All 2 entries tagged Patient

Lesson’s to be learnt…

Open any newspaper and you will be greeted with headlines telling of a “social care crisis”, of “bed blockers” and a “dementia time-bomb”. While many of the headlines are misleading and not helpful, the issue of an increasingly aging population and the increasing rates dementia are very real. As a medical student, we witness the problems increasing rates of dementia causes in the NHS on all our placements. On the Care of the elderly wards many patients were “medical fit for discharge” but remained in hospital due to social care issues, many patients with dementia can become aggressive and upset when they are confused and can be difficult for staff to manage and also upsetting for other patients. Observing the challenges dementia places on the healthcare system is no different in the psychiatry block. We spend some of our time in Old age psychiatry where most of the work focuses on dementia but also other mental illnesses that have presented in old age.

Spending time in the community memory clinics I saw patients presenting with a variety of memory problems. The memory clinic is designed to help improve detection rates of dementia and ensure patients receives the best medical treatment and social support. For example, if a patient is diagnosed early with vascular dementia, there is an opportunity to ensure they are on the best treatment for their high blood pressure and diabetes which could help reduce the decline in their memory. Slowing the memory decline can allow people to live independently for much longer and have a higher quality of life. Alongside the medical interventions, psychological interventions in the form of support groups for patients and carers can help maintain good mental health and help families cope in these difficult situations. Providing the right social support can also help patients stay at home longer with their families. Observing how the medical and nursing team all worked together to help these patients was interesting and it was great to see the positive impact the team had.

Treatment of dementia is focused on community care but sometimes it isn’t safe for patients to be at home or even in care homes if they have complex behavioural needs. As part of our placement we also spent time on the inpatient dementia wards. In contrast to any other ward I’ve been on, every patient had a completely individualised care plan that had been formulated through careful observation. Even though many of the patients had severe dementia, staff had spent time with them to find out what their interests were, what music did they like, what activities or food were there favourites? Spending the time getting to know the patient meant that staff could engage the patients in activities that they actually enjoyed and find out what was possibly upsetting them or causing anxiety. One patient that had previously been violent and aggressive was now calm and ready for discharge, no medication had been given, just time.

While I’m panicking about my prescribing exam it’s good to know that the answer isn’t always medication and that getting to know all of our patients, no matter what their condition, can make a huge difference. That’s certainly a lesson that will stick with me and I hope will make me a better doctor.

Joshua Galvin : 24 Oct 2017 15:59 |  Tags: Clinics Joanne NHS Patient Student Warwick |  Comments (0) |  Close comments |  Report a problem

Cradle to Grave…

Writing about web page http://www2.warwick.ac.uk/fac/med/study/ugr/

In medicine we are privileged to witness both the birth of new life and the end of life. During Core Clinical Education (CCE) 1 there were times when I started on the ward and enquired about a patient only to learn they had passed away; other students have been present for a patient's last moments and others have been present when families have been informed. All of these situations present unique challenges to doctors and to us as medical students. I still feel like an unwelcome intruder in these situations but the only way we will learn how to cope with these difficult times is by observing others. We have excellent teaching from doctors and nurses who work in palliative care in the local hospice, teaching us about care at the end of a person’s life. I’m grateful of any extra knowledge in the hope that it will help me when it’s my turn to cope with these difficult situations, although I'm prepared to feel like I said all the wrong things the first time knowing that after reflecting I will be better next time.

An equally pivotal moment in a patient’s life that we get to witness is their birth. In my first couple of weeks of CCE2 at University Hopsital Coventry and Warwickshire I have had shifts on the Labour ward (both day and night!) and have also spent time in the community with the midwives. These have been amazing experiences and have made me think a lot about what specialty I see myself in. Working with the team of midwives and Obstetrics and Gynaecology doctors was great, I got to spend lots of time with the patients and was able to provide a lot of practical help to the midwives as well as be a much needed distraction for some of the women whose contractions were pushing them over the edge! I was able to observe both natural deliveries as well as some emergency Caesareans.Seeing the team come together to ensure that it is no longer than 30 minutes from the time of the call to when the baby comes out was incredible. Seeing the midwives, anaesthetists, theatre staff and obstetricians all working as one to ensure both Mum and Baby are safe was incredible and I had tears in my eyes on several occasions. As a second year medical student we are limited in what we can do and therefore how helpful we can be, but we can talk to patients and reassure them, and nowhere is this needed more than on the Labour ward. Leaving my 13 hour shift and saying bye to a patient I had worked with for the last six hours I was really touched to be hugged by both the patient and the midwife who said I was a pleasure to work with, hearing this was so rewarding and makes you realise that no matter what stage of your medical career you can make a difference. I’ve learnt that One Born Every Minute is not entirely accurate but the Labour Ward is certainly filled with some very special moments that are great to be part of.

In our first year we learnt a lot about health inequalities and the effects of social deprivation on the health of both mothers and children. Nowhere is this highlighted more than when working with the community midwives. The community midwives spend a lot of time educating patients about their health and wellbeing and also take part in multi-agency schemes designed to support families in a variety of ways. Seeing pregnant mothers living in damp, overcrowded housing makes you realise just how important health professionals are in tackling poverty and social isolation. Working with the community midwives we spent a lot of time trying to find a good place to listen to a heartbeat in the antenatal clinic in cases where a baby was especially active (apparently a sign it’s a boy!) as well as spending time on postnatal visits ensuring families were coping and checking for signs of postnatal depression. What I really liked about Obstetrics and Gynaecology is that it is a specialty that takes a holistic approach, the whole family and social circumstances around a patient are relevant and can have a huge impact on outcomes.

As well as cooing over newborn babies I presented my summer project at the Warwick Academic Medicine Society’s annual conference, an amazing day filled with excellent talks from both staff and students and tonight I start my first week of the optional Student Selected Component (SSC) in Medical Education. There is definitely never a dull week as a medical student!

Joanne

Sarah Hill : 30 Mar 2016 09:58 |  Tags: Birth Caesareans Care Joanne Labour Mbchb Medicine Midwife Midwives Palliative Patient Student Ward Wards Warwick Wms |  Comments (0) |  Close comments |  Report a problem