All entries for May 2020

Fluid Charts and HCA life

I have been continuing my employment as a Medical Student Clinical Assistant at University Hospital Coventry. I feel as though I have really settled into my job role and learned how to do it proficiently. Things which at the start were a total mystery to me are now not so mysterious, nor nearly as scary. Specifically, aspects such as filling in fluid balance charts, attending to the personal hygiene of the patients and dealing with confused patients. These are things which we are taught the theory of at medical school, but never get the chance to practice in reality as these jobs are often done by the nursing and healthcare assistant staff. I’ve definitely exercised a completely different skillset to that which I was using as a student!

I had a lovely chat with one of the experienced staff nurses this week about how valuable this experience will be when I go back to placement and eventually (hopefully) start work as a junior doctor. Whilst medical school prepares us well in terms of our understanding of conditions and their management there are some things that I have only experience during my time working on the wards. For example, whilst we are taught in detail about the science of fluid metabolism I had never encountered a fluid balance chart before but now realise how crucial being able to both fill in and interpret one will be when I am a junior doctor. It goes to show there is only so much lectures and workshops can teach you and that there are many lessons to be learned by being immersed in the clinical setting!

I’m hoping some of my present experiences will make the transition to a junior doctor easier when that does happen, but presently I do feel as though gaps remain.

Another thing that I have enjoyed during my time working is how I feel like part of the team. I am, indeed, expected to contribute to the work of the HCAs and nurses and I feel as though I have approached the work with gusto. I have done lots of observations, some ECGs and even some bloods. I know that medical students who are working are all having different experiences and I am sad that I haven’t had a chance to do some more bloods, cannulas etc, which would provide good experience for me at this stage. I know other students working on other wards have had the chance to do these, but there isn’t much demand for these skills on my ward.

That brings me to an update about when placement will resume. We have been told that placements may resume either in July or September, depending on the NHS situation. We would still need to do all of the placements that we would have done anyway, but of course we have now missed at least 4 months of placement. I think the discussions at the moment are of moving our final exams to later in the year, not having an elective period and reducing our summer holiday before starting work. At the moment there are lots of “maybes” and it really depends on the course of the coronavirus. I hope that we do get back to placement soon, as I really miss Medicine. So stay inside, for my sake!

Megan Earle : 20 May 2020 12:17 |  Tags: Covid19 Jordan Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem

What day of the week is it again?

Week 8 of lockdown, aren’t we? To be honest, everything feels so much of a blur and all the weeks have moulded into one. It does however feel like an age since I was last wearing my stethoscope on the wards trying to appear like I knew what I was doing. Covid 19 has truly changed our lives and we as medical students are no different. As you have probably seen from Jordan’s updates, we have been given the option to work in local trusts and I have been allocated George Eliot's (Geliot) A&E department. I was amazed when I got offered it and I really have enjoyed it. I even have done my very first night shifts which are strange. Trying to stay up the night before is hard and I don’t think I would have gotten through the first one if it wasn’t for my good friend, Red Bull (other brands are available).

I have been lucky as it’s given me the opportunity to practise my clinical skills and I have mastered the art of small talk whilst doing cannulas. I have grown so much in confidence with these, just need to work on putting in the next gage (bigger diameter cannula) up as I seem to struggle with my pinks. One of the best parts has been having a good old chat with the patients. I had a lovely human the other night and we spend an hour chatting about the original VE day, being evacuated, the bombing of Coventry Cathedral (one of my favourite facts about WW2 purely because it was in a Sherlock episode) and the rest of their life. We found out we have families in similar parts of the UK and we chatted about Megan and Harry and baby Archie. It has been nice to get to do this as the department has been…let’s say…. Less populated than usual. We normally get to 3am and one have one patient in majors, so we sit and chat as a team. I even got my ECG done the other day!

The PPE was a novelty at first, but I wish I could get away with not having it on. The mask dries my mouth out quickly and constantly breathing in your own C02 makes a 12 hour shift that much harder. We haven’t had a problem with PPE at Geliot apart from the nice elastic masks running out meaning everyone has to wear the tie-on masks which we all hate. One positive spin is that the team cannot see how much I yawn at 3am! It’s one of the only times I have liked being someone who smiles till their eyes disappear.

I got to experience being in full PPE the other day as we had a peri-arrest Covid positive patient come in. I was only in it for 2 hours, but I was boiling and thirsty. The ICU team are heroes! The patient was fine, and I put in their cannula and took their bloods and before long, they were sent to the wards. I have also seen someone extremely sick from Covid. They unfortunately passed away in the department and I felt heartbroken for the family who couldn’t see their relative in their final moments. It was also the first patient I have seen pass away and it's a moment that will forever stick with me. Night shifts bring everything to the table.

