Episode 3 Junior Doctors: Your Life in Their Hands

Emergencies.

Bad behaviour.

-Bedside battles.

-Alfie, Alfie, Alfie, Alfie.

And buckets of blood.

It's a tough job being a doctor.

It's even tougher when you are young.

Am I right or not?

I feel like a child really. In their eyes, I think you probably are.

-I don't want to scare you.

-Untried.

-It's my second day.

-The first time any of us do anything we're going to be

-BLEEP.

And inexperienced.

-Everyone is in the same boat.

-Push it through. Twiddle, twiddle.

No-one knows what they're doing.

But after years of studying,

it's time to put theory into practise on medicine's frontline.

Clear!

Oh, my God! That's so close!

The eight junior doctors are sharing this house.

That looks really weird, doesn't it?

While Amieth and Ben already have a year's experience under their belts...

He's already eaten two lasagnes!

..newly qualified are Lucy, Aki, and Andy...

Amieth actually made it, but it was following my plan.

..Sameer, Milla and Priya.

-Where's my seat?

-You can come and join our side.

Five years of training can't prepare them for everything.

She's impaled her hand on the spike.

But when you're young and inexperienced,

it's hard to take charge...

-These are the questions we ask everyone.

-It's not helpful. I find it offensive.

..appear confident...

I know it's a bit miserable being in here. It's just a matter of keeping going.

..and on top of things.

No-one's died yet, which is good, but maybe I'm being a bit too careful.

# I need a doctor

# I need a doctor

# You know I love you. #

The junior doctors have been living and working together for four weeks now.

-What's up?

-I like your hair, Andy.

-What?

-I like your hair.

-Is it mental?

-It's nice.

Getting on with housemates and colleagues is the easy bit.

It's relationships with patients that's testing their skills.

I am running late this morning.

And when you only 20-something, taking charge can be tricky.

'I just feel I need to get older'

because at the moment, when I'm talking to an 80-year-old

and telling them what they should be doing, I feel quite young.

Learning to put patients at their ease in difficult situations

is something all juniors have to learn.

For second year, Amieth,

A&E throws up some challenging and unusual cases.

Tatyana is a 17-year-old barmaid brought in by her manager,

distressed and in pain.

And Amieth deals with her care.

Hello. I've come from resus with a request for a portable hand X-ray.

A lady has impaled it on a spike.

She's injured herself at work.

A spike that holds receipts has gone through her hand.

With the receipts still on it.

It's gone almost all the way through to the other side actually.

It's gone in very deep.

A month from now when it's no longer painful and it's funny,

then she'll like the photos by then.

Tatyana is frightened.

Amieth needs to calm her down and administer a sedative.

-Once I get a line in, we can give you some good painkillers. That will help.

-I can't.

Don't look. You've seen enough things going into your hands today.

You don't need to see anything else.

SHE MOANS

-Deep breaths.

-That's the worst of it over.

As soon as the sedatives take an effect and the barmaid is calm,

Amieth and his registrar can get to work.

-Make sure you keep all the receipts!

-I was going to say.

Are these the tips or just the counter slips?

They will need them for their records.

With the receipts out of the way,

Amieth's senior comes up with a plan to remove the spike.

You could just take this out.

-What we'll do is get a decent pair of pliers.

-It's very deep though.

Once we get her sedated, we'll get the bandage off and we'll have a good look at it.

To be perfectly honest, a decent pair of B&Q pliers

will be the most effective thing at yanking it out.

All right, I'll get my toolbox then!

Pliers?! You're just going to scare the patient.

A&E has a box of emergency tools.

The question for Amieth is which one is best for getting the spike out?

-A saw?

-A saw!

-A saw to start with?

This one? If you just pull it on to there.

-It's quite large.

-Wire cutter.

-That's what you'd use to cut bike chains and things!

-No, I'm just thinking that's going to be too big isn't it?

-Yes.

That looks pretty good.

Armed with some handyman's pliers, and with his patient sedated

but still conscious, Amieth will need to be fast and precise.

Get a good grip. I'll hold the hand.

-And then it's just, out.

-Yes, OK.

