CCE Specialities Week 4

Monday

Came down with a killer cold over the weekend so I decided to avoid sniffing over pregnant mothers to be and go in later for the clinical skills session at 1pm. I found out that actually I had chosen wisely as the clinic were only letting one student in so 2/3 of the students there got turned away, so I would have gone in early to spend the morning sneezing and feeling sorry for myself.

We had our oxygen clinical skills session in the afternoon essentially looking at what we would give to a patient based on their oxygen needs. Each oxygen delivery system has different flow rates so need to be selected based on the patients needs. We also got to learn about inhaler therapy using different techniques and learnt about equipment to test if the patient is able to use inhalers. This included some weird party blower type things that check the patient has the strength to use some types of inhaler. It was hilarious and we created our own New Year’s Eve in the room. Safe to say we all reverted to about 4 years old at this point. We then moved onto the peak flow instruments and that also turned into a bit of a competition. I was pleasantly surprised by my results, apparently I have the lungs of a 6 foot man….

I guess my classical signing lessons for virtually 4 years of my life payed off. (Yes, I can belt out a phantom song if it takes my fancy).

It felt like a really long afternoon and I was happy to just get back and nurse my cold. However, I had to make a quick stop as I had to pick my new phone up ! A better phone, more data AND a cheaper contract?!?! I was ready to collapse in bed when I got back , and that is exactly what I did (after a helping of my mums chilli).

Tuesday

I had been looking forward to this day as it was my first community midwife shift, this meant babies and lots of them. Well, I thought that, turns out I saw two. Our first stop was a beautiful two-day year old of which it took every fibre not to pick them up and give them a cuddle. I got to help out and take mums temperature and blood pressure which came a little out of the blue so I mentally had to check I could remember how to take a blood pressure (it’s OK, we did remember). It was apparent they had appeared before mum and dad were ready but apparently that’s how all babies arrive. I also got to see a 5 day year old visit where the baby was weighed and the heels pricked. The heel prick test looks for sickle cell, Cystic Fibrosis, congenital hypothyroidism and some inherited metabolic diseases. Amazing considering it’s all done by 5 drops of blood on a bit of paper. This house also had a bird in the corner who kept whistling the Adams family theme tune whilst we were in there providing a comedy element to this check up.

I then got to escape to Costa for 4 hours as the midwife was just doing paper work and I have to say, doing work in a coffee shop made me feel like the Instagram cliché I ultimately am. I hadn’t packed my laptop so I was working all off my phone which was annoying but the antenatal care learning objective is huge and I really needed to get started on it.

After wandering round the road system there (it was an industrial park which aren’t really catered for pedestrians) I found my way to the surgery and spent the next couple of hours seeing lots of baby bumps. I got to do the urine dipsticks (a task I can imagine the midwife was more than happy to give me) to check for protein in the urine which is an indicator of pre-eclampsia that can lead to deadly seizures in pregnant mums. Thankfully, all were good. I also got to feel some abdomens for baby and I think I need to keep practising this as I am a bit hesitant about pressing too hard on the mums tums and could only just about feel baby. I also got chatting to the midwife about the channel 4 documentary on mental health that was showing a mum who had gone through serious post-partum psychosis.

It was a pleasantly surprisingly good day and I could see myself working in obs and gyne which was extremely weird as I swore I would never go down this path and for someone who can’t see kids in their future yet, I became extremely broody……

Wednesday

First day of school again! It was our first day in GP which is something we start in phase two. I’m based at a surgery about 40 minutes away from campus which is brilliant as these practises can be flung far from Warwick. I arrived at the surgery at 10am (something which I also loved about them) and we were immediately made to feel so welcome and wanted. Something, I was worried about not happening. I was put in to observe a nurse in the morning and got to see a little one having their first jabs which got us on the topic of anti-vaxers. It’s becoming a sadly growing trend even here in the UK. Vaccines have been shown time and time again to be safe, effective AND LIFE SAVING. Autism does not develop from vaccines. I did not become who I am because my mum decided to save my life from measles, mumps, rubella, polio etc. In fact that paper was retracted exactly 10 years ago this week. Anyway, rant over.

