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Care of Surgical Patient Week 1

I’m going to level with you here, I was not expecting much from this block at all. Surgeons and surgery have this expectation attached to them that you are going to be ignored mostly for the block and spend five weeks in the corner staring at people moving their hands around. For once, I am so glad to be so far from being right.

Monday

New block, new me. And this time also a new hospital. Warwick hospital is the one hospital attached to the medical school that I have yet to see. And we were finally here for surgery block. Monday was just a day of inductions but K and I had decided to drive there the week before just to get to know where we need to be heading.

I arrived at the hospital and began to walk from the car park to the medical education centre which involves me walking through the hospital as I didn’t know any other way. Over at George Elliot all they have boxes of masks at each entrance, and it means that all staff and visitors have no excuse for not wearing a mask. So, I had turned up expecting this.

Warwick has decided to not do it this way. Great for budgets, not so great for me. I had to walk through half the hospital with no mask on as I didn’t have one in my pocket. It just so happened it was the busiest I’ve ever seen a hospital corridor, and I’ve got so many dirty looks. Thankfully, I managed to grab one from the canteen halfway up the corridor.

After that dilemma I made it to the medical education building and I had to sneak in behind someone as I didn’t have an ID card for the door yet. You can see how this morning is going.

Anyway we get there, and I managed to find a room and I set myself up for the day. Our first lecture was virtual, and it was just getting to know the clinical education fellow he was going to look after us for the five weeks of a surgical block. It was very weird all being on a virtual lecture, but all sat in the same room.

Thankfully, our second lecture was a face-to-face, and we had a formal induction to surgery at Warwick hospital. I know my blog is looked at and read by a good few number of people, but I never expected to get recognized. So, I was a bit lost for words when we had to introduce ourselves and the person running the session said ” no need Abbie I know you’re off Twitter”.

I do this weird thing in my brain where I forget that people on Twitter also real in real life, and it always takes me back when someone mentions what I’ve done on Twitter in reality. It was a laugh though, and I guess it’s just made me remember that real humans read my tweets.

We didn’t have too much information given to us before we arrived at Warwick, so on this day I was just a Fountain of questions and wanting to know everything about surgical block before we got started. I have to say this hospital was amazing and I got every single question answered.

We had a tour of the wards that we would be going on, and we got told exactly what time we should be there every morning, where the changing rooms were, where the best places were to get a free cup of tea or coffee, and what areas were green and amber which is a unique addition to life in Covid land.

I’d start the day with 25% hope this block, I left with 95%.

That day we also got retested for our Covid masks as I didn’t particularly trust the one that I was tested for at a previous hospital. We got to use the less scientific version at Warwick which basically involves you tasting a spray that they spray into a hazmat suit type headgear, and you do some weird movements just to see if the mask lets any of the particles in.

Going home that day felt weird. K now owns a car so we no longer travel in together as where we live it doesn’t make sense for us to drive to each other’s houses. So I got in the car, and normally we have a bit of an informal debrief at the end of the day joking and discussing what we have seen.

I know I didn’t have that and I was very aware of the empty seat next to me. Honestly, it feels like he has died 😀 . It does mean however, I can blast my musical songs out loud and have no judgement put upon me.

Tuesday

Slightly earlier start today with it being 8:30 rather than 9 o’clock. I still haven’t managed to figure out the new timings from my house to Warwick hospital so inevitably I was running late.

We had wound care teaching which was basically going over how we would assess and re-dress a wound. I am a total popaholic and nothing is more satisfying than seeing a big wound be absolutely drained of all the puss that’s in it.

We also were taught how to do flu swabs which is very current with the bug that’s flying around. It was a long morning as most of it was just being talked at, but at the end we had to demonstrate that we knew what we were doing and we were all passed with flying colours.

Everyone else decided to go home after that, but I found that I haven’t been working as well in my flat then I should be, so I decided to stay on at Warwick and go and work in the rain that we had been given for lunch.

This also meant that I was going to stay for the virtual lecture that we had in the afternoon about stomas and polyps. Which was both a mistake and the best thing I’ve ever done. I was expecting to be sat on teams watching someone talk us through a camera, can imagine my shock when the surgeon who was teaching us walks in the room that we had been assigned and there’s only me there.

