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Care of the Medical Patient Week 5

Where did this block go? I feel like we only started it 2 seconds a go.

Monday

We had planned to go in and attend a ward round with one of the Warwick MVP lecturers today. V is a lecturer most people want to get into clinics with, but we found he does a ward round on Ravenclaw Common Room every Monday, so naturally we wanted to go. I was looking forward to it as the Ravenclaw common room is a mixed ward that takes patients from A&E etc so there was going to be a lot of variety.

We were heading up to the ward and wouldn’t you guess, the two students who we bumped into trying to get into Gastro Clinic the other day, who were also going to the same ward, to shadow V. Why we don’t co-ordinate these things I have no idea……

It was fine though as they graciously gave way to us, and we hung around for V to show up, and hung around , and hung around. We eventually ended up bleeping V and turns out he was helping the finalists OSLERS. A bit rude of the finalists taking V away like that 😉

We ended up going for a wander to the Neuro ward (more like I dragged K there) and low and behold, a familiar face was there from second year in the form of a doc who used to do great teaching with us. Relieved, we decided to say, and we were in time for the ward round. Which did surprise me a bit as it was 9:40 by this point.

I could get used to DGH life.

We actually got such a good morning which was brilliant as this was something we were not expecting. The consultant was engaging with us and was teaching us with every single patient. I really enjoyed just being there. Everyone was there because of something that had gone wrong with their nervous system, and I was so there for it.

There were a couple of conditions that I had only read about in textbooks so I was loving the day for learning and being exposed to a speciality I have been DYING to see since day one.

We finished up chatting to a patient who had a really rare presentation that K NAILED whereas I had not a clue what may be going on.

***SPOLIER ALERT FOR MY YEAR GROUP*** (not that anyone reads this)

We ran and grabbed lunch, so we were in time for the afternoon COMET. Thankfully, this one was NOT on palliative care but on one which we all know about. Covid-19. That sneaky thing had managed to make its own COMET, and I was so here for it. Finally, back in my comfort zone and doing the logical side of medicine.

We had an A-E station of a critically ill COVID-19 patient, an ABG station (my brain has never had to work so hard) and a ventilation technique station which I relied mostly on my googling during COVID-19 to answer.

I know I still struggle, but hopefully , a bit of time and more experience will help.

After, I had to get back quickly as I had JASME chats which I was hosting. I hate hate hosting because , well, social skills, but it was a fantastic discussion today, and it’s nice to have a fully engaged panel.

After, I pretty much slept as it had been a long day. I swear my stamina is dismal at the moment.

Tuesday

Today we decided to go for our last morning on CCU which we were gutted about. We really like this ward and have come to know the doctors really well. Ok, K was secretly hoping one of the CEF’s would be there (they were not) and I was hoping to catch Dr V (who was also not about). Instead, we spent the morning semi blending into the background whilst the consultant grilled the docs in front of us.

However, we did have a lovely patient who we began to examine before the ward round cut in but during the round he came and chased us to show us more of his signs and to tell us more about his medical history. That was a first for us ! He also had a TEXTBOOK heart murmur so at least we got to see something useful.

We went to the Neuro MDT at 11:00 and low and behold, the same two people who we bumped into yesterday were there AGAIN. Honestly, same page thinking.

It was OK though because the consultant was lovely, so we were all there (huge room so plenty of space for social distancing) and we sat there and watched the MDT for three patients. After which the consultant paused and told us to go.

Honestly, in AWE of this guy. Recognizing we didn’t need to see 20 patients being talked about and that we had got all the use out of the MDT? Perfect.

K and I decided to call it a day there. We did have a hunt round our other ward for a blood (which there normally is) but nothing came up. Hence, we ran off to enjoy the weirdly good weather.

Wednesday

Up early today as we finally have Dr N’s clinic booked in. Which of course started at 8:30, I was pretty happy to get up though as I was looking forward to going over the endo side of medicine. Something we have hardly been able to touch.

It ended up being a bit less Endo and more Philosophy and calming us down about finals (something I needed more than K) but that didn’t really matter. I actually enjoyed the break and we began chatting about how technology in medicine is moving and what the future may look like. The finalists had just sat their OSLERS so we were also chatting about the layout of that and what to expect.

