Organised chaos…

No two weeks in hospital are the same, just as no two patients are the same. Routine is a word I am not familiar with at the moment. This isn’t necessarily a bad thing but it does mean I feel very busy and a little bewildered most of the time! These last few weeks I’ve spent time with a variety of different clinical teams. I’ve been in the TB clinic meeting a variety of patients with both latent and active TB which I really enjoyed. Rates of TB are increasing and it’s interesting to see the different groups of patients this can be a problem for, from healthcare workers exposed at work to homeless people living in damp conditions, and how the consultants and specialist TB nurses work with all these patients to help them.

I also really enjoyed my Child Health day which I spent in Paediatrics and in the Special Care Baby Unit (or SCBU!). I went on the Paediatric Ward round, meeting children and babies with their devoted parents who had slept with them in hospital overnight and then met the team who look after premature babies. In SCBU it was a quiet day on the ward with only two babies, the maximum capacity is up to 13 so the staff had lots of time to explain their work to me and the various complications that can occur in premature babies. I was just about to leave when a newborn baby was referred form the postnatal ward who was not able to feed and needed additional support. Seeing the team in action carrying out all the necessary checks highlighted to me that it’s never a quiet day in hospital and it’s is a real skill to be able to switch into action. Years of training prepare you for this and it is something which I’m only just beginning to appreciate.

In contrast to the quick action of the hospital GP seems relatively slow until you realise just how many patients are seen and how many problems each patient brings with them, all of which need addressing. Working efficiently to try and stick to 10 minute appointments is a skill in itself and many patients come in with multiple things they want to discuss which isn’t always possible. I am filled with so much respect with GPs with their ability to switch from one subject to another, even within one consultation. GPs are constantly making judgement calls about how ill a patient is, do they need a referral? Is it bacterial or viral? They make these calls in every consultation and in contrast to hospital doctors who have blood tests and imaging at their finger tips they have to do this based on their history taking skills and their in knowledge of the patient. Something that I’ve struggled to adapt to in second year is thinking about medicine in a multisystem way rather than compartmentalising things into separate body systems. When I’m on the respiratory ward I know I need to ask my respiratory questions and be thinking of respiratory disease but in GP a patient could walk through the door with anything. The breadth of knowledge that GPs have is something I’m severely lacking, but as with everything in medical school it will develop over time!

Developing our skills and gaining feedback is the main goal as a medical student in CCE and GP is great opportunity to conduct lots of histories and examinations in front of a senior doctor. Getting feedback from my first OSLER, an observed history and examination followed by questions about my differential diagnosis was terrifying but also really helpful. I now know which areas I need to improve but I also got a massive confidence boost when told about all the good things I already do. Proof that I have actually learnt something and that my quest to become a doctor is not the lost cause it sometimes feels when I’ve read the same paragraph about diabetes 20 times and are still none the wiser!

Joanne

Megan Earle : 10 Mar 2016 10:10 |  Tags: Joanne Mbchb Student Warwick Wms |  Comments (0) |  Report a problem