However, the surgeon was the surgeon that I’d been assigned to, and it was actually one of the best teaching sessions I have ever sat in. Sort of intimidating when no one answers the question online, so you feel obliged to, but we struggle on.

This was also the day when I realized Warwick surgeons are amazing. My assigned consultant brought up the fact he would sort bedside teaching and OSLERS with K tomorrow, without me having to bring it up. I think I nearly fell over, I’m so used to chasing people up for WEEKS. I still have a ticket from year 2 unsigned.

He also had a Harry Potter lunch box, 100 points to Gryffindor.

Wednesday

My first day of clarking. i have never clarked a patient before despite being in third year. This was something I was more than keen to change. I was assigned to the sorting hat ward for the day and, yes, I was a changed Medical student after.

I will never forget my first patient. I was nervous, stuffed up my ECG and couldn’t find a vein. But it was OK, I had not done an ECG in MONTHS and had completely forgotten where the pads go. However, I loved chatting with the patient, finding out what was wrong and escalating to the reg. It felt like all the studying and ridiculous amounts of work were paying off.

One of my patients was admitted and was unfortunately given a heavy diagnosis, but I had gotten on well with them on the ward and I knew it was going to be nice to follow up this patient through his journey at the hospital.

I was exhausted by the end of the day but so happy. Finally, being able to interact with patients and chat to them and do what I have been trained to do. That is what the pandemic took away from us and still takes away from us today.

Thursday

That morning I joined the post take ward round which started at 8am (ouch). This would give me the chance to A) find out what a post take ward round was and B) see the progress of the patients I clarked yesterday.

I was amazed at the progress of one of my patients. It is amazing what a simple bag (or a couple of bags) of fluid can do! They were severely dehydrated when they came in so seeing their progress was incredible.

I also helped the F1 out by managing the notes, so they were not juggling millions of files. It’s not much but kept me going whilst we saw the million and one other patients I had never met before.

In the afternoon, we had our simulation session. I love simulation as it gets us to practise as if we were independent FY1’s instead of med students shuffling round the back of the ward round. It was also a session to catch up with each other as our weeks are so busy now, I don’t even get to see K.

That’s another thing the pandemic has taken away. The chance to see others and catch up. There are some of my friends that I haven’t seen in over a year.

We ran several simulations of surgical emergencies that come into A&E. I volunteered to lead one which resulted in a diagnosis of acute gallstone pancreatitis. I really enjoyed it but I learnt that I need to slow down. Too easily I slip into recalling my notes and not taking head of the situation and asking for help, simply because, I forget I can ask for help.

That evening I was also struggling with a chronic hip problem. So, I had hobbled back to the car and by some miracle managed to get an appointment the next day.

Friday

In early again for endoscopy this time! I was intrigued as it’s something we are told about all the time but never see. I was with my consultant again so I knew it would be a productive morning. I got to see a vast array of different signs and this is going to sound really weird, but the inside of the ileum (the last part of the small intestine), is beautiful.

Jejuno and Ileum Normal -The Gastrointestinal Atlas -  gastrointestinalatlas.com
This is an image from Google but shows the villi which look like sea anenomy.

The teaching I got was incredible as well. I am not sure what it is about third year but suddenly, I feel like I have a place on the ward and people like having us there. They want to teach us and get involved. This is what I am here for.

I had to get big scrubs to cover my hip brace, so I ended up having to yank the trousers up every two minutes.

Saturday

Yes, I am slightly questioning why I am up for an 8am handover on a Saturday but we were scheduled to follow the SHO for the on call. This is essentially where any department can bleep the SHO (mainly ends up being A&E) for a surgical review and the SHO can decide if they need to be admitted or reviewed by a senior clinician or discharged.

I was also getting used to my new additions. I was given some crutches by the physio as the pain from the hip is ridiculous, but these were getting very annoying very quickly. They hurt my hand and basically signalled I was going to be a slight inconvenience. However, I need them. Hopefully, I can just rest my leg for the week and might not need the assistance in a weeks time.

Around mid-day I lost my SHO and wandered back to the ward and ended up finishing the ward round. It sort of came to an anticlimactic end, and I was left hovering round the ward not sure what to do. However, I got wind of a cholecystectomy happening in the afternoon and decided to hang around for that.

