0:00:06 > 0:00:08A typical night in A&E.
0:00:08 > 0:00:11It's like a battlefield.
0:00:11 > 0:00:14- Language!- Full of twentysomethings after a big night out.
0:00:14 > 0:00:17Lots of vomit, lots of unconscious bodies lying around.
0:00:17 > 0:00:19But not everyone's a casualty.
0:00:19 > 0:00:22Squeeze my fingers, please.
0:00:22 > 0:00:25Taking care of them is an army of doctors the same age,
0:00:25 > 0:00:28after five years of training...
0:00:28 > 0:00:30Cardiac arrest in A&E.
0:00:30 > 0:00:33..and a rigorous induction into hospital life.
0:00:33 > 0:00:38Take full advantage of being in a bloody good city and a bloody good NHS Trust.
0:00:40 > 0:00:44- Never done this before.- They face the reality of life on the wards.
0:00:44 > 0:00:49He was looking at my badge as if to say, "Who are you?
0:00:49 > 0:00:51"What do you know?"
0:00:51 > 0:00:55- Cardiac arrest. - And there's no room for error.
0:00:55 > 0:00:57I guess if I really messed up, I could kill someone.
0:00:57 > 0:01:01For the last three months, the junior doctors have been
0:01:01 > 0:01:04working in two of Newcastle's busiest hospitals...
0:01:05 > 0:01:07You're doing well, sir, you're doing well.
0:01:07 > 0:01:11..where they're dealing with life-and-death situations every day.
0:01:11 > 0:01:14This guy's really, really poorly.
0:01:14 > 0:01:16I don't want him to arrest.
0:01:17 > 0:01:19It's been a steep learning curve.
0:01:19 > 0:01:22Are you all right? You're looking a little...stressed.
0:01:24 > 0:01:28But now they're finishing their first placements and moving on to new departments.
0:01:28 > 0:01:31Having become comfortable over four months in something,
0:01:31 > 0:01:35- I'm back to square one at the bottom of the learning curve. - As they prepare to move on,
0:01:35 > 0:01:39do they still think they've got what it takes to be good doctors?
0:01:39 > 0:01:43The more I do, the more I realise how far I've got to go.
0:01:44 > 0:01:46I've still got that feeling of,
0:01:46 > 0:01:48"God, I can't believe I'm actually a doctor."
0:01:48 > 0:01:53And how will they cope with your life in their hands?
0:02:09 > 0:02:11Early morning in Newcastle.
0:02:11 > 0:02:14At the house, the junior doctors are getting ready
0:02:14 > 0:02:18for the last few shifts of their current four-month placements.
0:02:21 > 0:02:23First up is 28-year-old Keir.
0:02:23 > 0:02:26The world is a better place when it has coffee in it.
0:02:27 > 0:02:31Next is first-year doctor, 24-year-old Katherine.
0:02:31 > 0:02:34If you want to, we could share a cab. It'll only be two quid each.
0:02:34 > 0:02:38Yeah, let's do that. I hope it's not another day like yesterday.
0:02:38 > 0:02:40Yesterday I didn't leave until 6:45pm.
0:02:40 > 0:02:42As Keir and Katherine head to hospital,
0:02:42 > 0:02:4625-year-old Andy is just getting up.
0:02:53 > 0:02:58Always have to check if the milk is off or not - a certain someone has
0:02:58 > 0:03:01a habit of leaving the milk outside the fridge.
0:03:01 > 0:03:05Next up is 24-year-old Lucy.
0:03:05 > 0:03:09- How long does it take to dry your hair?- I would say about 20 mins.
0:03:11 > 0:03:15Finally, 24-year-old Adam is running late.
0:03:15 > 0:03:17Overslept a little bit.
0:03:17 > 0:03:21Not getting back into...the daytime pattern very easily
0:03:21 > 0:03:23from night shifts.
0:03:34 > 0:03:38If I don't bring something to eat, then I don't get time to eat.
0:03:47 > 0:03:51All the junior doctors are coming to the end of their current jobs.
0:03:51 > 0:03:55They've each got just a few shifts left before, as part of their ongoing training,
0:03:55 > 0:03:58they move onto new wards and departments.
0:03:58 > 0:04:01I guess you take the cap off to flush it.
0:04:05 > 0:04:10Moving from job to job as a junior is a difficult issue.
0:04:10 > 0:04:14As a doctor, at some point to have to start taking responsibility for what you do yourself.
0:04:14 > 0:04:18If we don't gradually loosen the reins, so to speak,
0:04:18 > 0:04:21and loosen the closeness of the supervision,
0:04:21 > 0:04:24then a doctor never learns to take responsibility for themselves.
0:04:24 > 0:04:30Second-year Keir has been working in plastic surgery for the last three months.
0:04:30 > 0:04:34His experience on plastics has helped him decide he wants to work with children long-term.
0:04:34 > 0:04:37'I love dealing with Paeds cases,'
0:04:37 > 0:04:40children are just the best patients.
0:04:40 > 0:04:44'It's a great challenge, but it's very fulfilling.'
0:04:44 > 0:04:50Before he finishes here, he gets the chance to assist on his first ever operation on a child.
0:04:50 > 0:04:54Can I check that you are definitely Kai Norman? Is that you?
0:04:54 > 0:04:59Three-year-old Kai was born without a fully developed thumb.
0:04:59 > 0:05:02Today it's going to be removed by the surgical team.
0:05:02 > 0:05:06I have never been in paediatric theatre before today.
0:05:06 > 0:05:10The obvious difference is that what you're dealing with is a lot smaller.
0:05:10 > 0:05:16So a scar that you create won't just heal with rubbing,
0:05:16 > 0:05:19it's also going to stretch as the hand grows.
0:05:19 > 0:05:23Keir is shadowing top paediatric surgeon Mr Rannan-Eliya
0:05:23 > 0:05:25who will be removing Kai's thumb.
0:05:25 > 0:05:29The only reason to keep it would be to able to save...
0:05:29 > 0:05:32As a reconstructive surgeon, you try not to throw anything away.
0:05:32 > 0:05:35The skin, even though it's a small amount,
0:05:35 > 0:05:36it could potentially be useful.
0:05:36 > 0:05:42What we're doing today with Kai is unfortunately some children are born
0:05:42 > 0:05:45without the structures on the thumb side of their arm forming properly.
0:05:45 > 0:05:49In his case, his thumb was sort of half formed
0:05:49 > 0:05:53and it was only attached to the palm of his hand by a very thin stalk.
0:05:53 > 0:05:57It's twisting and catching and therefore of no use to him functionally.
0:05:57 > 0:06:01At the end of the day, if we remove it, we can avoid it getting damaged.
0:06:01 > 0:06:05Does Kai suffer from any eczema, any asthma, heart conditions...?
0:06:05 > 0:06:08He has got a heart condition where he has a murmur on his heart.
0:06:10 > 0:06:13- No other medical problems other than that?- He has bad kidneys.
0:06:13 > 0:06:15He's only got one kidney working.
0:06:18 > 0:06:20Kai's complicated medical history
0:06:20 > 0:06:24means it isn't going to be a straightforward operation.
0:06:24 > 0:06:28Because of his cardiac problems, we can do it under sedation,
0:06:28 > 0:06:32- but we're quite happy to give a general anaesthetic.- Right.
0:06:32 > 0:06:35Any operation on a small child is potentially dangerous,
0:06:35 > 0:06:37mainly because of the anaesthetic issues.
0:06:37 > 0:06:40Anaesthesia at a young age, in Kai's case here,
0:06:40 > 0:06:44the operation itself is technically not that challenging.
0:06:44 > 0:06:47But it will be... There is a potential risk to him
0:06:47 > 0:06:49in terms of his lungs and his heart
0:06:49 > 0:06:52which we have to bear in mind.
0:06:52 > 0:06:57We're here for different sort of things - his kidneys and his arm.
0:06:57 > 0:07:00He's had bits of bladder problems.
0:07:00 > 0:07:02We're here quite often, aren't we?
