03 > 0:27:09Over the past few weeks, Keir has been learning the importance of a good bedside manner.
0:27:09 > 0:27:10'I think medicine'
0:27:10 > 0:27:14is just...is, you know, great fun and really dynamic.
0:27:14 > 0:27:19If you want some time off, you know, just...just make it an excuse!
0:27:19 > 0:27:22I would say that I've been using acting skills,
0:27:22 > 0:27:25'every day that I've been on the wards.'
0:27:25 > 0:27:29If there's not an arrow on, we might sew up that ear by mistake, and that would be silly!
0:27:29 > 0:27:30'Making people feel better,
0:27:30 > 0:27:33'that's what it is. And it's not just by giving them penicillin,'
0:27:33 > 0:27:36it's also by cheering them up.
0:27:36 > 0:27:38And that's what I like doing.
0:27:38 > 0:27:44Many of the patients in the Plastic Department need major reconstructive surgery.
0:27:44 > 0:27:48And it's the job of the juniors to give them emotional support.
0:27:48 > 0:27:53- Hey. How are you doing? - All right.- Good, good. Um, blood tests are back...
0:27:53 > 0:27:56Keir is looking after 20-year-old Dean,
0:27:56 > 0:27:58a builder with serious injuries after a motorbike crash.
0:27:58 > 0:28:03'Dean is an example of the sort of patient we see quite a lot in plastic surgery.'
0:28:03 > 0:28:05He's very young, very fit, very healthy.
0:28:05 > 0:28:11But came off his motorbike at quite a high, but LEGAL, speed.
0:28:11 > 0:28:16'And you know, it has pretty much destroyed the left-hand side of his body.
0:28:16 > 0:28:22'He's dislocated, ruptured, and broken his shoulder. He's broken his forearm in two places.'
0:28:22 > 0:28:26He's stripped the skin off his legs, you know,
0:28:26 > 0:28:30he's got very little function down the left-hand side of his body now.
0:28:30 > 0:28:32How's the graft doing?
0:28:32 > 0:28:35It was sore last night, I must admit, on the leg.
0:28:35 > 0:28:41Mm-hm. The orthopaedic surgeons put the shoulder back together and we're trying to put the skin back together
0:28:41 > 0:28:42'in his leg.'
0:28:42 > 0:28:47Keir and the team need to assess if Dean's first muscle transfer and skin graft has worked,
0:28:47 > 0:28:49or if he needs another operation.
0:28:49 > 0:28:54All of the nerve fibres that have been cut are all knitting back together
0:28:54 > 0:28:59and the ones that knit back together first are, helpfully, the ones that feel pain.
0:28:59 > 0:29:02I'll have a look at your painkillers
0:29:02 > 0:29:05and make sure that you're on the right stuff.
0:29:05 > 0:29:11With a complicated case, it's important Keir communicates everything clearly.
0:29:11 > 0:29:16He's been fantastic. Very good at describing and...
0:29:16 > 0:29:18you know, getting the picture in your head...
0:29:18 > 0:29:22Not all of us understand everything but he's very good at getting it over,
0:29:22 > 0:29:25so he's the best one that I've probably met, to be honest.
0:29:27 > 0:29:30After Keir and the senior team review Dean's progress,
0:29:30 > 0:29:34there's bad news. His arm is doing well but he needs further surgery on his leg.
0:29:34 > 0:29:40I've been notified that I'm going to have to have another operation now, for another muscle to get moved into
0:29:40 > 0:29:46my leg because it's such a big hole, a big gash in my leg that it literally needs filled up.
0:29:46 > 0:29:52So I'm not going to say I'm not worried about the operation, because it's something that's pretty major,
0:29:52 > 0:29:55but it's something that's got to be done.
0:29:55 > 0:30:00As a second year, Keir now has to face up to answering difficult questions.
0:30:00 > 0:30:05'Dean's injuries will... will take months to sort out.'
0:30:05 > 0:30:11If I'm asked by him, I can't say, "Oh, I'll get one of my seniors."
0:30:11 > 0:30:16'I am now in a position where I can answer his questions, and should.'
0:30:16 > 0:30:21It's Katherine's job to take some blood before his big operation.
0:30:21 > 0:30:25- It's pretty serious on Thursday, mind, isn't it?- Hm?
0:30:25 > 0:30:28On Thursday, it's pretty serious - what's going to happen.
0:30:28 > 0:30:30- The operation?- Yeah.
0:30:30 > 0:30:32- Yeah.- I kind of thought I'd be going home today.