I went down to the amber theatres and waited. Turns out it was not going to be happening for at least the next three hours so I thought I would sneak in and watch a nail being inserted into the bone whilst I waited. The team were all really lovely making sure I was catered for with my leg and I was having a good old chat with the rep for the system they were using getting to know all the instruments and what they were there for.

I was also having a good old giggle with myself as being an orthopaedic surgery, they had literal drills to get the screws in. Something I am normally used to seeing in my dads tool kit.

Finally, at 6pm the time came for the operation I had hung around to see. Except this time it was an appendectomy rather than the cholecystectomy. I was so glad I waited. This appendix needed out and was nearly falling apart as they handled it. I was also having a discussion with the anaesthetist about the agents they used and what each drug does. We don’t get a huge amount of teaching with peri-op so I wanted to make sure I had a good idea about what was going on.

Happy, I had finally wiggled my into theatres.

I eventually escaped at 8pm promptly ordering a pizza on my way home. Well, I did go in on a Saturday after all!

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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.

Posted in Blog, Medical, Medical School, Medical Student, medicine, Uncategorized

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.

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Surgery Block – Week 3

Monday

AAANNDD I am back. More awake than ever and ready to re-attack this block. I went to OPD and really enjoyed the morning. I needed that break to re-find why I was so enthusiastic about my degree. It was a quiet week but that was ok as it meant I could work my way back into clinical life slowly.

Kaludio and I decided to attend clinics in the morning and even sitting back in the room felt better. I was ready to get back to it and actually really enjoyed the morning. We left at mid-day as clinics can be draining so I decided to do some work in the evening.

I also had a JASME event where we talked about wellbeing, and it was really beneficial. There was also a staff member from KCL there which is where I hope to apply for my Academic Foundation Programme ! I hope I gave some sort of a good impression 😀

#squadgoals

It was a beneficial chat sharing experiences about keeping sane in this digital world. We are really starting to feel it here. I love the four people I see every day to bits but you do miss having catch ups on academic days with people you just bump into in the corridor. I just really miss normalilty.

The rest of the week was a quiet week. I had a shift on Sunday which will become important next week ….

Ok, Ima just going to tell you now. On the Tuesday, I had gone to work, gone to Leamington to the opticians and drove back to campus. As I got out of my car and walked into the flat I had an email come through:

Gutted ……

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Surgery Block – Week 1

Monday

I was pretty excited for this block. As someone who has considered surgery forever, but still shaky on the idea, I wanted to use this block as an opportunity to see if it was right for me.

We started with a day of workshops. However, within 10 minutes the guy running the workshops has stated – This is going to be a full on day – Cue my brain immediately disengaging.

However, one thing did get me through… Wagga Mummas. We decided as a car to go and treat ourselves as a pat on the pack for getting through Medicine block, we were halfway to Christmas – nothing could stop us now.

Tuesday

Early start but we didn’t mind. Apparently the hand over at 8am is the best way to know what is going on for the day so we dragged ourselves in. The surgical team were lovely and invited us to go on the rounds with them but in the end Kaludio and I decided it was best to leave. There were upwards of 10 doctors on this round and 4 other medical students. We would try again another day.

However, we were scheduled to go down to our new ward which happened to be the latest addition to GEH. The Sir Tom Moore Ward !!

It was an elective operation ward mainly sorting hips and knees. We were gutted however as the doctor who had been recommended to me as being great for teaching said he couldn’t have us in theatre as he had been moved to the smallest theatre known to man and there wasn’t enough room.

It was fine though, got to do some bloods and cannulas and decided to go and see if we could get in surgery after lunch.

We managed to get into day clinic which was just urology that afternoon. I somehow managed to select XL scrubs meaning I spend the afternoon yanking the scrub top down my back to remain decent :

Budget Smurf Right Here

I wanted to enjoy it. I really did. I don’t know if it was because I was tired (I didn’t exactly make my “week off” a break) but the surgeon spoke to my male colleague more than me and by the time we were three hours in I was done.

I even tested to see if it was just because my CP was more in the line of sight but even when he was sat to the immediate right and myself to the front. It still happened.

I went home feeling like rubbish. I can’t help being born the sex I was, but I am enthusiastic and genuinely considering surgery as a career. I am more than a baby making machine and it is sad in todays NHS that these stereotypes still exist. oh well.

