SUMMERTIME BLUES: MELANIE DE STRANGE KNOWS IT'S AGONY OUT THERE

I am in a quandary. As a senior practising nurse of 20 years' experience, I have just been offered a new nurse consultant post at my hospital. Can you advise me on the proper protocol when using the consultants' mess, and will I have to join the golf club?

Florence, Macclesfield.

This is the big one! To take your last point first, membership of the golf club (do they have golf in Macclesfield?) is not as important as once it was.

The new breed of NHS consultants has developed a taste for surfing at the local cybercafe in order to maintain their investment portfolios.

Protocol is tough. Do not be enticed into responding to their homely nicknames for you with some of your own; 'nursey', 'dearie', 'pretty little thing' and 'matron' are their favourites, irrespective of gender.

You will find that a quiet 'sir' will usually fit the bill (note, though, that female consultants won't talk to you at all).

Lunchtimes can be stress-laden. Always allow the senior consultant present to decide what you should eat.

Nibble small amounts only, and develop a taste for stodgy puddings. If patient details are being discussed, show a polite but ignorant interest.

Consultants don't like being corrected on their interpretation of X-rays by anyone who didn't train with them.

As a senior house officer, I worked for 106 hours almost non-stop last week. I am concerned that my concentration slipped slightly, and I may have mis-prescribed some drugs. What should I do to prevent this happening in future?

Hippocrates, London.

You should be more concerned about promotion prospects than treatments. Patients are a dime a dozen, but promotion opportunities are few and far between. Get your priorities in order.

Prescribing is difficult, but as a rule of thumb, most patients will respond well to paracetamol, insulin and/or Prozac. Just remember these three and you won't go far wrong.

Prozac is probably your best fallback position as the patients will feel better quite quickly, leaving you time to network.

What is 'the private finance initiative' and where can I get it ?

Duncan, Manchester.

Aren't all these new New NHS terms confusing? The New PFI is a new procedure by which we can all share in the new health improvement benefits of the New NHS through a new process of sharing, accounting and lifelong learning.

It is definitely not about saving money, and as such bears no relation to the discredited Old PFI of the Old NHS. Put simply, if you have an idea, tell someone at a merchant bank so they can make money out of it. See, I told you it wasn't about saving money.

They in turn will build you a new hospital in which you can be even more efficient, treat more new patients and use new resources more wisely so that you can pay their fees. This is called the public-private partnership and is a good thing. It is not about saving money.

I'm an acute hospital chief executive. How can I get a primary care group? All my friends have got one or more, but I just don't seem able to hit it off with them. As soon as I start to talk to a PCG, I get embarrassed and they soon lose interest. Please help me. I think I'm going to be left on the shelf for life.

Confused, Bristol

Don't worry, just be yourself. When you are approached by a PCG, remember they don't like you to be too pushy. Sound interested in what they have to say and agree with them. Take an interest in their hobbies and smile a lot. They'll soon get used to you.

You could try a quiet little dinner somewhere, but if you look too affluent they might think you are out of their league. Try changing your appearance to suit them. One useful makeover trick is to change the name of your hospital so that it has the word 'primary' in it. PCGs like primary things, but they hate all that secondary stuff. After all, who wants to play second fiddle to anyone? Once you have hooked a PCG, things will get easier, and after a few months you can go back to being the real you.