First 24 Hours in a Locum Role | Checklist for Doctors

You can know your specialty inside out and still lose valuable time on a first locum shift trying to find the right extension, access a patient record or work out who covers a ward after hours. The challenge is getting to know how an unfamiliar service works while taking on responsibility for patients.

A good first shift starts with three questions. What am I responsible for? Who do I call if I need help? Who will take over the work that is still open when I leave? Whether you are covering one evening or starting a longer placement, this checklist can help you get those answers early.

Before you arrive | Confirm where you fit

A few practical details are easier to settle the day before, particularly if you are starting overnight or at the weekend, when the usual administrative contacts may be unavailable.

• Check the booking details. Confirm the hospital or practice, campus, department, start time and where to report. Ask for a local contact who will be available when you arrive.
• Clarify your remit. Check your grade, which team or wards you are covering and whether the shift includes cross-cover, admissions or on-call duties.
• Ask how induction and access are arranged. Find out when you will receive your ID, login and bleep or phone, and who can help if any of these are missing.

A shift described as ‘medical cover’ might involve one ward or several teams. Knowing which applies gives you a better idea of what to ask at your first handover. The HSE’s induction guidance identifies clarity about the role and its responsibilities as a core aim of induction.

In the first hour | Get the essentials working

Introduce yourself to the nurse in charge or practice lead and confirm who is providing senior clinical support. Ask for the escalation route during your shift, including the backup if your first contact is unavailable. In a hospital, check how to summon urgent help and where to find the local protocols you are most likely to use.

Test your access to the systems you will need, such as patient records, prescribing, test ordering and results. If something is unavailable, tell the clinical lead early and ask what approved local process to follow. An access problem that seems manageable at the start of a shift can become more consequential when a result needs reviewing or a prescription is urgent.

In general practice, the equivalent checks may include the appointments system, repeat prescribing workflow and who handles incoming results, referrals and urgent patient queries once your session ends.

At the first handover | Turn the list into a plan

A long task list can make everything look equally urgent. Ask the outgoing team which patients need attention first, which tasks are time-sensitive and where they anticipate problems. Use the service’s agreed handover format and confirm any instructions that leave room for interpretation. HSE clinical handover guidance emphasises two-way communication and checking back on priorities. 

For each priority task, establish:

• What needs to happen and by when?
• What should trigger an escalation, and to whom?
• Who will review the result or follow up if it arrives after the shift?

If the instruction is ‘check the scan later’, clarify who will review it, how they will know it is available and who will act if it comes back after your shift. A named person or team and a clear next step make the handover actionable.

During the shift | Flag gaps while there’s time to fix them

If you discover you are covering more areas than expected, cannot reach senior support or are asked to take on work outside your competence, raise it promptly through the local clinical escalation route. Be specific about what is affected and what support or decision you need. For immediate patient safety concerns, use the service’s urgent escalation process. Ask the local team how to record and report any safety concern or incident in line with its policy. The Medical Council’s professional guidance provides the broader framework for doctors practising in Ireland. 

Before you leave | Close the loop on outstanding work

Set aside time to document your decisions and hand over incomplete tasks through the agreed local process. Prioritise patients who need reassessment, pending results, outstanding referrals and any follow-up already promised. Confirm that the receiving clinician or team understands what they are taking over and when action is due. Keep patient-identifiable information within approved clinical systems and handover channels.

If a booking detail created confusion, such as a change of reporting location or unclear cross-cover, let your recruitment consultant know once you have addressed it with the service. That gives the consultant something concrete to clarify ahead of your next booking.

Find your next locum role in Ireland

Whether you are exploring your first locum assignment or looking for shifts that fit around an existing post, tell us your grade, specialty, preferred locations and availability. At Locum Express, our consultants can help you find suitable opportunities and guide you through onboarding. Browse and apply for locum doctor jobs or speak to a Locum Express consultant.