Today I was fortunate to experience a meeting in which Consultants met with other Consultants (over the internet) to discuss current patients to ensure that everyone agreed about the plan of their future treatment. I was particularly interested to see that there were also representatives from a sister hospital as some procedures take place there as opposed to in the hospital where I had my experience.
In this meeting, one doctor whom I assume was the most senior led the discussion and concluded it by giving the best solution using all of the present doctors’ advice.
A question frequently asked in hospitals is whether to give frail elderly patients invasive surgery or whether the risk carried with the operations is too high. Doctors make decisions on the basis of amount of risk. Medication and surgery all come with risks and the decision to prescribe medicine or carry out surgery is done on a basis of severity of the patient’s condition and therefore whether it will improve the patient’s health in the long term. The lead doctor suggested that surgery must be the least invasive but most informative as possible. In the meeting I also noticed cost was a significant factor when deciding whether to allow multiple scans for the same person.
After discussing all current respiratory patients, the doctors went on to talk about the meeting of NHS deadlines. I was discouraged that they said that it was physically impossible to reach the NHS’ deadline to release results of CT scans when checking for lung cancer within 3 days. They announced that there was not enough money in the budget to employ another staff member to improve quality of service so they were forced to move their patients to other hospitals where they may receive a better quality of care.
I also visited the respiratory ward where I shadowed a Consultant and a Junior Doctor on their ward round. I was told that a ward round happens twice a day to check progress of the patients in order to ensure medication is working and therefore to advise the nurses about changing dosage or type of medicine being given to the patient. I noticed that Consultants were completely reliant on their teams of Junior Doctors who were prepared to check up on all other cases that the Consultant did not get round to seeing, and the nurses to give attention and medication where needed. I saw the doctors as kind, understanding, encouraging, intelligent and trustworthy.
I was interested to see that a teenage patient was brought to the adult ward even though their age suggested that they should be in the paediatric ward as the doctors from the paediatric ward believed that this was the best place for them due to the severity of their condition. I noticed a dynamic change in behaviour of healthcare professionals when the nurses failed to confirm with the Consultants and Junior Doctors about bringing young patients to adult wards. This is a growing issue in the NHS as mentioned in the program Hospital by BBC where they raise the debate about whether an empty intensive care bed in the children’s ward can be given to an adult if there are none left in the adult ward.
I enjoyed speaking to patients about quality of care in a private ward and feel that I improved their days by giving them my time to listen to their medical story – something which I enjoy doing weekly at the care home I work at. I loved speaking to them after my hectic time in the non-private respiratory ward as it felt more relaxed and enjoyable – it is a shame that every person cannot afford this quality of care. From talking to these people I learned the complexity of some people’s illness can stem from a simple lifestyle choice from many years ago which is most commonly smoking.
It is impossible for me to remember every condition I saw today however the most memorable thing was seeing the draining of the lungs into a transparent glass jar. It was so fascinating and the doctor explained to me that all the liquid is infection between the lungs and pleural membrane.
I look forward to my day in clinic tomorrow.