All entries for Tuesday 24 February 2015

February 24, 2015

A typical day in the life of a Med Student

Being a student in the acute environment can be great, but also a bit challenging at times. Here is a typical day on placement in A&E:

8.30am
Arrive and introduce myself to the consultant and nurse in charge today. Pounce on a junior and ask what they're up to. As its early, the department is quite quiet and the juniors are mostly doing paperwork, and no one is in a particularly friendly mood. I go to the notes trolley and have a flick through to see who might be good to go and see.

9am
Go and take a history and examine a patient with my clinical partner. The patient is an elderly lady with pneumonia who is with her daughter. The patient has already been seen by the doctors and needs admitting, but is waiting for a bed. She is quite happy to have a chat to us as she is pretty bored!

10am
We hear a resus alert over someone's bleep and ask if we can attend. Resus is where the really sick patients are brought into the department, usually by ambulance or helicopter. This time it's a lady who collapsed and had a cardiac arrest out shopping. She is receiving CPR, and my clinical partner helps with the chest compressions. The resuscitation attempt continues for about 20 minutes but unfortunately (like most out of hospital arrests), the patient didn't survive.

11am
Back Into the main department, and it's strange to go straight from a resuscitation attempt to clerking and examining patients in majors. There is a new patient to see and a junior agrees to watch me take a history and examine the patient, and then questions me on my management plan. I then cannulate the patient and take some bloods.

1230
Lunchtime! As a student no one knows whether you've eaten or not, and it's important to keep fed and hydrated, as I have learnt the hard way in the past! (If the worst happens sit down, put your head between your knees and ask someone for a glass of squash and a biscuit!)

1330
Back in ED and it's getting busy. The consultant checks to see if the next patient is appropriate for me to see, assigns me a cubical and off I go. I see a young woman with abdominal pain on a background of chronic bowel disease. I present my findings to a registrar and suggest a management plan, and the reg agrees with me and implements my plan- it's such a good feeling when this happens!

1500
The department is really busy now. The pressures on A&E are evident and it's frustrating for staff who want to see patients but who have no cubicles or spaces to see them as beds are clogged by people who are awaiting admission, but who haven't been moved yet due to the bed crisis in the actual hospital. Staff are quite stressed and there isn't much to do, so I pop down the corridor to minor injuries to see what's happening.

1530
A builder has cut his hand at work and can't make the bleeding stop. The doctor asks me if I've stitched anyone up yet (only pigs trotters so far) and asks the patient if I can help. The patient agrees,the doctor shows me what to do and I put in my first stitch. It's hard to say if I or the patient was more nervous, but we both did ok! I write the patients discharge summary and then an orthopaedic reg pulls me over to have a look at an x-Ray. I know it's a distal radius fracture, but In the heat of the moment the word, 'ulna,' comes out of my mouth, which provokes a 5 minute rant about the quality of medical school anatomy teaching nowadays. Oh well, you can't win them all, and I won't make the same mistake again.

1630
Time to head home!