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Life at sea as a Royal Navy GP

Profile: Surgeon Commander Mike Russell RN

dr mike russell

Photo: Anthony Colling

Roles: Royal Navy medical officer and GP trainer

Hours worked per week: Highly variable at sea, but generally one or two clinics per day. In the UK, six clinical sessions at a naval base plus one session in NHS placement

07.45 I head to the ship’s medical complex on ‘5 Deck’ to start my shift. My first patient is a chef with irritant contact dermatitis affecting both hands, probably related to long shifts exposed to heat and cooking fumes. At sea, skin problems are common, along with minor injuries.

I joined the Royal Navy in 2007 in my Foundation Year 2. After a militarisation phase, I spent six months preparing to be a seagoing medical officer, followed by time in submarines looking after a crew of 180. I then did my GP training in a mix of military and NHS settings.

I am now principal medical officer of the aircraft carrier HMS Prince of Wales, where I oversee a medical department of 12, including another GP, a practice nurse, a pharmacy technician, medical assistants and a dental team. This serves up to 1,500 personnel, including aircrew and those within the Royal Marines.

08.30 A male helicopter pilot in his mid-30s attends with ongoing neck pain, which is causing problems during flying duties. We agree he will probably require a period of grounding and stronger analgesia. Luckily we have a physiotherapist on board I can refer him to.

Occupational medicine is central to the job: nearly every decision requires me to assess a patient’s ability to perform their role. We have 15-minute consultations to allow occupational grading, and have to balance patient confidentiality with allowing commanders to do risk assessments.

10.00 Time for the morning ‘stand easy’ so I finish off some admin. For patient records, we use EMIS adapted for occupational grading. When at sea, it syncs every night by satellite with the UK record.

I then head to the wardroom (officers’ mess) to catch up with shipmates. The pilot patient I saw earlier is telling colleagues about his neck problem and there’s some lighthearted banter about his grounding: ‘Here comes doctor downgrade.’ I pour myself a cup of coffee.

12.00 I go to the ship’s mess for lunch and chat with colleagues; camaraderie is important at sea and I enjoy hearing what is going on outside the medical centre.

14.15 I receive an urgent call to a crew member who has fallen down a lift shaft. He is unconscious and requires airway support. I decide he needs immediate transfer to hospital. Our nearest city is Lisbon, 50 miles away; I talk to the captain and we prepare one of our helicopter crews to fly him, escorted by my GP colleague. Our port agent in Lisbon arranges a neurosurgical unit to receive him.

Although urgent cases are thankfully uncommon, I have to keep up to date with ‘battlefield’ advanced trauma life support and pre-hospital emergency care. Other emergencies I’ve dealt with include fractures, burns, progressive keratitis, acute coronary syndrome and appendicitis. We may also deal with non-crew emergencies on humanitarian missions; so far I have been deployed to Sierra Leone during the ebola epidemic and to the Caribbean in hurricane season.

The job also offers fantastic opportunities for sport and adventure training – I have been parachuting, skiing, mountaineering and mountain biking.

16.00 I finish my clinical work for the day. The sun is shining and the air department has opened the flight deck to visitors. I take the opportunity to go for a flight deck run, although I don’t feel quite up for circuit training with the Royal Marines today.

19.00 After dinner, I go to the bridge to chat to the navigator and watch the sunset, before phoning home. Then back in the mess I play Uckers, a board game that’s a naval tradition. Many colleagues use the evenings at sea to practise hobbies, such as learning the guitar or painting, or for postgraduate study.

For information on medical careers in the Royal Navy see tinyurl.com/royalnavy-medical-officer and follow on Twitter @MedicsNavy @HMSPWLS


          

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