0:07:02 > 0:07:04The last time was about seven months ago.
0:07:04 > 0:07:08We're doing well, really. Hopefully we're not staying in.
0:07:08 > 0:07:12I can't believe they put us in this room because we're supposed to be in and out today.
0:07:12 > 0:07:15We'll probably be staying, won't we?
0:07:15 > 0:07:19I hope not, cos Kai wants to go to the toy shop after here.
0:07:19 > 0:07:20Don't you?
0:07:21 > 0:07:24Get a new toy for being so brave.
0:07:27 > 0:07:30Before the operation starts,
0:07:30 > 0:07:34Keir and Mr Rannan-Eliya explain the procedure to Kai and his mum.
0:07:34 > 0:07:37Hello, Kai. Hi, are you all right?
0:07:37 > 0:07:40How are you? Are you OK?
0:07:41 > 0:07:44Can I have a look at your hand?
0:07:44 > 0:07:47So we're going to take that...away
0:07:47 > 0:07:51because it is becoming a bit of a nuisance, isn't it?
0:07:51 > 0:07:54- You keep getting it caught, don't you?- Does it hurt when it gets caught?
0:07:55 > 0:07:56Oh, dear.
0:07:56 > 0:08:01Hello, can we have Kai Norman brought along to theatre, please?
0:08:03 > 0:08:07While Keir scrubs up, Kai is put to sleep under anaesthetic.
0:08:11 > 0:08:16Surgeons need years of experience to perform a delicate operation like this,
0:08:16 > 0:08:18so Keir can only assist.
0:08:18 > 0:08:22On-the-job learning is all part of the junior doctor's training.
0:08:22 > 0:08:26The thumb has no bone, but there are tiny blood vessels and nerves
0:08:26 > 0:08:30that must be cut precisely to avoid leaving Kai with long-term problems.
0:08:30 > 0:08:34Is there chance of him getting a neuroma or scar there later?
0:08:34 > 0:08:38Absolutely. That's why... Not on the scar per se,
0:08:38 > 0:08:41but at the end of where that nerve regenerates, hopefully,
0:08:41 > 0:08:44instead of being on the scar.
0:08:47 > 0:08:49There is that risk, absolutely.
0:08:49 > 0:08:52If the nerve isn't cut correctly,
0:08:52 > 0:08:55it could cause a growth or tumour in Kai's hand.
0:09:10 > 0:09:14They've cut the nerve, and the thumb is removed successfully.
0:09:16 > 0:09:19Despite having spent three months on the plastics ward,
0:09:19 > 0:09:21Keir knows he's still learning.
0:09:22 > 0:09:24'It was a nice little...
0:09:24 > 0:09:29'operation to see. I thought that they would literally tie it'
0:09:29 > 0:09:32or get a pair of scissors and cut it straight.
0:09:32 > 0:09:34But actually, for a simple procedure,
0:09:34 > 0:09:38it was a little more complicated than I thought it was going to be.
0:09:38 > 0:09:42It would've been nice to have had a go at it, but I think that when
0:09:42 > 0:09:46you're dealing with children, you need to be ultra-cautious.
0:09:46 > 0:09:50Having a go with an adult and leaving a scar
0:09:50 > 0:09:52that's not quite perfect,
0:09:52 > 0:09:55is very different from having a go with a child
0:09:55 > 0:09:58and leaving a scar that's not quite perfect.
0:09:58 > 0:10:02And I'm not the person to give Kai a perfect result.
0:10:02 > 0:10:05Knock, knock. Hello!
0:10:05 > 0:10:07How are you doing?
0:10:07 > 0:10:12Mr Rannan-Eliya is impressed by Keir's progress as a junior doctor.
0:10:12 > 0:10:16Keir has moved from being fresh through to now his second year
0:10:16 > 0:10:18and he's shown quite a lot of qualities
0:10:18 > 0:10:21into making sensible decisions, making good plans
0:10:21 > 0:10:24and being safe, which is ultimately what it's all about.
0:10:24 > 0:10:28He's got a bit of an anaesthetic hangover.
0:10:28 > 0:10:31'Even though he's now in his second year following Medical School,'
0:10:31 > 0:10:33he's got a very long way to go
0:10:33 > 0:10:37to becoming a fully independent hospital practitioner.
0:10:37 > 0:10:39Because there's an awful lot to learn,
0:10:39 > 0:10:42an awful lot of skills to practise and develop,
0:10:42 > 0:10:45and at the end of the day, there's nothing to beat experience
0:10:45 > 0:10:48- in terms of learning. - See you later, young man.
0:10:48 > 0:10:52- Are you going to say bye? - Are you going to say goodbye to me?
0:10:53 > 0:10:56He's turning into a teenager already!
0:11:10 > 0:11:13Hello, my name's Suzi, I'm one of the doctors here.
0:11:13 > 0:11:15Tell me a bit about what's been going on then.
0:11:15 > 0:11:20Also coming the end of her current assignment is Keir's housemate, Suzi.
0:11:20 > 0:11:22She has spent the last three months in A&E
0:11:22 > 0:11:25where a new emergency case has just been admitted -
0:11:25 > 0:11:29a three-week-old baby has been brought in by her worried parents.
0:11:29 > 0:11:32She's been crying for the last couple of hours, from the morning.
0:11:32 > 0:11:36She's not normally crying that much.
0:11:36 > 0:11:39BABY CRIES
0:11:39 > 0:11:42Continuous crying can be a sign
0:11:42 > 0:11:45something is seriously wrong in a newborn baby.
0:11:48 > 0:11:53Is that her normal cry, or is that a bit...?
0:11:53 > 0:11:55- It's not her normal cry.- No.
0:11:55 > 0:11:59- Is it normally more like a proper scream?- Yeah.
0:12:04 > 0:12:07Suzi examines her tiny patient.
0:12:07 > 0:12:10With a baby, it's hard to know what's going on,
0:12:10 > 0:12:14but her experience on A&E is telling her that something is wrong.
0:12:14 > 0:12:16We'll do some more observations on her
0:12:16 > 0:12:21and we'll do her temperature and I'll chat to one of my colleagues here.
0:12:21 > 0:12:24I'll get them to come and see her as well. OK?
0:12:24 > 0:12:27Parents are a bit concerned and with babies,
0:12:27 > 0:12:30it is quite hard because you don't get any clues.
0:12:30 > 0:12:32They don't say what's going on.
0:12:32 > 0:12:35Babies that are well will cry with all of their lungs.
0:12:35 > 0:12:38With her, I don't know.
0:12:38 > 0:12:39Maybe it'll all be absolutely fine,
0:12:39 > 0:12:42but I'm just going to err on the side of caution
0:12:42 > 0:12:46and speak to Paediatrics. It's their specialist area.
0:12:50 > 0:12:51Can you speak to me?
0:12:51 > 0:12:53My name's Suzi, I need to ask you a few questions.
0:12:53 > 0:12:57Suzi spent the last three months working on A&E,
0:12:57 > 0:13:00the sharp end of acute medicine.
0:13:00 > 0:13:03I'm waiting for a cardiac arrest call to come in.
0:13:03 > 0:13:07- I'm really excited, but also really scared!- Since her first day,
0:13:07 > 0:13:10she has had to deal with everything from heart failures...
0:13:10 > 0:13:12MAN GROANS
0:13:13 > 0:13:14..to heart throbs.
0:13:14 > 0:13:18Suzi, you are the best trainee doctor ever.
0:13:18 > 0:13:22She's proved herself a capable doctor on the A&E ward.
0:13:24 > 0:13:27The reaction I saw from Suzi, was absolutely brilliant.
0:13:27 > 0:13:32And she's learned that in this job, a social life comes second.
0:13:32 > 0:13:34It's 1am on a Saturday night
0:13:34 > 0:13:36and everyone else is out having a drink.
0:13:36 > 0:13:39I'm here and helping so it's fine.
0:13:39 > 0:13:42Coming to the end of her assignment on A&E,
0:13:42 > 0:13:45her three months' experience means she isn't fazed
0:13:45 > 0:13:48by a difficult case like baby Adla.
