Monthly Archives: August 2015

Addenbrooke’s Hospital- day 3

Oncology

I almost cried sometimes! I don’t know why this ward made me more sad than the other ones. Maybe it’s because the look sick- thin and pale.

The doctor who was carting me around for the day was going to spend most day in surgery so she invited me to go look. It wasn’t the messy kind of surgery with incisions and whatnot, it was the bone stuff with lots of needles!

The first one I got to watch gave me a huge shock, it’s definitely something I’ll remember forever. She gave me the basics of what they were going to do “We’re doing a bone marrow biopsy.” but I didn’t exactly think about what that meant and just stood in the corner to watch. After they set everything up they called the patient in, anethetised, and got in there. All I could think at the time was “this isn’t so bad.” and then it happened- they shoved a huge metal rod into that little child and shook it all about!!! My facial expression changed in an instant, from calm anticipation to shocked and a little bit scared. I didn’t faint or anything but I’ll admit that I was feeling a bit…

The anaesthetist just laughed at me and got on with it.

I know that the bone marrow biopsy may hurt (definitely look horrible) but it’s necessary to help the patient get better. At that moment in time, I was questioning whether I would be able to do that but hey, what’s med school for? The doctor had to do some more bone marrow biopsies and lumbar punctures that day and I eventually got used to it  so who’s to say that I wont be able to do it myself sometime in the future.

The other thing I learned was that some babies are easier to anesthetise than others!

Cystic fibrosis clinic

There were patients ranging from toddlers to teenagers, all accompanied by their parents of course. The parents we all very organised and strict when it came to what they needed to do for their sick child; diet, exercise, the whole shebang! It seemed to be harder for parents of teenagers because you can’t just feed them what they’re supposed to eat no-questions-asked or make a game out their physiotherapy exercises!

The clinic was set up very differently o the ones I’d been into on previous days because it wasn’t just one doctor seeing the patient it was the nutritionist, the physiotherapist, the nurse and the consultant. Dude, some many healthcare professionals walked in and out of those rooms that I got a little confused because the parent and child never seemed to come out. My first time sitting in the clinic, I didn’t know that there was more to come so I followed the nurse when she left the room!

Day 3 complete! Work experience over.

In all 3 of the days I only got to witness 1 patient receiving the news of a diagnosis. In this case it was to an inpatient so the parents already knew that there was something very wrong, they even had a couple of guesses themselves.

Did you get to witness it during any of your placements? If not, would you have liked to? Yay or Nay?

May God bless you,

Diana Perira

 

Addenbrooke’s Hospital- day 2

AM Handover

It was pretty fast today, compared to yesterday.

There was an issue with a patient not agreeing to be discharged even though the doctors believed that the patient was set to be discharged. I asked how do you deal with that situation? Answer: call the Emergency Department to deal with them and get back to work.

Training

Many of the doctors from the handover then went to some training in a special room in one of the wards. The training was about taking care of a fitting child.

Most of them were guessing what to do next and a neurologist consultant took charge of the mock situation and led the team. At the end, the doctor in charge of the training told the neurologist that she did very well and that she was right to take charge of the situation even though she wasn’t the first to arrive at the scene because she was the one who knew what to do. The lesson from that was to do what you got to do to save a patient, even if you don’t want to be a bit rude to your coleagues I’m sure they’d prefer to be shoved out of the way than to lose a life.

Dude, doctors really never stop learning; learning how to save a life! Through research, training and experience.

Paediatric Gastroenterology

You’ve got to make compromises (benefits vs side effects), try not to undermine anyone and all of that whilst keeping the patient’s well being as top priority. As I was in paediatrics, it’s also very important to make all decisions with parent’s consent. Duh!

The hard thing about all of that is… well, all of it! You have to think about everyone and everything.

