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PRHO on the Titanic THE ARTICLE THAT BMA NEWS REVIEW FAILED TO PUBLISH . SUBMITTED ON 8th May 1998 . NO PUBLICATION TO DATE I am a junior doctor who qualified from University College London in June 1999 with a bright future to look forward to and all the enthusiasm for clinical medicine that medical school had armoured me with. This was until three months into my PRHO job with a firm change I was struck down with the truth of the workings within the Trust . I was left unsupported as a junior doctor at City General Hospital, Stoke on Trent with critically ill patients . No SHO was available and no registrar was contactable and this would be a day to day activity which constantly plagued me . In the short staffing and money saving ploys of the NHS , I was left to care for 30 patients myself and persistently blamed if acutely ill patients were not treated properly. The ward had no access to an ECG machine , th nurse to patient ratio was below that compatible for good patient care and one had to deal with ill patients single handedly with no nursing staff to assist. Basic care such as observations( blood pressure , temperature etc) required for any clinical decision were not being done for days on end. I was frequently asked to do them and single handedly care for a ward full of patients which was a practical impossibility. Faced with death one morning and with no help and using what knowledge I had out of medical school was the most terrifying experience . Their life in your inexperienced hands and no help anywhere. In desperation and as a cry for help I made a phonecall as all my seniors were uncontactable. The phonecall I made was to the nursing directorate . This was after an agreement with the sister in charge for extra nursing staff so that at least minimal observations that were required should be done and emergency help could be obtained . I spoke to the head of nursing at the medical directorate and informed her that we needed more nursing staff . I was screamed at and told that we had adequate nursing staff and that I didnt know what I was talking about and " how dare I ring her as I was only a junior doctor " . The phonecall was the beginning of my problems or shall we say the Trust's problem . The next day I was ordered to apologise to the directorate for my "rude behaviour ". I was ostracised by the nursing staff from then on and humiliated persistently . My clinical judgement was questioned for the first time as no one had taken the criticism well . I was blamed for negliegent incidents persistently until one night I was oncall and a needlestick injury occurred on the ward which was blamed on me. I was the scapegoat floundering in a mess with no support from my registrars and SHO's had deserted me for fear of their careers and reputation and all the intricacies of human nature . I was reported to the Health and Safety who tool me to be interviewed as a criminal under the PACE Criminal Evidence Act . I was treated like a criminal for something I did not commit. The trust and nursing directorate issued statements to implicate me in this . Humiliation and your interview being taped in a small room with a window in the roof reminded you that this was not what one envisaged that medicine would be . My seniors informed me that I was stressed and implied that I was depressed and had psychiatric problems . I asked for a transfer from the ward and through all the lies from the directorate I was given a transfer which was later revoked . I was then told that " noone had witnessed the offer of a transfer, it was therefore my word against two people. " I was labelled as a " trouble maker " and to this day I probably am! I am what " they" made me. My seniors knew I was in trouble yet they left me helpless threatening me with my career and references and all the things the medical population fears most . " Under the circumstances Dr Pal , I dont think it would be wise for me to provide you with a reference " were sentences I would hear very frequently , yet a few months before North Staffordshire Royal Infirmary has this to say about me :
A few months later Dr Bowling denied me and refused to provide me with a reference quoting the " events that had gone on in North Staffordshire " I was forced to resign until my postgraduate tutor who has been the only person to help me , rescued me and placed me in general practice to complete my registration. My second PRHO position supposed to be in City General Hospital but the atmosphere was rife with the madness of the directorate . I was subsequently pervented from getting any surgical jobs I applied for despite attending a number of interviews . I discovered after discussing the situation wih one of my consultants I attended an interview for that there was information provided with regards to my competence. The Clinical Director had spoken to the consultant I applied to and explained to him hat I had " problems " and that I would not psychologically be " up to the job" . I was devastated and horrified that my freedom of choice had stopped . I was being trapped into doing a job in Stoke on Trent and for whatever reason tat Trust wantd me there . Legally, a PRHO has no protection by law if the conditions of employment are not suitable . Unfair dismissal is only applicable if one works for three years .Mine is a story that is the truth and I was left with non support or protection and the trust attempted to take advantage of this . It is a frequent occurrence for egclerking patients for waiting lists initiatives , being left stranded without support etc As we have no protection, and at the fear of our careers or infact the above example , we will secretly do whatever we are told. We unfortunately are still victims of what is discussed on the golf course . I dared to stand by my principles and unwittingly escalated a domino effect that was catastrophic. Junior doctors are an easy target for the superpowers we know as the TRUST . The issue of PRHO protection and vulnerability is an important one . I survived in a sinking ship because I was lucky to have a mentor Dr Alwyn Ralphs , a general practitioner who I was placed with at the twelfth hour who taught me many things that hospital medicine could not , one of which is to have the courage of my convictions . Many would have deserted , taken the first plane out and others would not have survived . these are the target individuals one needs to protect as there are many potentially good doctors who simply are forced to flee . RITA PAL
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