Another early finish that day. K and I have been in every day this block, so we are trying to slow things down this week, so we get some sort of rest for Surgery. We did end up driving over to Warwick though as we both wanted a practise before Monday during rush hour. I actually really enjoy the drive. I’ll have to go over to old Warwick if I finish early one day just to soak up the town that the uni is named after (and situated nowhere near).

Thursday

Our last day! Well, unofficial last day, but we have decided to give ourselves the last day off. Today we had a booked in palliative care experience morning which I had been slightly dreading since the fateful COMET.

However, it turned out to be a good morning. We started off linked on to the MDT via a tablet and then got to shadow nurses as they went to see the patients they were looking after in the hospital.

I got to go back and see one of the patients on the ward who I had met before in a MDT meeting. They were struggling to get them to feed, so I sort of took it on myself to try and have a go myself. I did everything, hand them the spoon, put the bowl under their nose so they could smell the food. I even went on the hunt for biscuits and cakes just in case they took their fancy. Nothing. I think between us all, we had tried everything except pick the food up and physically put it in their mouth, which is kinda the definition of torture. They were not refusing food for a palliative reason but due to dementia so it more of encouragement rather than just leaving the food in the hope they might eat it.

I am surprised about how much I enjoyed that. I wish I could have seen others but K and I are both shattered so I think we were running out of charge by lunch. That day we also had to do the end of block admin so we handed back our keys and had our last lunch and ice cream. I think I should have a loyalty card for that ice cream bar. At least my bank is going to be slightly happier now and hopefully my waistline will start to shrink a bit.

But it is good ice cream.

Friday

I wish I could say I had a lie in. I WISH. Instead, I dragged myself out of bed much earlier than I would have liked to and headed over to the big teaching hospital for an MRI of my slowly “getting to the point where I want to chop it off” hip.

It has been playing up a lot. Meds don’t help it and physio has not helped (I think it has made it worse) so we decided to give it a scan to see what was going on. So, here I was 7:30am, in a hospital.

Even though I had planned my clothes to have no metal in them, it still was terrifying being loaded into the machine. Just in case you haven’t realized by now, I have quite bad anxiety so all I could think about was being glued to the machine because I had forgotten one bit of metal.

However, I didn’t get sucked into a lifetime of chilling in the MRI machine and spent half an hour getting scanned. I always forget how small the openings are for MRI machines, so I was a bit panicky when I got loaded in but after a while it was OK and I had a nap.

They also scanned my knees (which is also great because they are stuffed up too – thanks mum for making me grow up dancing which I think has shot my knees) and I got to take a peek at the scan. They showed me very quickly the images, but I was not looking too hard at them because if I miss read them and thought I had seen something, I will be worrying about it for the rest of the time till I have my next appointment. However, it was pretty dam cool seeing my own hip and knee joints.

I treated myself to some M&S croissants (glared at the colin cake) and got myself back home for meetings.

The first was with a rep from Elsevier as I was being inducted into the ambassador programme. The best part about it was I DON’T HAVE TO DO ANY PLUGGING.

I am so over being a rep for a place and having to plug everything onto my uni Facebook pages because I know it annoys people and people don’t read it. However, this programme sounds amazing and I can’t wait to get involved.

I also had one final meeting which was my end of block sign off. Despite me sending the forms about 6 times however, nothing got through to Dr V so it was an awkward 10 minutes.

We then get to the best part of the day. Pizza. We haven’t seen the two gals who we used to travel with EVERY DAY since November so we arranged to meet up and catch up on all the car stories we had missed.

What a pretty good way to end the block …….

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Care of the Medical Patient Week Four

Got to be honest, been putting this one off as I didn’t want to relive last Thursday considering I made an idiot of myself.

Monday

Since the disaster of the lost weekend thanks to my vaccine, I decided to make this a half say. We went in for a morning of teaching which was meant to be face to face but found it all to be moved online.

I am so grateful to have the teaching as we barely had any last year but the trip to the hospital is 23 miles round so we could have been saved the journey. Projectors are also not amazing at reproducing X-rays of lungs so it took away some of the teaching. However, it was a much-needed review of asthma, COPD and TB. TB was something which I sort of knew but needed a review so it was good to go over this condition in detail.

