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A Much Needed Update: Placements and Snow Days

It’s been way too long since I last posted- placement and OSCE prep took up most of my time, then I came home for the Easter break and catching up on sleep became my main priority.

Anyway, how did the rest of placement go?

My week with oncology was more emotionally draining than I thought it would be- lowest point was actually getting teary in a very long breast cancer clinic, because a lot of the women had just been recently diagnosed. So their worry for not only themselves, but how it would impact their spouses and children really got to me. It was such a mum reaction that reminded me so much of my own mother, that I called her straight after the clinic to tell her to please check her breasts regularly for changes. Breast cancer really ain’t no joke.

As part of oncology, I also got to spend time with palliative care teams, which again was pretty sad, but I learnt a lot from the team about the importance of sensitivity when it comes to DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) conversations, as well as how the goal of care is make sure patients are as comfortable as possible when it comes to end of life.

The remaining three weeks of placement were spent back in psychiatry with the mental health liaison team, and going back to suicide risk assessments was very tough. The most difficult patients I spoke to were the teenagers with eating disorders, who had been brought in to hospital for feeding because they had refused to eat. It really broke my heart to hear the stories of how their issues with food began; kids can be so so mean to each other, and what the patients had gone through with their peers was just awful.

I was also really surprised by how easily the patients had accessed pro-anorexia websites and Instagram pages, as some of them mentioned how they had been encouraged by strangers online to skip meals and stop eating. So scary! The patients I spoke to were eventually referred to specialist centres for their eating disorders, as they had continued to refuse food in the hospital, so there was nothing further that could be done for them. So sad 😦

The only slightly positive thing I took from my brief time in child and adolescent psychiatry was that I definitely want to work with children and young people in the future – to be able to make even the slightest difference in the lives of such patients would be quite something.

The rest of my time in psych pretty much blurred into one, to be honest. I saw schizophrenic patients, patients admitted after overdoses, and a lot of patients with depression. I know now that psychiatry definitely isn’t for me, because I really struggled with how draining it is, and I have so much respect for health care professionals involved with mental health, as their strength and resilience is inspiring.

On a lighter note, we had not one, not two, but THREE snow days due to the ‘Beast From The East,’ so placement was cancelled for those days, yay! Unfortunately, due to still recovering from my achilles rupture, I had to stay indoors to avoid slipping on the ice, but my housemates were super cute and built a snowman with me so that I wouldn’t feel too left out:

(Yes, they’re quite pathetic looking snowmen but I’d never made one before so humour me please).

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Module 11 Placement: Week 1 (Psychiatry)

“Suicide is not about wanting to die, it’s about not wanting to live.”

Psychiatry is tough. Very sad and very intense- on arrival on my first day at the hospital with Mental Health Liaison, I didn’t even get a chance to take my coat off before we were told that we had to go do a suicide risk assessment on a patient that had been referred to the team. Yikes.

We’ve only practised on actors, so to be told to do a proper assessment on an actual patient was quite the challenge. I’m  not going to say it went okay, because confirming for yourself that yes, someone does want to kill themselves is never okay, but we were direct with our questions, and documented our findings in the notes, so we did it to best of our ability.

The remainder of our first week was pretty much more of the same- get there in the morning, given new patient to go see (usually referred to psych with low mood), assess their mental state, and present findings to the team. By lunch time we would be quite drained, so we were allowed to call it a day by about 2 in the afternoon, so that was good.

This week I saw a patient with schizophrenia for the first time, and what an experience it was. As we were talking to her, she seemed quite distracted and kept looking to the side, and it was only midway through the consultation that it dawned on me that it was the voices she was hearing that were distracting her. So it was really interesting to see how auditory hallucinations actually present in real life.