Ready now?

Get them further down. Get more in the middle. That's it.

Right, now, I'll tell you when.

OK, ready? Go.

GIRL MOANS

Big breath, big breath. All done, all done.

Big breaths. Just relax. Big breaths.

-Just try and relax a little bit.

-It came out very easily.

Amieth's success impresses his colleagues.

-Have you finished?

-Yes.

-You've taken it out?

-We managed to get it out.

Oh, my God! Well done, you!

The sedation worked pretty well.

She was sedated enough to pull it out

but then woke up as soon as we did it, so that was perfect.

Very impressive. That's very good.

But before leaving, Amieth makes sure Tatyana is on the mend.

How are you feeling?

That's good.

You might feel a bit drowsy for the rest of the day after the sedatives,

but hopefully that's the worst of it over now.

And you've got the spike as well I see.

-You've put a nice safety cork on the top.

-Yes. Thank you.

-All the best.

Amieth's calm bedside manner

has helped him through a tricky emergency.

Tatyana can leave the hospital spike free.

-Do you know how to pop a list down?

-No.

If I show you that, and if you do that all this week when you get in.

Across the hospital, Sameer has only been a doctor for a few weeks.

I will. I will talk to you first.

Just to introduce myself. I'm Sameer. I am one of the doctors.

Sameer has been called to see a patient with liver disease

who is demanding immediate medication.

Where is the pain exactly?

So does anything make the pain worse or better?

I just need to make sure I've got the whole story, but I will be as quick as I can.

It's a real test of Sameer's patient skills.

The man is an alcoholic and ex drug-user.

I want to talk a bit about the drug use.

How long have you been using and what kind of drugs have you...

It would just be helpful. It's just a question of...

There's a reason for it.

Don't worry. We don't have to talk about it in that case.

Can I just move on to...

It's a bedside battle that can only be won with experience.

It can happen that you go to talk to these,

I guess, difficult patients at times,

and you almost get hijacked.

The key is not to get flustered, not to panic,

and not being too confrontational.

If the patient or the family members don't have much confidence in you as a doctor,

then it's going to be very difficult to deal with them on any level.

The patient is given medication.

For Sameer, it's been a tough lesson in handling difficult situations.

I still feel awkward inside

and I've only dealt with a few patients

with these kind of problems before.

I think it just comes with practise, but you never feel completely comfortable with it.

First-year Andy is also being challenged the on the orthopaedics ward,

which specialises in broken bones.

A man is about to have an operation

but has chosen to ignore Andy's instructions not to eat or drink.

Did I not communicate to the nurses clearly enough?

It's not your fault. If you've told the nurse, what more can you do?

I know, yeah. As long as I made it clear enough.

You've written it clearly there. They have no excuse.

They would have seen this yesterday

because they should be reading the notes.

But maybe I wasn't clear enough verbally. I thought I said, but...

Nurses should still be reading the notes, Andy. Don't blame yourself.

Andy's doing very well.

The main thing is trying to build up his confidence a bit.

A lot of the time, he's right, but he doubts himself lot.

My role is also supporting him and encouraging him in his decisions

because I think he's quite hesitant, which is completely normal.

It's a massive responsibility.

Despite the mix up, the patient knows he shouldn't be eating.

Andy spots more incriminating evidence.

A chocolate wrapper by his bed.

Sophie, he's just been munching away on that as well!

-He's only had a little bit.

-Just say from 9.

And four milligrams of Milky Way!

Right.

Despite being only 22,

Andy must assert his authority as a doctor and explain the consequences.

Please don't eat anything else.

This is the first time I've had this situation, I guess.

The patient not really cooperating

with what's needed for the treatment.

But you know, at the end of the day, it's his choice.

If he doesn't want it, well, you know...

You have to really find out if he wants it.

As soon as we know anything, we'll let you know, OK?

Junior doctor Lucy is based on the rheumatology ward.

Would you just sit forward for us so I can have a feel of your neck?

Just lift your chin up.

Many of her elderly patients are in hospital for long periods

and gaining their trust can be crucial.

I'm going to draw the curtains round and listen to your breathing.

