Friday was the final day of my work experience at the QEH, and its safe to day that despite my hectic and busy week I definitely didn’t want to leave.
Again, I spent the morning doing the TSS ward round, but this time with a consultant, two F1 students and two ‘soon to be’ F1 students. There were a few patients I had seen every day of the week, showing that despite the aim for patients to leave TSS after 72 hours in the current situation of the NHS and QEH, this just wasn’t possible as beds, clinics and homes were not available for them to go to. The consultant had a very busy day, so the ward round was completed quickly, with lists and lists of jobs for the F1’s to do before they went home. After discharge letters, taking bloods, requesting scans and looking at X-rays, I spent the afternoon in a gastroenterology clinic.
The clinic was a different environment to that of the ward, and reminded me much more of a GP surgery. There were a variety of patients with different symptoms and illnesses, some losing weight unexpectedly, some gluten intolerant, some with IBS. In the same way as symptoms and illnesses varied, there were patients form all walks of life, elderly, a young mum with her 3 year old, a teenage girl, an alcoholic who appeared to have been drinking already. Again, each was spoken to differently despite the same questions being asked, depending on if they were nervous, experienced in controlling illness, alone or with family. There were two cases which stood out for me, the first a young anorexic girl, who was being investigated as the cause for her anaemia was unknown. The consultant realised when she was alone, that this would be a difficult consultation as she had nobody to support her – calling in a nurse to ‘chaperone’ eased and relaxed the environment, meaning there was comfort for her when she broke down in tears. This was a difficult conversation as she was worried the consultant would tell her GP her weight, missing her parents (who were on holiday) and worried about her future. The consultant was reassuring, never rushing or pushing her and making time for all their patients, something which is easily lost in a busy afternoon.
Breaking bad news is, I’m sure, something every doctor dreads. Unfortunately, the end to my work experience placement was not a happy one. The consultant I had been shadowing had to break the diagnosis of lung cancer to a patient. During an ultrasound of her liver, shadows had been found, and later scans showed that these were also found into her lung. While it seemed the patient was almost expecting this diagnosis, it was still an incredibly difficult conversation, again with a nurse present . The doctor was very clear that he wanted to keep the patient in the loop, as many decisions and discussions were taking place behind their back. The important aspect of this conversation was making the patient aware of the support network available for them, the opportunity to ask any questions and to write any down when she thought of them to ask later.
I had an incredible, eye opening week during my work experience. I would recommend it to anyone considering medicine, as it has shown me both the highs and the lows of life in a hospital. I have realised the sometimes mundane tasks of an F1 doctor (sometimes they felt like secretaries) and how doctors are seemingly always rushing from one place, clinic or ward to another. Most importantly, it has shown to me that its a tough career, busy, with a lot of responsibility and hard work, but if you truly enjoy and love what you do (as everyone I met did) it is definitely worth it.
I am definitely excited for the future, and everything it may bring.