On a positive note, I’m walking without crutches now! Physiotherapy is tough but it’s going well, and it’s so great to be on two feet again, especially when my lasting memory placement at this hospital last term is the exhaustion from hobbling around the paediatric department… ahh, what a journey it’s been. Thanking God for progress, determined to be able to walk without a limp with time!
(If you, or anyone you know, needs help, has been feeling very low, or just wants someone to talk to, call the Samaritans on 08457 90 90 90 (UK). Please don’t suffer in silence; there are options, you are not alone.)

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Module 10 Placement: Weeks 3 & 4

Paeds OSCE is over, hallelujah!

Overall it wasn’t too bad but as always, I made silly mistakes, so it’s in God’s hands now! The OSCE was at the hospital I did my module 2 placement in, so it was good to see my PBL tutor from first year again. No matter what my results turn out to be, I’m just glad that I was allowed to do the OSCE on crutches; they even made adjustments to make things easier for me, so that was much appreciated.

So how were the final two weeks of placement?

Snow
The snow/ice definitely made getting around on crutches a bit trickier, but massive thanks to York Girl for being such a babe and driving me in, so nice!

I got to sit in and observe some great clinics – particular highlights were Gastro and Neonatal Outpatients, where one of the doctors said that I had the “makings of a great paediatrician” after I did some accurate developmental assessments; that really made my day!

Paediatric BLS was pretty fun; I got a lot of time to work out the logistics of getting down to the floor from my crutches to do compressions, and our tutor was very patient and understanding. BLS ended up being one of my smoothest stations in the OSCE, so hopefully the examiner thought so too.

I started neonatal week with a Baby Check Clinic, which involved head to toe assessments of new born babies, and it was the cutest morning of my life to date OMG. So. Many. Babies. It really was adorable and I almost couldn’t cope.

During a SCBU (Special Care Baby Unit) ward round, I learned so much about the complexities of balancing family dramas with social care intervention, and ofcourse, managing the patients’ conditions. So. Much. Drama. I was just in awe of the patience of the healthcare workers in dealing with it all, because boy oh boy, if I could write up some of the stuff I’ve heard…

Being on SCBU was quite something for me because The Keen One a.k.a. Kenny and I spent the first weeks on our lives in SCBU, as we were born quite early, so seeing little twins there made me think, “I was one of you!”

The neonatal unit was soooo cute though! (Yes, I know I’m massively overusing the word ‘cute’ but IT REALLY WAS). The ward gets quite a lot of knitted things given to them, so the extra toys are put out for anyone to take, as long as they give a donation. So ofcourse I had to get some:

Koala
Cute toy

During my neonatal nursing session, I got to feed and carry some of the babies, and it was just everything. They were so small and I got so broody and it was the best. I have no pictures of myself with the babies (professionalism and all that), so here I am with a bae(by):

Me and bae(by)

Placement ended with a mock OSCE that was really helpful, and made me feel less worried about the real thing, so again, praying I’ve done okay!

Overall, Module 10 was great – I enjoyed placement so much, and I was really blown away by everyone’s kindness. I’m positive that I want to do paeds in the future, so I’m glad that after years of wanting to get to 4th year to see if it was for me, it really lived up to my expectations. YAY 🙂

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Module 10 Placement: Week 2

Guess who’s now on 50% weight bearing??

I had the first of the wedges removed from my boot yesterday, so I can start to put a bit more weight on my healing leg, yay for progress!

Second week of paeds placement has seen me battling an awful cough and cold, which hasn’t been great, but lozenges and water have kept me going. I’ve mostly spent my time in various clinics, but I’m still enjoying it though, so I haven’t been put off quite yet.

Neuro clinic was particularly interesting because I saw 14 year old twins with Charcot Marie Tooth, so that was pretty cool. Their personalities reminded me a lot of The Keen One a.k.a Kenny and I, so getting to examine them was really fun.

Paediatric Physio was a bit of a bummer because a lot of the patients didn’t turn up for their appointments, but I got to sit in a Talipes Clinic and watch as they put a Ponseti method cast on the patient’s legs, so it wasn’t too bad.

