CCE Specialities Week 9

Monday

Second to last week of the block ! And a bit of a mix to kick the day off. We have community week this week, so instead of dragging myself to UHCW, I dragged myself to a GP nearby. It was also an odd morning as it was the first time driving to placement. It was slightly terrifying but I can’t even begin to tell you how amazing it felt. I arrived at 9:15am (aaah lie in!) and we got briefed about what was going to happen. In second year our community week looks at palliative care patients and how end of life care is delivered.

We played a quick game of school nurses, practise nurse, district nurse or health visitor and our team came second missing out on a bag of haribos. We went to a hospice in the afternoon. I already knew what to expect with my nan having passed away in a lovely hospice where I live but I was intrigued about if it was the same everywhere. It was weird walking in. It felt the same but part of me twinged a bit. I don’t think I’ve got over my nan going. I was in the middle of dissertation hand in, finals revision and it all happened quickly. I had a call on the Friday asking if I wanted to come home because it was soon. I remember being stood in the middle of the street feeling like I’d ran into a brick wall. My nan was a second mum to me. I decided to stay at uni. We wasn’t sure when she was going to go, and with everything going on. We agreed it was better for me to stay at uni.

After her funeral I had to head back to Preston to do my viva for my dissertation, work for the summer and then move out. Almost the week after, I started a summer job where I was working 8-6pm some days for the entire of August and half of July and then before I knew it, I was starting Med School. It’s weird, I can’t explain it.

Anyway, back to the actual point. We were given a tour of the hospice by one of the most energetic doctors I have ever seen but it was nice to sit down and learn about palliative care and how there is no curing in hospices. Only pain management, and keeping the patients comfortable.

We then had to go and interview a patient, which I was slightly dreading. I was scared that I was going to say something stupid or put my foot in it. However, the family were lovely and I was so grateful for them taking the time to chat to us and tell us about their hospice experience. We came out feeling humbled and amazed that places like this can exist. However, most of them rely on charitable donations to run, so it’s possible that these places could one day go leaving thousands to die in depersonalized hospital beds.

Tuesday

Tuesday morning was a bit of an admin morning which I nearly didn’t get to see. I arrived and asked security to let me through but I was grilled about why I was there, who I was to see and who I was (despite the orange cone lanyard hanging down off of me). Thankfully, the receptionist came in and saved the day.

We presented our mini health needs assessment finally getting that box ticked off for this year and then discussed the patients we saw yesterday. After lunch, we went to a baby clinic seeing the opposite end of life to what we had already seen. It was completely different to what I was expecting but we got to see baby checks and at the end I was happy as I got to play with a small toddler for 10 minutes. I swear to god I am a child.

We drove home and to my horror ended up on the infamous Coventry ring road. I don’t know who designed it but an exit and joining slip road as one?!? I was screaming inside but somehow made it back to campus alive.

Wednesday

Wednesday is normally GP day but our GP was on annual leave so we had it as a day off. Day off was in commas as I had a tonne of admin to do including getting my black box fitted, booking rooms in the med school for the JASME conference in November, picking up prescriptions and having to sort out my home comforts scheme including washing up after people who’ve used mugs and sorting out the blankets chucked everywhere. I could go off on a rant but I wont.

I also managed to get a gold dust GP appointment. My hip has been painful these past months and now it’s affecting me during the day so I need it check out. We think it’s just tendonopathy but I am having an X-ray to check it’s not anything more than physio can sort out.

I also got semi-dragged to the med school by one of my friends to attend a wilderness talk. I’m not interested in wilderness medicine but it was their dad giving the talk so I decided to hobble up there. IT was actually a really good talk and I became engrossed with all the travelling doctor stories to Papua New Guinea, Mount Kilimanjaro and Syria. The tribe in Pappua New Guinea still used basic archery to hunt and use in tribe wars but the detailing on the arrows was incredible. We even got introduced to the blood stick which had been removed from someone’s abdomen and still had the blood on. Nice.

Thursday

Another half day off as we had Psych workshops in the afternoon. I wasn’t sure what to expect from these as we had already had our psych week and it was less than ideal. However, they were actually really useful. It was 5 scenarios with SIM actors covering different psych conditions such as self-harm, low mood and MMSE exam. However, just my luck I get alcohol abuse and the most intense SIM I have ever met. He actually apologised to me after because he had to be so mean !