Paediatric surgery clinic

Some parents are lovely and really easy to attend to, whilst others… not so much. All people are different; parents are people, so they won’t all be the same. BUT just talk to them all politely, in parent language and give the information they ask for if you know it (if you don’t know it, say that!). You may see the same kind of case over and over again but, for goodness’ sake, keep in mid that the parent hasn’t! That’s their child in pain dude. Of course they’re going to be distressed and not knowing what’s up isn’t going to help.

Babies were the main patients that day and babies are just little people. Little people who cry. A lot. Only 1 of them didn’t cry during examination. That one opted for hitting the surgeon’s arm with his mega muscles instead.

That’s not him, but he was totally as cute!

Day 2 complete. Only 1 last day to post!

Isn’t it great that good doctors never stop learning? Yay or Nay?

May God bless you all,

Diana Pereira

 

 

 

Addenbrooke’s Hospital- day 1

It took me a while to score such a sweet placement but I got it! Addenbrooke’s Paediatric department got moi for 3 whole days last month 😛

These are the accounts of the little journal I carried around with me. Enjoy!

AM Handover

Duude! I had at least some  idea of what a handover was like before I got thrown in there but I was still very fascinated by it all. At least one member of each paediatric team was there and at one point there were registrars, consultants, junior doctors and even some medical students form Cambridge University  were there. It wasn’t as crowded as I’m making it sound! There was just a wide array of people to stare at.

There was a little disciplinary issue because someone handed their bleeper to a doctor and left before their shift ended. The doctors we all reminded that if that happens, they shouldn’t take the bleeper. I would feel bad for the patients if I had to refuse to take a bleeper for a doctor that is quite clearly not keen to be there but I also understand that we shouldn’t allow people to get used to behaving like that; worse case scenario, they could leave without telling anyone at all and endanger the patients under their care!

There was a quiz on gastro oesophageal reflux disease to teach everyone  about it and I’m quite proud to say that I got 1 out of I’m-not-saying-how-many correct!

There were two emergencies overnight, to which a couple of doctors got bleeped to and they had to leave the handover for a bit. There were some general complications and other teams were asked to look at the patients. They would then have to discuss why they think that the team should go see that patient, for example, whether that problem was really gastroenterological or not. So that this doesn’t happen:

When I heard that only two people were set to be discharged I wondered if the wards were simply not very busy but that hypothesis was thrown out the window when I went on the ward round.

The final thing that I learned from hand over was that no matter how well you did they first time you saw a patient, be prepared for them to come back (probably with the same problem) and  it may not be you who’s seeing them so make sure your records up to date and correct!

 Paediatric Neurology

When that hand over ends the doctors all go to their respective departments and have another handover there and once again, doctors and nurses got bleeped and had to leave. Busy life, what can you do? BTW, they walk really fast! It’s important to keep your team up to date with what they’re to expect that day.

I went on a ward round with a neurological consultant and her specialist neurological registrar and I just had to ask when they got the time write the notes for each patient. Answer: Go around with a big computer cart and type as you go along. If there isn’t one available wait or try to remember and type it up later.

Before I was shooed off to clinic, I got to witness something that annoyed me very much at the time- a doctor who had volunteered to go check on a returning patient that morning kept saying “Do we really need to do anything?” regarding the health of a patient who quite obviously had something wrong with her. You can see how that’d hit a nerve for anyone, right? When I ponder about it now and I think I mentally overreacted because he probably didn’t mean it in the way I was seeing it, it’s probably just the way he speaks/phrase he’s used to saying. He probably meant that they couldn’t do much more on the neurological side. But it’s a good thing  he didn’t say that to the parent though!

I didn’t say anything or complain because all the other doctors agreed with him and plus, he know far more than me anyway!

Neurology clinic

I didn’t spend much time there but it was made very clear to me that years of experience in the field is pretty darn helpful. Experience dude, experience is key! For example, to distinguish between the types of fit and determine whether it was epileptic or not just by looking.

Day one complete! See you tomorrow for day two.

I wonder, should I have done work experience in a different department? Yay or nay?

May God bless you all,

Diana Pereira