Care of the Medical Patient
My current placement is Care of the Medical Patient, which is an overarching block which touches on many different areas. Medical patients include cardiology patients, respiratory patients, gastroenterology patients and many others. One area which comes under the umbrella is neurology and stroke care and for this block I have been attached to a stroke ward at George Eliot Hospital. Initially, I was apprehensive about being on a stroke ward because of how poorly stroke patients can be. In addition to this, I would say that personally neurology and stroke is one of my weakest areas academically. I think the anatomy of the brain and spinal cord is so complicated, I struggle to get my head around it. I suppose it’s good that I will get some practice in this area and hopefully become more comfortable with this area. Last week we attended a ward round on the stroke ward with one of the stroke consultants during which the consultant did some teaching about the management of various types of stroke. It was a really useful experience and we even got the chance to do some examinations as part of the round which was a good recap of the neurological examination (one of the hardest ones!)
Then, last Friday I attended an outpatient clinic looking after Parkinson’s Disease patients. Parkinson’s is a disease where one of the chemicals in our brain (dopamine) becomes depleted and this leads to issues with movement, including tremor amongst other issues. Having never seen a patient with Parkinson’s disease before I hadn’t appreciated the fact that there are many different types of the disease and that the course of the disease is so individual. Some patients progress quickly and some people remain stable and do not get any worse for years and decades. I also hadn’t realised how multi-disciplinary the management is. For example, Parkinson’s patients often have help not only from doctors, but specialist nurses, speech and language therapists, physiotherapists and dieticians.
This week I had been booked on to attend an ILS course (Immediate Life Support). All medical students have to have this course to be able to graduate as doctors and it teaches resuscitation in a hospital setting – including skills such as managing an airway, doing CPR and using a defibrillator. I really enjoyed the course and it sort of drew together and consolidated several sessions we have had before. None of the information or skills were new to us, but the application and practice using simulated sessions really refreshed that knowledge and I’m sure will be really useful revision for finals.
The week ended with Friday afternoon which was small group teaching on ECGs and heart problems. Being able to interpret ECGs (electric scans of the heart) is one of the most difficult skills expected of junior doctors, so having some recap and revision of some of the most common rhythms was useful. I haven’t seen an ECG in a long time as I have been doing Paediatrics, Obstetrics and Orthopaedics, so I had completely forgotten everything! Luckily, I quickly clicked back in with looking at ECGs and feel much more confident having a go now! Next week will be a busy one, with a few teaching sessions and hopefully some clinical skills practice. It should be a good one!