Thoroughly exhausted, I trudged the 20 minutes back to my car but then did a diversion to ASDA to pick up a blanket covered in bumblebees I had been craving for weeks. I was a very happy bee that evening.

Friday

Back to community for a final day. We were sent out with the District nurses and it has to be the most eye-opening experience of my life. We were mainly doing wound dressing but that wasn’t the part that gave me the biggest reality check and learning experience. It was seeing the conditions some of our patients live in. It’s so easy to forget that patients have lives outside of the hospital and what world we are sending them back to once we discharge them.

I got back to the clinic and was still struggling to take in what I had seen that morning. I was chatting with the nurses about what I had seen and they were telling me stories of some of the patients they had seen. I was also surprised by how many patients smoke in their own homes despite all the advice they probably had been given. However, we are not there to judge, I just couldn’t help but wonder how much of their environment was having an effect on their health.

It was a quick afternoon. Just more tick boxing and showing that we had done the e-learning we were supposed to do. Everyone kept going on about 5 certificates. I was so confused, I had one overall one but it looked correct. Turns out, the 15 modules I had worked my way through on one evening, could have been only 5 and that I had spent four hours doing these modules when I could have spent one ……..

I slammed my head down on the table in misery. Serves me right for not reading the module handbook really. Before we left for the week we had a chat about cornona (we are all confused as it if we need to worry or not) and were treated to some amazing cakes by our placement lead. Worry not , I have the recipe !

I headed back and after picking some McBurger sauces up from McDonalds (judge me, go on), I headed back to a Friday evening supposedly catching up on work …… that did not happen.

Sunday

Woke up today with the news Corona has spread to Coventry with one patient being treated in UHCW for it. Here we go ……

CCE Specialities Week 8

Monday

Peri-op week begins! That means early rises and long days of standing on my feet. I rolled out of bed at 5:30am and got in for 8:15am ready to begin. We had been assigned theatre 2 and so saw a lot of hernia repairs.

We had a short morning as we had teaching on otoscopy in the afternoon. Ears have been a fascination of mine since I seem to have so many problems with them. The doc was lovely and she was trying to prep talk me into not going off Neuro. To be honest, I stood in a theatre the other day and a little part of me lit up but I think the ship has firmly set sail on that one. It was nice to see a female clinician building up med students though. Come to think of it, this entire block, I’ve seen 5 female doctors in 10 weeks. Yes, I’m slightly biased because I’ve been on specialities meaning I’ve done a lot of work with midwives but I don’t know. Maybe, this will change next blocks when I am actually on a ward for more than 5 days.

Tuesday

The first full day in Peri-op! We spent the first 20 minutes working out that Warwick had actually scheduled us into a theatre instead of leaving us to wander like lost lambs which is a nice change. Today was a lot of urology meaning I saw a LOT of bladders. We went to take a history off one of our first patients and half-way through I became very aware that they were alarmingly on it with their meds and were telling us the exact things we wanted to hear. I asked what their jobs were and they are actually a health professional! Suppose that answers my questions about their amazingly in-depth knowledge!

We got to see each patient being put to sleep with the use of I-Gels today rather than tubing which we saw yesterday. They look oddly weird and like they shouldn’t work but are actually easier to work with:

Image result for I gel
The I-Gel is supraglottic meaning it sits above your glottis near your vocal chords.

We saw some botox injections for bladder problems particularly in those with MS to prevent the bladder contracting as much as it does enabling the patient to re-gain continence.

After lunch we went into another theatre as we were told that we would be watching the same operation 5 times in our theatre which isn’t exactly beneficial. This time I got to insert a cannula AND GOT IT IN (on the second attempt). We’ve been told techniques with the cannulas this week and encouraged to begin to develop doing them one handedly. I was worried about this procedure, as it is really fiddly and you could do with an extra set of hands really to do it. However, now I have done one, I know I’ll be able to help a bit more on the wards next block.