We've taken him off his oxygen to see what he's saturating at. He's been a bit better.

Since her first day, Lucy has been caring for 92-year-old Robert Beck,

who's suffering from a chest infection.

Stick your tongue out. Did you have some breakfast this morning?

-Not yet.

-You haven't had any breakfast?

-No.

-Not even a cup of tea?

-I had a cup of tea, yes.

That's what medical students are for, so where are you?

Would you mind getting some tea and biscuits for Mr Beck?

-Thank you. How do you take your tea?

-Milk, no sugar.

-Well done.

-No sugar.

OK. It's coming up.

Building relationships with patients

is something that has come naturally to Lucy.

-Hello, sir.

-Hi, again.

Are you the new doctor everybody's excited about?

-I don't think so. That won't be me.

-I thought you were.

-No.

Right, all done.

-That's an English rose. That's for you.

-That's very nice.

Hello. How are you? Have you been having a sleep?

After the ward round, Lucy continues to monitor Robert's condition.

You're looking a bit brighter. Are you feeling a bit better?

Catch it when you can! Are you warm enough, because you feel quite cold?

It is cold. I think it's that window. Shall I get you another blanket?

I can put it round your shoulders then.

We can do that.

Milk, no sugar, isn't it? We know your tea order.

-Then you can have another sleep.

-OK, love.

-All right?

I like my patients. You get to know them.

You see them when they're ill, better, when they go home, come back,

seeing that journey is interesting.

I've learned a lot from it.

Lucy is doing incredibly well

and she is one of those doctors

who was born with a stethoscope round their baby neck.

She's very kind to the patients, she's going to be fantastic.

I will see you later. You enjoy that tea.

But Lucy's attachment to her patient will soon be tested.

MUSIC: "Cheers" by Rihanna

After a hard day on the wards, the juniors share their experiences.

We hope to discharge one of my favourite patients in the next few days.

Why are they your favourite? What's so good about them?

They've been there for ages. And...he's just as cute as a button.

You know when you start to know things about somebody

and get to know them day-to-day?

Those are the patients I get a soft spot for.

I don't get that because most of my patients

are in and out so I don't get time to bond with them.

I become close to mine because they're there for months.

You wouldn't realise this but patients that are really nice,

grateful, get a better standard of care in hospital.

Do you?

I think subconsciously the nurses, doctors, everyone around

gives them more time and is more willing to go

that extra mile for them because

they genuinely have affection towards that patient.

I found it's when you meet people's families you get a feel for them.

You see a people's families in A&E because they come in with a relative.

I only really see relatives as a useful means of finding out

what's been going on with a patient.

-You are ridiculously practical!

-Like a machine!

In A&E you don't have time to be pally

and offer a cup of tea to the family.

I love that. I'd be shit in A&E.

Do you go up like, "Hello, you're a relative,

"you must be a communication tool to communicate with the patient. Good to meet you."

Something like that. In my most robotic voice.

-Hello.

-What time do you start work today?

-11. It's 7am!

I know, that's why I'm not up.

The junior doctors are slowly settling into a routine.

First-year Priya is leaving to start her day in general surgery.

Work!

-Handbrake.

-There's no handbrake.

I've got to go see a patient downstairs.

Junior doctors need to be at the beck and call of their seniors

-at all times.

-Where's my phone?

Her mobile has vanished, lost somewhere on the wards.

Crap, I've left my phone upstairs.

The trouble is she's expecting an important call from her boss, Panos.

Not there.

Hi, Andy. I've lost my mobile phone.

-Celebrations here.

-It's not here.

I'll have to go to AEU.

No! Maybe I didn't leave it in the loos.

Whilst Priya is tracking down her phone,

housemate Andy has equally pressing business.

24-year-old Jason is constipated after an operation.

Hi, Mr Potterill.

I'm just going to pull the curtain round. How is the stomach pain?

This morning I woke up and it was really bad but it's getting better.

How are your bowels at the moment?

-They're still sore but it's getting better.

-Have you passed a stool?

-No.

-You still haven't?

-No.

-I need to do a PR - a rectal examination.

I need to put my finger up your back passage.