0:30:32 > 0:30:38Mm. You've had some of your skin moved around, haven't you? To cover up where your skin's been taken off
0:30:38 > 0:30:41by the motorbike accident. Not all of it's taken
0:30:41 > 0:30:45so he needs some skin or muscle taken from somewhere else.
0:30:48 > 0:30:55The surgery to repair the hole in Dean's leg could take many hours and there's no guarantee of success.
0:30:57 > 0:31:03The blood vessels in the flap that have been attached to the blood vessels at the site of the injury,
0:31:03 > 0:31:05he's worried that they'll clot off or go into spasm
0:31:05 > 0:31:10'and the flap won't get enough blood supply and will basically just die off.'
0:31:10 > 0:31:14If the operation fails, Dean could lose his leg below the knee.
0:31:22 > 0:31:26Back at the house, it's an important day for second-year Jon.
0:31:26 > 0:31:30I get my results of my surgery exam today.
0:31:30 > 0:31:31Exam results...
0:31:35 > 0:31:37Exam results. That might do it.
0:31:39 > 0:31:42Ah, right. Yeah.
0:31:42 > 0:31:45I didn't pass.
0:31:45 > 0:31:49Obviously, I'm disappointed. Nobody likes to take stuff and fail.
0:31:49 > 0:31:53I probably didn't dedicate enough time to it as I should have done.
0:31:53 > 0:31:55I didn't revise as much as I should have done.
0:31:55 > 0:32:01A lot of people, when they qualify, are very swept up in the job and the career and stuff.
0:32:01 > 0:32:05I think me personally, I want to still have a life and,
0:32:05 > 0:32:09yes, I want a career, but not to the detriment of everything else.
0:32:18 > 0:32:20Suzi's also feeling low.
0:32:21 > 0:32:27So with a few days off, she's heading home to Ireland to get some support from Mum and Dad.
0:32:27 > 0:32:35They know me better than anyone else. So their feedback and things is always very useful.
0:32:36 > 0:32:39Her parents are keen to find out how she's coping with work.
0:32:39 > 0:32:43I think confidence is an issue, personally. If you're having
0:32:43 > 0:32:46a bad day, sometimes you don't feel as confident and things.
0:32:46 > 0:32:51You know, say if you kind of think, "Oh, I always ask that question, and the registrar has asked me,
0:32:51 > 0:32:54you know, 'What did the patient say to that question?'"
0:32:54 > 0:32:58I didn't ask it on that one time. I think, "Oh, I should have done it."
0:32:58 > 0:33:02And I think I've got high expectations of myself.
0:33:02 > 0:33:08You're not, by nature, somebody who goes around blowing her own trumpet all the time.
0:33:08 > 0:33:11- Yeah, I know. I'm not.- So to speak. - Yeah.
0:33:11 > 0:33:15So I think maybe that, and yet I would like you to feel that...
0:33:15 > 0:33:19- I know what I'm doing.- Yes, exactly. I think you know what you do at work.- I think that's coming, yeah.
0:33:19 > 0:33:23Her parents know that Suzi is her own worst critic.
0:33:23 > 0:33:28I suppose as a child she probably lacked confidence.
0:33:28 > 0:33:31"So and so is better at sport and so and so is thinner than I am..."
0:33:31 > 0:33:32She's always been...
0:33:32 > 0:33:38I don't know, very hard on herself, in some respects, but then I suppose, at the end of the day, it's what's
0:33:38 > 0:33:45- made her work very, very hard, because she's always wanted to be the best she possibly can.- Yeah.
0:33:47 > 0:33:52Suzi's brother, who's just qualified as a pilot, is also home.
0:33:52 > 0:33:54- How are you?- Good to see you, Suzi.
0:33:54 > 0:33:56- I'm very well.- Well.
0:34:07 > 0:34:12When I started my first week or two, actually flying passengers, doing my line training,
0:34:12 > 0:34:16it was just... Everything was so fast
0:34:16 > 0:34:21and I thought I'd never get my head around it in the end but then after a while you get the confidence.
0:34:21 > 0:34:24- Yeah.- Something just clicks
0:34:24 > 0:34:27and it all just comes together.
0:34:27 > 0:34:30I've always known that I can do things but I don't come across very confident sometimes.
0:34:30 > 0:34:36- Like in loads of things. - When it comes together and you get good results it must be rewarding.
0:34:36 > 0:34:38Oh, yeah, yeah, yeah. Like...
