I was lucky enough to ‘shadow’ an Advanced Nurse Practitioner for the last few days who was extremely keen to help me learn about applications for medical school, practical skills for becoming a doctor and how to professionally interact with patients from all walks of life.
When on the road to home visits we discussed the structure of the NHS and I was able to gain first-hand experience of the interaction between nurses, GPs and care workers by listening to discussions on the phone of the best options for the current and future situations of patients. This particularly helped me in understanding the role of doctor as a leader and coordinator of the healthcare team, as the nurse always checked in with the GP to ensure everything was recorded (medicinal and social information), and highlighted to me the extreme importance of team work for a successful healthcare system.
The practical skills that I was taught and used on many patients were; taking blood pressure and pulse, locating a pulse, applying a nebuliser, determining concentration of oxygen in the blood, listening to the chest through a stethoscope, interpreting tested urine samples and taking temperatures. Whilst I understand that it is not what you ‘do’ that interests med schools (it is ‘what you learn from what you do’), by practicing these basic observational skills I was able to distinguish the different ways the advanced nurse treated each patient. It helped me appreciate the exceptional quality of healthcare we have in this country due to every patient being treated individually and of equal importance (eg. any race, any age, if able bodied or disabled, both genders). An example of this extra care taken that I noted was when I was asked to remove my surgical gloves when taking a blind woman’s blood pressure due to the fact that the difference in texture between glove and hand may have caused confusion and discomfort. This taught me that the patient and their concerns must always come first, and that early patient contact is essential to learn to deal with the large variety of different cases that we, as doctors, will come across.
I learned how to deliver bad news to a patient when the ANP made me tell a very reluctant lady that she must go to hospital. I spoke in an empathetic but firm manner, ensuring that she understood exactly why the admittance was necessary. After delivering the news I offered to help her change clothes and pack her bag so that she felt clean and ready to go to hospital when the ambulance arrived. I learned that doctors and nurses usually do not have time to offer to help with these things which made me feel sad. The ANP praised me for the way I handled the situation.
I will always remember the ANP’s professionalism in remaining calm and driven, even in difficult situations. He demonstrated many attributes that stand for great healthcare and that must be expressed by all healthcare professionals. This included being empathetic as opposed to sympathetic, self-aware in letting patients explain their problems and resilient through continuing to visit more patients, even after visiting a patient whose condition had significantly deteriorated.