-It's uncomfortable but it's got to be done.

-I've had one before.

Then we'll give you senna, a stimulant laxative,

and that should work.

-All right?

-All right.

-There'll be a chaperone with us.

-Fine.

So what are you having done?

A rectal examination. Sounds like fun(!)

I just had an enema, I'd had some suppositories

so what's one more thing?!

PR, put your finger up their back passage, it's not very comfortable

for them but it's a really important thing they do in medicine

and you've just got to let the patient know

it's like any other investigation. You get on with it, I guess.

And just find some lubricant.

Something that patients can find awkward and embarrassing

must be treated as just another investigation by junior doctors.

The trick is to get the patient to relax.

All's well so Andy prescribes laxatives.

Then lets nature take its course.

In general surgery, housemate Priya still can't find her phone

and is missing an urgent call from her boss.

Hello, I come without a needle but I've lost my phone

so I'm checking if I left it here.

Here it is. On the floor.

Thank you. Seven missed calls.

Crisis averted indeed.

Panos, Panos, Panos, Panos. Shoot.

This is Priya's first ever job.

Until now she's always depended on her family

for financial and emotional support.

-Beautiful.

-Thanks, Mum.

It feels like my family and I are in this jungle

that is the world together and suddenly

the baby cub, me, has had to go out and hunt for kill by herself.

At the beginning it's difficult, but in time

I will become king of the jungle.

But winning patients over has sometimes proved challenging,

especially when taking blood.

-A sharp scratch coming up.

-Ow! Ow!

Like all the junior doctors, Priya needs opportunities

to build her confidence and improve her bedside manner.

She's been invited to perform a small procedure.

You only put on the sterile gloves when you make the cut?

-You can do that.

-Her job is to drain an abscess from a patient's armpit.

The patient's aware that it is Priya's first time.

It's an auxiliary abscess, so it's over here, of course.

-What you need is a steady hand, all right, you don't shake.

-OK.

You go in, firm, and every single movement is purposeful.

-You will be supervising me anyway.

-Supervising you closely, yes,

and I will be there if you need any help, OK?

Try and get the hair out of the way.

Ouch. That's criticism, Michael.

-Is that a criticism?

-Constructive.

-Ah!

OK. Now I'm going to go ahead with the cut.

Again, you need to plan your incision, which way you're going to go.

-So you need to go like that.

-Transversely.

-So from there, like that.

-OK.

Start here?

No, you go from the centre, from the area of maximum tenderness.

-Here?

-A bit more straight. Don't worry, we're not doing anything.

We'll tell you when we go.

Basically, what you need to do, you hold it like that,

you go in and make a slight cut like that.

-You don't go... With purposeful movements.

-OK.

I'm going to make the cut now.

Yes. I'm watching.

Even with an anaesthetic to numb the area,

the patient can still feel what's going on.

-That's fine, stop.

-Yep.

-Are you in pain?

-A little bit, yeah.

-OK.

Let me just...

-HE CRIES OUT IN PAIN

-OK, all right.

OK. Now we'll drain the abscess.

That's the worst bit over.

I'm just going to squeeze now, squeeze out the pus.

-All right, gently.

-That OK?

-Yeah, yeah.

You shouldn't concentrate on the abscess,

you should also be looking at the patient's face.

If they're in too much agony, you don't keep squeezing.

-Just clean it up a second.

-This is your plaster.

Sorry it doesn't have a smiley face on it!

-Job done. Excellent, well done.

-Thank you.

It's a big learning curve for Priya.

You can make the incision a bit deeper,

next time, and put a bit more local anaesthetic, but overall,

-I think you have done very well.

-Thank you.

You did everything systematically and I think, you know,

-it's a very good start.

-Thank you.

There were a few blips on my part during the course of it,

but I guess it was my first drainage, so...

..I can only learn from it.

MUSIC: "The A Team" by Ed Sheeran

On the rheumatology ward, Lucy's bedside manner

is striking the right note with her elderly patients.

Hello, lovely. What have you got there?

Is that cake? Very nice.

But one of her favourite patients, Robert, is causing her concern.

How are you feeling at the moment?

