It's all about the SHO...

Whenever I’m working a weekend, I always cast a glance over the SHO rota. At this point my heart usually sinks or sings. The junior you are working with can really make or break an on-call shift.

I’ve encountered several types of SHOs during my time as a registrar. Some I can honestly say I would trust more than myself. Others provide a unique set of challenges in terms of team working and management.

Below I’ve described the different types of SHOs I’ve come across in my line of work and the specific challenges and benefits they present! These are partially fictional characters and not specific to any particular individual. Myself, I think I was a cross between a ‘terrified’ and ‘obsessive compulsive’ SHO. These traits definitely persist as a registrar, creating some interesting moments when placed with the ‘disorganised dreamer’.

The ‘Know It All’

  • There’s no point in telling this particular individual anything. They clearly know it already and are ready for consultancy! Constructive feedback is not appreciated. After all, this is their

    second year in paediatrics and what can a mere registrar have to offer. They change your management plans,         talk over you at handover and never ever ask for help (even after that fifth attempt at a cannula). Managing this     SHO is a registrar nightmare and consultants may need to be involved.

The ‘Terrified’ one

  • Trembling and fretting their way through admissions, this individual lives in fear of making a mistake. God forbid they make a minor decision or fail at a procedure. Much hand holding is required in order to build up their fragile confidence. That doesn’t mean they won’t get there in the end with a little encouragement along the way and a little patience and understanding to make sure their medicine doesn’t become too anxiety-driven…

 

The ‘Obsessive Compulsive’

  • This particular SHO, often female but not always, will never ever forget to complete a task or hand it over. Their brain is organised into neat compartments and they get a genuine thrill from ticking off their jobs list. Everything is going swimmingly until an unexpected crash call and ten simultaneous admissions puts everything out of kilter! Flapping and anxiety often results. Paediatrics is unpredictable and always will be. Learning to go with the flow can be valuable, especially if you don’t want to forcibly remove the job’s list from this SHO’s hands when they become a registrar.

 

The ‘Disorganised dreamer’

  • Floating around in a ‘semi-horizontal’ state, you can’t help but like this pleasant individual. Two hours into an on-call though and you’re tearing your hair out! This particular species does not understand the importance of a good list! Patients arrive from nowhere who you know nothing about. Simple administrative tasks are not completed, blood requests not signed. At no point, do you as a registrar feel you have a grasp of what is going on. You may end up following your junior around, asking repeatedly how far they have got with the jobs. Unfortunately they’ve lost the jobs list somewhere and neither of you can remember…This might have you all in a ‘tither’ but your SHO is off dreaming of what he or she had for dinner last night.

 

The ‘Fed up’ one

  • Often found wandering around in ST2-3, this SHO didn’t sign up for filling in rota gaps, endless e-portfolio sessions and never-ending baby checks. They are disillusioned with the system and disillusioned with paediatrics. They’re not sure when they last learnt something new and have just failed their second written exam. This is a job, not a vocation and their unenthusiastic half-arsed approach brings the whole team down. A frank chat about how you used to feel this way but things got better may be in order…

 

The ‘Good one’

  • This SHO is worth their weight in gold and there are plenty of them about. Treat them right and help them in any way you can. When you’re a consultant they’ll be your fantabulous registrar!

@drkatysiobhan 
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