After, I went home supposedly to do work but that didn’t happen. Stopped off at the new Aldi on the way home (I am re-converted) and joined in for a peer teaching course. They started running this course last year at Warwick and it’s designed to make us better peer teachers which is something I want to upskill on and I know it will make me look better when it comes to Medical Education Fellow jobs (something I know I want to do when I leave Medical School). It was really enjoyable however, I started to bang my head against the wall. Why does no one talk in teams?! It makes the session go on for longer and makes it painful to watch.

I then went straight from that to sort of getting some work done that evening but I am struggling so much with getting work done at home. I am tired most of the time and I think I have worn out my study space. I need to mix things up when I have the time but I never seem to find this time.

Tuesday

Today we decided to get some clinic time in Gastro. The car park was a nightmare so I sent K in early to get into the clinic but we were already beat, by some of the consultants own students. It is a bit hard to argue with that. We wandered around and thanks to some lovely HCA’s and Nurses, I managed to get into Foot Clinic.

I had braced myself for a morning of uclers (which wasn’t helping my already feeling ill because of not eating breakfast and sensitive to smells state) but actually turned out to be a really useful and informative morning. I spent the majority of my time with the podiatrist who was answering all my questions, and we got on well.

To my surprise, I actually coped well with the uclers as they were all really well maintained and healthy. That’s my own bias kicking in really. I do feel ashamed for having that initial reaction to the clinic, but I am so glad I did join.

I was shown how to examine uclers, how to care for them, and then unfortunately, what to do when the foot was in danger. I even got to try and do a foot Doppler. I was asked “do you want to do one?” and may have said “Yes” a little too quickly.

i really enjoyed this morning but had to go before the end as I had teaching at 12:30 on frailty. We had a PA who delt a lot with strokes, so I was in my element. Even on her exit she said, well I’m going to see a patient at home now so if anyone wants to come? I replied ” Don’t, because I will follow and come with”.

I don’t know what’s happened recently, I feel like I have suddenly come into my element and this confidence has come out of nowhere.

We then had THE BEST TEACHING in radiology ever. No PowerPoints in sight (+1000 points to Ravenclaw) and a doctor who was funny and told us to PUT DOWN OUR PENS.

They then proceeded to pull out lots of PHYSICAL X-ray graphs and we played spot the diagnosis. I learnt so much and it was so engaging. This is teaching we need, and I took a lot away from just listening to a lecturer who was engaged.

After the lecture I attended a meeting with some staff and students to organize our disability away day. We are finally making progress with the scheme and I am really excited with what the potential this scheme has.

Wednesday

Manage to wiggle our way into a Neuro clinic today of which I was beyond excited about. We got to sit in with one of the Neuro’s from UHCW as they saw patients with movement disorders.

I was so happy to finally be in a clinic of something that normally gets such a bad rep at Medical School. I love Neuro and we do not get ANY time in rotation in it. I’ve had to learn all of medicine these past few weeks on a cardio ward.

We got to see the SLICKEST upper and lower limb neuro exam ever (the reflexes were incredible and that is the exam I aspire to be able to pull off one day). We were also taught the specifics of Parkinson history taking and specific tests we can do to look for Parkinsons in patients.

We also found out our teaching in the afternoon had been moved to 3:30pm as was online! Cue K and I high tailing it home. Well, when I say home. I had some important filming to do first:

Yes, it’s the return of everyone’s favourite YouTube ASMR doc! This time it was the ear exam which is ironic considering I have stuffed up ears and am currently waiting for my next ENT appointment to figure it out. I’m telling you, the concentration I had to pull for the hearing exam was hard as the recurrent infections have affected my hearing.

Thursday

Here we go, not my finest moment. We decided to head to breast clinic in the morning as it was a highly rated clinic, and it lived up to its reputation!

I ended up hanging with the radiographer who in between converting me to radiology, spent the morning teaching me how to read Ultra Sounds, Mammograms and the process of taking a biopsy. It really was a good morning and they were so encouraging of me even when I pointed out something obvious like a “rib”. As they were so lovely, I let the fact they kept calling me Abigail slide…….

Then we had a palliative care comet. I was actually pretty excited about this as I missed my surgical comet thanks to a COVID-19 quarantine. I was in the corridor waiting (it works like an OSCE but gets you to learn on the spot things and has no bearing on your grade) and joking around with everyone. I love the team at Gelliot, and I am gutted to be leaving them next week. However, I got into the second station and fell apart.

