How To Say No As A Junior Doctor

This article was originally published on LinkedIn on August 6, 2020.

Yes, you can say no!

With July finishing up and August rolling in, after a brief delay many new doctors are now working in the public health system. At almost- if not all levels of staffing someone is new. After one month of being in that position, persons can still feel uncomfortable to stand up to seniors (and other staff) and use the word no. 

While in this article, I will be focusing mostly on the intern dynamic with supervising and other staff, I believe many other levels of staff may find this useful. 

Why is it important to say no?

Following blindly can lead you down a hole of burn out, abuse and downright danger. Fresh staff are usually taken advantage of- simply because they are new to the system and may not know the ropes. Not everyone will be there to guide you, therefore learning who are allies from early on is good. 

Saying no, also helps you create appropriate boundaries with colleagues and increases your own confidence in dealing with uncomfortable work interactions. 

When to say no?

It is impossible to type out every single scenario that can happen, so here are some general principles. Often times there is also a caveat- which will be addressed later in this article. 

Say no when you’re uncomfortable. Say no when you feel unsafe. Say no when you don’t have the expertise to perform a specific task without guidance/ help. Say no when it’s not your job. So no when you are unable to do it or in some instances don’t want to do it. 

How to say no?

  • Be confident. There is nothing wrong with saying no, even if this person is your consultant. 
  • Give a reason- but not all the time. If you are uncomfortable with performing a task, say so. This then provides an opportunity for you to be guided by someone with more experience, allowing you to garner and improve a new skill. If you feel unsafe, say why, is the patient boisterous? Is the environment unsafe? Do you not have adequate protection? This provides an environment for problem solving and learning. 
  • Ask why first. You might be asked to do something, especially when it comes to patient management, that you don’t agree with, or you think might be incorrect. Always ask why, maybe your seniors see something you don’t see or even vice versa! Also, if you’re ask to do a task that isn’t your “job” consider that it may be for an emergency or one off situation versus taking advantage of you.
  • Escalate to your senior. Maybe you are simply being taken advantage of and being put to work unfairly. Speak with your senior- if you feel that that is not enough, put pen to paper and write a letter to the appropriate persons. Do not be afraid to make formal written reports or express your concerns through writing. Always follow up verbal conversations with a quick email. 
  • Know the facts (and the protocols). If what you’re being asked to do breaks a specific protocol or guideline, speak up. Remember safety first, both for yourself and a patient. At no point can you be asked to do anything to endanger yourself.
  • Defer responsibility. There is a reason we discuss patients. Always document with who and when you had various discussions. 
  • Be respectful. 
  • Know when to stand your ground. This is especially when you’re being asked to do tasks that can be delegated to other staff or you feel you have been given an unfair share of the responsibility. Rest and meals are important in preventing burn out. For this one, I hope you can read between the lines!

Saying no can be very difficult, especially if you don’t feel as though you can say no! Well, I’m here to tell you, you can. Saying “no” doesn’t always have to be a negative thing, but can open up the road to fairness, respect and learning new skills and lessons. 

Did I miss anything? Share with me in the comments!

Dr. Samantha C. Johnson

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