I was chatting to the anaesthetist running the op and asked if she could sign my cannula off for me. Here at Warwick we need a skill, a case based discussion and (a Warwick special) OSLER signed off every block. So far I have one CBD, and nothing else. The sign off’s also have to be done by a ST3 and above which is (to put it politely) annoying as hell. I figured she was a consultant and when I asked she said she would ask the consultant as she was not a doctor. I sat there confused. How were you running the anaesthetics if you were not a doctor? Turns out she was an anaesthetists associate. I have never heard of it before but it is like the physicians associate, just for anaesthetics! I was really interested and we were chatting about the training and why she chose to do it. The consultant eventually came in and he asked me to send him a ticket….. he still hasn’t done it. #medstudentproblems

Wednesday

Second to last GP day 😦 We decided to spend the morning sifting through our mini-needs health assessment which was becoming a pain. We weren’t entirely sure what we were doing (and to be honest to this day I am still not sure what had to be done) however, we managed to get a presentation together that somewhat resembled examples we had been given. At least I am an expert on Alcohol in Coventry now.

We had our student run clinic in the afternoon in which we got to do our GP OSCES (yes as well as the sign offs in hospital, we have to get them done in GP too!). I actually managed to manage an entire consultation by myself and the pride inside me was huge. IT was a simple case of overuse of a muscle which you normally grab the old ibuprofen but due to co-morbidities (a bunch of rapidly growing cells with its own protective bubble and blood supply), we couldn’t use this. I suggested heat and told them to put their feet up this evening and have their partner make all the teas. They seemed to like that treatment plan. I got amazing feedback from my GP. Apparently, I have a way of putting patients at ease, which surprises me as I am shaking with nerves inside. I love the consultations and developing the med student- patient relationship even in the short time we get. I had never thought GP would be my style, but I am becoming to love my Wednesday afternoons. Despite being on the spectrum, I am a weirdly chatty human. I don’t know. Knowing me, next week I love everything to do with oncology but we shall see.

Thursday

I was meant to go into today but I woke up ill and dizzy. I think it may have to do with a certain examination coming up but, after having the day off. I felt amazing and re-energized rather than an exhausted wreck. Early mornings, late nights, long journeys AND my medication make every day seem like a 48-hour stretch. My clinical partner comments on how much I yawn but I honestly can’t help it. I am so looking forward to my week off in ……… 12 weeks.

Friday

Early morning again as we had the deans breakfast. It’s essentially free food for a chat with the dean of the medical school, the pro-dean of education and our lovely Deputy Head of the programme and Lead for Learning & Teaching (I had to google that). It’s great because we actually get to raise the issues affecting us directly and even bring things up that the med school are completely put in the dark about (like a certain nearby medical school’s students popping up in one of our hospitals despite the hospital telling WMS we were the only WMS students there). I also raised an issue about our formative. Weirdly, it got released 2 weeks before the end of the block and I was no where near done with my learning which I thought was a bit unfair. I asked if it could be moved and later that day it got extended to the end of the block – result!

I then went to CBL with a mountain of croissants from the breakfast and tried to pay as much attention as possible. It was slightly different today as instead of mountains of text (hell yas) we have four short videos. I actually enjoyed it (apart from me and one of my friends cracking up at the first one because it was meant to be a really patient but the actor kept bringing his script into the frame). It was good because it got a good discussion going and distracted me from the horror of what was coming.

At 12:08pm, I stepped into the car for my third driving test. I wasn’t expecting much. I had failed twice already AND there was a storm today. Rain and unfamiliar roads. A winning mix. At 12:50 I pulled back to the test centre and held my breath whilst the examiner put the GPS away in what seems like the LONGEST wait ever. He then looked at me and I HAD PASSED !!!!!!

I HAVE FINALLY PASSED MY DRIVING TEST !!! I WAS FREE !!! My driving instructor was laughing as he said it was the loudest celebration he had ever heard (did you expect anything less from me?). I was so happy, no more 5am starts, no more waiting 20 minutes for a bus not to turn up, no more rude bus drivers or stinky passengers, and the most important thing. No more being trapped on campus.

I headed back and joined in a VLE session looking at equality and equity. However, I quickly picked up that VLE debates don’t work well on Friday afternoons. There was some discussion but most of us were tired and keen to end the week. Even after my happy lunchtime, I kept zoning in and out of the debate. Not a good look 🙂

Finally, we were freed and I collapsed home to spend the next fours hours sorting out grown up car insurance. I got an ok deal, I wasn’t expecting much being a new driver but I am ok with the deal I got. Finally, something good has happened to me in 2020.