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Acute Block- Week Two

Monday

I wish I could write a little less of “online teaching” again, but I am afraid that is all I did have this morning!

This time we were going acid-base, which I believe will never ever stick in my brain. It looks at how effectively your lungs and kidneys are doing at removing waste from your blood and how effectively your lungs are ventilating the body. Did you know that your kidneys technically get rid of CO2 too?

In the afternoon, I had the shift I had been craving for on the Friday previous. MDU essentially has become our hospital’s secondary A&E. So, when we turned up, we got to clerk patients, do their tests and come up with our own management programmes, closely watched of course. It’s also prime time to get some sign-offs done, as we have access to staff who are Reg level and above (yet another of Warwick’s quirks).

We saw a DVT which turned out just to be some tendinopathy…… classic. However, it did get me a CBD and a Mini-cex signed off 😀

K and I split from there and did our own patients. I stayed near the assessment area, so I could get some more clinical skills done such as ECG’s, bloods, VBG’s, cannulas. I was having a productive day. A cannula in first time and a background noise free ECG.

However, I needed to do some more practise on clerking, so I went back to seeing patients and taking their histories, which lead me to the best doctor who I could have met. A Neurologist! I geeked out slightly, and we chatted about training as a Neurologist and I found out their wife was a space doctor.

Geeked out.

One of our patients needed some fundoscopy doing, which is a skill I hadn’t yet used an awful amount. There’s also the problem that I can’t see with one of my eyes, so I can only do half of an exam. However, I did the half that I could do AND I SAW THE BACK OF THE EYEEEEEEEEEE.

I have never felt so proud in all my life.

The last case we saw was a case of how, as doctors, we need to balance the medicine with social prescribing. We had a patient who had been discharge but had come back into the department due to an incident in the car park.

It was a demonstration about how it’s important to work with family, patient and everyone involved in the car of a patient to ensure they are cared for the best way possible. I saw the family out as it was my own time to leave (I need to leave on time as I’ll burn out) and saw them off.

It was a nice moment, even if they said how much of a lovely nurse I was…..

You can’t win every battle!

Tuesday

We just had one online session on ethics today. In the ED, ethics really does come into play, especially when you have unknown patients who require life changing treatment but can’t advocate for themselves. I am interested in ethics surrounding these critical decisions, so it was good to chat through cases like these.

Wednesday

Hauled myself into A&E today. I was situated in majors and was hoping to get to see some patients by myself, but this was more of a shadowing opportunity. It didn’t matter too much through, as I got to see a good variety of patients. A broken humerus, some impressive lacerations and a case of …. gastritis.

However, despite wanting to scream that people should be at the GP’s/ Pharmacy/ 111 to get advice, my doctor who I was shadowing gave me one bit of advice:

To us the body is like a book, we can read it, sort of understand it and figure out what is wrong. For our patients, the body is like a book written in a completely different language, a small twinge could be anything from a sore muscle to cancer. It’s part of our job to translate the book and explain there’s nothing to be worried about.

My last patient was one who would forever stick with me. i saw a patient who had been through something that was of highlighted importance around the football games with the European cup. It felt weird to be examining someone who was of the same gender as me, who had gone through something I couldn’t imagine. I know I am not meant to do this, but I gave them a huge hug at the end of the consultation.

I went away from the department that morning feeling reflective. I had seen all spectrum of patients, and I found myself wondering what would happen to them. I really did enjoy that morning, all different patients, all different conditions. The only downside is you don’t get to know your patients but no ward rounds 😀

Thursday

The tiredness is really starting to creep in now. We are at the end of week 17 of a 20-week block in which I have been in everyday bar a couple. I am shattered. My alarm went of at 7, so I could get up and go to AMU. I hit the snooze button and went back to sleep. I woke up at 3pm. 3PM?!?

I felt a bit disgusted with myself, but happy I did have that sleep. I obviously needed it, but I felt so bad to have missed a day of placement. I got up and did some light work that needed doing, and collapsed back into bed after taking an anti-histamine tablet to get me to sleep. Guess I am learning the FY1 way of managing sleep already.

Friday

Just an online academic day this time! Thankfully, a weekend of record heatwave awaited. I decided to do as much of the academic day that I could do outside. I wanted to get a bit of a tan and enjoy the rare sunshine we got in the uk! This also involved some inventive ways of keeping my laptop cool:

That weekend, I had my family come up for a visit. I am grateful to live close that they can visit without me having to haul everything back down to Kent either suffering a train ride or the M25. I also appreciated the dogo time.

I feel my grandad and my dog have some unspoken bond…..

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