Accident and Emergency | Consultant in Emergency Medicine

Dan

What is your role?
“As a consultant in emergency medicine I work in the A&E department, helping to treat some of the 125,000 or so people we see in A&E every year.

“My job is about three-quarters clinical (working with patients) to a quarter non-clinical. I am one of 12 consultants in the department and in my clinical work my day is divided working in different areas of the department: pitstop (where we rapidly assess patients on arrival), majors, where we see serious cases and minors. I also do a ward round on our short-stay Ward 101.

“In these cases I am seeing patients directly and I am also advising junior members of staff on how to treat patients.

“I do on-call shifts where I am at the hospital for eight hours until midnight, then contactable overnight by phone. Very occasionally I am called in but usually, if I am needed, I can advise over the phone.

“My non-clinical role involves mentoring staff, doing appraisals and making sure training is up-to-date. I am also involved with improving the training we offer to new doctors and making our workforce sustainable.”

Why did you want to do this job?
“I had always wanted to work in acute medicine, at a hospital. I went out to Australia as part of my training and worked in emergency medicine there and really enjoyed the work, the variety of patients coming through the door.

“I love the clinical side of things less for the drama and adrenaline – though that still gets you – but more for the people; the staff I work with and who I have such great camaraderie for and the patients who come in, each so different.

“When a resuscitation goes well it can be really rewarding, definitely. But it is just as rewarding to take the time to talk to a family about their loss, or help give care to someone at the end of their life, making sure the care is as good as it can be.

“To do this job well you have to be able to make quick, incisive, informed decisions; you have to be able to work well under pressure and work well within your team. You need to be able to delegate well but possibly most importantly, to communicate with everyone around you and make sure that 20 staff around you are all talking to each other. That’s vital.”

What do you like particularly about Derby Teaching Hospitals?
“For me, the reason I came to Derby, and that I keep coming here, is that I get on so well with my colleagues. There is a real camaraderie with the other consultants but then as part of the wider team, we all get on well, whether it’s nurses or foundation year doctors – we all have a way of picking each other up and buoying each other through difficult shifts.

“Derby is a busy hospital: we’re in the top 20 or 30 for numbers of attendances but I like that, I like the pace and the way there’s a lot going on here. I think the work we’ve done to make emergency medicine sustainable here, to make sure we have enough staff and that staff can leave on time is great.

“Here I feel encouraged and supported in developing in my career. I’ve been here four years and I have been able to move into a lot of different areas. That’s a great opportunity.

“I’ve been involved in developing an innovative training programme here in Derby. We now offer Emergency Medicine doctors tailor-made rotations to learn new skills in relevant specialties, and we can work with doctors pursuing an application for the Certificate of Eligibility of Specialist Registration (CESR), which will help get them placed on the specialist register and apply for ED Consultant posts.”

If you’re interested in joining the Derby Teaching Hospitals team, search our consultant vacancies now.

Alternatively, you can watch the following video to find out more about training in Emergency Medicine at Derby Teaching Hospitals.

Why did you decide to take part in the programme?
“I was put forward by a few people and I agreed to do it on the proviso that I would not have to do any acting. I have no problem being followed as I do the job I love but I didn’t want to have to retake things, do things a certain way or in any way be anything but real.

“I thought it was also a good chance to show people what an A&E department is really like. I think there is this really big national and local profile of emergency service and it’s not quite accurate but it is having an effect: only 50% of our training positions are actually filled. There’s a misconception that working in A&E is really bad for personal life, that it’s hard to strike a good work-life balance and that the hours are terrible. But, no: actually, in A&E, because we have such structured handovers, people working shifts go home on time at the end of their shifts almost all the time.”

How was it working with the camera and crew?
“The crew understood quickly how we would need to be able to carry out our work at all times. That came first. And to be honest, when you’re at work in an A&E department things happen quickly so I found I forgot the crew were there.

“They were quite clear, telling people to be normal, do their jobs – though that’s easier said than done – and made an effort to get along with everyone.”

How do you think viewers will react to the programme – especially the parts you appear in?
“I hope they will see that for this department to work well at all, we have to work as a team. I hope the importance of all the roles and especially the communication between everybody, is the most important thing. I hope they see the possibility of working in A&E as a positive one, and that it really is a good department to work in. And I hope they see that if they come here as a patient, they will get the best care possible.”

What will you remember most about the experience?
“It was the first shift I had worked with the film crew and we were about two hours in when I was talking with the registrar and I heard a woman shrieking, ‘my husband has collapsed!’ The cameras started rolling and followed me to where I found a man who had gone into cardiac arrest and we were able to resuscitate him.

“The crew caught it all but never once interfered, they did it very discreetly. I could tell afterwards that they had got something very important and I think that while it was very powerful, it was a very natural scene and it was a great outcome, which was purely down to the way the whole team handled the situation.”