0:34:38 > 0:34:45It's, like, satisfying, being able to, like, not fix people that are sick but, you know, think that
0:34:45 > 0:34:50they've got a cannula in because I did that, or they're feeling better because I've been in here
0:34:50 > 0:34:54managing them in resus on my own, and they're alive, still!
0:34:54 > 0:34:56Yeah. I didn't think you'd be a doctor, you know.
0:34:56 > 0:34:5710 or 15 years ago, I didn't.
0:34:57 > 0:35:02- Once you'd decided to do it, I didn't really have too much doubt that you'd achieve it.- Thank you.
0:35:02 > 0:35:06Argh! Don't tickle me!
0:35:06 > 0:35:08SUZI SQUEALS
0:35:11 > 0:35:17- Be good, be good, be good.- Take care, then.- Bye! Thank you for having me home.- Oh, don't mention it.
0:35:17 > 0:35:19- Take care, Suzi. - See you soon.
0:35:19 > 0:35:21Take care.
0:35:28 > 0:35:33After a few days at home, Suzi's spirits are back up.
0:35:33 > 0:35:38'I do feel as though I'm up to the job in A and E, even though sometimes it's really hard
0:35:38 > 0:35:44'and challenging and I have bad days and I think, "I could have done that better"'
0:35:44 > 0:35:47or blah, blah, blah... But in any job, even if you're great at that job,
0:35:47 > 0:35:52you're going to have bad days, because we're only, like, human after all.
0:35:53 > 0:35:58Back in Newcastle, Adam's just finishing nights.
0:35:58 > 0:36:02Keir and Katherine are starting their day on the Plastics Ward,
0:36:02 > 0:36:04where Dean is recovering from his operation.
0:36:08 > 0:36:10- You all right? - How are you doing? You all right?
0:36:10 > 0:36:13Yeah, good. Feeling better at all?
0:36:13 > 0:36:16I do feel rough, yeah. I was bad last night, but...
0:36:16 > 0:36:21- I don't know whether you've heard it off the nurses, my stories and that, but...- No! What happened?
0:36:21 > 0:36:24Well, it was very hot in here. Let's just say it was hot in here and...
0:36:24 > 0:36:28- Oh, and you'd just had a bit too much morphine, and...?- I had a lot of morphine in us
0:36:28 > 0:36:32and I kind of thought all the nurses were walking around in their underwear, like.
0:36:32 > 0:36:35And I did ask her, "Have you been walking around in your underwear?"
0:36:35 > 0:36:40- She went, "No, no - you'll make us go red."- Aw.
0:36:40 > 0:36:42- Were you in the theatre?- No.
0:36:42 > 0:36:46We did actually pop down but they'd finished by the time we got there.
0:36:46 > 0:36:47It was quite quick, wasn't it?
0:36:47 > 0:36:49Mm, it was quite quick.
0:36:49 > 0:36:52- Well, I think they're pretty pleased with it.- Good.
0:36:52 > 0:36:55Everyone that's come in has said that it looks good, like.
0:36:55 > 0:36:57I deserve a bit of good luck now.
0:36:57 > 0:36:59Definitely, yeah.
0:36:59 > 0:37:02I think it's especially important to have good relationships
0:37:02 > 0:37:05with the patients on Plastics because whilst a lot of patients
0:37:05 > 0:37:07are in and out in two or three days,
0:37:07 > 0:37:10we have a lot of patients on who are quite long-term.
0:37:10 > 0:37:15Even though the operation went well, Dean's future is uncertain.
0:37:15 > 0:37:18If the graft doesn't take, he could face losing his leg.
0:37:24 > 0:37:27SIREN WAILS
0:37:28 > 0:37:31Do you want me to call X-ray in a bit, then?
0:37:31 > 0:37:33- Yeah.- Right.- Yeah.
0:37:33 > 0:37:36Suzi's back on A and E. The unit's very busy.
0:37:36 > 0:37:39The senior doctor is already dealing with
0:37:39 > 0:37:44two critically ill patients and there's another on his way in.
0:37:44 > 0:37:49- You're going to take this for me, then?- Yeah. Is that all right?- I'll be here, yeah.- Yeah, so just like...
0:37:49 > 0:37:54An elderly man has been rushed in with breathing difficulties.
0:37:54 > 0:38:00It's a chance for Suzi to prove she can handle a critical case by herself.
0:38:02 > 0:38:04Albert?
0:38:04 > 0:38:06How are you feeling?
0:38:06 > 0:38:09His blood pressure is extremely low.
0:38:11 > 0:38:13What does he sound like?
0:38:13 > 0:38:15Rattling everywhere.