0:13:48 > 0:13:50She consults her boss on what to do next.
0:13:50 > 0:13:55Three weeks old, just a bit unsettled since this morning.
0:13:55 > 0:13:58I was going to speak to Paeds about them.
0:13:58 > 0:14:00Anything more apart from being unsettled?
0:14:00 > 0:14:04Normally doesn't cry, but has quite a whingey cry.
0:14:04 > 0:14:09Settled if she's still, but if you try and move her and things,
0:14:09 > 0:14:11she gets very irritable.
0:14:11 > 0:14:15Temp was 37.5 earlier, just going to get them to do it a second time
0:14:15 > 0:14:17and see if anything has changed.
0:14:17 > 0:14:21Repeat the obs, stick a pad in and try and get urine.
0:14:21 > 0:14:23Speak to Paeds. Good.
0:14:23 > 0:14:27To find out exactly what's wrong, baby Adla is referred
0:14:27 > 0:14:31to a specialist children's doctor for further investigation.
0:14:31 > 0:14:33This case has been good training for Suzi's next job -
0:14:33 > 0:14:36working with newborn babies.
0:14:36 > 0:14:41I think any practice with babies and children is always good.
0:14:41 > 0:14:45Obviously, my next job is going to be on special care
0:14:45 > 0:14:47and doing baby checks and things.
0:14:47 > 0:14:52It is good to get practice handling babies, although sometimes I feel a bit...
0:14:52 > 0:14:56awkward as I've never had a baby and don't know how to hold them properly.
0:14:56 > 0:14:58But I'm sure it will come to me,
0:14:58 > 0:15:00otherwise I'm going to struggle!
0:15:03 > 0:15:08Around the hospital, all the junior doctors are on their last few shifts
0:15:08 > 0:15:10in their current jobs.
0:15:10 > 0:15:14Jon has been learning that there's never a dull moment on the emergency assessment unit.
0:15:14 > 0:15:16I need to draw on your leg, unfortunately.
0:15:18 > 0:15:23And for Andy on paediatrics, it's been getting to grips with treating kids and teenagers.
0:15:23 > 0:15:25Deep breath in.
0:15:27 > 0:15:33Back in plastics, Keir is working in their specialist children's trauma clinic.
0:15:34 > 0:15:36Right, hello.
0:15:38 > 0:15:40His experience on this placement
0:15:40 > 0:15:44has helped him learn a lot about treating children.
0:15:44 > 0:15:49Children don't like you when you poke their burns or examine their heads.
0:15:49 > 0:15:53You've got to have little tactics to try and distract them.
0:15:53 > 0:15:56BABY CRIES, HE MAKES WHINING SOUND
0:15:56 > 0:16:00I don't know why that noise works, but it works every single time!
0:16:01 > 0:16:07OK, it all seems to...have closed really nicely.
0:16:07 > 0:16:09No need for an operation with this one.
0:16:11 > 0:16:15The good paediatric doctors can occupy the child really well
0:16:15 > 0:16:18or can deal with the parents really well.
0:16:18 > 0:16:20The great ones are the ones
0:16:20 > 0:16:24who are able to become a four year-old briefly.
0:16:28 > 0:16:29That is a beauty.
0:16:29 > 0:16:34Over the last three months, it's not just his patients that Keir's entertained.
0:16:34 > 0:16:37I'm not embarrassed, I'm not embarrassed at all.
0:16:37 > 0:16:40I was thinking of opening a bottle of something fizzy.
0:16:40 > 0:16:43THEY LAUGH
0:16:43 > 0:16:46His work with children on the plastics ward has helped him
0:16:46 > 0:16:48make a big decision about his future.
0:16:48 > 0:16:51Shake my hand, excellent.
0:16:51 > 0:16:55I think medicine, particularly medicine involving children,
0:16:55 > 0:16:57is great fun and dynamic.
0:16:57 > 0:17:00Are you a bit frightened?
0:17:00 > 0:17:02There's no need to be frightened.
0:17:02 > 0:17:05In a few days, Keir will be starting his next assignment
0:17:05 > 0:17:11on the paediatrics ward, so he's making the most of his experience of treating kids on the trauma clinic.
0:17:11 > 0:17:14Hello! Are you Gabby?
0:17:14 > 0:17:17It sees a lot of children with minor gashes and wounds.
0:17:17 > 0:17:20Keir and the team have to decide if they need stitches.
0:17:20 > 0:17:23You're certainly the cutest patient I have had all day.
0:17:23 > 0:17:25He says that to all the girls!
0:17:26 > 0:17:31His next patient is two-year-old Gabby, who has a deep gash in her forehead.
0:17:31 > 0:17:34She's fell against an iron chimney.
0:17:38 > 0:17:41Initially as soon as it was done, quite a pool of blood,
0:17:41 > 0:17:43but it stopped as soon as the pressure was applied.
0:17:43 > 0:17:46You're not a forensic pathologist, are you?
0:17:46 > 0:17:50These are exactly like the photographs you get from forensic pathologists!
0:17:50 > 0:17:52OK, let's pop you on here, shall we?
0:17:57 > 0:17:59Well done.
0:17:59 > 0:18:03Keir needs to asses if Gabby's wound needs stitches,
0:18:03 > 0:18:06or if it can just be closed with sterile surgical strips.
0:18:07 > 0:18:10Once kids injure themselves,
0:18:10 > 0:18:12they will have scars whatever we do to them.
0:18:12 > 0:18:15Our job is to make the scars as neat as possible
0:18:15 > 0:18:19and that is why operating on children and giving them neat scars
0:18:19 > 0:18:22is of paramount importance for us.
0:18:22 > 0:18:26The wrong decision could leave Gabby with an ugly scar.
0:18:26 > 0:18:27Silly noise!
0:18:27 > 0:18:31It doesn't look infected, it looks very clean indeed.
0:18:33 > 0:18:37I'm not sure whether we would even stitch that up
0:18:37 > 0:18:40because I think it has actually closed really nicely.
0:18:40 > 0:18:42You're VERY brave!
0:18:44 > 0:18:47You're very brave indeed, aren't you, Chuckles?
0:18:47 > 0:18:51I'll just go and speak to the boss about it and see whether we would need to close it.
0:18:51 > 0:18:55I don't think we would need to do anything with it, to be honest,
0:18:55 > 0:18:58but I'll just go and chat to the big man.
0:18:58 > 0:19:01But with only a few months of experience on plastics,
0:19:01 > 0:19:04it's not a decision Keir can make alone.
0:19:04 > 0:19:06He calls in his senior registrar for advice.
0:19:06 > 0:19:09Hi, I'm one of the other doctors, just come to have a look.
0:19:09 > 0:19:12This is Gabby and she has fallen over playing yesterday
0:19:12 > 0:19:14and struck her head on an iron chimney
0:19:14 > 0:19:17that is in the garden.
0:19:19 > 0:19:24I wasn't convinced that it definitely needed stitches.
0:19:24 > 0:19:27- 50/50, isn't it?- It is.
0:19:28 > 0:19:33I just thought if we steried it, it might...close naturally.
0:19:34 > 0:19:36Yes, that is certainly an option.
0:19:36 > 0:19:37How old is she?
0:19:37 > 0:19:39Two, just gone two.
0:19:40 > 0:19:44- I think we ought to operate on this. - Oh, right.
0:19:44 > 0:19:48She is a two year-old and as she grows, that gap will grow.
0:19:48 > 0:19:51Keir had thought Gabby's wound didn't need stitches.
0:19:51 > 0:19:55It's assessments like this that only come with experience.
0:19:55 > 0:19:59'It is very difficult for somebody'
0:19:59 > 0:20:02who has limited experience in plastic surgery
0:20:02 > 0:20:05to come in as a junior doctor in plastic surgery
0:20:05 > 0:20:08and make difficult decisions like that,
0:20:08 > 0:20:11especially when they've not seen many of these wounds.
