So, during half term, I spent 5 days at a hospital doing work experience…you may or may not be interested in what I saw, but if you are, here is a summary (quite a long one) of our amazing week!
I spent the day in the Cardiology Unit, and also the Cardiology Day Unit. I started off in the general Cardiology Unit (after a very stressful morning, consisting of me losing the necessary paperwork, causing me to run late, causing me to have to go straight to the bus stop instead of meeting my friend, Charlotte, who actually knew where the bus station was, causing me to go to the wrong bus station, causing us to miss the bus so we had to drive behind it and get on at the next stop…yeah, that was fun…). So, back to business, I spent the morning in the general Cardiology Unit. I started off by watching an ECG, which was really interesting, as I learnt how to connect the nodey-things to the patient. I then followed the patient into a consultation with a nurse, where we discussed the patient’s symptoms, other medical issues, and other things that could have contributed to the chest pain. I really liked this, as I got to see the patient-nurse (or doctor) relationship, and the obvious trust the patient had, and the caring side of the consultant.
I then got to visit the angiography side of Cardiology, which I would’ve done in the afternoon, but unfortunately there were no angiograms taking place, so I went with Charlotte to see this. We got to see the insertion of a stent, which I found amazing! For those of you who don’t know, a stent is a structure that is used to widen blocked arteries, in order to prevent myocardial infarction. The stent is inserted through the femoral artery in the groin, using a catheter. Before the stent is put up, a balloon is blown up inside the blocked artery in order to widen it. The balloon is then removed, and another balloon is inserted, and blown up, but this one has the stent around it. This balloon is then removed, but the stent is left behind. Yet another balloon (many, many balloons…as Charlotte’s brother remarked when we told him “It’s like a party in there!”) is put up, and blown up, just to ensure that the artery is back to normal. The catheter is removed, the patient sewn up, and everything is as it was, however, the patient now has an unblocked artery 😀
Then we had lunch…pretty average affair…although Charlotte was given a knife and fork to eat her soup with…not much happened.
However, after lunch was when the real fun began! Charlotte went to the general Cardiology Unit, where I had spent my morning, and I went to the Cardiology Day Unit, where I wasn’t really sure what to expect…imagine my surprise when I was asked if I wanted to see a pacemaker being fitted! Did I say yes? Of course! So off I went to get changed into the “blues”…unfortunately I didn’t get a photo…I also got to wear the hat and mask, although I wasn’t anywhere near the patient, I was just observing. It was a two hour long ordeal for the patient, although it didn’t feel so long for me-the time flew by!
After the room being prepped, the patient was brought in, and sedative and local anaesthetic applied. A small incision was made on the upper left hand side of the chest. I would describe the whole procedure, but I feel some of you might get bored, so if you want to, here is a link that pretty much describes it: http://www.nhs.uk/conditions/pacemakerimplantation/pages/whathappenspage2.aspx
One of the exciting things about this pacemaker was that, instead of the usual 2 wires, three wires were used. This is known as a biventricular pacemaker, and is used to resynchronise the heart in the case of cardiac failure. When heart failure occurs, the left and right ventricle often start to beat out of synch, and as they are not pumping together, there is often not enough blood being pumped around the body, so the heart is also not getting enough oxygen, so the heart ‘fails’.
The procedure took about 2 hours, however, it certainly did not feel as long! It was an absolutely amazing experience, and I enjoyed it so much, especially as it was all really well explained to me by a fantastic member of staff at the hospital!
After getting up at the ridiculously early time of 6 in the morning, Charlotte and I spent the morning in the Neonatal Unit of the hospital. We spent time in both the Neonatal Intensive Care Unit, and also in the Special Care Baby Unit. We observed the feedings, weighings, ward rounds, and general checks of the babies. All the babies we saw were very premature babies, with issues such as possible diabetics, babies who had inhaled meconium, and babies with breathing issues, due to their prematurity.
The babies were fed through a tube through the nose, where a formula of Actimil and EBM (Expressed Breast Milk) is drained into the stomach through the use of gravity.
All-in-all, I found the morning very interesting, however, I don’t think that I could specialise in Neonatal, as there is so much pressure on the department, as not only do you have a very sick baby, you also have the parents to deal with as well. The department seemed quite busy, as there was always a baby to check on or feed, and it was really useful to observe how the department coped with the more stressful cases.