0:38:15 > 0:38:20- Kind of coarse...- OK.- ..crackles. But I'm going to listen to his back in a second.- OK.
0:38:20 > 0:38:22He's not looking very well.
0:38:22 > 0:38:23No, I'm worried about him.
0:38:26 > 0:38:31I'm just putting some fluid up because the patient's blood pressure's very low. Dangerously low.
0:38:31 > 0:38:36After listening to his chest, Suzi suspects a serious chest infection.
0:38:36 > 0:38:38I think it could be septic.
0:38:38 > 0:38:41It means that he's ill from an infection.
0:38:41 > 0:38:44Very sick. That's the long and short of it, really.
0:38:46 > 0:38:48I'm just going to take some bloods.
0:38:56 > 0:39:00She orders a chest X-ray, to confirm her suspicions.
0:39:03 > 0:39:08Yes, he's had a chest X-ray and James has seen it and thinks it's more...
0:39:08 > 0:39:13infection, rather than heart failure, so now we're just working on bringing his...
0:39:13 > 0:39:16blood pressure up a bit and his pulse down a bit.
0:39:16 > 0:39:19Suzi's diagnosis is right.
0:39:19 > 0:39:23She resuscitates the patient with fluids and administers antibiotics.
0:39:28 > 0:39:31Do you need anything else for him, James?
0:39:39 > 0:39:41Are you feeling any better?
0:39:41 > 0:39:44- Uh-huh.- That's good, and you're able to speak now. Brilliant.
0:39:44 > 0:39:48He looks a little bit better now than he did when he first came in.
0:39:48 > 0:39:51He's a bit more alert. He's looking around.
0:39:51 > 0:39:53His blood pressure stabilises.
0:39:53 > 0:39:56Wow! 90 over 52.
0:39:56 > 0:39:58We're winning.
0:39:58 > 0:40:05Suzi's patient has gone from being critically ill to stable and it's a massive boost for her confidence.
0:40:05 > 0:40:08I feel quite, like, alive.
0:40:09 > 0:40:13I like helping people. That's why I'm here.
0:40:13 > 0:40:19And I felt more, like, clear and concise, which isn't a forte of mine,
0:40:19 > 0:40:20but I'm working on it.
0:40:20 > 0:40:24It's a work in progress, my self-confidence.
0:40:29 > 0:40:34On the Plastics Ward, Katherine's patient, Dean, is hoping to be discharged.
0:40:34 > 0:40:40Things are looking good. Everything's fantastic on the leg. It's healing well.
0:40:40 > 0:40:43Basically, just waiting to go home. I'm ready to go home now.
0:40:46 > 0:40:51The plastic surgeon, Mr Alrawi, wants to see if the graft has taken.
0:40:51 > 0:40:55So you dangle it twice every day.
0:40:55 > 0:40:57They're doing it twice. Morning and afternoon.
0:40:57 > 0:40:59Righto.
0:40:59 > 0:41:01Has it always been like this?
0:41:01 > 0:41:02- Yeah.- Yeah.
0:41:04 > 0:41:05WINCES
0:41:07 > 0:41:10Does it look really good though?
0:41:10 > 0:41:12- Yeah, looks good.- Yeah?
0:41:12 > 0:41:16I think you're doing well, at this stage but there's still some raw area.
0:41:16 > 0:41:18It potentially can become infected.
0:41:18 > 0:41:20- Stay over the weekend. - Stay over the weekend, yeah.
0:41:20 > 0:41:24- Yeah, you reckon?- That all right? - If it's got to be done, it's got to be... I'd like to go home, like.
0:41:24 > 0:41:28I know you want to go home but this is a big-time
0:41:28 > 0:41:32- operation so you don't want things to go wrong after all this time.- No.
0:41:32 > 0:41:35'The recovery from this operation,'
0:41:35 > 0:41:38or from this type of injury, takes around 8 to 12 weeks.
0:41:38 > 0:41:45'Things can go wrong. More of those young people are passionate and are keen to go back on their feet.'
0:41:47 > 0:41:48If they overdo things,
0:41:48 > 0:41:52and they don't comply with what we told them to do, so...
0:41:52 > 0:41:55So hopefully he'll be all right.
0:41:55 > 0:41:58He sounds a sensible chap, so he should be all right.
0:41:58 > 0:42:05Dean's clearly disappointed but Katherine's job now is to help keep him positive.
0:42:05 > 0:42:09- Are you getting a bit fed up of this place?- I just want to go home. Just let us go home.
