Filler My most unfortunate mistake

Courtesy towards NHS staff is a must

BMJ 2003; 326 doi: (Published 15 February 2003) Cite this as: BMJ 2003;326:372
  1. Cyrus Abbasian

    I had just started as a new medical house officer in an eminent teaching hospital on the south coast of England, having recently completed my surgical job. Like all new doctors, I spent the first few days finding my way around the wards and getting to know the routine. I was booming with enthusiasm and confidence and was somewhat arrogant. The job certainly was not easy. A typical day consisted of an endless ward round, and during on-calls we would be lucky to have a few minutes to ourselves. On a typical post-take ward round we saw more than 20 new admissions, and, with an on-call commitment of one in four, we were always on the go.

    I was initially taken aback by the enormity of the workload in a new environment, and my initiation was not made easier by being on call on the first day as well as the first weekend. Junior doctors can react to such situations in many ways. My response was to be uncharacteristically arrogant, patronising, and even occasionally rude, and, as a new face in the hospital, I made a lot enemies very fast. I was surprised by how quickly most of the staff, including nurses and medical staff, realised that I was a potential troublemaker and someone who needed to be watched. This led to a flood of informal complaints to my consultant, so that, within days of my starting, he summoned me and told me that I was the worst house officer he had ever had. The combination of workload and friction with other staff reached such a level that, by the end of my second week, having worked non-stop for 10 days and done four on-calls, I was considering resigning. I was exhausted, frightened, and very bitter, feeling that I had been treated as a scapegoat.

    After a relaxing weekend, however, I pulled my strength and my wits together and, after some thought, realised how wrong I had been. The words of my senior house officer kept echoing in my mind. He had warned me about how important it was to establish good rapport with the other staff and thereby get them on my side. I turned up to work on time on the following Monday and managed to partially redeem myself within a few weeks. Unfortunately, the damage had been done and, as first impressions last, even with all my good intentions I could not totally clear my name.

    The most important lesson I learnt is the fundamental importance of dealing diplomatically with colleagues. Working in the NHS is demanding and highly stressful for everyone, and, by being polite and courteous, even if others are treating you differently, you can make a lot of difference. You then will realise that you become more efficient, as you can flourish in a pleasant multidisciplinary environment where all can function, attain their full potential, and best serve the patients' interests.

    And here is something for senior NHS staff who have to deal with new house officers every six months. Please realise how much pressure they are under at the start of their careers; their arrogance and even discourtesy may just be part of their coping mechanism. It may be better if you gently habituate them into their new role instead of reacting defensively and ripping them apart.


    • We welcome articles up to 600 words on topics such as A memorable patient, A paper that changed my practice, My most unfortunate mistake, or any other piece conveying instruction, pathos, or humour. If possible the article should be supplied on a disk. Permission is needed from the patient or a relative if an identifiable patient is referred to. We also welcome contributions for “Endpieces,” consisting of quotations of up to 80 words (but most are considerably shorter) from any source, ancient or modern, which have appealed to the reader.

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