FY1 Induction Pack

Derriford Emergency Department

Dr Becky Kingdon Dec 2024

Welcome!

• This might be your first job out of medical school, or you

might be nearing the end of your FY1 training.

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• Starting in ED can be daunting, but you’ll have plenty of

support during your rotation.

• You will have a clinical supervisor in ED, and should receive an email with their details when you start. If you haven’t received this, contact Dr Becky Kingdon to find out.
• You should schedule a meeting with you supervisor in the first couple of weeks of starting.
• You will get a full induction in person when you start your rotation.

Educational Opportunities

The ED education website has more information on education

in the ED.

Gaining confidence in all areas of ED, as well as in practical procedures (from bloods and cannulas to suturing and fracture manipulation) will be valuable for your career as you progress. Make the most of the opportunities available!

As an adult learner, you will be responsible for taking advantage of these, and will be expected to be proactive in gaining the competencies you require.

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Where will I be working?

You will be assigned an area to work when you start your shift

• Majors
• Ambulatory majors
• Paediatrics
• Resus
• (Minors)

When clerking please don’t cherry-pick patients. The EPIC will expect you to be seeing patients in time order unless there is a specific patient they request for you to see.

What will I be doing?

We expect you to clerk all patients (other than minor injury

patients) fully, completing a clerking form on Nervecentre and

including

• Presenting complaint, history of presenting complaint
• Past medical history (birth details and developmental hx in paeds)
• Medications
• Allergies
• FH/SH where relevant (safeguarding - all paeds, some adults)
• Examination (A-E)
• Differential diagnosis
• Management plan including investigations and treatments

Senior Reviews

• You must have all of your patients physically reviewed

(preferably by a senior doctor - a doctor in burgundy - red tops).

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• You should complete your clerking before you speak to a

Senior (unless you are worried about your patient and they need an urgent review).

• Have a provisional plan written down, including whether you think the patient will be admitted and discharged. Make sure your clerking is submitted on Nervecentre.
• You do not have to have investigations back in order to speak to a senior about your plan.
• Work out any risk scores that you think are relevant (e.g. Well’s, HEART score, PERC) before you present the case.
• Once you have spoken to a senior, don’t ‘shop around’ for another opinion - ask the same doctor if you need further advice.

How quickly should I see patients?

When you first start, it will take you longer to see patients.

We would rather you did a thorough job than rushed.

If you are stuck and don’t know what to do with a patient ask early.

If you are at the end of your FY1 year, we would expect you to be seeing around one patient an hour in majors as a rough guide.

You should see the next patient rather than waiting for all investigations are back for your patient.

Investigations

• If you see a patient who hasn’t had bloods and needs them, do it yourself rather than waiting for an HCA to be available.
• All outstanding investigations that you have requested (e.g. bloods, x rays, CTs) are your responsibility to check, even when the patient has been seen by another specialty.
• Specialist investigations such as MRIs should be discussed with a senior before booking.

Prescriptions

• As an FY1, you can complete the Boots eTTA

prescriptions for patients being discharged.

Two weeks of medications can be prescribed on these prescriptions.

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• You cannot give TTA medications from the cupboard without

another doctor signing the prescription.

• You cannot issue FP10s (outside prescriptions).

Miscellaneous rules…

You should not complete Treatment Escalation Plans (TEPs).

You should not issue sick notes.

You should have all ECGs checked by another doctor, and all chest pain or paediatric ECGs checked by a senior (burgundy/ red top) top doctor.

Handover

• When you leave your shift, all patients must be handed

over and the name of the new clinician entered on

Nervecentre.

• You must not hand over to other FY1s. All handovers go ‘upstream’ to more senior doctors.
• If you are within 30 minutes of the end of your shift/ Tuesday foundation teaching, don’t pick up a new patient unless you can finish seeing them and hand over a complete plan.

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Further Resources

General induction information can be found in the Induction

tab of the Education Website here:

https://sites.google.com/view/derriforded-education/home

There is essential reading there to complete.

Information on the Foundation Programme and required competencies to complete FY1 are found here and here.