Work Experience in a Hospital – day three

This morning as I sat in a respiratory clinic at the hospital, I was greatly inspired by the Consultant that I shadowed. They were intelligent, compassionate and clearly respected by all of their fellow doctors and members of the healthcare team. Junior Doctors constantly came to the Consultant asking questions and for second opinions about treatments and the best plan for their patients, while nurses were extremely happy to support them in any way they could. It appeared that the Consultant made their patients feel comfortable, relaxed and positive even when the prognosis was not so positive. Whilst they always showed that they were in control to their patients, once they leave the room the Consultants were extremely busy answering calls whilst looking at other patients’ test results and giving second opinions for Junior Doctors. I learned that a doctor must be able to multitask to a high enough standard that they can be focusing accurately on more than one patient at the same time. The Consultant approached talking to their patients in a very different way to the two Consultants that I shadowed on Monday as the Consultant today explained what they thought was their current problem and history, allowing the patients to correct them, whereas on Monday the Consultants would let their patients do the talking then prompt with questions. Both methods seemed to please the patients.

As a doctor you must explain everything that you are doing. The Consultant was very empathetic when they delivered less positive news – always concerned about questions that may be in patients’  heads, so the Consultant always explained their decisions of medication to them so that the patient was not concerned or confused. The Consultant attempted to explain patients’ conditions without them feeling awkward, embarrassed or less able, speaking scientifically and empathetically appearing to understand exactly how the patient was feeling. The Consultant also offered them professional psychological help due to their frustration of the disease.

Many illnesses affect peoples’ state of mind due to it causing a lower quality of life. An example of this is when patients are unable to walk due to not having enough energy (from lack of oxygen) when their legs do in fact work perfectly. Patients often explained that this not only had a negative effect on them but also on their families who they were extremely reliant upon to transport them from place to place.

Today I also learned about drugs that may be able to replace antibiotics in the future. These drugs are a much lower dose of antibiotic to boost your own immune system to fight the pathogenic bacteria that has infected your body cells. I hope that more doctors use these drugs as it will reduce antibiotic resistance, although I have to say that I am not educated in the knowledge of their side effects and I was told by the doctor that they currently only work in very select cases.

During the afternoon I shadowed a fourth year medical student in the Acute Medicine ward (AMU). I was interested to hear a heart murmur which was confirmed by a Junior Doctor after the medical student hypothesised the specific type of heart murmur. I noticed how knowledgeable the medical student was when they explained in detail everything about the specific heart condition to the Junior Doctor.

It was interesting to see the dynamic in the ward with students reporting to Junior Doctors and Junior Doctors reporting to Consultants. There was clearly a hierarchy in amount of experience but everyone respected and supported each other, concerned about one another especially about those who were on call last night.

I encountered patients who suffer or have suffered recently from bronchiectasis (had also had had a thoracotomy) causing wheezing and coughing after having a lung tumour removed, lung scars causing nodules to appear on their CT scan,  recurring chest infection, osteoporosis, chronic asthma, polymyalgia rheumatica, exercise induced desaturation causing breathlessness, pulmonary embolism, lung collapse, breast cancer, severe emphysema, low T Killer cell count and a heart murmur.

Emily Buchanan

 

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