We had to talk to a “patient” about their wishes for their last few days to weeks and fill out a RESPECT form with them. It could not have gone any worse than it did. I completely forgot how to structure a conversation, and it threw me when the patient responded with “Call me Mrs Smith please”.

Suddenly I became incapable of getting words out. I froze and lost any capability of making a sound. I was offered to re-start the session but I just completely lost it and came out of the session a bit shaken.

In the next session it was a bit more straight forward, but I was still a bit shaken from the previous session. I was asked the first question, and it all just came tumbling out. I became a blubbery mess, and it wasn’t because I just had to talk to a “dying person”.

The finalists had started their finals this week, and it just hit me how near we are to the end. Next year I will be a doctor and suddenly have responsibilities. Now, not knowing something wasn’t a case of a few marks, but could be potentially lethal. I didn’t feel ready for that. Now, I was so ashamed if I didn’t know something. I’ve been trying to work at night and feeling like I am getting nowhere because of the sheer amount of work. I’m sat here trying to remember things and just can’t retain any material.

Thankfully, I had amazing staff sitting there with me and I tried to pull myself together to carry on the session. It really wasn’t the situation, it was just the straw that broke the camel’s back.

After K and I stopped off at McDonald’s to get milkshakes because we deserved it after all that. I took time to myself that evening. It took me 4 hours to recharge to speak again and in that time I just sat sewing my scrubs getting them just the way I like them, covered in neurons and stars ……

Friday

Academic Day. Nothing huge to report. Sat behind a computer all day. I had tried to go for a swim in the evening but my hip literally allowed me all of 10 minute in the pool. I had to get out and take 45 minutes to get changed plus an extra 30 minutes to do a 10 minute walk home. The takeaway was a ‘I’m feeling sorry for myself” treat ,:D.

One more week to go.

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Care of the Medical Patient – Week Three

Wow , two weeks left of this block. Scary

Monday

Bank holiday

Tuesday

We decided to not attempt the ward round before teaching at 11:30am today. It was the day after a bank holiday, and you just know it was going to be chaos. That did mean however we were roaming the hospital car park for 40 minutes trying to find a space. We were in one car park when I witnessed a doctor scale a grass bank in their 4X4 and park neatly ontop of the bank.

My KA and I were not even going to attempt that.

We eventually got a space and were only 2 minutes late which in medical student speak, is bang on time. We had an hour on palliative care and then had a free afternoon which Klaudio and I were determined to fill.

We ended up in Respiratory clinic as we had not had that much exposure to lung related things thanks to COVID-19 (closest I have been to a Resp ward was on the day we got taken out of placement and were sent away within two minutes). I really enjoyed the clinic and it was good to see other areas of medicine and look at x-rays in clinical context.

The consultant also wrote with a fountain pen which I have not seen being used in forever. I’ve tried to get back to using a fountain pen but alas, has not happened due to having weird handwriting and a lack of patience with them!

I felt good. We ended up leaving at 6pm but you know what, it was a productive afternoon, I learnt a lot, and thats all I can ask for.

Monday was also the debut of my bumblebee scrubs – of which I love to pieces.

Wednesday

Our first day without anything pre-scheduled for a while. We headed up to our other ward Beauxbatons (can you get the theme I am going with here) which we normally steer clear from. However, today was changeover day and we were hoping to get some new F1’s to adopt us.

And we landed a JACKPOT. i walked into the doctor’s office and 70% recognized the FY1 sitting there. She started talking and yep , it was B who I did Revue with !! (It’s hard to confirm identities under masks).

The rest of the doctors began filing in and we knew this ward was now going to be one we could rely on. Klaudio and I joined in on the ward rounds which were super quick as there were various welcome meetings to get to. We had a patient who was scared and worried about dying. The ward round moved on but I couldn’t leave them like that. I grasped their hand and said that it was going to be ok and that they were not going home to die. They smiled and seemed to relax a bit. I believe they had dementia so just that little hand hold meant a lot to them.

After the ward round ended we tried to get some bloods but if veins were opposing magnets to needles, this patient certainly had them. They were more than willing to be a human pin cushion but that isn’t what we want for patients. So the standard two tries later and we left it to the doctors. It was so frustrating as these veins were incredible…

In the afternoon we tried to get into another clinic. This time ENT. I seem to have an affinity to this speciality, but that is purely because of my medical history. I was excited and we hung around for half an hour because we were early, then time for the clinic arrived but no consultant. We checked the notes to make sure there were face to face of which there were but still no consultant.