Do you? Let me shut the curtains, we'll have a proper chat.

Aged just 25, Lucy needs to be able to offer emotional support

to patients at the other end of life.

Are you? What are you nervous about?

What's just round the corner?

I don't think so.

I know it's a little bit miserable being in here.

It's just a matter of keeping going.

And you look good. You do.

The secret is, Robert, I like having you here and we want to keep you.

But I don't want you to be nervous.

I know. I know it's human nature.

And I don't think it's very pleasant for anybody being in hospital.

I'm sorry it's been like that.

I know you do.

You've been in here now for about two-and-a-half weeks

and because you've been in for that long I want to carry on

and make sure that you get home and you stay at home and you're well.

Because I think we can do that. Honestly, I do.

Don't you just want to take him home? I just want to give him a cuddle.

He's lovely. He's one of my favourites.

You shouldn't really have favourites, but I do.

I think it's difficult sometimes to not become too emotionally attached.

But I wouldn't want her to lose that empathy and warmth she clearly has.

You need to build a relationship with patients.

They're often vulnerable when they're in hospital,

going through a difficult time of their lives and it's important

they realise and know we're on their side

and we're working our hardest for them.

I'll see you later.

On the orthopaedics ward, patient Jason is due to go home

but Andy has cause for concern.

I've noticed some of the tests are a little abnormal

so I want to basically repeat those before he goes home

just to rule out anything potentially serious.

Hi, Mr Potterill, I'm just going to get some bloods quickly,

if that's all right?

Sharp scratch.

Sorry. You've got very wiggly veins. It's hard to keep them down.

-Is that a good thing?

-You've got big veins but they just keep moving.

I'll run to the laboratory

and providing they've returned to normal, you can go home. All right?

-Yep.

-See you soon.

It's not good news...

Blood results are back and some of them have got a little worse

and things aren't quite right and it would just be better

for you to stay in another night and do a few more investigations.

-OK?

-Yep.

-All right?

-Yep.

-See you soon.

It's the first time Andy has used his powers as a doctor

to keep a patient in hospital overnight.

If he doesn't, he risks sending Jason home sick.

I was stressed because I don't know

if I'm erring on the side of caution too much.

I think I probably am but it's not until you get more experience

that you can make decisions more readily to send people home with things like that.

All right, guys, I'll see you both soon.

-Yes.

-All right, cheers, bye.

HE CHUCKLES

What?!

There we go.

It's the end of the shift.

The junior doctors head back to the house.

I think this is my road.

The end of a long day brings a fresh challenge for Priya.

I don't know how to park.

Oh, man. Hilarious.

Right, OK, in theory, I know what to do.

Luckily, her housemate Andy is around to help.

Are you struggling to park a bit there?

You'll stop me if I hit it, right?

You're quite far away from the kerb, Priya.

You kind of need to go that way a bit and get flush with the kerb.

-I don't know what that means.

-Turn the wheel a bit.

-Which way?

-That way.

-You're looking from behind, yeah?

-Yeah.

OK. Stop!

Don't say "stop" like that! It scares me.

I don't think our teamwork is working that well!

OK. You'll be fine this far away from the kerb, you can move it tomorrow.

-Good work, team.

-Good work, Andy. High five.

-Yeah!

While the junior doctors' long hours are limiting the household diet,

Priya has a personal supply of home cooking.

We have the delights from Mummy and Daddy Mangat's kitchen.

My parents, or my mum, tends to cook a lot of food for me

and send it down to London.

It's my home away from home.

Hey, Lu-Lu. I was wondering if you guys know how to cook rice.

-I think we can maybe stretch to cooking some rice.

-Well done!

I'm more than willing to share my homely delights.

Oh, my God, that is amazing!

-Thank you so much.

-Don't touch me!

-I've had such a shit day today, I'm so happy. Look at this!

-To see me?

-Well, that, partly.

-And the food that I bring. You're so chauvinist!

Look at this, Mangatgourmet.com!

-Forward slash, looks delicious.

-You are so lame!

-What?!

Hope you enjoy my culinary attempt.

ALL CHEER

-Poppadoms!

