Read a first-hand account of what life is like for an NHS paediatric registrar working in London.
This article was not written by any of the NHS staff featured in The Hospital.
'For the last six years, I've worked as a paediatric registrar at a London district general hospital. My day starts at 8.30am and ends at 9pm when I hand back to the night team. I think I have a healthy work/life balance, but there are some elements of my job that are tough.
'It's quite common for an 'inebriated child' to be referred to me by A&E staff. A lot of the drunk youths I deal with are extremely rude to medical and nursing staff. Verbally aggressive teenage lads are relatively common and actually intimidate me - I'm a paediatrician who is used to dealing with children, not with aggressive older children with adult-related problems.
'From a medical point of view, the most shocking cases I see are children who have drunk so much that their conscious level drops to a point where they can't breathe adequately or protect their airway from their own vomit. I once had an 11-year-old boy referred to me in this state – he was admitted to an intensive care bed, put to sleep by an anaesthetist and put on a breathing machine until such time that the alcohol had worn off and he was able to regain consciousness alone.
'More alarming from a social point of view was a 12-year-old lad who had been out drinking with his father. They'd been drinking in public places after a win on the horses and were subsequently found by the police on the street. The son was unconscious and his dad completely inebriated. When they arrived at the hospital, the dad became abusive to medical staff and had to be removed from A&E. The child's mother was unable to come in to hospital as she was at home looking after young children. She claimed to have no friends or family who could help out and, as a result, the child had to be admitted and picked up the following day.
'I often get angry that my time is being wasted on problems that have been brought on by the child themselves. It's frustrating that they are getting my attention when there will always be other patients – in need of care through no fault of their own - who would benefit from my care. It's an extremely difficult situation; if a drunk child takes the last remaining bed on the ward, we spend the rest of the shift transferring acutely ill children to another hospital that can care for them.
'I don't think my help is really appreciated by the young drunk people I treat. I'm not sure that many of their parents appreciate it either. I do sometimes struggle to feel compassionate about patients whose irresponsibility has lead to them being in my care, but professionalism comes first, and I will never let my feelings get in the way of a patient's medical needs.
'It's fair to say that most kids who drink heavily lack support – either at home and at school. They are often bored, lack guidance and have little fear of consequences. None of them have insight into the dangers of drinking. Some of the kids I encounter think drinking to excess is funny. Unfortunately, an 'inebriated child' will often be from a difficult social situation and when that's the case, they'll be referred to social services.
'I'm not sure what can be done to address these issues – I am fairly pessimistic about the state of London's teenagers in general! But despite my grumblings, I do love my job and wouldn't change it for anything. I love children and I love medicine, and it's extremely satisfying to see kids come in sick and leave healthy.
'I once treated a young girl who had been admitted after deliberate self-harm. She had a background of social problems and had taken an overdose of pain killers. After she'd been discharged and reviewed by mental health and social services, she decided she wanted to become a nurse and later came back to volunteer on the ward. It's that kind of positive outcome that makes it all seem worthwhile.
'But the NHS is suffering as a result of society's irresponsible behaviour. We don't really have enough resources to deal with the number of acutely sick children out there, and there definitely aren't enough staff or beds to deal with the increasing workload that today's social problems create.'