We waited half an hour before deciding to call it a day. It was frustrating but what can you do. The HCA’s were lovely at updating us but I felt sorry for the patients who were hanging around with the possibility of their appointment being cancelled.

We treated ourselves to ice cream for our patience:

I only have two weeks left to make the most of this ice cream bar ….

Thursday

Wow, it was so hard waking up today. Despite having Monday off, we are both shattered and feel like we have done a whole week already. it was time for our ILS course which is Intermediate Life Saving.

Basically, we had covered a lot of this already, but it was a step-up from just carrying out an A-E approach to MANAGING a crash call.

I really enjoyed this day. I LOVE simulations and it gives me a chance to practise what I have learnt and feel just that little bit of a professional. Thankfully, only one five minute lecture for the whole morning and we were off learning how to manage airways and ventilate an unconscious patient.

We then got to learn how to use the defib, how CPR felt in real life (my arms are still not right typing this out on a sunday) and how difficult a one handed jaw thrust and mask holding is. We also got some free snacks which I am always more than up for.

Klaudio and I had our OSLERS in the afternoon which step up this year. We get assessed based on final level. I wanted to get off on a good foot, but I did keep in the back of my head that I am literally 3 weeks into the so called “learn management” year so not to hate myself if it goes badly.

I got a patient with a good history, but I was hit with the classic chatty patient. My history was 15 minutes long which was frustrating. It’s just a skill I really need to hone down. As much as I am interested in the patient, I just need the information I need out of them before I find out what their great uncles on their dads side employment was….

It was an unusual presentation. Though arrhythmias are meant to be our bread and butter by now, this particular one I had not seen before in a clinical context. It was hard coming up with the management and I defiantly stumbled my way through this.

I think I did ok. Results are still to come in, and they don’t matter with regard to the degree but the Type A personality of mine want’s to do well, naturally.

Friday

End of the week at last. I think Klaudio and I only managed to drag ourselves out of bed due to it being the end of the week and we are going back to Hogwarts ward.

We got told a consultant who loves to grill us would be there today so we were a tad nervous but it ended up being our favourite consultant AND a doctor we had already worked with on another ward. So shaping up to be a good morning !

We have also discovered that although we cant get onto the PC’s (because even though we have logins, we get get onto the system) we have access to the printer. We took FULL advantage of this and photocopied the ward notes (IE – handover sheets) so we could follow along on the ward round but of course made sure to dispose of them before we left.

The ward round was brilliant. The male bay ended up being the weirdest round as all the patients were up in their chairs having a good old chat between them with some even moving around to chat perched on the end of beds. There were some BRILLIANT murmurs including the classic one you expect to hear on wards and some sweet patients.

I was helping a lovely patient put her socks on after the consultant took them off and she asked if I was a doctor or a nurse. I was shocked. No one had ever asked that before. They just assume I am a nurse and call me so. I giggled and said I was TRAINING to be a doctor. She said ” oh that’s nice, I never know what to call you lot”. I said orange badges mean students and how nurses have uniforms etc but said I was really grateful for her asking.

I don’t mind being called a nurse. They do such amazing work and I admire the way they can handle all bodily fluids. I am a whimp and even the sight of flem sends me retching. I suppose it’s just annoying but not too much of a fuss with patients. They are ill afterall.

I made sure her toes were cosy and carried on with the ward round. The team were so lovely and we felt so included and were sharing the giggles and teaching.

We then ended up in the last bed which was in a side room. The TV was on in the background and we checked on the patient and had a discussion about his care.

However, something was distracting me. On the TV behind the consultant was BBC news. Prince Phillip had pictures being shown in a weird montage that was slow and fady. I remember thinking he was either dead or it was his birthday. I couldn’t see the writing though and the news reporter was only wearing a black jacket and not all in black.

However, it soon went to breaking news, and I was able to read he had died. We all knew it was coming but it’s so sad with him being weeks off 100. This day was getting more packed by the minute.

