First Day at NHS - A roller-coaster experience

It was difficult 14 days in self-isolation and finally, I am stepping out of my house to the outside world. This brought in itself a different level of excitement and anxiety at the same time.

I got an email from my HR on my last day of quarantine. They asked me to send an account opening letter from my bank to enroll me in the payroll. I downloaded this from the ‘statement and documents’ section of the Barclays App and sent it to them. Then, I received a second email asking me to report to the rota co-ordinators office with the following list of documents:

1. Passport

2. BRP

3. Tenancy Agreement

I was also asked to report at around 12:30 PM (and not at 8:30 AM) as they knew I will need some time to get my occupational health clearance and collect my BRP from the post office on the first day. As advised, I went to the Staff health assessment room of the Occupational Health Department. One of the nurses there filled up some of my personal details in the system and took my blood for various serological tests like HIV, VDRL, Hep B, Hep C, and antibody test for Measles and Varicella. She also took my consent to do a TB blood test from the same sample, also called an IGRA (Interferon Gamma Release Assay). I had a UK pre-departure TB clearance certificate obtained for my Tier 2 Visa. I asked if that will make me exempt from this IGRA test, which they denied saying that IGRA is a completely different test than what I did there. I have heard some of the trust accepted this TB clearance certificate, so it depends on the trust policy regarding whether or not to exempt you from this extra TB test. I was also given a leaflet regarding what to do if I get a positive test result. It clearly mentioned that I need to meet the Respiratory Consultant and would need to start on Anti Tubercular Therapy if there is a reactive result. This gave me a different level of anxiety because I have heard many IMGs, especially from South Asian countries testing positive and having to start on drugs for a few months. They also gave me the first dose of Hepatitis B vaccine at the same time. So, altogether got two pricks as the first impression in the NHS ;P I was told that I will need a second dose followed by a blood test to see if I am developing an antibody as well.  Likewise, they also checked my BCG jab scar on my arm.

After done from Occupational Health Dept, I immediately caught a bus from just outside the hospital and headed towards the post office. After reaching there, they asked for my passport and provided me my BRP immediately. Then I returned back to the hospital, had some lunch, and headed towards the Rota Co-ordinators' office. I met my rota co-ordinator and he was there, all prepared with my 6 months roster in his hand. He started explaining all my rotations, normal working hours, long shifts, floating shifts, on-call shifts, my daily job, bank holidays, study & annual leaves, etc. I felt a little overwhelmed right after entering the room. I was told that I will be shadowing for the next 1 month. They call it supernumerary SHO to such doctors here. He was asking me if I had any questions, and there I was left startled not understanding anything from my rota. Lol, I still nodded my head and then was taken to the access control office. They took my photo for my ID badge. From there I was taken straight to the IT login access room. They provided me the 3-day locum pack login access. I was told to complete the IT training by then, to get the permanent login access. This was all adding up to the anxiety that I already had before coming in. Then finally, the most decisive moment was when they revealed my department under general medicine that I am going to be posted for the duration of the next 6 months from the 12 months period. They said its - AFU. I didn’t even know what that stands for and I asked it. It was indeed an Acute Frailty Unit, which has now been converted to a dedicated Covid receiving ward. Damn, the last thing I didn’t want and it is a - covid ward.

I was then handed over to a medical SHO with whom I was shadowing for the next 1 month. He took me inside the doctors' office and introduced me to everyone. I changed my dress and put on the scrubs. I waited there in the office for a while, and a registrar doctor came and took off my all fears and anxieties. Following were his lines and that still reverberates in my ears - 

‘Hi, Dr. Sid welcome to the NHS and welcome to our department. Though this is called Acute Frailty Unit, in fact, this is an Acute “Friendly” unit. We have the coolest consultant you will ever see in the entire life and also the very best team in the hospital. Since we are the covid receiving ward, they never understaff our department and we are never overworked like other departments. Since we already know there are covid positive patients, so we can always take precautions, unlike other wards, where you go without proper precautions and later the patient turns up to be covid positive. So be calm and relaxed here, we all are friends”.

Those were the much-needed words that tranquilized my mind and soul. I hope I will become a registrar like him in the future, easing off the pressure from my junior colleague with such reassuring words. Kindness should be contagious. 

After staying there observing all their activities which were of course not entering my head at all, it was 5 PM, and then it was the time to sign off for the day from the department.

The very first day was nothing sort of an experience like a roller-coaster. All the mixed emotions. Hectic, overwhelmed, excited, anxious, relaxed, and reassured everything in a single day. Next will be my blog on "shadowing in the NHS", which I just completed today as I am writing this blog. Thank you for reading this.