-This looks so nice.

-What's this? This is really nice. It's lentil-y.

-I don't really know.

It's very difficult to maintain a life

outside of the hospital at the moment.

I wake up at whatever, 6:30am, I come home at 9pm.

-Eat, sleep. Cycle starts again.

-Amieth, you've been working for a year.

-Do you find yourself completely limited to medicine?

-No.

It's about finding time to come home at the end of the day

-and cooking your own meal instead of just getting a sandwich.

-Thank you, Priya!

You'll find that as you get better at the job, everything becomes easier.

I got up too early.

That's really annoying. 15 minutes too early.

It's another early start for Andy.

Even a few weeks in, I feel like I'm slow.

OK, no-one's died yet, which is good,

but maybe I'm being a bit too careful.

Maybe... Not careful, just a bit more efficient with what I do.

Back on the ward, Andy's first job is to check on Jason's health,

the patient he kept in overnight.

That's really good, his blood results are looking better.

They were quite high, some of them, but they're coming down,

so that's really good news.

Hi, Mr Potterill. I guess good news, really.

The blood results show that some of the abnormal blood results

are coming down, which is good, because they were high.

-I don't think there's any reason why you need to stay.

-Sweet.

-We need to get you home. So I think you should...

-Fair enough.

-We'll discharge you. OK?

-Cool, thanks.

-You need to get dressed and stuff. All right.

-Thanks.

-No worries.

'I guess yesterday I was a bit concerned that maybe'

I'd worried about something that wasn't an issue.

But even if there was a 1% chance of something serious,

if it actually happened, it would be catastrophic.

Speaking to my consultant, she said, you did the right thing

because you've got to rule these things out.

And Andy's patient is reassured.

Andy's been super thorough, I've been here for a long time

and he wasn't sure what was going on.

It's been really nice to have a nice doctor, refreshing,

to have someone keep me in track like that.

Can you come and look at this man's rash?

On Lucy's rheumatology ward, Robert has got much worse.

He's got a really funny rash.

He's had funny skin issues since he's come in. This is a bit different.

Robert, sweetheart? It's Lucy.

We're just going to have a quick look at your rash on your tum. OK?

Hello, I'm Kate, I'm another one of the doctors.

We're all looking at your rash. Just on your tummy.

It's here. This has changed, this is new, this. It wasn't like that.

This is different. This is all new, his arm started like this.

He's really poorly, isn't he, today? Really poorly.

He's just deteriorated, really, over the last 24 hours.

And he's so much more drowsy than he normally is,

it's not normal for him to be like that.

Just keeping an eye on him, really.

Just getting the right people looking at him as well.

So we'll have to see how he goes.

Earlier in the week, Sameer's confidence

was undermined by a difficult encounter with a patient.

Now he's meeting with his educational supervisor, Dr Pelly.

I found that a lot of what you learn in medical school, you just...

it's just, they're just words, really.

-And you just know, it's basically how to answer questions.

-Sure.

But when you actually do it in practise, it's a lot different.

Like everyone who starts a new job, it's a bit of a shock.

You're a student, suddenly you're qualified.

Suddenly people expect you to know and do all these things.

And you look a bit tentative, which, I think I can remember being

extremely tentative, so I have no problem with that.

You have to learn to almost slightly act the part in a funny sort of way,

because that's what's expected of you.

If you're naturally quite a shy person, which I certainly was,

and I think you're that end of the spectrum, it's quite a transition

to go onto being what people would expect you of you.

So persevere.

Thank you.

Sameer returns to the general medicine ward,

keen to work on his bedside manner.

We looked at your bloods yesterday, sir, and they've got a lot better.

-So they're improving all the time.

-Bloods, you say? Blood test, yeah.

-How's your tummy?

-It's a little bit tender.

-Where is it tender?

Across here.

We did an X-ray of your tummy, and that was normal,

but showed we needed to give you some laxatives.

And if you can get a sputum sample for us, we'd be even happier.

-Will do. I'll do my best.

-See you later, sir.

-Thank you very much.

Yeah, you know, I feel more comfortable when he comes up.

He's got a sort of calming effect. He's very good.