Wednesday

Outpatients department. Stress in the morning as there was not a single car parking space to be found, but eventually we got one the other side of the hospital.

We were a bit sceptical about today, we hadn’t heard good things about OPD however, we were really suprised. Klaudio and I got into a cardiac clinic. Cardiac is not my strong point but it was so useful to be able to go over basics again and the common conditions. The consultant was lovely, and I was finding I was vastly preferring this way of placement over hanging around on the wards looking sheepish. It was basically 1:1 teaching. Plus although STM ward was great, there was no doctor at the grade we needed to get sign offs. Why we have to be signed off my a ST3+ to do a blood I still don’t know.

Thursday

Wasn’t in until 2:30 today for suturing. I was SO LOOKING FORWARD TO THIS. It was even better than the workshop was run by two female doctors and despite being the only female medical student in the session, it was weirdly empowering.

I really enjoyed learning this skill properly. Holding the tweezers like a pencil will take some getting used to but I really enjoy suturing. It’s almost peaceful ! However, it was also ridiculously painful as for the SECOND time that week I had managed to burn my hand, this time being with steam from roasting veggies so resting the clamps on my fingers was excruciating.

Not perfect, but I am getting there !

Friday

Today was my breaking point. I was sensing something was going on with me all this week. I was snappy, moody and shattered. That isn’t like me.

We had gone to the early meeting again but this time the trust had brought in the new PPE of having a visor as well as a mask. This was a disaster for me. I struggle to hear any way thanks to the damage to my ears from the infections. This was made worse with masks and now there was an additional layer of plastic in front of everyone mouths. I could not hear a thing. I was becoming sensitive to all the noises around me and if I didn’t get out of hospital soon, I would not be fit enough to drive.

That weekend I was signed off by my GP for chronic stress. I needed to up my medication changes, and it was not safe for me to drive whilst I ws getting used to the new dosage. It was my own fault to be honest. I had signed myself up to too much during our week off, and now I was paying the price. However, I didn’t want to be off the full two weeks. I only missed ODP once and the two ward times which I was not too fussed about because I was starting to get annoyed with the whole turn up and hope for something to do approach to things.

It was good to stop though. I didn’t let myself touch my work and I spent the days cleaning the flat and watching rubbish TV. After two days I felt the old me coming back and I knew I was going to be ok to go in from the next week. Sometimes, you just have to stop before you break.

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Medicine Block – Week 9

Final week next week. It’s been a haul, but we are also presently surprised how quick it has gone. My diary is absolutely chocca this week. Not just with presentation list but the new first years start this week too. I do feel sorry for them, Covid has taken away their first year from them and they are doing everything from home bar one day a week for anatomy and clinical skills. However, at least first year is just 95% lectures so they haven’t lost out on too much.

This week we also have the non-international students arriving to campus meaning that my block will be full of freshers once again ……. gulp.

Monday

Went to the hospital today to try and get some experience on the wards. It’s difficult though when the consultants and doctors are running around trying to get things done and you can’t even log on to the IT systems to be helpful.

At 11am I scooted off to an empty lecture theatre and was honoured enough to be asked to speak to the first years on their first day! My talk was apparently titled “Succeeding in Medicine” which I was slightly confused about as I had scraped a past and had at least three breakdowns in the run up to exams but we persist 😀

It was important to me that I made sure the Freshers didn’t make the same mistakes as I did. Academic tips are cool but useless if you are too burnt out enough to use them. I was really touched to be given this opportunity. I feel like I am a mess of a human most of the time so by having that offer, it picked me back up off the ground !

Thursday/ Friday

These blogs are so hard to write day by day, so I think I’ll just start having to skip days when nothing happens. On Thursday I actually got to meet some of the first years, they were allowed one day in to meet their CBL groups and I guess, see the building that’s meant to be their home.

It was bizzare. I remember my first day like yesterday, and now I was in my third year of education here giving advice from the other side. I think I may have pushed student seminars just that little too hard though.

On the Friday I managed to score something I have been wanting for a year now – a sacred WMS water bottle !

We got a map of walks when we joined so to see the first years with bottles did make a few eyes go green.

One of my lecturers commented on my tweet saying he had plans to steal one for me anyway and instantly earning the empty spot of favourite lecturer since Jamie left last year.