0:42:09 > 0:42:14You don't like to see patients being stuck in hospital for any length of time but it's always nice
0:42:14 > 0:42:18when they're so positive and cheerful and it makes your job a lot easier, I think.
0:42:18 > 0:42:22Ah, cheers. THEY CHUCKLE
0:42:28 > 0:42:30While Katherine comforts Dean, Keir has been called to
0:42:30 > 0:42:34the Children's Clinic on plastics.
0:42:34 > 0:42:38- He's seeing six-year-old, Aleysha. - Can you feel me tickling your foot?
0:42:38 > 0:42:43OK. OK, and can you feel me tickling the top of your foot?
0:42:43 > 0:42:44Can you feel me tickling the side of your leg?
0:42:44 > 0:42:48Can you feel me tickling the other side of your leg?
0:42:48 > 0:42:51I really enjoy the challenge of working with children.
0:42:51 > 0:42:55They are great fun and you've got to use a lot of lateral thinking
0:42:55 > 0:42:58in order to distract them from the thing that you want to do.
0:42:58 > 0:43:04- How old are you, Aleysha?- Six.- Six. Excellent. Good. I liked being six.
0:43:05 > 0:43:08I was six a very long time ago.
0:43:08 > 0:43:10A good age to be, six. OK.
0:43:12 > 0:43:14Do you have any questions at all?
0:43:14 > 0:43:16No.
0:43:16 > 0:43:17No, OK.
0:43:17 > 0:43:19We're going to need to put some stitches in just to close it up
0:43:19 > 0:43:23because it's quite a deep wound and it's also in an awkward place.
0:43:23 > 0:43:27Every time she bends her ankle, it'll pull so we need to keep it together.
0:43:29 > 0:43:33OK. Erm, I'll see if we can get it sewn up today.
0:43:33 > 0:43:35OK.
0:43:35 > 0:43:37If we can't, it will be tomorrow.
0:43:39 > 0:43:43But I'm working on trying to get everybody seen today. OK?
0:43:43 > 0:43:48Working out on what level you can talk to people from child to adult,
0:43:48 > 0:43:53child to adult, and not come over as immature
0:43:53 > 0:43:54but, at the same time,
0:43:54 > 0:43:58not come over as unable to communicate with a child.
0:43:58 > 0:44:04So it's a real kind of acting challenge in many ways,
0:44:04 > 0:44:06which is probably why I enjoy it.
0:44:06 > 0:44:08You have to change character a lot.
0:44:15 > 0:44:18Adam has finished his night shifts on emergency admissions
0:44:18 > 0:44:21and is going back to work on the respiratory ward,
0:44:21 > 0:44:22where he first started as a doctor.
0:44:28 > 0:44:31I learnt a lot in EAU, definitely a lot more than
0:44:31 > 0:44:34I learnt in respiratory, just because of the nature of the job.
0:44:34 > 0:44:36The EAU is so varied
0:44:36 > 0:44:40and it's just really good for being a well-rounded doctor.
0:44:40 > 0:44:43Whereas on respiratory, I haven't made any executive decisions.
0:44:43 > 0:44:47I think it's probably going to be a bit like being a ward monkey again.
0:44:48 > 0:44:51I don't know. There's pluses and minuses with it, really.
0:44:54 > 0:44:56But when he gets there,
0:44:56 > 0:45:00he's straight into working with patients, helping Dr Burns.
0:45:02 > 0:45:04They're seeing 86-year-old Elsie,
0:45:04 > 0:45:06admitted with breathing difficulties.
0:45:06 > 0:45:10- Right, I'll be honest with you, we haven't got all the answers yet.- No.
0:45:10 > 0:45:11I think we need a repeat chest X-ray
0:45:11 > 0:45:15and we need some repeat bloods today.
0:45:15 > 0:45:17- We'll get you there, we'll sort you out.- Are you sure?
0:45:17 > 0:45:19Oh, yes, we'll sort you out.
0:45:20 > 0:45:22- We're not there yet, I'll be honest with you.- No.
0:45:22 > 0:45:24It's been nice to see you and we'll see you again.
0:45:24 > 0:45:26- Thank you very much.- Thanks.
0:45:30 > 0:45:35- It's a pulmonary oedema? - It could be, couldn't it?
0:45:35 > 0:45:38This is not a normal X-ray at all.
0:45:38 > 0:45:40The thing is with Dr Burns, he's really
0:45:40 > 0:45:43good at teaching as he goes along.
0:45:43 > 0:45:46That's really, really helpful.