In the afternoon our amazing consultant spent a good half an hour (probably more) teaching us about Aortic Stenosis and my brain was on fire. This was incredible. However, he did assume we were second years so wasn’t teaching us management. It was a good 15 minutes in before I got an opportunity to correct him. I wish we had different badges or lanyards to denote year groups like other medical schools instead of resulting to my technique:

That afternoon I went to get my second jab at the place where it all started, UHCW !! I was excited to go and turns out the BBC are filming at UH for the new series of Hospital (my favourite programme):

All my sign offs completed !
These bump devices were used to maintain social distancing

And that was the end of a looonnngg week. Im thankful I left my jab till last thing on the Friday as the side effects came out of NOWHERE. I was knocked out for the majority of Saturday sleeping all day bar a couple of hours. My joints ached, I had the headache of a lifetime and was shattered. However, one sleep later and I was good to go.

What a week.

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Care of the Medical Patient Week Two

Monday

Straight of the bat at 9am with a bedside teaching session. These are sessions where we get a doctor (aka someone who knows what they are actually doing) to take us and teach us conditions at the patients bedside. We had a fascinating patient with both a lung and heart problem which baffled us no end. You mean patients can have more than one thing wrong with them?!?

I managed to get my history “just” under time, but it is difficult to get the histories down under time with real patients as everyone wants to chat. In our exams, SIM patients are given a script so know exactly what they need to say and when – hence OSCE’s being timed.

Anyway, this was an interesting patient as it was difficult to nail a diagnosis from the history. You learn pretty early on in medical school that you should have an idea of a diagnosis at the end of the history. Your examinations and investigations serve to rule out other differentials rather than back up your own. However, at the end of this case. I had no idea.

We had a discussion about our case afterwards and it was one of the best teaching sessions I have had, so now Klaudio and I officially have a favourite doctor.

After our session we ended up rushing back home as we had an online lecture for which we thought we had to be on teams for.

Turns out we could have just stayed at the hospital as it was a virtual/ live event. Oh well, more time to work and then an earlier time into bed for me! (Yes, I am an old granny who likes being in bed by 11pm).

In the evening I also released my TikTok parody to Dr Glaucomaflecken which got a lot of views on TikTok, all except from Dr Glaucomaflecken. I will make it my life’s mission to get him to see it (or maybe not because of you know – whole whole becoming a doctor thing).

Tuesday

Online Learning

Wednesday

Full day on the wards to ourselves ! We decided to head to radiology to see some pacemaker insertions as we didn’t get to see our lovely patient get their pacemaker the other day. I had forgotten how heavy lead gowns are and felt as if I had the weight of the world on my shoulders (which – is very representative of a medical degree).

It was a fascinating procedure and the doctor running the procedure again was lovely and talked us through what we were seeing on the x-ray. It did slightly clear things up, but I have to admit – I believe X-rays will be forever a black and white mystery to me.

I was in awe of the technique. A whole life-saving device inserted via a couple of wires. The procedure went on a little longer than expected but wow. Taking our gowns off at the end was a relief, I think I had forgotten just how heavy they were. The doctor came out at the end and sat down with us and took us through what was going on. I even began to understand why the x-ray machine was moved in certain positions and what the reason was for the minor delay.

I don’t know. I’m not sure if it’s because we are third years, but Medicine is starting to feel more serious now, like I am actually studying for the rest of my career, not just an exam.

Heart pacemaker: MedlinePlus Medical Encyclopedia

We ended up grabbing a lunch after and attempted wards. We went to our Hogwarts ward as we knew the doctors better there and we were not disappointed. Our favourite doc was there plus a Warwick Grad FY2!! I swear 1:2 doctors we meet are Warwick grads. Must be something in the water keeping everyone round Coventry.

We ended up chatting to the patient who had their pacemaker fitted the other day and then chatting further about ECG’s and pacemaker affects on ECG’s. We may be getting a bit cocky, but I think Klaudio and I are finally getting used to ECG’s.

Thursday

April Fools Day!!! I had been thinking about how I could get a prank in before 12pm and I DID IT. Managed to convince Klaudio that the beloved Ice Cream bar at Gelliot was closing. Well, I managed to have him fooled for all of 10 minutes but I count that as a win.

We had a case based discussion session which was useful as we talked through taking a history of a patient presenting with a fall ( a lot more to consider than you might think) but it was a bit rushed. There was a miscommunication between Warwick/ Hospital and us so it ended up being more of a mini-cex session than CBD but it’s ok, still got something out of it!

