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Care of the Surgical Patient – Week 5

The final week! Woah this block has gone by so quickly….

Monday

This week was always going to be a quiet week for me, so it’s not a surprise my first session was online breast teaching. I had gone through this a lot before, so there wasn’t too much new material. This meant it was a good revision and re-visit of an important topic.

I then had bedside teaching in the afternoon, which was a good opportunity for me to chase up unfinished tickets. These tickets are the bane of our lives here. It’s why I try to get mine signed off on the spot. I still have outstanding ones from SECOND year.

Thankfully, we had the same CEF who was due to sign off a ticket for me, so it was easy to get a reminder to them. We visited a patient who I thought I had seen before, but turns out they were a new admission. I still swear I had seen them before ….

There was also another patient admitted to the ward who I definitely was familiar with as I clarked them in my first week of surgery. I got to have a catch-up with them, and we had a good old chat. I love it when patients remember you and you remember them. As Med students, we move around so fast that we rarely get to follow patients up and see them through. i hope they are ok now 🙂

Tuesday

My final day in surgery. I got myself in early as I was going to have to get in early anyway, so I might as well spend the whole day in surgery. I tried to scrub in, but the surgeons said it would be very unlikely.

So, I decided to hang around with the anaesthetics team and I got to do my first intubation, which was amazing and significantly easier than doing it on a dummy. I felt great, I had wanted to do one for ages, and it just made my day and distracted me from only scrubbing in once out of the 15 weeks of surgery block I have had.

I did get to see a gallbladder removal, which was pretty cool, as it’s the only “basic” procedure I had not yet seen. I got to see the bladder after, and they are not kidding when they say bile is green. I almost could not believe that had been in a human only moments earlier.

I also got to feel cancer of the bowel. You can easily forget just how different to normal tissue, cancer can be. I got to feel it, and it became obvious as to why people present with large bowel obstruction with these types of cancers.

It was a long day, and I was in a lot of pain by the time I had left. I was thankful to the scrub nurse who was also trying her best to get the surgeon to allow me to scrub in, but alas it wasn’t to be. I didn’t necessarily need to help, but it would have been nice to be closer to the action to see.

Wednesday

Day off today! Well, sorta. I had arranged with Dr Gill to film again. However, I enjoy this, and it actually gives me a chance to go over examinations I haven’t done since I was in first year.

It’s nice to have a chat with someone who’s managed to get through the other side of Warwick. I also seem to have been adopted by the ASMR fan club. Which is kinda nice to be honest.

Thursday

Final day of the block ! Well, at least in my head. I headed in at 8:45 am (ended up being 8:30am because I can’t get to anywhere on time for the life of me). I ended up chatting to the nurses when my consultant rocked up behind me and told me off for being early. That’s a new one.

We headed over to the ward where we were going to do my OSLER. I had a patient who was nice, easy to get infomation out of…

but.would.not.stop.talking.

I was being timed, so I had only got 1/2 through the history when time was up. I need to practise being able to interrupt more, but in a polite way. Sometimes, I just don’t need to know your great great uncle had constipation (not a real example).

The same went for the examination, I just need to be a lot quicker about these things.

I did, however, get the diagnosis right…ish. Completely forgot about appendicitis and stumbled my way through the questions at the end.

Not my proudest performance, but I am glad I got through. My consultant gave some really useful feedback, and although I definitely need to improve. I feel like I am on the right track. I also managed to get my block sign off done there and then so once that signature was down. That’s surgery block completed.

I had also bought a tens machine over the evening, so I was also walking without crutches for the first time in a while, which felt AMAZING.

As you can tell, it was a good day.

In the afternoon we had our final SIM session but I was having to multi-task at the same time as we had our disability away day.

I am part of the disability network crew here, which has been newly set up to help students who have disabilities get through the course. I had in charge of everything to do with neurodiversity (unsurprisingly) and during the away day (basically, a blanked out section in staff’s timetables, so they can attend training etc) I did a talk on transitions.

Med school is hard for someone like me who craves routine or at least a decent plan. However, sometimes, it just isn’t going to be possible to do that, especially in the world of healthcare where day to day activities can be impossible to predict.

I want to try and help as much as I can to make things easier, and I spoke about how much the change from phase one to phase two clinical learning burnt me out and how, come December, I didn’t want to come back to Warwick (spoiler alert: I did).

I introduced my concept of a mentoring scheme to the staff which went down well (and nearly 7 weeks later I still haven’t emailed them about it) and overall it was a really positive day.

We finished up the SIM session whilst the disability away day was still going on, and I listened to the rest of it whilst I was driving home. Yes, home home.

I got stalked doing academic day at home