0:45:46 > 0:45:50He's always asking me what I think of chest X-rays and it's fantastic
0:45:50 > 0:45:51because I feel like I'm actually learning something as I'm
0:45:51 > 0:45:55going along, as opposed to being a mindless drone.
0:45:55 > 0:45:57It's easy in F1 to actually become deskilled,
0:45:57 > 0:45:59compared to as a medical student.
0:45:59 > 0:46:03If you just go along doing all the admin jobs and don't do any thinking.
0:46:05 > 0:46:09Adam's given an opportunity to assess a patient himself.
0:46:09 > 0:46:12So how are you doing, sir? How's the breathing?
0:46:12 > 0:46:19- It's getting back to normal. I still have the shortness of breath.- OK.
0:46:19 > 0:46:22Are you managing to walk a bit further than you were before?
0:46:22 > 0:46:27- Oh, yeah, I've been up, I've walked to the coffee shop.- Oh, yeah.
0:46:27 > 0:46:29- Twice yesterday.- Oh, yeah. - And twice on Saturday.
0:46:29 > 0:46:32- Can I have a listen to your chest? - Certainly, yes.
0:46:32 > 0:46:36It's nice to review patients myself.
0:46:36 > 0:46:38I feel like I'm actually doing something useful.
0:46:38 > 0:46:40Just doing jobs on their own and not reviewing anyone,
0:46:40 > 0:46:44not making any executive decisions, sucks.
0:46:44 > 0:46:46Actually reviewing one or two patients is really good.
0:46:46 > 0:46:50I think it's really important for my own kind of self-confidence
0:46:50 > 0:46:52and to keep me going.
0:46:52 > 0:46:55I've actually had quite a pleasant day, to be honest with you.
0:46:55 > 0:46:58I've just realised that.
0:46:58 > 0:46:59It does get easier.
0:46:59 > 0:47:03I think the hardest time is shortly after qualification.
0:47:03 > 0:47:05They're finding it extraordinarily difficult,
0:47:05 > 0:47:07they've suddenly lost a lot of confidence
0:47:07 > 0:47:09because they think they know nothing.
0:47:09 > 0:47:12They are normal, healthy individuals going through unusual
0:47:12 > 0:47:15periods of stress and they just need a little bit of nurturing.
0:47:17 > 0:47:20I've got to have matured so much since the first day.
0:47:20 > 0:47:24I care less about money and about materialistic things,
0:47:24 > 0:47:28about superficial things and about pointless things.
0:47:28 > 0:47:31I feel like I've got a purpose in life now.
0:47:38 > 0:47:41Suzi's also been given a break on A&E.
0:47:41 > 0:47:45A patient has come in with a serious gash on her arm.
0:47:45 > 0:47:50- How did you do this?- I was slightly inebriated last night, shall we say.
0:47:50 > 0:47:53I went to the toilet and forgot there was a bath mat
0:47:53 > 0:47:56and I was wearing my high heels and I fell right over the bath mat,
0:47:56 > 0:47:58right through the bathroom window.
0:47:58 > 0:48:02Suzi's senior is trusting her to perform the stitches.
0:48:02 > 0:48:06- It's the first time Suzi's done this.- I don't sew anything.
0:48:06 > 0:48:08I don't know how easy the sutures are going to be.
0:48:08 > 0:48:12I've only done it on mannequins before. It'll be interesting.
0:48:12 > 0:48:13She won't be on her own.
0:48:13 > 0:48:17Richard will guide her through, but it's still nerve-racking.
0:48:17 > 0:48:20- Do you have any models I can have a quick play on?- No.
0:48:20 > 0:48:23- I'll talk you through it.- Yes.
0:48:24 > 0:48:28- Suzi must decide what kit she will need.- One per cent.
0:48:29 > 0:48:31She'll need a steady hand.
0:48:37 > 0:48:40- Comfortable there?- Yeah, yeah. - It's gonna be a little bit stingy.
0:48:40 > 0:48:43- All right?- That's fine.- Try and keep nice and still. All right?
0:48:43 > 0:48:48That's fine. I've got three tattoos, I've got 17 piercings.
0:48:48 > 0:48:50This is a walk in the park.
0:48:53 > 0:48:56Richard demonstrates with the first stitch.
0:48:58 > 0:49:00You're going in perpendicular to the skin.
0:49:00 > 0:49:03Follow the curve of the needle round.
0:49:03 > 0:49:06And pick it up with the forceps.
0:49:06 > 0:49:11That's the no touch technique, which helps keep the wound nice and clean.
0:49:11 > 0:49:17- That's one.- Yeah.- Two times round. - Mm-hm.- Grasp it just at the end.