In the afternoon we got to meet our mentor Dr O who would be supervising us through this 7 week block in GP. I expected the first session for us to just be observing her and watching but nope. Immediately we were chucked in front of patients. GULP. It was actually amazing and showed that we’ve reached that stage in medical training where observation isn’t enough for us and we want to get involved with everything that was going on. I really enjoyed it but I need to learn to direct my consultations. I did over-run partly because I was dealing with a condition where I wasn’t sure what I was doing and partly because my patient liked to talk. They were lovely, I just need to be a bit more assertive. In fact, they are coming back next week so I am gong to read up on their condition so I have a better idea of what to do next.

Me and Klaudio left that day feeling accomplished and like we were progressing on our medical careers. I dreaded this clinical learning but you get so much more out of talking to patients and getting involved than a thousand lectures could ever give you. Kaludio mentioned thinking of GP as a career but I am going to need a bit more convincing.

Thursday#

It’s currently 9am and I haven’t slept since Wednesday morning. I was up in A&E all night and basically just went straight to my 8am lecture at the hospital (luckily) but halfway through I had hit the wall and basically called it a day. I was annoyed as I needed the day to get sign offs but I guess luck isn’t on my side today. However, I did make progress in trying to meet my consultant so I guess I got one thing out of today.

Friday

Academic day! A slight lie in and I’m off to the med school for CBL. I have to admit, I get so tired during CBL that it is hard to stay focused. I am also a bit tetchy about CBL at the moment as the learning outcome list is huge and often the points seem leaps and bounds away from the case. However, that’s more my agg. It paediatric week and we got treated to a lecture by one of the lecturers who restored my faith in medicine during AC1. He was Irish and training to become a GP but makes his lecture just interactive and enjoyable.

However, I had to scoot early as I had a GP appointment to talk about my SNRI’s. I don’t think they are working as things had happened that week outside the medical world that had caused me to come crashing to the floor and question everything I thought I knew, I was also still shattered from the Thursday so I wasn’t coping. I had my meds upped in the evening just to see how I am with the side effects so I am going to see how I cope for the next two weeks.

I then high tailed it back to the MTC as my personal tutor had come to Warwick to check in on us. I said that I was just tired and a bit stressed but I was kinda coping, which was true. I still loved my course and I’ll just see how everything goes. It was a quick in and out meeting (plus a quick 5-minute vent to a friend) as I had a THIRD meeting that lunch about my absence at the beginning of term. It was not anything bad, I had done everything the Med School wants us to do but it was just to see how I was doing catching up and if anything else needed to be done. I took the opportunity to mention that sign offs here can only be done by ST3 or higher rule was annoying and seemed excessive for year 2. Other med students (yes, I network!) can be signed off my any grade doctor and band 6 and above nurse so I wondered why Warwick was different. The reason was to prepare us for F1 which I can see the logic, but I am only a second year medical student at this point.

At the end of the meeting it was time to run to lecture as I was slightly late and ended up having a working lunch due to having been in meetings all afternoon. Lectures on academic days are becoming a bit of a cause of chuckle with me. My year isn’t exactly the model year for showing up to lectures but now our lectures are sign in, the lecture theatre is constantly full.

The afternoon lectures looked at paediatric development and I got to chat to the doctor at the end about making up my paeds rotation which I really want to do as it’s not only a sign off but an area of medicine I love. I’ve got two weeks at the end of the block of peri-op that will be a good time to slip two days of paeds in so I am hoping to do it then.

That weekend I also was teaching for Block Three physiology day. I had chosen to do the basal ganglia as it was a part of medicine I loved. It’s the first time it’s been taught at a physiology day so I was keen to split apart the anatomy from how the system functioned as I was also teaching it on anatomy day. I really do love teaching, I know there is going to be Med Ed in my future career and I know in F1 I will be teaching those from KCL and the new Kent and Medway medical schools so I am keen to build up my teaching skills from day one. Here’s to more knowledge imparting on unwilling victims !!