That's so nice.

Someone says that when you're a doctor, that's really good.

That kind of... I've just had a really busy day,

and there's been lots of patients who've been a bit grumpy,

but that just makes it so much better.

That's kind of why you'd want to be a doctor in the first place.

It's a big day for Andy, he's one year older.

Happy birthday!

I would give you a hug, but...

The worst thing about birthdays is the morning, we hate mornings.

I'm 23 today.

It's an important day for Andy at work too.

He's the first port of call for any surgical emergency

across the hospital.

PAGER BEEPS 58524. Come on, let's ring.

Hi, it's Andy here, I just got a bleep from this number.

I've just been called to see a guy who's quite unwell from the sounds of it.

His blood pressure's dropped. And, yeah...

PAGER BLEEPS Go and see what's going on.

There is no time for indecision.

The patient's thought to have internal bleeding.

He's dehydrated and at risk of a heart attack.

Having managed to get urgently needed fluids into the patient,

Andy wants a second opinion.

-Hi.

-Hello.

We've got a patient and he's becoming quite unwell this morning.

His blood pressure's dropping. It's 70 over 40 now.

His SATs are dropping.

I had a listen to him and his chest sounds all right, but...

-I'll look at him now.

-That'd be brilliant if you could.

-OK, yeah.

Confident the patient is now in expert hands,

Andy's still concerned he's losing blood,

so his next job is to organise a transfusion.

A suspected GI bleed.

Drop in haemoglobin, drop in blood pressure,

so it's fairly urgent, actually.

Finally, the team manages to stabilise the patient.

Andy's proved he can make a string of correct decisions under pressure

and the experience has boosted his confidence.

'It was pretty scary, really, cos you think,

'if I don't do something quickly this guy could have a cardiac arrest.'

So I kept pretty calm and just got on with it. It wasn't too bad.

Yeah, it was scary definitely.

You know, exciting as well.

This is the first time I've had to deal with something which is

an emergency.

So, yeah, a mixture of emotions about that.

Any medical problems in the past?

Like all the junior doctors,

housemate Priya has also been lacking confidence.

But in front of needle-shy Katie she needs to show she's in charge.

What we're going to do is put in a line to take some bloods.

I'm just not great with needles. I just won't look. It's fine.

-Otherwise we'll have to do it twice.

-No, I'll go with your option.

Probably better! Julian's going to take some blood.

What's more, she's now overseeing a medical student, Julian.

-Are you happy for him to...

-Yeah, that's fine.

Everyone has to start somewhere.

-Sharp scratch coming.

-Yeah, sure.

Sorry about that.

No, you just carry on. Ignore my crazy sounding noises.

Are you still trying to take blood?

The needle's out. I'm sorry that it's hurting.

Try pulling it out a bit. Stop there.

-How much of the needle have you pulled out?

-A tiny bit.

Yeah, pull a bit more of the needle out.

Let's see if we get some flash back. Yeah, that's fine.

OK, it's a lot more painful when you put it in like that

so it's probably best to just...

If you lose it, it stings a bit.

I'm really sorry.

Julian did a really good job but it slipped a little bit.

-Do you mind if I have a go on the other side? I'm sorry.

-It's fine.

-Sorry.

-No, no.

-I feel really rubbish now.

As with these things, sometimes they don't quite go quite the way

you want them to but that's completely fine.

It's good to get some experience.

He feels a bit bad about it so my job is to reassure him.

I'll tell him to keep it up and, with practise, he'll become better.

With the patient, Katie, now agitated,

it's down to Priya to calm her down and attempt to take blood.

Something she struggles with herself.

The needle's the bit I have issues with. That's why I'm not looking.

If you just keep telling me what you're doing

cos that really helps me not panic.

OK. I never use this technique but I might try it.

No, sorry, this is about cleaning.

I'm not experimenting on you. Don't worry.

-My mistake.

-That's all right.

-If I had my eyes open I could see what you were talking about.

-Yeah.

OK, so well done. Deep breath.

-Sharp scratch.

-Yeah, that's fine.

-OK?

-Yeah, that's fine.