Outside of ward work, we have been given our SSC2 projects to do. We are all currently doing a systematic review. I found a topic similar to that of my original project but I am finding the software…..tricky. Let’s say I have come close to sending my computer on a horizontal trajectory through the window and onto the ground outside. However, it’s no different to the problems I faced in my undergrad dissertation except this time, it’s computer software and not human brain cells letting me down.

We are due back to placement at the end of June pending on how the third years get on. The crisis will impact my degree even beyond this year as we found out our third-year placements will be one week shorter and, depending on any future lockdowns, my second-year placements could also be made shorter. It’s scary to think, but this will affect the future training of doctors. Interestingly, I prefer doing the 12 hour shifts as opposed to turning up onto a ward hoping for something to do. I have learnt a lot more, even my ECGs are coming along! I think we would benefit training like student nurses and having shifts instead of popping in. That is just me though, I have a lot of time on my hands at the moment!

'Til next time!

Hattie Trigg : 15 May 2020 08:12 |  Tags: Abbie Covid19 Mbchb Patients Student Wards Warwick Wms |  Comments (1) |  Close comments |  Report a problem

Uncertainty

For the last two weeks I have been continuing my employment at University Hospital Coventry as a Medical Student Clinical Support. As I discussed during my last blog, this is to help the NHS deal with the increased demand expected because of the COVID-19 pandemic. So, what have I been up to? Well, I am currently working 24 hours a week, which is 3 days of shifts from 12:00-20:00. Whilst at work, I am acting as a Healthcare Assistant, so helping to wash, dress, reposition, feed and just generally look after patients on the ward. In addition, I am allowed to carry out observations. These are done regularly for all hospital patients every couple of hours or so, usually by the qualified nurses on the ward. A standard set of observations includes blood pressure, pulse rate, breathing rate, consciousness level and temperature. We have been very busy on our ward, so I have helped the nurses by doing some of these observations and letting them get on with the drugs rounds and other duties that require a qualified member of staff. Medical students are taught to do observations as part of examinations (i.e. pulse for cardiovascular examination), but we aren’t taught to do observations in the same detail as nursing students. Having the opportunity to carry out so many has definitely increased my confidence and is hopefully a useful skill to take forward into my medical career when we finally go back to placement.

I have been settling into my ward and getting used to working again, as well as learning everyone’s names, which is slightly more difficult when you’ve never seen their whole faces as everyone permanently wears a mask while at work. I’d never realised before having to wear a mask which covers my mouth just how expressive my face can be and how much I use facial expressions to convey meaning whilst talking. I’ve been quickly learning how to use my eyebrows more to express more emotion – an unintended side effect of PPE (Personal Protective Equipment!)

Then I suppose I should discuss what’s happening with our course currently. Things are on hold until the NHS has dealt with the COVID-19 outbreak, at which point we should resume placements. It’s very difficult to say when the NHS will be stable enough to also deal with teaching us, but the University has posited July as a potential resume date, at which point we will have lost 3-4 months of placement. Final exams would be potentially pushed back from February to May and we would then do placement well into 2021 (when originally without COVID-19, placements should have ended December 2020 before revision and then finals in Feb 2021). There is a lot of uncertainty at the moment which is causing a lot of anxiety for everyone, and this is worst for the current third years who are the most senior medical students and so have the least time to make up any lost learning before graduating.

All of this anxiety about the future has been affecting me personally and my course-mates – we have joined the course to become doctors, but not just doctors for the sake of it. We want to be good doctors, who are able and good at doing the job of looking after people. For me personally, I don’t want to qualify and then feel like we aren’t as good as the years that have gone before us and those that come after us. Thus, it seems like a steep climb to the end – we will be out of practice with everything having had a 4 month gap, with less time to get to the same standard as our forebears in a changed NHS which may be unable to give us the same education as previously. I think this mountain must be surmountable – but at what cost? Added to that is the generally gloomy news; of economic uncertainty, of social isolation, of deaths in the news daily. The mental health impact on the UK mustn’t be discounted and I think will haunt us for years to come. As a former historian, I feel as though we are watching history unfurl before us – a turning point as real as the world wars, the nuclear age, the bubonic plague. As before, the solution is courage in the face of adversity – believe in better times and look after each other and we may yet see an end to this nightmare.

Megan Earle : 11 May 2020 08:58 |  Tags: Covid19 Jordan Mbchb Student Warwick Wms |  Comments (0) |  Close comments |  Report a problem