Coping with Pressure

Abstract

The Foundation Programme is tough. New doctors have to cope with taking responsibility for patients for the first time and managing the logistical difficulties that inevitably face those working in a complex environment. They often have to balance multiple competing priorities. Perhaps computed tomography (CT) scans need to be requested by 9.30 a.m. if they are to be scheduled for the same day, Mrs A has chest pain, Mr B is an outlier on a distant ward and has become acutely short of breath, and Mr C’s relatives are angry because they have been waiting to speak to a doctor for an hour. You are part- way through taking blood and have three bleeps to answer (all potentially important but conferring new tasks), and your consultant needs to complete the ward round before her clinic starts . . . This would not be a remarkable day by any means. It can be difficult to balance these responsibilities and do so without cutting corners. Criticism is inevitable as it is rarely possible to keep everyone happy all of the time. Questions within this section will explore your resilience and ability to work under pressure. Through your responses, you will need to demonstrate a willingness to remain flexible, manage ambiguity, and adapt to changing circumstances. The ability to remain calm while handling stressful situations arising with patients, relatives, and colleagues is of the utmost importance. Problems must be resolved directly but may require a diplomatic approach to avoid conflict. It is therefore important to speak to others respectfully, seek help early on, and remain aware of your own limitations. There is growing recognition that such pressures can have long- term health implications for junior doctors. You must be aware of threats to your own health, and the British Medical Association (BMA) has reiterated that you have a duty to ensure that your ‘health problems do not affect patient care’. Informal (so- called ‘corridor’) consultations are discouraged, and Good Medical Practice (2013) is clear that ‘you must, wherever possible avoid providing medical care to yourself ’.