I've taken it out now. No more needle in now. There we go.

-All done. Bit of a mess.

-That's all right.

The worst bit is completely over.

No more stabbings, promise.

-No looking.

-OK. I can see the blood, it's fine.

It's more the needles than the blood, but I will not look anyway.

We're done now. We're done, we're done, we're done.

It's all over. You did it. You survived.

It's a confidence boost for Priya,

as she proves she can handle a difficult situation by herself.

Don't be upset. We'll do plenty more. Your technique is good.

It happens to all of us.

-It happens to me as well.

-Thank you very much.

-You're welcome. Thank you.

See you later.

Priya's a hard worker, gets on with the task and is getting

on well with the rest of the team, so I think it's a promising start.

Over in Rheumatology, there's some news for Lucy.

Hello.

I like your pyjamas. They're snazzy.

After a worrying decline in his health, Robert's made a recovery.

-They're blue.

-There's a stain.

-Yeah, they do actually, don't they?

-Yeah.

-You'll have to iron them out later.

-Will I?

-Yeah.

-Are you feeling all right?

-Not too bad.

Are you not so sure? You look nice.

You've got nice rosy cheeks.

Thinking about you.

He was a bit cheeky. That was unexpected.

Never been like that before. I didn't quite know what to say.

He's obviously feeling a lot better. I've enjoyed having him here.

He's been a lovely patient but, in the end,

they don't belong in hospital.

They should be at home, so it's good.

He's actually been quite stable for a while now.

I think we should make plans now to get him back.

He's going today at lunchtime, yeah.

-Everything's ready to go.

-OK.

Here's Mr Beck's medicines to go home with.

Bless him, he won't be able to carry that bag.

Quite a lot there.

Finally, after caring for Robert since she started,

Lucy's come to say goodbye.

-Hello, Mr Beck.

-Hello.

-Oh, you're all ready to go.

-Yes.

I will hopefully, in the nicest possible way,

not see you again because you'll stay fine.

At last, Robert can go home.

-Bye, everybody.

-Bye!

-Bye, smiler!

'I will miss him cos he was lovely.

'He was always a friendly face on ward round'

and so grateful of any input at all.

You do get fond of patients that have been here so long,

but, at the at the same time,

people shouldn't be in hospital for that long.

He's an old man.

He should be enjoying his life so it's actually really nice

and satisfying to see him leave.

-Are you ready, Mr Beck?

-Yes. Goodbye.

All our juniors are growing into their roles as doctors,

but the youngest is turning 23.

It's been a hectic week for Andy

but tonight he's celebrating his birthday.

We need more clothes for him. We should give him a hat and stuff.

We could put Milla's fur coat on him. That would be pretty funny.

It's his chance to invite friends from home

and an excuse for all the juniors to let their hair down.

Hey, how's it going?

-Hi.

-Happy birthday!

-Thank you.

-Oh, mate, leave the medicine. You're at a house party now.

-Sorry.

He seems to be having a good time. He's got a big grin on his face.

# Happy birthday to you. #

THEY CHEER AND APPLAUD

Guys, thank you so much for coming.

It's been an amazing birthday, seriously. Awesome, awesome.

Probably the worst speech anyone's ever done.

THEY CHEER AND APPLAUD

I'm 23.

I've definitely learned a hell of a lot in the past few weeks at work

and I just feel a lot more confident in my job.

Making decisions.

Generally more self-assured and grown up as a doctor.

I'm starting to enjoy it a lot more too.

'I didn't feel like a doctor at the start.'

You think once you get your badge you'll feel like a doctor

but it's not like that.

As you get experience and feel more comfortable, you feel like a doctor.

It is a complete change, a revolution in my life.

I think having to take everything so much more seriously

has been a bit of a realisation.

Next time, can the juniors fit the image of a doctor?

Apart from elevation, I can't offer anything.

-As they face persistent patients.

-Why can't no-one help me?

-Questioning colleagues.

-AMT?

-I would have thought the AMT would be nine or ten.

-You can't guess it.

And their own high expectations.

-It's just complete

-BLEEP

-basically.

Subtitles by Red Bee Media Ltd