0:49:18 > 0:49:23- Then pull and give it a little twist to lock the knot.- Okey-doke.
0:49:23 > 0:49:28- Now, it's Suzi's turn. - Good luck.- Righty-ho.
0:49:28 > 0:49:32With her senior supervising her first attempts, the pressure's on.
0:49:32 > 0:49:36So perpendicular, like that. Then, in like that.
0:49:37 > 0:49:40- And a flick of the wrist. OK.- Mm-hm.
0:49:40 > 0:49:43- With this hand, holding it like that.- Yeah.
0:49:43 > 0:49:45Like a pair of chopsticks.
0:49:45 > 0:49:46- Like that?- Yeah.
0:49:48 > 0:49:51Good. Excellent there. Pick it up before you lose it. OK.
0:49:52 > 0:49:53Pull it through.
0:49:57 > 0:50:03- One, two and the end.- OK.- And the twist locks the knot.- Right, yeah.
0:50:03 > 0:50:06If you lose the tension at this point, you have to start again.
0:50:06 > 0:50:08- Yeah.- Are you OK with that?
0:50:08 > 0:50:10Right through.
0:50:14 > 0:50:15Just twist. Good.
0:50:28 > 0:50:30Yeah!
0:50:32 > 0:50:33Well done, you.
0:50:33 > 0:50:35Thank you for being so good and just sitting there.
0:50:35 > 0:50:37You're welcome.
0:50:37 > 0:50:41I'm really impressed. They look really neat. It didn't hurt.
0:50:43 > 0:50:47Thank you for being so good and patient with me. It was very useful.
0:50:47 > 0:50:49- Yeah!- Thank you!
0:50:49 > 0:50:51No bother.
0:50:51 > 0:50:53I've just done my first stitches!
0:50:53 > 0:50:56- What, what, what?- I've just done my first suturing, yeah.
0:50:56 > 0:50:58I put in some stitches!
0:50:58 > 0:51:00That was a good job for a first go.
0:51:00 > 0:51:02I was really nervous, in case you couldn't tell.
0:51:02 > 0:51:06I was like, "I can't grip anything. My hands aren't working!"
0:51:06 > 0:51:10My hands also are red, with all the sweat I've been perspiring under those gloves. Thank you.
0:51:10 > 0:51:14That was really, actually, kind of fun.
0:51:14 > 0:51:16She did a good job.
0:51:16 > 0:51:20Slow and steady wins the race, as they say.
0:51:20 > 0:51:23It's another boost for Suzi.
0:51:23 > 0:51:24A&E's very different
0:51:24 > 0:51:26to any of the jobs that Suzi or any of
0:51:26 > 0:51:28the other junior doctors will have done beforehand.
0:51:28 > 0:51:31You get patients off the street, if you like, and you're the first one
0:51:31 > 0:51:35to deal with them and that's quite a daunting thing to do to start with.
0:51:35 > 0:51:38But you can really see that Suzi's confidence
0:51:38 > 0:51:41and ability to deal with these sorts of problems has really improved.
0:51:44 > 0:51:52While Suzi's on a high, John's back on EAU, mulling over his surgery exams.
0:51:52 > 0:51:58I got my, like, mark breakdown and I only missed out on passing by seven marks,
0:51:58 > 0:52:04which kind of makes it a bit worse, but, you know, whether you miss by a mile or an inch, you still miss,
0:52:04 > 0:52:09so I wasn't good enough on the day, which is fine. I can accept that.
0:52:09 > 0:52:11That's all part of the learning process.
0:52:11 > 0:52:16I think, when I go back into it the next time, I'll definitely do more revision.
0:52:21 > 0:52:25In the plastics department, there's good news for Dean.
0:52:25 > 0:52:30- After nearly a month in hospital, he's finally going home.- Hello.
0:52:30 > 0:52:31I shouldn't even be saying hello.
0:52:31 > 0:52:34I should be saying goodbye! Finally.
0:52:34 > 0:52:36- It's been a long time.- I know.
0:52:36 > 0:52:38And how is the foot bearing up?
0:52:38 > 0:52:40Healing good, to be fair.
0:52:40 > 0:52:42You're going to be walking before you know it.
0:52:42 > 0:52:45I'd be surprised if you didn't run back in here.
0:52:45 > 0:52:48I might just skip. I don't know. I'll see what takes my fancy!
0:52:48 > 0:52:52Patients can stay with you, in your mind, for different reasons.
0:52:52 > 0:52:56Sometimes they're patients who've had horrid complications.