0:20:11 > 0:20:15It was a thing of lack of experience rather than lack of judgment.
0:20:15 > 0:20:19The stitches will be dissolvable, although you'll be able to see them.
0:20:19 > 0:20:21They'll dissolve in a week's time.
0:20:21 > 0:20:23I'll organise all of that.
0:20:23 > 0:20:27OK, tinker. She is the most gorgeous patient
0:20:27 > 0:20:29that I think I have ever had.
0:20:39 > 0:20:42First-year Lucy is coming to the end of her assignment
0:20:42 > 0:20:44on the gastro ward.
0:20:44 > 0:20:48- Knowing his history, I'm not sure if we'll improve it that much.- That's fine.
0:20:48 > 0:20:51- I was having problems. - Thanks for letting me know.
0:20:51 > 0:20:57They treat diseases of the digestive system and deal with some of the sickest patients in the hospital.
0:20:57 > 0:21:02Lucy's had to learn to cope with patients dying, which the team on the ward know can be difficult.
0:21:02 > 0:21:06'For some reason you may have a spate of them,'
0:21:06 > 0:21:10sometimes two or three deaths in a row and then go several weeks without having anybody.
0:21:10 > 0:21:14Obviously, it's better for us, the relatives and the patients
0:21:14 > 0:21:18if we manage to get them better and back home,
0:21:18 > 0:21:22even if it is for a short period of time.
0:21:24 > 0:21:28Many patients here are in hospital for a long time.
0:21:28 > 0:21:31Lucy has become attached to one in particular -
0:21:31 > 0:21:35she's been on the ward since Lucy's first day.
0:21:35 > 0:21:38Her motions are worse again.
0:21:38 > 0:21:40Oh, no. Really?
0:21:40 > 0:21:43Her elderly patient is suffering a severe bowel infection.
0:21:43 > 0:21:46Lucy has only got a few shifts left on the ward
0:21:46 > 0:21:51and before she finishes, she wants to see her patient well enough to be moved to a nursing home.
0:21:51 > 0:21:55They described it like...baby poo.
0:21:55 > 0:21:57But she is still eating.
0:21:57 > 0:21:59We need to keep her going on that,
0:21:59 > 0:22:03because the problem is if she doesn't eat, she's not going to get better.
0:22:09 > 0:22:14In her first few months, Lucy's been learning that the job can be emotionally challenging.
0:22:14 > 0:22:19It's probably the worst news that she is ever going to hear, ever.
0:22:19 > 0:22:22Her life has literally been taken away from her like that.
0:22:22 > 0:22:25She's had to learn that, even as a doctor,
0:22:25 > 0:22:27she can't save everyone.
0:22:27 > 0:22:31'I am definitely learning that there is a limit to what we can do as medics.'
0:22:31 > 0:22:34We are only human and in some ways, if we could turn
0:22:34 > 0:22:39into the super hero, that would be great in terms of actually having to save people and cure everybody.
0:22:39 > 0:22:41In reality, that's never going to happen.
0:22:41 > 0:22:46But back on the ward, Lucy is very concerned about her patient's condition.
0:22:46 > 0:22:49She's really, really confused and really dehydrated,
0:22:49 > 0:22:52and although we're not treating her infection actively,
0:22:52 > 0:22:56if she's dehydrated, we should give her fluids to make her more comfortable.
0:22:56 > 0:23:01Basically, the decision was made last week by Dr Gunn with her family
0:23:01 > 0:23:05that she wasn't going to be actively managed any more
0:23:05 > 0:23:06and that she was for TLC -
0:23:06 > 0:23:09just giving her a bit of love, really.
0:23:09 > 0:23:10If she gets ill again, like she has,
0:23:10 > 0:23:14we're not going to give her antibiotics because what's been
0:23:14 > 0:23:17going on with her is she has come in, she's getting recurrent infections,
0:23:17 > 0:23:20treating one infection and precipitating another illness.
0:23:20 > 0:23:23We've tried for a long time.
0:23:24 > 0:23:27The decision that's been made is the right one.
0:23:27 > 0:23:32That doesn't make it easy because she is still someone's grandma, still someone's mum.
0:23:32 > 0:23:34Because the patient isn't responding to medication,
0:23:34 > 0:23:38all the team can do is make her as comfortable as possible.
0:23:38 > 0:23:41She's just gone downhill so much.
0:23:41 > 0:23:45- It's really sad.- In a funny way as well, her knowing she not going home
0:23:45 > 0:23:49hasn't helped because she's probably lost the will a little bit.
0:23:50 > 0:23:52Oh, dear. Never mind.
0:24:01 > 0:24:04I might be a while longer, I'm afraid.
0:24:04 > 0:24:09Also coming to the end of her first job is Katherine, who is working on plastics
0:24:09 > 0:24:14where she's responsible for processing pre- and post-surgery patients from several clinics.
0:24:17 > 0:24:20You remember all the important things
0:24:20 > 0:24:23because you just spend all day looking at your lists,
0:24:23 > 0:24:26you remember everything important there is to be done.
0:24:26 > 0:24:29But it's a nice security thing.
0:24:29 > 0:24:33It's quite satisfying to tick things off once you have done them as well.
0:24:33 > 0:24:39But with patients waiting for her in clinic and a full surgical ward, she has a growing list of things to do.
0:24:39 > 0:24:43The time pressure is stressful rather than the actual job.
0:24:43 > 0:24:47You just feel like you're not doing a good job because you're so rushed all the time.
0:24:47 > 0:24:52Everyone wants you to do their job first and you've got lots of people from different wards and different
0:24:52 > 0:24:58members of the team, doctors and nurses all wanting different things and having different priorities.
0:24:58 > 0:25:01You can't end up pleasing everyone,
0:25:01 > 0:25:05and I think that's the most stressful aspect of the job.
0:25:07 > 0:25:09I'm so sorry it has taken so long.
0:25:10 > 0:25:14Over the last few months, 24-year-old Cambridge graduate, Katherine,
0:25:14 > 0:25:19has sometimes found herself swamped by the workload of a first-year junior doctor.
0:25:20 > 0:25:23I'll come back and do that when I've...
0:25:23 > 0:25:25I've got quite a lot of jobs to do.
0:25:25 > 0:25:29Let's just stop then. The busier you are, the more you need to stop.
0:25:29 > 0:25:33She has finally proved her potential as a doctor.
0:25:33 > 0:25:36Have you ever had any tests done on your liver?
0:25:38 > 0:25:42- I think he's got a bit of an enlarged liver.- Good spot.
0:25:42 > 0:25:45I think I'm getting better.
0:25:45 > 0:25:46Slowly.
0:25:46 > 0:25:49I think it's going to be a while before I settle in.
0:25:49 > 0:25:53I don't feel massively confident about my organisational skills yet.
0:25:53 > 0:25:59Now after three months, she needs to prove she's learnt to handle the time pressures of the job.
0:25:59 > 0:26:00Hello, Mr Punton.
0:26:02 > 0:26:05You're getting a bit of a tight chest.
0:26:05 > 0:26:07Can you tell me a bit more about it?
0:26:07 > 0:26:09Mr Punton has come in for an operation,
0:26:09 > 0:26:13but is now suffering breathing problems.
0:26:13 > 0:26:15When you say it's tight...
0:26:15 > 0:26:18do you mean you wheezy?
0:26:19 > 0:26:22Have you had any problems with asthma before?
0:26:22 > 0:26:24You have problems with asthma normally?
0:26:24 > 0:26:26I just need to find a nurse.
0:26:28 > 0:26:31I can't find any anywhere!
0:26:33 > 0:26:36Hi, I'm really sorry. Could someone do some obs on Mr Punton?
0:26:36 > 0:26:40I can't find the nurses looking after him and he's getting a tight chest.
0:26:40 > 0:26:42I think it's his asthma, because he's got asthma.
0:26:42 > 0:26:46Katherine's housemate, Keir, is a second year on the ward
0:26:46 > 0:26:48and she asks him for a second opinion.
