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Acute Block – Week Three

Monday

Another day of online teaching today – still thoroughly melting. I was super grateful that I could sit in front of the fan all day rather than in a hospital melting in my scrubs.

I also treated myself to a hammock so I could fully enjoy the sun, whilst not breaking my back or being away from the life line of WIFI.

Pure Bliss

Tuesday

Had my OSLER today, which is one of the sign-offs we had to do per block. I knew it was going to be in ED, which means I could potentially have any sort of presentation. Thankfully, I got chest pain, which was something familiar.

I had a patient around my age, so it was nice to be able to chat and relate to something, which makes the awkward pause around examination a lot easier. The doctor examining me was also nice and chilled out (which I am finding a lot of in A&E) so we had a good conversation about chest pain differentials which is something I need to brush up on.

And that was it. Another day over and all my sign-offs complete three weeks early.

Wednesday

Back in the hospital for ITU shift today. I was looking forward to this, as it’s not a part of the hospital you tend to find medical students. I was a bit nervous as I didn’t want to catch Covid when I still have 2.5 weeks of the block left to go, but it was actually an important day I won’t forget.

I got to see a range of procedures, arterial lines, bronchoscopy, ultrasound guided arterial lines, CPAP, neuro conditions. I was in awe at just the range of patients in there. We were also taken straight into the team by a junior doc who obviously felt a bit sorry for us.

I really got a lot out of this day.

Thursday

SPOLIER FOR WARWICK MED STUDENTS – SKIP THIS DAY

We had simulation at UHCW today, which was BRILLANT. We were put through several scenarios of a patient deteriorating in various areas of the hospital. I love simulation. I learn best by doing and simulation lets us have a whole day of doing.

The best part about this day was the last scenario. We all got one sense taken away from us, sight, sound, touch, speech and movement. I had movement so was sat down on a chair not able to see any of the obs or anything of the patient.

Of course it was utter chaos and by the end I was on the floor with laughter but did teach us a lot about managing a deteriorating patient. Some times we are going to be trapped by bodies unable to move, sometimes it’s going to be loud when we can’t hear. I really did get a lot out of this day and having lunch in the new staff garden at UHCW just made it even better.

Friday

I had the day off on friday…prepping for

Saturday

My nightshift as a medical student. We were scheduled to go on a nightshift at the smaller hospital (I guess it’s quiter so they would have more time to supervise us). We showed up for the 8pm handover (despite me getting no sleep in my nap before) and got seperated into A&E and ward work. I headed over to A&E for our first patient who was covid positive. It was a bit scary to see someone with covid as bad as they were. Two negative lateral flow tests lie by their side which I tried to ignore.

I left the reg to deal with that patient as there was nothing much I could do and went to wander round A&E in the hopes of someone else adopting me. I found the reg in the room I was waiting in (by some wormhole affect I am assuming) and I agreed to wait by the phone for ITU to call back. Big mistake.

ITU called and I ended up giving a very garbelled message with no clue about patient details or specific needs. I apoligised but thankfully it was a good human at the end of the phone.

I waited around for a while, took a history off someone and then my reg came back. We went to see two patients on the wards (one of whom had a sudden drop in GCS) so learning about all the causes and investigations was interesting.

It was nearing 2am when I was reunitied with K and we were sent off to see a patient who had just been admitted with hypercalcaemia to take a history and examine them before the doctors arrived.

The patient was lovely but when they opened their history with “well in 2009…”my heart sank. I could feel my eyes becoming heavy and it requires a lot of patience to work with patients who can’t narrow down histories. K took over half way and I ran to get their notes as they claimed to not have any other health conditions. Of course, they had a list of co-morbidities but it doesn’t matter too much to us. As long as we get them one way or the other.

The patient had a urine sample so I ran to go and give that a dip and we didn’t see anything untoward on the strip. It was 3:30am by the time we finished. Thankfully, the docs let us go then. We are normally only expected to turn up till 12/1am but we decided to go as long as we could before we became zombies. So we wandered out of A&E at 4am ready to collapse back into bed.

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