All 28 entries tagged Wards
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January 27, 2020
Term didn’t exactly start out how I wanted it to. I pictured jumping into clinical life, getting to know my consultant and getting to grips with managing hospital life with solo learning. My immune system, however, had different ideas. So, instead of getting sign offs done and (more importantly) enjoying paediatric week, I was at home with a mammoth ear infection (think IV morphine) thoroughly researching the patient journey. However, I eventually got back, managed to set off my hall’s fire alarm cooking biscuits (and suffered the mocking of 90X 18 year olds) and started my clinical life in care of the elderly.
I hadn’t thought much about this speciality to be honest. I was so driven on surgery and neuro that the idea of being on the ward caring for elderly hadn’t taken any of my interest but,now I’m drifting away from the idea of surgery, I found that I loved being on the ward and getting to know the patients there. We arrived at 9am on Monday morning and I felt immediately included into the team which was amazing. You always hear of these horror stories of being left out in the cold as such but it was like we were important to the doctors there. We sat in on the board round which involved a lot of medical abbreviations but thankfully I was able to keep up as I’ve decided to use a tablet to take notes, which means I can quickly google things I don’t understand. The team even stopped at one point to explain lasting power of attorney and what they can do if they feel the appointed person isn’t acting in the patients best interests. We were also alerted to a flu diagnosis on the ward meaning everyone was told to get their flu jab (my clinical partner was virtually dragged by a nurse to get his!). I had mine earlier as I wanted the free pen and sticker to go with it. Even at 23 years old I can’t resist a sticker…..
We were assigned to a consultant and as a group of three took a history, general and focused exam on a patient who had been admitted with shortness of breath. She was lovely and had so much to say so we were struggling to steer the conversation in the direction we needed to. I think it’s being British, we never want to be rude! My history taking has definitely taken a turn for the worse since OSCE’s last year (sorry, Prof Patel!) so I need to review my structure. We were then taken aside and given some tips on OSCE skills and common mistakes to avoid. I had some slight tachycardia during this point as I’m 60% sure the consultant was examining me in my exam last year when I completely forgot to ask patient details!
The rest of the week flew by and I got two sign off’s done. There was a potential third sign off but if I have learnt anything this week, it’s that elderly veins are hard to draw blood from. You can hit the vein and they will not bleed, yet when you remove the needle they bleed everywhere and you panic inside to stop the bleed and not look completely incompetent (totally didn’t happen to me this week).
We have also been in the presence of an amazing F1 who was chasing us around the ward telling us to go and see patients, recommending certain exams to do on them and offering us procedures at every stage. He was lovely and a Warwick grad! It does make you feel like there is a light at the end of this tunnel when you see someone who was once in your boat out there and doing well. He was also teaching us at every stage he could (even getting dragged away by the consultant because they had to get work done). I hope to be like that as an F1 one day. I know I am going home for F1 now just to save costs and be near family so, I will have Kings College and the new Kent and Medway Medical School students to teach so, I am hoping to pass down Warwick Wisdom. If I get there!
I love being able to teach myself the topics we need to know and I am finding it easier to retain information. I just have to get used to being tired after hospital as at the moment all I want to do is go to sleep! I'm looking forward to the rest of the block as I am on O&G, finally going to GP placement and going back into theatre with anaesthetics, a speciality of which is now growing on me. I guess that’s it for me now, good luck to all our amazing final years with their finals! You will all SMASH it!
How is my Psychiatry block treating me? Well, I’m enjoying it more than I thought I would! I mentioned in my last blog about the clinical skills lab; well now I can report back as to what it was like. The skills lab is basically a simulated practice of how we would manage a psychiatric patient. The Medical School get professional actors to act out a “character” and we get a chance to practice taking a history from them as if they were a real patient. The “character” I got to talk to was a patient who had MUS (Medically unexplained symptoms). This is an interesting condition as the character was convinced they had stomach cancer and were experiencing symptoms. However, they had been investigated by specialists and there was no sign of cancer, so the symptoms were suspected to be psychiatric in nature. This doesn’t mean that the patient is making it up at all – in this condition, the patient experiences these symptoms as if they were real. However, they were not due to cancer, and could be eased by psychological talking therapies and psychiatric treatment. It was a difficult one to do as you have to be very careful to listen carefully and acknowledge that the patient IS experiencing these symptoms but also have in the back of your mind that the patient doesn’t have cancer. I wasn’t sure how to do this, but went for something reassuring such as “I can see that the symptoms you are experiencing are distressing for you”. Overall it was a very useful learning experience as psychiatric histories can be difficult.
This week I also had some stressful news – I’ve been hacked! Someone was trying to log into my personal email addresses and social media accounts. Luckily, they didn’t access anything, but it still scared me into changing all my passwords and wiping my laptop and phone etc in case they were bugged. I always think you can’t be too paranoid about these things so I changed everything. I think my paranoia about being hacked in that week probably met the diagnostic criteria for Paranoid Personality Disorder, but hopefully everything is okay now I’ve changed my passwords!