0:26:48 > 0:26:52Keir... Mr Punton is feeling tight chested.
0:26:52 > 0:26:54He's asthmatic.
0:26:55 > 0:26:59- Getting nebulisers... - Has he had his inhaler?
0:26:59 > 0:27:03No, he hasn't got one. He just has nebulisers.
0:27:05 > 0:27:08- He's never had an inhaler? - I don't know.
0:27:09 > 0:27:12Check what medications he usually has.
0:27:12 > 0:27:16- He's not written up. - I know he's not written up for them, but check...
0:27:22 > 0:27:26He said he's normally on nebulisers. He hasn't had it today.
0:27:26 > 0:27:28Has it been crossed off?
0:27:29 > 0:27:32Keir decides to speak to the patient himself.
0:27:34 > 0:27:35Hello, sir.
0:27:37 > 0:27:39How are you doing?
0:27:39 > 0:27:43Have you got any heart problems, any lung problems?
0:27:45 > 0:27:46Just asthma.
0:27:46 > 0:27:49No-one has ever said anything about your heart RATE before?
0:27:52 > 0:27:55I was told that you were feeling very wheezy and chesty.
0:27:58 > 0:28:02Phlegm? So you feel like there is something you want to cough up.
0:28:02 > 0:28:06We'll give you some water in a nebuliser
0:28:06 > 0:28:08to try and clear anything
0:28:08 > 0:28:11that might be in your chest that you feel that you want to bring up.
0:28:11 > 0:28:16- I don't think there's any need for any Salbutamol.- OK.
0:28:16 > 0:28:19And what about an ECG?
0:28:19 > 0:28:21Yes, I'm going to talk about that.
0:28:21 > 0:28:23- There you go.- Cheers.
0:28:23 > 0:28:29- So an ECG...- Yes, let's get an ECG, let's do...some bloods.
0:28:29 > 0:28:32I just need to do something. I'm going to be a while.
0:28:33 > 0:28:36Can I order the ECG for you?
0:28:36 > 0:28:39- Yes, please.- Are you OK? You're looking a little stressed.
0:28:39 > 0:28:42No, it's just that I have a long list of things to do.
0:28:42 > 0:28:46While Kier writes up the notes, Katherine just needs to arrange
0:28:46 > 0:28:50an ECG to check the patient's heart rate.
0:28:50 > 0:28:54But today isn't a good day for ordering ECGs.
0:28:54 > 0:29:00I'm supposed to be seeing a patient in clinic, but I need to go and do this ECG first.
0:29:00 > 0:29:03The ECG department are understaffed,
0:29:03 > 0:29:08so they can't come up and do the ECG, so I'm doing it myself.
0:29:08 > 0:29:10I'm back, Mr Punton.
0:29:10 > 0:29:13I'm just counting down the ribs to make sure
0:29:13 > 0:29:16I'm putting the stickies in the right place.
0:29:16 > 0:29:20You just need to keep very still when the machine starts recording.
0:29:20 > 0:29:22OK, let's switch it on.
0:29:22 > 0:29:24ECG MACHINE BEEPS
0:29:27 > 0:29:29The results need further investigation,
0:29:29 > 0:29:33but it means Katherine's other patients will be kept waiting.
0:29:37 > 0:29:40I'm not entirely sure what's going on, but I'm not stressed about it,
0:29:40 > 0:29:44because I can look it up on the internet, I can ask about it.
0:29:44 > 0:29:48I'm more stressed about the fact I've got a patient waiting down in clinic
0:29:48 > 0:29:50whilst I'm trying to sort this out,
0:29:50 > 0:29:53and no-one's answering the phone in clinic,
0:29:53 > 0:29:56so I've no way of letting them know, so they just think
0:29:56 > 0:30:00I'm not bothering to turn up when it's cos I'm sorting out something more important.
0:30:00 > 0:30:02Yeah, it's just on his notes.
0:30:02 > 0:30:05The tests have revealed a faster than normal heart rate.
0:30:05 > 0:30:08It could be a sign of further problems.
0:30:10 > 0:30:14I mean, this bit is completely regular.
0:30:14 > 0:30:17What I might do is I might just walk down to EAU
0:30:17 > 0:30:21and show this to a medic and see what they say.
0:30:21 > 0:30:23With a bit of help from Kier,
0:30:23 > 0:30:26Katherine can now get on and see her waiting patients.
0:30:26 > 0:30:29I've still got all this to get through, and it's 4pm
0:30:29 > 0:30:30and I have patients to see so...
0:30:33 > 0:30:40I was hoping to make a gym class that starts at six, but there's no way that's going to happen now.
0:30:40 > 0:30:44She may still be running late, but her three months' experience
0:30:44 > 0:30:47have taught Katherine essential lessons about being a junior doctor.
0:30:47 > 0:30:53I think I've definitely learnt to grow a thicker skin in my first few months as an F1.
0:30:53 > 0:30:57I think I'm not getting as stressed about the little things any more.
0:30:57 > 0:31:01I have my moments when it gets busy,
0:31:01 > 0:31:03but I think I'm a bit more chilled out,
0:31:03 > 0:31:06and maybe a bit more confident.
0:31:06 > 0:31:09She's learnt a lot in the four months, and I'm sure
0:31:09 > 0:31:13she'll take that onto her next ward that she has to work on.
0:31:13 > 0:31:16We will miss her and, you know, it is sad.
0:31:16 > 0:31:20I suppose because you're following her journey, you've followed her journey
0:31:20 > 0:31:23from the beginning, really, and just watched her grow, I suppose.
0:31:23 > 0:31:25I'm getting emotional! Eeh,
0:31:25 > 0:31:29she's just so lovely, she's really canny when you think about it.
0:31:29 > 0:31:31It's difficult. You get me on a good day and I'm like,
0:31:31 > 0:31:34"Yay, I love my job, I can't believe they pay me to do this,
0:31:34 > 0:31:36"I'm doing a really good job,"
0:31:36 > 0:31:41and then I go home at the end of the day feeling really satisfied, like I've done my best.
0:31:41 > 0:31:43And the next day it can just be horrendous,
0:31:43 > 0:31:47and you go home feeling completely and utterly demoralised
0:31:47 > 0:31:51and hating your job and thinking, "I can't believe they pay me so little!"
0:32:00 > 0:32:03On the gastro ward, Lucy is dedicating her remaining time
0:32:03 > 0:32:07to helping her long-stay elderly patient.
0:32:07 > 0:32:10I'm going to see if I can get some fluids in her quickly,
0:32:10 > 0:32:13get her hydrated, because if she's got diarrhoea again,
0:32:13 > 0:32:16she'll get dehydrated because she's not drinking enough.
0:32:18 > 0:32:22Her condition hasn't improved, so Lucy and the team decide
0:32:22 > 0:32:26to give her intravenous fluids to replace the liquids she's losing.
0:32:27 > 0:32:30How are you this morning?
0:32:33 > 0:32:35Are you feeling a little bit confused?
0:32:43 > 0:32:45Tired, yeah.
0:32:46 > 0:32:48Yeah, that's tight, isn't it?
0:32:51 > 0:32:54I'm going to pop my head in and see you again a bit later, all right?
0:33:06 > 0:33:07She's just really poorly.
0:33:10 > 0:33:12Completely confused.
0:33:12 > 0:33:15She's just a lovely old lady and...
0:33:15 > 0:33:18she's just getting poorly.
0:33:18 > 0:33:19And...
0:33:21 > 0:33:24..I just don't really... It's just hard.
0:33:24 > 0:33:28You kind of know there's nothing more we can really do for her any more.
0:33:29 > 0:33:32Lucy has become emotionally attached to her patient,
0:33:32 > 0:33:36who has been on the ward throughout Lucy's placement here.
0:33:36 > 0:33:38Fine. That was your temperature.
0:33:38 > 0:33:42She was just being sweet, and I was, "I've got to get out of here. I'm just going to cry."
0:33:42 > 0:33:46I just went in just now, and she was just so sweet to me.