If you’ve ever wanted to know what it’s like to do a paediatric simulation session with reduced mobility/on one leg, you’re in the right place because it’s actually not too bad! I was hopping all over the place (my balance has gotten quite good over the last few weeks), but doing an ABC assessment was okay. So I’m feeling a bit less stressed about being on crutches for the OSCE.

Prescribing will always be my Everest, but getting there slowly…

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Module 10 Placement: Week 1

I’ll start with the less cheerful stuff, because I might as well get it out of the way.

The lowest point of this week was crying in the doctors office. I was aching all over from hobbling from our clinical skills building to the ward for an impromptu ward round, which I was 20 minutes late to. I absolutely hate being late to things so that made me feel crap, I’d just had an IV drug session that didn’t go too well, and I was just so frustrated by my immobility, because I’d thought that having the cast off would give me more freedom. I’m still on crutches, so yeah, that sucked.

And now, on to the good things.

I LOVE PAEDS.

This is definitely what I want to do because I’m really enjoying it so far, and for the first time ever, I’ve wanted to stay longer in clinics. I just love how varied it is, because paediatrics covers such a wide age range, so I’ve seen different presentations and conditions on the ward and in clinics.

I just love kids so much! Paeds is definitely making me broody, but I’ve always enjoyed working with children. Having a younger brother and young cousins, as well as being a Sunday school teacher in the past, has given me a lot of experience with being around young children, so interacting with and examinining them comes a bit easier to me.

Being on crutches for the placement I’ve been looking forward to most sucks, yes, but I can start doing some toe touch weight bearing now, so less stress on my wrists on the crutches, yay!

I continue to be blown away by the thoughtfulness of people towards me; from York Girl’s car lifts (so blessed that we’re in the same group), to the patience and understanding of consultants when I arrive late, and the clinical skills staff putting out chairs with pillows on them for me in teaching sessions, everyone has been really kind.

Scrubs and Crutches

We’ve had quite a lot of teaching on Safeguarding Children and Non-Accidental Injury this week, which has been pretty heavy and harrowing, but ofcourse, very important.

Another low part of this week was getting told off and asked to leave theatre, as the Sister nurse said me being there on crutches was a health and safety hazard, and that it was wrong of me to come. I tried to explain to her that the medical school and surgeon I was following had okayed it, but she wouldn’t budge and kept telling me to leave.

As you can imagine, this made me quite upset, and I got teary again because I don’t take well to being shouted at unfairly. It was particularly frustrating because I’d arrived just before 7am to follow a patient through their journey before and after surgery, so I was missing him being put under anaesthetic.

I was found by the consultants in my teary state, and they got really annoyed at the Sister’s dismissal of me. So they called a meeting with her team and fought my corner, arguing that it was unfair for me to miss out on important teaching when I was in no one’s way in theatre. They took full responsibility for any repercussions that might come about from me being in there, and even provided a stool for me to sit on, so that I could be comfortable as I watched the procedure.

I was just speechless and blown away by kindness again, how nice of them, right?

I was super proud of myself for managing to fit into scrubs- my first time wearing trousers in over a month. Can you tell that these are extra extra large bottoms that I’m wearing to fit my boot??

Scrubs and Crutches 2

Overall week 1 of paeds has been quite eventful; can’t wait to see what next week will bring!

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Module 6 Placement (Renal, Urology & Endocrine)

The last four weeks of placement have been very draining. Early buses and days filled with teaching, ward rounds and clinics have made it difficult for me to find time to revise for end of year exams, so my hopes of being able to post more frequent blog updates were dashed. Apologies to my keen readers, I can still see how many people are reading my posts, so I appreciate the views!