After lunch, we went down to the General Outpatients Department, where it seemed they weren’t expecting our arrival! We ended up sitting behind the Reception Desk for about 30 minutes, which wasn’t as boring as you might think! We found out that, although we’d only been at the hospital for a day and a half, we’d seen more of the hospital than the receptionist there, and she’d been working there for quite a while…we also got to see a helicopter land!!! The receptionist’s job is a vital part in the hospital, and they get very little recognition for what they do, so I feel that they need more appreciation from the community, as they have to deal with some rather belligerent individuals, and also have to be very organised! Charlotte and I then got split up 🙁 and I went to go and look at some patch tests…this may not sound very interesting, but I actually found it quite engaging, as I had spent a morning in the dermatology clinic in another hospital, and I had seen the results of quite a few patch tests, so seeing them being set up was very useful, and really helped to deepen my knowledge of patch tests and how they work. Quite simply, a lot of common allergens are individually mixed with some vaseline, and put into syringes. A small sample of the mixture is then put into a (labelled) tray. The tray is then put onto the skin, and left on for a bit (as needed in order to test the allergies). If the patient is allergic to any of the substances, the skin underneath reacts, and the dermatologist can look at what allergen was touching that bit of skin, and therefore determine what they patient could be allergic to.
After setting up several patch tests, I went to sit in on a consultation in the GOP unit. The patient had been struggling with stomach pain after having an operation to fix a hiatus hernia (a hernia where the stomach, and possibly other internal organs, have risen up above the diaphragm due to this hernia). The patient had recently had another, unrelated, injury, where they had wrenched their side, causing the hernia to disrupt, and causing pain to the patient. The patient was adamant that the pain was due to the hernia, and when told otherwise was not pleased. It was interesting to see how the consultant dealt with this-very calmly-and explained to the patient what they thought was going on.
Although today was not quite as interesting as yesterday, I still found it invaluable, and enjoyed it.
After another early morning, Charlotte and I arrived at the hospital, and headed for the Radiology department. We spent the first 30 minutes observing X-rays, which included an X-ray of a spine, a knee, a pelvis and a chest X-ray. It was surprising how quickly the X-rays were carried out, however, about half the time spent on each X-ray was used to position the joint correctly, as if the positioning is not quite right, it can lead to an inconclusive, useless X-ray. Also, all pelvic X-rays that are carried out are when the patient is standing, as if there is no weight being borne on it, it may not show up the problem as effectively. The spine X-ray was really interesting, as the patient had had an operation which meant screws had been put into the spine to keep it in shape, however the X-ray showed that two of these screws had broken/become unscrewed. This was then recorded, so that this could then be taken care of at a later date.
Charlotte and I then split up, and I went to the Ultrasound Department. I found this the most interesting of all the departments I visited, although I only saw two ultrasounds. One of these was a general stomach ultrasound, as the patient had had several issues. This was inconclusive, as it did not show anything new in the patient. I then saw an ultrasound of a thyroid gland, which had been very swollen, so had had over 10 millilitres of fluid drained from it. This showed that there were several lymph nodes in the right thyroid gland, so the patient was then to be referred to the Oncology Department. The last ultrasound was really entertaining, as the patient was quite elderly, and when told to “put their right arm down, and put their left arm up”, began to sing the Hokey-Cokey, which the doctor carrying out the ultrasound gladly joined in with. They then began to discuss One Direction, which was very interesting to listen to.
I then went to the MRI department, where I saw the end of a liver MRI scan, which Charlotte had seen the beginning of. I didn’t find this quite as interesting, as there was a lot of sitting around involved, however, I did learn more about how MRI scans worked. I then watched them set up for the MRI for a patient with breast cancer.
After the hour spent in MRI, I went to the Computer Tomography Department, however I was only there for 15 minutes or so, as there was a lot of confusion about who was meant to be where, so if you want to know more about CT scans, you should probably look at Charlotte’s blog, as she spent an hour (I think) observing CT scans.
After lunch, we ventured to the MAU (Medical Admissions/Assessments Unit). We got to meet some junior doctors, who not only took us around to see some cases, but also gave us some ‘invaluable tips for med school’. Firstly, we saw an elderly patient who was having lung issues. They had lost quite a lot of weight, and were experiencing breathlessness. They were also on medication for blood/bone cancer, and had also had a hip transplant. Due to the obvious breathing issues, the junior doctor decided to refer the case to the Respiratory Unit, and the consultant (who checks all the cases that the junior doctors assess) agreed to this.
We then saw a case involving a morbidly obese patient, who had a rather nasty rash. The doctor tried to take some bloods, but due to the obesity it was quite hard to find a vein, so it took them quite a long time to actually get the blood. The rash had no apparent cause, and was not itchy or painful, so the junior doctor was unsure what to do, so left the case to the consultant to decide what to do.
And now for the tips for Med School-some of these are serious, some not so, but I found all of them useful:
It’s not as hard as everyone tells you. The thing that’s difficult about med school is that there is a lot to learn, but there are other courses which are just as intellectually demanding.
Don’t be scared to apply as a post-graduate, or to take a year out.
There will be days when you just sit in your room and cry. (Well that’s encouraging…)
Get LOTS of stationary.
Do caring stuff.
“Follow your dreams…”
A-levels aren’t that important (if you apply as a post-graduate)
And practise the UKCAT test online lots!