0:33:46 > 0:33:47You look at someone.
0:33:47 > 0:33:51She didn't have a clue what was going on, you just think, "Oh..."
0:33:51 > 0:33:54I'm just a soppy idiot like that, that's all.
0:33:54 > 0:33:59The emotional side of doctoring is all part of the juniors' learning curve.
0:34:01 > 0:34:04Right, anyway...I'll be fine.
0:34:04 > 0:34:08I need to write her notes and move on to the next person, and it'll all be better.
0:34:08 > 0:34:11- Here you are, I brought some for all of yous.- Thanks!
0:34:11 > 0:34:13- There you go.- That's amazing.
0:34:13 > 0:34:15- Pauline made it. - Caramel shortbread... Mmm!
0:34:18 > 0:34:20Wow!
0:34:20 > 0:34:22That's bloody amazing.
0:34:22 > 0:34:24You can't help anybody...
0:34:25 > 0:34:30..or tell anybody how to work their emotions. You've got to...
0:34:30 > 0:34:33- It's life experience, it's... - It'll come with it.
0:34:33 > 0:34:37She will learn in time
0:34:37 > 0:34:41and learn by the experience that she's had, how she's coped with it
0:34:41 > 0:34:45and how she, in herself, will learn to cope with it, really.
0:34:47 > 0:34:49'Doors closing.'
0:34:55 > 0:34:58Back at the house, after another long shift,
0:34:58 > 0:35:02Lucy has a special recipe for stress relief.
0:35:05 > 0:35:08Today, I've had a really long day, I've had a busy day
0:35:08 > 0:35:10in terms of things going on with patients
0:35:10 > 0:35:14and horrible situations with patients, so actually, coming home
0:35:14 > 0:35:16and doing this is very therapeutic for me,
0:35:16 > 0:35:19because it means I can get lost in it a little bit,
0:35:19 > 0:35:21enjoy something a bit different.
0:35:21 > 0:35:23I find it so relaxing,
0:35:23 > 0:35:27and I really enjoy making things for people, you know.
0:35:28 > 0:35:30Even if I haven't got a purpose for it,
0:35:30 > 0:35:33I really enjoy that side of it and just...
0:35:33 > 0:35:35I don't know, looking after people, I guess,
0:35:35 > 0:35:37that comes into it a little bit as well.
0:35:37 > 0:35:42If medicine goes to pot, I'm going to do a professional cookery course, I think, open a tea room!
0:35:50 > 0:35:54While Lucy's baking, housemate Suzi is heading to choir practice
0:35:54 > 0:35:57after a demanding day at the hospital.
0:35:57 > 0:36:00I don't want to be late, I hate being late for things!
0:36:00 > 0:36:04The long hours of a junior doctor can make having a life outside work hard.
0:36:04 > 0:36:07CHOIR SINGS
0:36:16 > 0:36:20'It's nice to do something else challenging apart from my job.'
0:36:20 > 0:36:23Just being able to sing and not think about my patients.
0:36:23 > 0:36:24It's quite calming as well,
0:36:24 > 0:36:28like the things that we're singing are quite kind of pleasant and nice,
0:36:28 > 0:36:30which is good. Yeah, it's really fun!
0:36:39 > 0:36:44All the junior doctors are coming to the end of their current placements.
0:36:44 > 0:36:47At the hospital, Adam's arriving for one of his last shifts,
0:36:47 > 0:36:50while housemates Jon...
0:36:50 > 0:36:51Lucy...
0:36:51 > 0:36:55and Andy are already hard at work on their wards.
0:36:58 > 0:37:02That leaves Katherine and Keir at home together.
0:37:02 > 0:37:04I woke up feeling very sleepy and grumpy,
0:37:04 > 0:37:08and then I came down to the kitchen, and the cake fairy had been.
0:37:08 > 0:37:11She always knows when you need cake,
0:37:11 > 0:37:13and it just magically appears.
0:37:13 > 0:37:17I make no apologies for this at all.
0:37:24 > 0:37:27Suzi is coming to the end of her four months on A&E,
0:37:27 > 0:37:30but tonight's shift is going to be another first.
0:37:32 > 0:37:34This is the new A&E at the RVI,
0:37:34 > 0:37:36so the other one is closing
0:37:36 > 0:37:39tonight at midnight officially.
0:37:39 > 0:37:42And this is the new one, and it's all very nice and shiny,
0:37:42 > 0:37:46and it smells all new. And there's no patients!
0:37:46 > 0:37:49What more could you ask for in an A&E department?!
0:37:50 > 0:37:55But it won't be quiet for long. Tonight, Newcastle's state-of-the-art £10m
0:37:55 > 0:38:00accident and emergency department will open for the first time.
0:38:01 > 0:38:04It's so different and so big.
0:38:04 > 0:38:08We're in reception, which I'm sure very soon will be quite busy
0:38:08 > 0:38:11when all the patients arrive.
0:38:11 > 0:38:14The place is so weird, it's so quiet.
0:38:14 > 0:38:17A&E is not normally a quiet place.
0:38:18 > 0:38:22At midnight, the old A&E closes, and all of Newcastle's ambulances
0:38:22 > 0:38:26will be sent to this new department instead.
0:38:26 > 0:38:30Suzi and the team will have to get used to the new surroundings
0:38:30 > 0:38:33and treat up to 200 emergency patients.
0:38:33 > 0:38:38It's a huge night for all our staff, anxiety levels are through the roof.
0:38:38 > 0:38:41The department we're moving to is about three times
0:38:41 > 0:38:43the size of our previous department,
0:38:43 > 0:38:45and I think the new doctors
0:38:45 > 0:38:48are going to find it hard
0:38:48 > 0:38:50because they don't know where things are yet.
0:38:50 > 0:38:55No-one really knows what's going to happen, and obviously
0:38:55 > 0:38:59we're doing the same job, but it's a totally new building.
0:38:59 > 0:39:01Apparently it's different to use the phones here.
0:39:01 > 0:39:04Pretty basic things, but half of what we do is based on speed,
0:39:04 > 0:39:08and if you don't know what you're doing, then it's much harder to go faster.
0:39:08 > 0:39:13Suzi will be the first junior doctor to try out the new department.
0:39:13 > 0:39:15I've only got to know the old A&E,
0:39:15 > 0:39:19and then it's, like, let's change everything to the new A&E.
0:39:19 > 0:39:22I know how everything works over there, but not here,
0:39:22 > 0:39:25I don't even know where everything is here!
0:39:25 > 0:39:30Suzi and the team have just a couple of hours to get to know their new department
0:39:30 > 0:39:34before the first emergency patients will start to arrive.
0:39:34 > 0:39:37We don't quite know what's going to happen tonight.
0:39:37 > 0:39:41It is a waiting game, and we hope things go smoothly.
0:39:45 > 0:39:51Upstairs, on the wards, Suzi's housemate Adam is also on nights.
0:39:51 > 0:39:54He's part of a team covering several different wards.
0:39:54 > 0:39:59I'm kind of getting used to the whole night-shift rhythm a little bit.
0:39:59 > 0:40:02I don't enjoy it, but I'm getting used to it.
0:40:04 > 0:40:08His first job is a simple procedure - taking blood.
0:40:08 > 0:40:10Hello, sir.
0:40:14 > 0:40:17I think it's the other chappie I'm looking for.
0:40:17 > 0:40:20I think it's the other chappie I'm looking for.
0:40:20 > 0:40:22I'll let you get back to sleep.
0:40:24 > 0:40:27Sorry to wake you, sir, my name's Adam, I'm one of the doctors.
0:40:27 > 0:40:31I do have to take some blood from you some time in the next hour or so.
0:40:31 > 0:40:34'It started out busy tonight and I've got a lot of things to do.'
0:40:37 > 0:40:40To be honest, all nights start out busy.
0:40:40 > 0:40:42I don't know how it'll pan out.
0:40:45 > 0:40:5124-year-old first-year Adam started his career as a doctor with high expectations.