Every Tuesday we have small group teaching on psychiatric topics to help pad out and support the clinical experiences we are getting. This week it was on the topic of psychopharmacology (drugs used in mental health). It was exciting as a lot of the teaching was on how to use these drugs and side effects, considerations etc, which makes it very clear that we need to be stepping up our knowledge into actually managing patients ourselves. It is slightly scary that in a year’s time exactly we will be sitting our final exams and soon after be qualified doctors…yikes! The safety blanket of being a student, where it is perfectly acceptable to say “I don’t know” will be replaced by actually having to look after patients (albeit with support).
On Wednesday of this week we also had a CAMHS clinic (Child and Adolescent Mental Health), where we sat in with a consultant who was seeing children and teenagers. I enjoyed this as the child side of mental health focuses around development and family issues which means that you are not only dealing with the patient, but often parents, school, social services. I really enjoyed this clinic and our consultant was fantastic and very good at explaining what was going on. I think we must have done okay as the consultant then contacted the Psychiatry coordinator and gave some lovely positive feedback about us. Often a lot of feedback in medicine is negative or neutral and rarely given at all, so it really does mean a lot to get some positive feedback. It reassures us that we are doing everything right and gives us a morale boost. At a time of generally low morale in the NHS, positive feedback can be a very powerful tool to tell us when something goes right. One consultant who I worked with in my gap year between my first degree and medicine pioneered “Learning from Excellence” which formalises positive feedback in the same way that incident reporting is formalised. Positivity can be a powerful tool against burn-out and understaffing. Google “Learning from Excellence” to learn more about the philosophy – it may change your perspective and encourage you to offer positive feedback for a good experience. That’s all for this week – remember to say so if you have a good experience!
January 14, 2020
So, the weeks have arrived, officially no longer hiding in the lecture theatre and instead thrown onto the wards. Transition weeks are here. We had an induction on the Tuesday of the first week essentially giving us some of the ropes and then it was up to us. Kaludio and I decided to wander over to the anaesthetics department in search of our consultants who weren’t around meaning we were slightly adrift as we didn’t have anything to do. However, I remembered that the staff on Ward 1 are lovely and we decided to go down and do some bloods if we could. We bumped into an F1 who was also a Warwick Grad! It is so nice to find people who know what you are doing and what you need as they have been there themselves. We asked if it was ok to hang around and Dr Stroud was more than happy! He took us on some junior doctor ward rounds, essentially checking up on patients and chatting to them about how they were feeling. He asked us to listen to the lungs and do a quick abdominal exam and as we repeated back to him, he wrote our findings into the patients notes. Kaludio and I were slightly terrified at this, and I think we were double checking ourselves on every patient. However, it felt amazing that we could contribute something to the ward, and I think we started to feel a little like doctors in that instance.
We then got invited to endocrinology teaching which meant FREE SANDWICHES! We were also taught more about delirium in patients, a topic we had covered in AC1 but it was good to get a refresher and talk through an actual case of delirium in the hospital. We had to sneak out early though as we had to meet Klaudio’s consultant. I was nervous as I had pictured consultant as not wanting to have anything to do with their students, but he was lovely and knew what he wanted out of us. He told us his clinic and days he was the anaesthetist in surgery. He does cardiac and neuro cases of which I was excited about as well, you know about my obsession with Neurosurgery.
I then decided to head back down to Ward 1 to try and get some blood taking done, there was also a cannula to do but I didn’t feel confident enough to do one. I ended up taking a couple of blood sample off a lovely gent and we got talking about student life and what my favourite tipple was. I mentioned that it was cider and then because I’m from Kent, we went on a tangent about Kentish apples and strawberries. The blood taking took me 20 minutes and even Dr Stroud popped his head around the curtain to check I was ok, I need to stop having a good old gossip with my patients. I got the blood sample and as I was pulling back the curtain, I ended up in a whole ward chat about northern drink prices and how “ I really don’t sound northern” despite having spent the past three years living in Preston, good to know my southerner roots are still in tact !
I also went back the next day and ended up chatting with the gent again but halfway through our conversation paramedics turned up and took him away to rugby. Inside I was a bit heartbroken as I think I’ll always remember that patient as the one who taught me how much I love patient contact. However, there was also another patient on that ward who needed a friendly face just to chat to, so I ended up comforting them for most of that afternoon.
I have loved my time in transition weeks. I didn’t get to meet my consultant as I was Ill on the day, we were supposed to meet but I have a whole 10 weeks to find him during CCE so I am not too worried about that fact. I had been feeling a bit down about medicine but finally going onto the wards, feeling like we were being of use and putting some of my knowledge into use felt amazing and I now feel just a little more like a doctor. I am excited for the next block as it’s all the specialties we cover in year 2. It’s a packed block but I would rather have it in January off the back of a rest rather than as the last block before exams. So, I guess I can now call myself a clinical medical student, and that’s not terrifying at all !