0:52:56 > 0:52:59Sometimes they're patients who have recovered despite the odds.
0:52:59 > 0:53:06But Dean is just going to kind of be there as somebody who, despite really
0:53:06 > 0:53:11disabling, debilitating injuries, had a positive face all the time.
0:53:11 > 0:53:16His injuries have severely limited his mobility,
0:53:16 > 0:53:19and he will pull through because he wants to.
0:53:19 > 0:53:21- It's been a pleasure. - Thank you very much.
0:53:21 > 0:53:24- No problem. Brilliant.- Cheers, mate.
0:53:24 > 0:53:26- Bye-bye.- Thank you very much.
0:53:26 > 0:53:28I'm getting to go home. 27th day here.
0:53:28 > 0:53:34I'm happy it's eventually come round and the operation went really well and it's really healing fast.
0:53:34 > 0:53:36I'll be coming back here.
0:53:36 > 0:53:38When I can walk, I will walk into this ward and I'll give them all
0:53:38 > 0:53:40a hug because they've been so good to us.
0:53:40 > 0:53:46Keir and Katherine can reap the rewards of time well invested and a positive outcome.
0:54:09 > 0:54:13Tonight, Keir's cooking for his house mates. It's a chance for them
0:54:13 > 0:54:16to get together at the end of a long week.
0:54:20 > 0:54:22This is just really simple.
0:54:22 > 0:54:25It's just salmon with
0:54:25 > 0:54:27kind of pork and apple stuffing.
0:54:27 > 0:54:30Well, cheers. Here's to...
0:54:30 > 0:54:33Here's to civilisation!
0:54:33 > 0:54:35Civilisation and plastic cups.
0:54:35 > 0:54:38Kier, did you get a specific recipe for this, or...
0:54:38 > 0:54:40- No.- Did you not?- No.
0:54:40 > 0:54:41- You just made it up? - That's incredible.
0:54:41 > 0:54:43This is just all made up.
0:54:43 > 0:54:47Shall we just...get married or something?
0:54:47 > 0:54:50Would that work for you? Because this is really pleasant.
0:54:50 > 0:54:53- OK.- Sorted.- OK.- Brilliant.- Yesss!
0:54:53 > 0:54:55Takes all the stress out of my life.
0:54:57 > 0:55:02Are you finding things as hard as you thought you would?
0:55:02 > 0:55:06I haven't found it harder than I thought it would in terms of the work itself.
0:55:06 > 0:55:08What I've found hard is to actually take care
0:55:08 > 0:55:10of myself and work at the same time because so far,
0:55:10 > 0:55:13all I've done is neglect myself for four weeks.
0:55:13 > 0:55:17Even on a night off, work is never far from their mind.
0:55:19 > 0:55:21I suppose when you talk to a lot of people who
0:55:21 > 0:55:24aren't doctors, they kind of ask you what sort of doctor you want to be,
0:55:24 > 0:55:26where you want to be a consultant.
0:55:26 > 0:55:28Consultant is not even in my brain.
0:55:28 > 0:55:30You know?
0:55:30 > 0:55:35I don't have this image of me as a consultant in my head at all.
0:55:35 > 0:55:36- I don't.- I don't.
0:55:36 > 0:55:40I wish I could. But it just seems like a far-off dream.
0:55:40 > 0:55:46I think I'll always question whether I'm up to the job, and I think it's an important part
0:55:46 > 0:55:51of good medical practice to question yourself.
0:55:51 > 0:55:53Obviously, I have bad days.
0:55:53 > 0:55:57That's fine. But I feel as though, yeah, I can do this.
0:55:57 > 0:56:00And even if I have a bad day, I think, it's been a bad day but I can
0:56:00 > 0:56:02go back and do it the following day and the day after that.
0:56:05 > 0:56:06CHILD CRIES
0:56:06 > 0:56:08- Next time...
0:56:08 > 0:56:11The more I do, the more I realise how far I've got to go.
0:56:11 > 0:56:14They're coming to the end of their first placement.
0:56:14 > 0:56:18Having become comfortable over four months in something,
0:56:18 > 0:56:21I'm suddenly back to square one, at the bottom of a learning curve.
0:56:21 > 0:56:25Have they got what it takes to stand on their own two feet?
0:56:25 > 0:56:27I can't find anywhere!
0:56:27 > 0:56:30Are you all right? You're looking a little stressed.
0:56:30 > 0:56:33Subtitles by Red Bee Media Ltd
0:56:33 > 0:56:37E-mail subtitling@bbc.co.uk