0:40:51 > 0:40:55Ideally, I would want to make a difference to as many people
0:40:55 > 0:40:58as possible and do something that was absolutely huge.
0:40:58 > 0:40:59In essence...
0:40:59 > 0:41:02I want to save the world!
0:41:02 > 0:41:06Assigned to the respiratory ward, he soon discovered some of the job
0:41:06 > 0:41:07wasn't that glamorous.
0:41:07 > 0:41:1160-70% of the job is probably paperwork, I reckon.
0:41:11 > 0:41:13It's just not stimulating at all.
0:41:13 > 0:41:16But when he's had the chance to treat seriously ill patients...
0:41:16 > 0:41:18How are you doing?
0:41:18 > 0:41:22He's not well, not well at all.
0:41:22 > 0:41:25..he's proven he's got the medical knowledge.
0:41:25 > 0:41:28Do you think I can give him furosemide? Is it a decision I should make?
0:41:28 > 0:41:31- If you're comfortable and know what you're doing...- Sweet.
0:41:31 > 0:41:33I knew it, I knew it!
0:41:33 > 0:41:37And he's shown he has the makings of a good doctor.
0:41:37 > 0:41:39How are you feeling today?
0:41:39 > 0:41:42Much better than what I did yesterday.
0:41:42 > 0:41:44Good. I'm glad to hear it.
0:41:44 > 0:41:45Seriously, good job.
0:41:45 > 0:41:49Adam is coming to the end of his first job as a doctor
0:41:49 > 0:41:50on the respiratory ward.
0:41:50 > 0:41:53He's made good progress but, like all the juniors,
0:41:53 > 0:41:55still has a long way to go.
0:41:55 > 0:41:58He's doing well. He's a good member of the team.
0:41:58 > 0:42:00He can stand on his own two feet,
0:42:00 > 0:42:04but the question is what you're asking of him.
0:42:04 > 0:42:08He's receptive to learning and hearing some new ideas and thoughts.
0:42:08 > 0:42:11That's the most important thing -
0:42:11 > 0:42:15that you're receptive to the process of getting better,
0:42:15 > 0:42:18day on day, week on week, year on year.
0:42:18 > 0:42:20That's the most important thing.
0:42:20 > 0:42:22For me, confidence is a bit of an issue.
0:42:22 > 0:42:26I think I come across as someone who's confident
0:42:26 > 0:42:29and thinks they know what they're doing - ish.
0:42:29 > 0:42:32But in reality, I'm very much questioning myself
0:42:32 > 0:42:36every step of the way and always feel like I need to ask a senior.
0:42:36 > 0:42:41Even though I know something might be right, I just can't take the decision on my own. I need to check it first.
0:42:41 > 0:42:43That's good practice at my stage, anyway.
0:42:48 > 0:42:51We're just going to open the doors now because people have arrived
0:42:51 > 0:42:54before we were quite ready.
0:42:54 > 0:42:56They're so keen!
0:42:56 > 0:43:00In accident and emergency, the new department is officially open.
0:43:00 > 0:43:03It's not long before Suzi has a patient.
0:43:03 > 0:43:07It will be one of her last as an accident and emergency doctor.
0:43:07 > 0:43:09How are you feeling, then?
0:43:09 > 0:43:12- Not too good. - Tell me about what's been going on.
0:43:12 > 0:43:16Catherine has been brought in with severe shortness of breath,
0:43:16 > 0:43:17but that's not the only problem -
0:43:17 > 0:43:21she has a history of chest problems and lung disease.
0:43:21 > 0:43:24I've been on antibiotics, I've been on steroids,
0:43:24 > 0:43:27- and I'm still the same, put it that way.- OK.
0:43:27 > 0:43:31It's something Suzi has seen several times on A&E
0:43:31 > 0:43:34so she knows exactly what tests she needs to do.
0:43:34 > 0:43:38I need to take a blood test from here which I'm sure you've had done in the past.
0:43:38 > 0:43:41I hope you're good, because I go mad with them
0:43:41 > 0:43:43when they take it from there.
0:43:43 > 0:43:47Sharp scratch coming now, OK?
0:43:50 > 0:43:51You OK there still?
0:43:53 > 0:43:56How was that?
0:43:56 > 0:43:59- I'll give you 8 out of 10. - Oh, that's all right!
0:43:59 > 0:44:01Fine with that.
0:44:02 > 0:44:04The chest X-ray is back.
0:44:04 > 0:44:08Suzi refers the case to her senior, Jim, for a second opinion.
0:44:08 > 0:44:12She feels she's been trying to keep herself out of hospital,
0:44:12 > 0:44:16but this morning, it just got...too bad.
0:44:16 > 0:44:18- It sounds like it's infected.- Yeah.
0:44:18 > 0:44:22Get the rest of the bloods and I'll cast an eye over it.
0:44:22 > 0:44:26It's serious enough to mean a stay in hospital.
0:44:26 > 0:44:31Suzi orders some more blood tests and refers Catherine to another ward for further treatment.
0:44:32 > 0:44:35She can then move on to her next patient.
0:44:35 > 0:44:37Do you feel wheezy at the moment?
0:44:37 > 0:44:39You sound a bit wheezy.
0:44:39 > 0:44:44By the end of the shift, it's business as usual for Newcastle's accident and emergency team.
0:44:44 > 0:44:48I'm finding where everything is which slows things down a bit, but...
0:44:48 > 0:44:53thankfully it wasn't too crazy so there was time to be slowed a bit.
0:44:53 > 0:44:57By the time it gets to Friday night and everybody's going out
0:44:57 > 0:45:01and getting drunk, I'm sure it'll be a very different story.
0:45:04 > 0:45:07It's gone really well. The staff have done brilliantly.
0:45:07 > 0:45:10There's been a lot of support staff in the background to help them
0:45:10 > 0:45:13as a safety net in case anything did go wrong.
0:45:13 > 0:45:17Fortunately, I haven't needed to use them and they've coped really well.
0:45:17 > 0:45:21The patients are coming and being seen, being treated and leaving, so that's great.
0:45:21 > 0:45:23Couldn't have asked for anything more.
0:45:25 > 0:45:29It's the end of an era, as the old department closes for good,
0:45:29 > 0:45:31and Suzi is coming to the end of her placement.
0:45:31 > 0:45:34'I've decided to leave A&E.
0:45:34 > 0:45:37'Even though, at times I found it really stressful,'
0:45:37 > 0:45:41I've had more kind of responsibility than I've ever had in the past,
0:45:41 > 0:45:44which is obviously quite scary.
0:45:44 > 0:45:46But it's gone well, I think.
0:45:46 > 0:45:49Over the last three months, Suzi has matured well.
0:45:49 > 0:45:52It's a short time for a junior doctor,
0:45:52 > 0:45:57but I would class her as an above-average trainee.
0:45:57 > 0:46:00She has a quick grasp of knowledge
0:46:00 > 0:46:04and she gets stuck into things very quickly.
0:46:04 > 0:46:09What I've seen so far of her, she will make a sound physician.
0:46:22 > 0:46:27Lucy's on her final shifts on the gastro ward, but before she leaves,
0:46:27 > 0:46:30there's some good news about her long-term patient.
0:46:30 > 0:46:32What is the actual plan for her?
0:46:32 > 0:46:36- Well, they're coming to assess her today.- Right.
0:46:36 > 0:46:39- She can go tomorrow.- Brilliant.
0:46:39 > 0:46:42Thanks to the efforts of Lucy and the team,
0:46:42 > 0:46:46the patient's condition has improved and she is now well enough to be moved to a nursing home.
0:46:46 > 0:46:50They've got a bed, she's diarrhoea free, so she can get out of here.
0:46:50 > 0:46:52- Yeah.- I'm so pleased.
0:46:52 > 0:46:57She'll never get home home, but at least we're getting her out of hospital, which is a massive step.
0:46:57 > 0:46:59I didn't think we would get that.
0:47:01 > 0:47:04I'm just coming to say ta-ra,
0:47:04 > 0:47:06because you're off in the morning, aren't you?