Anyway, how was placement? Well I’m still not a fan of the kidneys, but I don’t hate them as much as I did before. Nephrologists are pretty dang smart and seem to just have all the knowledge, so they’re pretty cool. One of the consultants we had teaching with spent one session going round the group, asking us questions individually, so that was very intense. The same consultant also put me on the spot during a ward round and asked me to take blood from a patient. I haven’t practised venepuncture since last year, so I was quite nervous, but luckily the patient had good veins, YAY.

Urology was very … meh. So many testicles and penises, and just no. Definitely not for me. I finally know the function of a scrotum though, so yay for that? Highlight of urology was getting to catheterise an actual patient in theatre, which was quite cool. Again, I was put on the spot by the surgeon, so I was very nervous because everyone was watching, but I got it in the urethra in one go, YAY.

(P.S. Shout out to the clinical skills tutor at the hospital I was in for being such a total babe, and I will explain why in another post, stay tuned x)

Finally, diabetes and endocrine. I really like endocrine – all the different axises and feedback mechanisms can get quite confusing not going to lie, but it all makes sense when you sit down and think things through. I find it similar to haematology in how it involves a lot of data interpretation and it’s a bit more chilled out, so I really enjoyed it. Diabetes was more dull because the diabetic clinics got quite repetitive, but the antenatal diabetes clinic was a particular highlight. SO MANY CUTE KIDS.

In other news, today was my end of module OSCE, which included stations on catheterisation, cannulation, data interpretation, as well as a shared decision communication skills station on dialysis. Overall it wasn’t too bad; there was definitely one station that I know I could have done better in, and I made some silly mistakes in other stations, but I’m glad it’s over and I can focus on written exams next week. Jesus, take the wheel!

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Module 8 Placement (Gastro) & End of Term

In the four years that have passed since I started this blog, I think this is the longest I’ve gone without an update.

To say this semester has been busy would definitely be an understatement, but I’m home now (YAY), and now have more free time (YAY again), so I can go back to blogging; I’ve really missed it.

A lot has happened in the last month, so I’ll start with some highlights from gastro secondary care placement:

Getting to scrub in and help out in theatre was really fun! It was useful to practise scrubbing in properly for the first time since first year, and the consultant we were with was very patient, such a nice man! The procedure was a panproctocolectomy (removal of the whole colon), and it was quite the procedure- so. much. blood.

I was absolutely grilled on CT interpretation during one of our sessions, and I never got to thank one of my colleagues, who sneakily whispered answers to me, saving me from embarrassment in front of everyone. The person probably didn’t think much of what they did, but it was much appreciated, and meant a lot.

We got to clerk patients from A&E when I stayed out of hours, and this put us on the spot because we had to present our findings to the consultant, and come up with management plans. I felt more junior doctor than medical student that evening, and it made me so excited to graduate and start doing it properly!

In a liver disease clinic, I watched the consultant give a fantastic explanation of Hepatitis C to a patient, and it was truly the best information giving I have ever seen. SO GOOD. The clinic also made me realise that I’d been quite judgmental about IV drug users in the past, so meeting an actual drug user completely shattered my misconceptions and prejudice.

I’m definitely not a natural at suturing- I struggled initially, and it took me a while to get the hang of it, but I’m think I’m there now… well, sort of.

Suturing

We received the results of our OSCE today, and I passed, HALLELUJAH. I’m just so relieved, because the OSCE was the toughest one I’ve had to date; suturing and ERCP interpretation were particularly not great, and not going to lie, there were definitely some tears afterwards, so I’m just grateful to God that overall it was okay.

What else have I been up to? Well the annual charity fashion show was last month too, and I modelled for New Look and the Nigerian Society, and it was so much fun!

New Look 2017Nigerian Society 2017

I’m also finally done with being a student caller for the year, and we managed to raise over £180,000 for various programs across the university, so I was honoured to a part of it all.

Boy am I glad the term is over though! With work and placement and volunteering and revision and well, socialising, ofcourse, it’s been very draining, so looking forward to relaxing over the next week at home 😀