Now that I’ve been working in the NHS for over 5 years — and I’m pursuing a career in one of the most competitive surgical specialties, plastic surgery — people often assume I’ve always had it together.
But I still remember my first few weeks like it was yesterday.
I started out as an SHO, and honestly? I was completely overwhelmed.
I didn’t know how the hospital worked. I wasn’t sure what I was expected to do. And most of the time, I felt like I was just trying not to mess anything up.
If you’re starting your first NHS job — whether you’re an FY1, FY2, or SHO — I want you to know you’re not alone. It’s completely normal to feel unsure at first.
So I’ve written this post to share 10 things I wish someone told me when I started.
Real, practical advice to help you feel more confident, stay safe, and survive the chaos of your early days on the wards.
Let’s dive in.
1. It’s okay to feel unsure
When I walked onto the ward on my first day, I felt completely lost. I didn’t know where anything was, who anyone was, or even where I was supposed to stand.
But here’s the truth: no one expects you to know everything. Not the nurses, not the seniors, not your consultants. You’re there to learn. And the only way to do that safely is to ask questions and admit when you’re unsure.
2. Ask early — don’t wait until things go wrong
One of my biggest early mistakes was trying to figure everything out on my own. I didn’t want to bother anyone. I didn’t want to seem incapable.
But waiting too long to ask for help can lead to problems — and stress. Seniors would much rather you ask a “silly” question early than deal with a mistake later. Honestly, most of us don’t even remember the questions we were asked — we just respect that you cared enough to ask.
3. The bleep will stress you out — but it gets better
I’ll never forget my first on-call shift. I was juggling bleeps for cannulas, reviews, fluids, and “quick questions.” I felt like I was being pulled in ten directions at once.
I learned quickly: write everything down. Who bleeped you, what they need, and what’s urgent. Not every task needs to be done immediately — prioritising is key.
4. Your jobs list will save your life (not literally, but close)
At first, I scribbled jobs on gloves, scraps of paper, or tried to keep them in my head. That failed fast.
Once I started using a structured jobs list, everything changed. I could track what needed doing, follow up properly, and feel in control — even on the busiest days.
5. Handover properly — your patients (and night team) will thank you
I didn’t realise how important handovers were until I started getting poor ones myself.
You don’t need to write an essay — just be clear:
What happened?
What’s been done?
What still needs to happen?
Good handovers keep patients safe and build trust with your colleagues.
6. Learn how your hospital works — not just the medicine
No one teaches you how to book scans, find the right forms, or chase bloods in your specific hospital. But these are the things that slow you down and stress you out.
Ask the nurses, ward clerks, or other juniors — they’re usually more than happy to show you.
7. Don’t take things personally
You’ll get snapped at. You’ll be ignored. You might get blamed for things that aren’t your fault.
Take a deep breath.
Most of the time, it’s not about you — it’s about the pressure people are under. Stay calm, stay professional, and talk to someone you trust if something really gets to you.
8. Learn to say “not right now” — kindly but clearly
When you’re swamped and someone bleeps you for a discharge summary, it’s okay to say:
“I’m just with a sick patient at the moment — I’ll get to it as soon as I can.”
That’s not rude. That’s responsible.
9. Take care of yourself — seriously
There were days I didn’t eat, didn’t sit down, and didn’t even pee. That’s not sustainable.
Bring snacks. Drink water. Sit when you can. You’ll do a better job if you’re not running on empty.
10. You don’t need to be the best — just safe, kind, and willing to learn
I used to think I had to be the fastest, smartest person on the ward. But that’s not what people remember.
They remember if you were reliable. If you cared. If you asked when you didn’t know.
You don’t need to know everything — just show up, do your best, and keep learning. That’s more than enough.
💬 One last thing…
I’ve actually put together a whole guide for junior doctors who are just starting out — based on everything I wish I had known when I started.
It’s called:
🩺 The Junior Doctor Survival Guide
Practical, honest advice for FY1s, FY2s, and SHOs starting NHS jobs.
Inside, you’ll find:
What to expect on your first day
How to survive your first on-call (without freaking out)
What to do when you’re not sure what to do
How to hand over without annoying the night team
Dealing with awkward situations and tricky people
10 things I really wish someone told me when I started
It’s short, supportive, and super easy to read — even during a break on shift 👇
Your First NHS Job: Made Easier
This guide gives you the tools to feel more confident, stay safe, and handle the real challenges of your first NHS job — without the stress.
Click Here