The Christmas holidays have finally arrived! I don’t think we have ever been so grateful for December to show its face as we are all pretty tired and in need of a rest. However, there has been a lot going on over the last few weeks of term that have been exciting to be involved in.
We had Revue 2019 which is an evening where we put on a comedy sketch night evening for the rest of the med school and staff. It is my favourite evening of the year and the final week of preparation is my favourite as it’s just lots of pizza and team spirit as we push to the end of the 4-week rehearsal slot. I decided to just throw myself in this year and I was dancing (something I haven’t done since I was 14) and acting and singing in the end of act songs. Our normal sketch of Warwick V Buckingham (the only medical school we share a hospital with) went down well and I got to play a Warwick student. There was a point where I was crying dramatically which was snapped and is the most memorable picture of me I have ever seen. It was such an amazing night and we managed to raise a lot for a local sexual violence survivors’ charity, so it was all for a good cause.
I also made my debut as a Keynote speaker which felt weird to be standing at the front of the lecture theatre instead of sitting on the seats. It was for the MMI day run by a group of WMS medical students targeting widening participation students in the local area. Ollie had messaged me before asking if I was Miss or Ms, I asked if neither was an option, apparently it wasn’t. I don’t do formality! I was talking about medical school interviews and one thing I wanted to do was to avoid just regurgitating what is already out there on websites, instead focusing on aspects often missed such as supporting each other in teamwork. Normally, you just show off about being a leader and follower, but I believe that the aspect of comradery and support is just as important. One point I hammered on about was resilience. As grad entry students, most of us have seen our fare share of downfalls and built up that resilience which is so important in the tough world of medicine. I was given a huge box of chocolates to say thank you and as much pizza from lunch as I wanted, of which I was more than happy about!
I also got to finally partake in the long-held Warwick tradition of peer teaching. I taught in the anatomy and physiology days for block two and I found that I enjoyed it! Going back over my notes from first year was a bit surreal as it only hit me then how much work I had done over the Easter holiday last year but it was useful for making my sheets for the first years. It also meant I was refreshed on topics we had covered more than a year ago which considering one of my topics was drug metabolism, was actually a good thing! The physiology day brought its own challenge of having 12-minute slots to deliver topics normally taught in 60-minute lecture slots. It was hard but I decided worksheets were the best way to go here. I really did enjoy my weekend of teaching, it was a bit surreal to be teaching as I was always in awe of the second years last year who had passed the first year exams so to be able to be in that position myself this year, is amazing.
Teaching has also given me a bit of food for thought over my future career. I had never really considered the AFP programme, but I recently found out it also involves medical education as your “academic rotation” and now it’s something I am looking into. I am interested in medical education and developing my teaching and presenting skills so I can see myself applying to AFP come fourth year now!
So, now it’s Christmas. I am so grateful to be able to have 4 weeks off just sleeping and relaxing. I know next year is going to be a slog so I want to re-charge as much as possible. It also means I get to have a cuddle with my dog, something which I really need!
I hope you all have a lovely Christmas and I’ll be writing again after the 25th!
January 02, 2020
Here it is, Merry Christmas! The previous two weeks have been the lead up to Christmas and I’ve had some much needed down-time and relaxation. I’ve been doing some reading, and you guessed it, its medical. I’ve been reading ”Unnatural Causes”, which is the autobiography of a forensic pathologist who performs post-mortems and visits crime scenes when the police are suspicious about the cause of death. It’s quite interesting learning about a doctor who has a role which involves no work with (live!) patients. It goes to show that the medical profession is a broad church, with lots of different potential roles.
Another thing which always happens at Christmas is the inevitable questions from family members about their medical problems and the inevitable awkward explanation that I am not in fact a doctor at all….Most awkward is when grandparents introduce me as the doctor which of course isn’t true and I have to explain that I’m only a student with basically very little useful knowledge at all. Unless they want to know the steps in the vitamin D cycle of course (probably not very useful…)
This week I also received an email from my research project supervisor about my project. Now you may remember that I have now submitted my project, but we both think there may be something interesting in our results. To that end, we want to maybe do some more work on the project or look to submit an article to a journal. My supervisor emailed me with some leads on where we could take the project next, and I just need to consider the best way forward. Watch this space!
I think the interviews for Warwick have taken place already and most applicants will be waiting to hear back. Good luck if you are waiting – if it was meant to be, it will happen. If you don’t get a place, don’t worry, dust yourself off and try again next year! If you have an interview coming up, the only advice I can offer is to be yourself. I helped with the interviewing a couple of years ago and it is very obvious to the interviewers when an interviewee is stretching the truth or not being genuine. You’ve done the work experience, so just be yourself and let your personality shine. You’ve got this!
By the time of my next blog, I will have started my first Specialist Clinical Placement in Psychiatry. I’m nervous; but more because of fear of the unknown than anything else. Wish me luck!