0:47:06 > 0:47:08I'm not here tomorrow.
0:47:10 > 0:47:13So I just wanted to come and say...
0:47:13 > 0:47:16all the best and I hope it all goes well settling in.
0:47:16 > 0:47:18Don't you try and get up, missy!
0:47:18 > 0:47:20Don't want you falling over!
0:47:24 > 0:47:27Take care of yourself, won't you?
0:47:28 > 0:47:31Make sure you get that bacon sandwich first thing tomorrow morning!
0:47:35 > 0:47:38'It's weird that we're both leaving at the same time.
0:47:38 > 0:47:41'It's a strange closure, but quite nice.'
0:47:41 > 0:47:44We were expecting the worst last week, but she's picked up completely.
0:47:44 > 0:47:48She's a lot happier, eating well and everything.
0:47:48 > 0:47:52However long she's at the nursing home, she's a stronger lady
0:47:52 > 0:47:57than she was and we finally got her out of here diarrhoea-free and everything.
0:47:58 > 0:48:04This has taught me a lot. It's taught me about social care for patients, making sure patients are happy.
0:48:04 > 0:48:06That's just as important in their recovery
0:48:06 > 0:48:10as making sure their medication is OK, which is another thing I've learned.
0:48:10 > 0:48:15Hopefully it's prepared me on some level for my next stage.
0:48:15 > 0:48:19Lucy's more than ready to move on.
0:48:19 > 0:48:22She's just so interested in what she does.
0:48:22 > 0:48:24She likes what she does.
0:48:24 > 0:48:29She's got feelings so she can look at things from different angles.
0:48:29 > 0:48:32The fact that she's a people person,
0:48:32 > 0:48:34I think she'll go very far.
0:48:35 > 0:48:38After four months, all the junior doctors
0:48:38 > 0:48:40have finished their first placements.
0:48:40 > 0:48:43They've faced serious emergencies...
0:48:43 > 0:48:46MOBILE BEEPS Cardiac arrest.
0:48:46 > 0:48:49..dealt with challenging cases...
0:48:51 > 0:48:54I just can't see or feel a vein at all.
0:48:54 > 0:48:57I don't want to take it out of that arm.
0:48:57 > 0:49:01- ..as well as the more unusual. - Are you able to get any of it out?
0:49:01 > 0:49:03Has any broken off?
0:49:03 > 0:49:06I saw a man that had a toilet brush up his bottom!
0:49:06 > 0:49:09They've learned that bedside manner is key.
0:49:09 > 0:49:12Lift this leg straight up in the air, keep it there.
0:49:12 > 0:49:14I can tickle you here and there.
0:49:14 > 0:49:18They've had to come to terms with the fact they can't save everyone.
0:49:18 > 0:49:22This poor lady has been told the worst news that she's ever going to hear.
0:49:22 > 0:49:26Her life has literally been taken away from her like that.
0:49:26 > 0:49:28They've had good times...
0:49:29 > 0:49:32Yes, I got paid!
0:49:32 > 0:49:36- ..and bad.- Basically days like today make me want to quit medicine.
0:49:36 > 0:49:38And had some fun along the way.
0:49:44 > 0:49:49And they're still only at the start of their careers as doctors.
0:50:02 > 0:50:04Today, all the junior doctors
0:50:04 > 0:50:08are beginning work in their new departments.
0:50:08 > 0:50:12As they start back at the bottom, do they still think they're up to the job?
0:50:12 > 0:50:14The more I do, the more I realise
0:50:14 > 0:50:19how far I've got to go and how much work it's going to be.
0:50:19 > 0:50:22There's just so much stuff that I don't even know.
0:50:22 > 0:50:27I don't know if I'll ever be sat there thinking, "Yes, I'm a good doctor, doing a good job
0:50:27 > 0:50:30"and I'm happy with the way things are going."
0:50:30 > 0:50:33I think I'm always going to think there's more I can be doing,
0:50:33 > 0:50:35or something I can improve on.
0:50:35 > 0:50:38Junior doctors spend the first two years in a hospital
0:50:38 > 0:50:40moving around different departments.
0:50:40 > 0:50:44It's the best way for them to build up the experience they need.
0:50:44 > 0:50:47Jon is starting on the orthopaedic ward.
0:50:47 > 0:50:49I feel like I've got a lot more knowledge
0:50:49 > 0:50:52in terms of the medicine that I knew.
0:50:52 > 0:50:57But in some respects, I'm right back at the bottom again
0:50:57 > 0:50:59learning about orthopaedics.
0:50:59 > 0:51:02It's swings and roundabouts.
0:51:02 > 0:51:06Keir will be tested on paediatrics, the children's ward.
0:51:06 > 0:51:08I've been looking forward to Paeds
0:51:08 > 0:51:12since I first got confirmation that I was doing it.
0:51:12 > 0:51:14So, yeah, I kind of feel like...
0:51:14 > 0:51:17I'm in the place I want to be.
0:51:17 > 0:51:21I'm now in a situation where having become comfortable
0:51:21 > 0:51:23over four months and something,
0:51:23 > 0:51:25I'm back to square one at the bottom of the learning curve.
0:51:27 > 0:51:30Look at the screen. You'll see the microscope pass through...
0:51:30 > 0:51:35Adam's challenge will be looking after critically-ill patients in intensive care.
0:51:35 > 0:51:38I'm not going back to square one.
0:51:38 > 0:51:41I've come here with experience and knowledge from my first job
0:51:41 > 0:51:45and I'm a lot more comfortable about being a doctor
0:51:45 > 0:51:48and a lot more together as a person. I'm less fluffy,
0:51:48 > 0:51:50less flapping around.
0:51:50 > 0:51:53I'm fairly excited by the next four months ahead.
0:51:53 > 0:51:55Something like this is what I needed.
0:51:55 > 0:51:58I want to get stuck in.
0:51:58 > 0:52:01Lucy is going into a completely different environment -
0:52:01 > 0:52:03researching genetics in a laboratory.
0:52:03 > 0:52:06You're learning every single day.
0:52:06 > 0:52:11Although I've been working four months, I still feel like...
0:52:11 > 0:52:12there's such a way to go.
0:52:12 > 0:52:17I certainly feel like I've come quite a long way since that first day
0:52:17 > 0:52:19when I stepped onto the gastro ward
0:52:19 > 0:52:21and just felt like a rabbit in headlights.
0:52:21 > 0:52:25Andy will be learning how to pass on his medical knowledge -
0:52:25 > 0:52:29he'll be teaching anatomy to future junior doctors at the university.
0:52:29 > 0:52:31A right femur or left femur?
0:52:31 > 0:52:33'It is a little bit nerve-racking'
0:52:33 > 0:52:35in the first teaching session.
0:52:35 > 0:52:40I keep having to feed them more information.
0:52:40 > 0:52:45They are asking questions, which is a good sign and means they are interested in learning.
0:52:45 > 0:52:47I think I'm enjoying it so far.
0:52:50 > 0:52:53And from life and death on A&E,
0:52:53 > 0:52:56Suzi is looking after newborn babies.
0:52:57 > 0:53:02I think at first you're kind of finding your feet and things,
0:53:02 > 0:53:06hoping that you're going to be OK. But as you get into your second year,
0:53:06 > 0:53:10hopefully you get a bit older and think, "I can do this."
0:53:10 > 0:53:13Even if I have a bad day, I think, "It's a bad day,
0:53:13 > 0:53:14"but I can do it the following day
0:53:14 > 0:53:17"and the day after that and a hundred more days after that."
0:53:17 > 0:53:21That's the way it goes. BABY CRIES
0:53:21 > 0:53:23I've still got that feeling of,
0:53:23 > 0:53:27"I can't believe I'm actually a doctor!"
0:53:27 > 0:53:28Like, a doctor!
0:53:28 > 0:53:31That's quite...cool, I suppose.
0:53:52 > 0:53:55Subtitles by Red Bee Media Ltd
0:53:55 > 0:53:58E-mail subtitling@bbc.co.uk