We started off the day by going to Endoscopy, which is perhaps not the best way to start your day…well, especially not Charlotte’s day, as she almost fainted…I was originally in colonoscopy, but due to Charlotte’s fear of Gastroscopys, we ended up swapping, so if you want to read about colonoscopys, as she saw some quite interesting cases, go over to Charlotte’s blog and have a read!
I saw six cases throughout the morning, involving problems such as acid reflux, oesophagus checkups, indigestion, trouble swallowing and general stomach pains. Most cases appeared to be fairly vague, however, some linear stomach ulcers were discovered in one patient, but aside from that, it seemed quite odd.
In endoscopy, a scope is put down the oesophagus through the mouth, and the patient has to swallow in order to get the camera down there, which was often quite uncomfortable for them, and quite a few patients found it rather traumatic, and were crying and gagging, which was not very pleasant. In some cases, biopsy’s were taken, by taking a tiny pinch of the cells lining the oesophagus. This looked as though it would be quite painful for the patient, however none of them seemed to feel any discomfort. For about half the cases, the patient was given a sedative in order to calm them. It also meant that they couldn’t remember most of what happened, which was probably a good thing, as a gastroscopy is not the most pleasant thing to have!
Now for the exciting bit…the afternoon! It had said on the programme that we were meant to be going to theatre for the afternoon! So we went to the anaesthetist department, as instructed, and we waited for about 30 minutes…nobody had appeared. So I went into a bigger office bit and explained who we were, why we were there, and could we please go into theatre? It turned out that, once a year, on a Thursday, all the (non emergency) anaesthetists have a meeting in the afternoon…and just our luck, it happened to be today…so, after 10 minutes of talking to friendly people about what we should do, we found ourselves heading towards the emergency department, which was really exciting!
After getting ourselves into ‘blues’ again, we went into the actual theatre, where there was an elderly patient on the table, who had a cancer of the large bowel. They had been brought in due to a suspected perforation, which was going to be investigated by the surgeons. After cutting open the lower stomach and exposing the large bowel, it became clear that there was no perforation, however, since they had exposed the large bowel, they might as well remove the cancer whilst they were there. They did this by using a surgical stapler to cut about a foot of the large bowel out, to ensure that they had removed both the cancer and any surrounding lymph nodes or cancerous tissue. They then used the surgical stapler to staple the ‘loose ends’ of the bowel together, which I found really interesting, as it was truly amazing how they just joined two bits together. They then sutured everything up, and that was that. Another really interesting thing was that, even though they had removed 30cm of large bowel, the patient was unlikely to have any major effects, which I found truly astonishing. We were shown the removed cancer, and how it had blocked the passage of the large bowel, and it was interesting to see the black mass of cancer in comparison to the softer, pink tissue of the large bowel.
We then left to go home, but this was definitely my favourite part of the week, as we were stood right next to the surgeons as they carried out the procedure. We were given only three instructions:
Don’t touch anything green (as this is sterile and otherwise we would contaminate it)
If you’re going to faint, sit down.
If you do faint, faint backwards (as we have better/more important things to do than look after you).
Today was pretty average…we spent the morning in the wards, which I actually found really fun. We each went with a junior doctor, and followed them around, which was quite interesting. I realised that being a doctor isn’t just about patient contact, there is also a LOT of paperwork involved! I’m not joking, about 50% of the time was spent filling out various forms! I also got to see quite a funny case which involved trying to take blood from an anaemic patient…with a fear of needles. They were adamant that the doctor could ‘only touch them once’ with the needle, and then proceeded to make that very difficult for the doctor by flinching every time they came near! Eventually we got some blood samples, but it took quite a while, and this was useful, as it showed that sometimes you do have to deal with difficult patients, and if you get one, you just have to deal with it! Charlotte and I then joined together, and went with a friendly gastroenterologist who was just about to set off on his ward rounds. This was interesting, as we got to see a large variety of cases, and how the doctor had to change to treat the specific needs of each individual. There’s not really much more I can say about this due to patient confidentiality, but if you ever get the chance to go on the wards during work experience, take it, as its extremely valuable, as it gives you a realistic insight into what doctors do.
We then went back to MAU for the afternoon, which was good, as this time, instead of watching the doctors talk to the patients, we actually got ‘let loose’, and were allowed to go and talk to several patients on our own! We met quite a few ‘characters’, such as a pair of neighbours, who were, to put it simply, cat-obsessed! Although we started off discussing the patients medical condition, we quickly digressed into general conversation, and I found it really lovely to just be able to chat to the patients as real people, as often you forget that they have a background, and aren’t just cases that need to be solved.
That was the end of our week of work experience, and I enjoyed every bit of it! I encourage any aspiring medics out there to definitely try and get some work experience, as it is so valuable, and not only is it useful, I found it really fun!
Sorry for the VERY long post…
Until next time…
(P.S. To see Charlotte’s interpretation of the week, click here to see her blog!)