We decided to take the final week of the block off. We had completed everything we needed to do, and we desperately needed a week away. We did go in for our final GP session and treated ourselves to cake from the bakery near it – only to have three bites and have the biggest sugar crash about an hour later:

We also had our FIT testing for our masks for surgery block as we will be using these in theatres. Unfortunately it was 7:30am all the way in Nuneaton – dragging myself out of bed was hard, but we got rewarded in watching each other look ridiculous for 10 minutes each.

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Medicine Week 8

Slightly stressful start to the week. Over the weekend my tablet decided to delete all the notes I had made since the beginning of August. I was devastated and just had a good cry on the Sunday night before coming up with a plan of attack. I had to get nearly 4 weeks worth of work done in one. Luckily a huge bulk of time is taken up with just finding the material so at least I didn’t have to do that again.

Monday

Drove everyone into hospital today and went and hid myself in the library. I like the gelliot library. Small and useful. I did feel odd sitting in my scrubs, but they were comfy and that is all I needed. Actually managed to get a fair amount completed. I was hand writing my notes as I didn’t trust technology, so my hand was cramping but at least I could be sure nothing was going to be deleted.

Scale of 1-10. How panicked did I look?

I also had my monthly meeting with the GOSH ambassadors. We were talking about the projects we would like to do, and I suggested hoodies which I really really want. It was odd having a meeting hunched up in the corner of a room near a plug socket. However, we muddled through, and we eventually left, so I could get back and enjoy my last full week of very few freshers on campus. We already had some early arrivers, so they could quarantine in time for freshers week to start – not that they could do anything though !

Tuesday

It was my turn for the fabled ODP morning, despite the fact we normally went to OPD anyway. It is a source on agg as we normally just get turned away from this as the receptionists don’t know where our appointments are. However, being a driver, I put my foot down. I wasn’t wasting petrol. I marched to the education office and kinda set it out. It’s not fair on us to be wasting petrol, especially when our hospital is the furthers from WMS. I eventually got put into my clinic, turns out it had been running every week, but it was the receptionists who had the wrong information. It was a productive morning, but I was happy for the clinic to end as it was freezing in the room (as windows have to be open for COVID-19 ventilation) and I was still agging out about my huge to do list.

Wednesday

Off to GP land again, this week we had to get our audits done. They are essentially checks to make sure the surgery is performing to NICE guidelines, and it’s something we have to do with Warwick that basically was a pain in the behind to get done. I hate doing things I don’t quite know how to do but thankfully one of the GP’s from the partner surgery came to our rescue. There’s a RCGP website that basically takes you through every step and even does some of the maths for you! Work Smart – Not hard 😉

Thankfully I got most of the data I needed so I can easily write this up at home. The GP was busy getting appointments done so we were released early – que jumping in the car to go home and get – you guessed it – more work done.

Thursday

First shift of my new job today! I can’t tell you how happy I am to finally have an income ! I am not allowed to say too much about my job, but I am happy to be helping on the Covid-19 front. Even if it is in a small way. I really do love this job as if we are quiet, I can get on with work and there is technically no set work hours so I can do as much or as little as I liked.

Managed to turn up early and have time to drink my free Prett coffee in the sun.

I worked for the morning and then went back to the flat to try and get the list finished. I promised myself papa johns if I finish the list at the end of the week and I can almost taste the Pizza! I also had some marking to do for JASME which is an organization I have recently joined the committee of and I am loving every second. One of my twitter friends is also on the panel who I had no clue about until I had secured the role! Feels weird to be marking the essays of a national competition.

Friday

My favourite day of the month – BURSARY DAY! I also had a self-made deadline of getting a poster finished for a competition I had entered (guess who didn’t get their poster done). I like having these scheduled days off, they are so needed to allow us to catch up on everything as this is really starting to feel like a self-taught degree.

I also am enjoying getting to go swimming more as I am trying to loose weight and make my clothes fit more comfortable and it’s doing wonders for my sleep!

Saturday

Rapid typing to get this poster done. I hated this project but I wanted to get it sorted and out there so I had something to show for it. I also clearly can not condense infomation as this was my poster after about 4 hours of fiddling around:

Oh well – maybe next time 😀