All entries for Monday 10 February 2014

The strange things that may go through your mind when you first visit a ward

“Hello, my name is Amritpal Sandhu, and I am a first year medical student”. Before starting Medical School I would have given anything to be able to legitimately use this phrase, but when it first became a reality I felt completely different. I’m not nervous about talking to patients; in fact I look forward to it. Before coming to medical school I had spoken to lots of patients, and even more nerve racking, lots of relatives, and it was always the best part of my day. So why did it all feel different on my first day on the wards?

At Warwick you are put on the wards for half an afternoon every week from the second term. Your experience will vary based on your group (groups of four), your consultant and, of course, the patients you get to see.

My first time on the ward as a medical student was very different to any other experience I have had on a ward. All of a sudden I found myself hyperaware of everything I did and said. For starters there is the stethoscope and what to do with it, something that still causes me quite a stir! Do I put it round my neck and feel like a pretender the whole time and pray no one mistakes me for an actual doctor? Or do I keep this piece of medical equipment out of sight, in my trouser pocket next to my phone, keys and (unused) chewing gum only to go through the ultimate struggle every time I try to extract it? I seriously envy my female colleagues who are savvy enough to carry around a small bag they can use to house this attention grabbing piece of kit, so much so I have even considered trying to bring the bum-bag back into fashion!

Then there was the decision on how to introduce myself to a patient resulting in an internal monologue that that sounded a bit like this: “Do I shake their hand? Do I use their first name or last name? Do I smile? Well, of course I do….don’t I? Wait, they’re ill, you don’t want to seem happy they’re ill! Fine, I’ll smile, but I won’t show too many teeth”. You would think I’ve never worked with patients before!

Finally, once I had gotten over myself and these quite frankly bizarre and distracting thoughts, it was time to sit down next to ‘my’ patient and take a history. For those who don’t know, a history is an interview with a patient where they tell you what has led to them being in hospital. You also need to find out about any other health problems they might have and a whole long list of other important information you need to gather. If you do it right it feels like a conversation between two people, you get it wrong you can feel like you are interrogating someone. It is a juggling act. You want to:

• Make the patient feel comfortable
• Ask all the right questions
• Get all the relevant information
• Make the conversation flow
• Think of questions that will help you eliminate the nastier things
• Try and diagnose the patient whilst you are talking to them
• And, most importantly, listen to what the patient is saying!

Halfway through the first history I took I realised I was too focused on trying to remember what was wrong with the patient that I completely forget their name! Luck was on my side however and it was written in big capital letters above their bed, let this be a lesson, being observant (or lucky, as I was) pays!

All jokes aside, the first time you are on a ward it is pretty surreal, and upon reflection a lot of the pressure I felt was created purely by me. Perhaps it is because it is drilled into us from day one that we are representing the medical profession, a profession that we are still working very hard to become a part of. Or maybe it is because no matter how many times you practice taking a history with your mates nothing can quite replicate what it is actually like with a real patient. It takes a while to realise that patients don’t expect you to know everything and are happy to explain things you don’t understand and are very forgiving when you do forget things. It takes even longer to realise that no one really notices the silly things you will obsess over and you’re not constantly in the way, even though you may feel as though you are.

Although it may sound as though it is pretty scary, as soon as you find your feet it is great fun being on the wards and talking to patients. It is a real privilege to be in the position you find yourself in as a medical student and I cannot wait to enter the clinical phase. I hope to spend a lot more of my time on the wards with patients and a lot less of my time with PowerPoint presentations and flash cards!

Sarah Hill : 10 Feb 2014 12:56 |  Tags: Amrit Doctors Hospital Mbchb Student Wards Warwick Wms |  Comments (0) |  Close comments |  Report a problem