I then went to meet my consultant who was reporting cardiac MRI scans and it blew my mind the sheer detail of the picture. We talked through his timetable and what wards he does and when so I hopefully will have a better idea of planning my week out!

We decided to cut the day short after that as we were both shattered for some reason so went home to do some work in the beautiful sun that we were getting treated to.

and you know what….. I actually did manage to get things done on a week that I had found it difficult to get into the swing of work. Gangrene on a Thursday evening. Mmmh mmh mmmmmmh

#Problemsofamedicalstudent

Im thankful we have masks to cover up the acne that is caused by the masks.

Friday

Good Friday

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Care of the Medical Patient Week 1

Monday

Online Learning (I’ve decided not to describe these as we all know what Teams teaching is like).

Tuesday

Online Learning

Wednesday

AND WE ARE BACK !! Wow, it really has been a while, huh? It honestly felt like second year was never going to end. One and a half years trapped in a year that kinda feels like a stop over between clinical and non-clinical but now, we are full pelt to the finish line.

Technically, I am now a finalist as our Years Three and Four are merged into one year but a shot of … well… horror and terror shoots through me when I say that.

We had a intro to the block and headed straight to Ward Hogwarts where we had been assigned. I was a little hesitant as I was through with the whole hanging round the wards thing hoping for something to do.

Boy was I about to be surprised.

We had a ward round on our tiny little ward which was a tad crowded but I have never had so much teaching on a ward round in my life. The consultant encouraged us to interpret ECG’s for them and I even felt confident to step forward and examine patients during the round. I kept catching eye contact with Klaudio with both of us shocked at this level of teaching.

We had interesting patients including diabetic feet (something amazing with this patient but can’t go too much into detail), COPD, Atrial Flutter and Fribilation (will I ever get my head around the difference between these two, stay tuned to find out). We even chatted to someone who was due to have a pacemaker fitted! Our consultant also seemed to be a lover of bedside echos and spent time orientating us to the image in front of us.

It felt so good. We heard there was going to be a cardioversion in the afternoon so ran off to get lunch and make it back for the procedure.

A cardioversion is shocking a heart which is in A Fib/ A Flutter back into sinus rhythm. It sounds backwards to shock a heart which is not in V.Fib but is actually the gold standard treatment for A fib and A Flutter ! We had to go up to theatres as our patient was a bit risky but wow. It was amazing to see.

They were made a bit drowsy to begin with (well, you would want to be drowsy too if you were going to be shocked) and their heart rate was roughly 150 upwards. One shock administered later and it dropped to 80bpm. That was a drop of 70bpm in less than 10 seconds.

Medicine is amazing.

Thursday

Back in again, but we had teaching in the morning. I love having this amount of teaching. It really does help with guiding what we should be learning. First topic up was Stroke. Except our teacher was not in the room.

I remember back in Primary School we would come up with concepts for the future and one of the suggestions was a virtual teacher, and here I am living the reality.

It felt a bit big brotherish to have a massive face up on the screen with us sat in the room but did end up working well and I enjoyed the rest of the morning !

Unfortunately, having teaching in the morning means the rest of the day is a bit awkward. You miss ward round and bloods so there tends to not be much else to do. Oh, well.

Friday

First Academic Day of Third Year ! Wow, and what a hit of reality this was. The whole first half of the day was taken up with talks about UKFPO (the process of applying to our FY1 jobs) and our various extra exams such as the SJT and PSA.

I think during the morning it was a slap of reality. I can’t believe that I am so close to finishing. I don’t feel like I’ve been here long enough for that to be the case. I remember first year like yesterday and second year was a nightmare I am willing to forget.

I sat there listening to all this information about the application process and the exams just having a crisis. This was all getting too real.

But we survived, and I spent the rest of the afternoon learning about prescription writing in hospitals and wrote my first ever mock prescription:

That felt pretty good.

We also had our first CBL session which meant another new group. We actually have a good mix of interests and personalities so the session was ok! I never thought I would spend 2 hours talking about UTI’s and Nitrofurantoin (Antibiotic for UTI’s).

And that was it. My first full week in my Care of the Medical Patient Speciality Block.

Here we go.