Katharine House Hospice Voluntary Work

Volunteering at my local hospice has taught me a lot about patient care, for instance I now realise how many different people are involved in providing support and treatment for the patients. Throughout the day, nurses, physiotherapists, doctors, nutritionists and volunteers work together as a multidisciplinary team to make sure that the patients are comfortable. I was surprised at how much there was available to do at the hospice – we put on craft activities, talks or patients can have a massage or have their hair done. 

Although many of the patients have similar illnesses or symptoms, each person is unique and we treat everyone as an individual – many people like to have their own particular arm chair that they like to sit in, or a particular biscuit or cup for their tea. Everyone chooses their own meal from a menu and they can request special food or treats. It’s so important to keep the hospice sterile and we make sure to keep clean and wear gloves when preparing food or tea, but take them off when we serve the patients, to be less clinical. I’ve noticed how small things like these make the hospice such a comfortable and homey environment to spend time in, helping the patients to feel at ease. 

I’ve also seen how much the patients gain from their time at the hospice. They are able to talk to each other and relate to each other about what they are going through. Many of the patients told me how they get annoyed when people say “I know how you feel” because they don’t, but having the support and reassurance of others going through the same or similar conditions can be really beneficial. The hospice is a place where people aren’t afraid to talk about how they feel and they can say that actually, they’re not feeling fine when asked how they are. 

I’m really enjoying my time volunteering at the hospice. It’s improving my communication skills; talking to the patients about their families or outings or jewellery is really fascinating and I’ve been lucky enough to meet some lovely interesting people. I’ve also greatly improved my domino skills after playing so many games with the patients there! 

Stafford Hospital – Day 4

This morning I arrived at the hospital early so that I could get to theatre and change into scrubs. I had to wear special shoes and tie my hair up inside a hat. When we went into theatre I had to make sure my hands were thoroughly clean and I wasn’t allowed to touch anything to prevent the spread of infection. There was a patient having open surgery so they had to be put to sleep with a general anaesthetic. The surgeon explained to us what he was doing, as he opened up the abdomen and looked at the large intestine. There was a lot of smoke produced as the surgeon cut into the patient’s abdomen and it didn’t smell very pleasant, but I was really lucky to be able to stand so close and see right down inside the patient. The surgeon had to remove part of the patient’s bowel because it was badly infected and the surgeon said this could either be due to diverticulitis or cancer but he found that the patient had severe diverticulitis. Once he had removed the diseased part of the bowel and reattached it, he had to make sure that it was completely sealed. They filled the abdomen with water and pumped air through the intestine; there were no bubbles, which meant that the bowel had been stitched together and there were no gaps. The surgeon was then able to put in a drain, and then two other surgeons stitched the patient back up. The whole operation took about three hours and it was really fascinating to watch and I was glad that I got through it without feeling queasy. I was surprised at how many people were involved in the operation. There were a few nurses, two anaesthetists monitoring the patient and giving them medication throughout the procedure as well as the consultant surgeon and two other surgeons who helped him operate. It was really exciting to watch how they all worked together efficiently and to see how they worked as a team with the consultant surgeon and the anaesthetist in charge. 

After lunch I went to an occupational therapist outpatient clinic, which was really interesting. They specialised in hands, and many of the patients had sprained or fractured part of their hand and needed to rebuild the strength by doing special exercises and they also had to bathe their hand in hot and cold water. I was able to try out some of the exercises and have a go with some of the weights used to build up strength in your hands. It was really good fun and I got a good insight into another healthcare profession with a lot of patient contact. 

Stafford Hospital – Day 3

I started the day in Endoscopy with a gastroenterologist who did two colonoscopies, while we observed. It was really fascinating to watch as it was like surgery but less invasive and the patient didn’t have to be anaesthetised. It was like playing on an x-box or playstation as the doctor had to have very good hand-eye coordination to navigate the endoscope through the large intestine. I watched as the doctor stopped some bleeding in the bowel of a man who had had radiotherapy, and then watched the doctor remove three polyps from a man’s bowel.

Then in the afternoon I went to Cardiology and watched a transesophageal echocardiogram – it was interesting to watch how the doctor gained the trust of the patient before giving them an anaesthetic to put them to sleep. Afterwards I attended the Angina Clinic, where patients were doing exercise tests to see if they suffered chest pain when their heart was stressed. I enjoyed the clinic as the doctor had time to chat to the patient and gain a history before examining them and then working out a plan for treatment if needed. 

In the afternoon a nurse showed us around a cardiovascular ward, telling us about some of the different patients. She told us how the patients who were violent, or at a high risk of falling due to a stroke were in beds opposite the nurses’ station so there would always be someone watching them to make sure they were OK. She taught us how to take blood pressure and measure temperature and oxygen levels of patients, which I really enjoyed because I had to use practical and communication skills. We were also able to talk to a junior doctor about applying to medical school and about what life is like in a medical career, which I found really useful and informative.

Stafford Hospital – Day 2

In the morning, we went to see Diagnostic Imaging. First I looked at x-ray pictures of different parts of the body and saw how the image diagnoses illnesses, such as secondary lung cancer, because the tumours show up as small black marks in the lungs. I saw collapsed lungs, joints and fractures and saw how the image can tell you how a patient broke a bone because they fell in a certain way.

Then we had a talk from a nurse about the importance of hand washing and keeping clean in the hospital, to stop people suffering as a result of illness picked up at the hospital. She also showed us the radio substances containing barium or iodine, that patients drink so that images can be taken inside their body, and she showed us catheters and instruments used when operating, such as stents.

Afterwards I went to the general x-ray area where all of the x-rays are done. The nurse showed me how they receive a request form for an x-ray which tells them the area to x-ray; why they need to x-ray that area; and some information to justify why an x-ray will be beneficial to the patient, because there is a risk when an x-ray is taken as it is radioactive and can cause mutations.

She showed us the x-ray rooms and explained how they worked. The nurses told us that if a patient is at risk because they have had a lot of x-rays, a warning flashes up on the screen and they have to question whether an x-ray is actually beneficial or not. We also saw a CT scan which was really interesting to observe.

In the afternoon we went to Critical Care and saw the amazing facilities for the critically ill patients there. There were lots of dialysis machines and ventilators, which most of the patients there relied on. There were trollies ready for emergencies – e.g. one patient’s tube in his trachea came out and he couldn’t breathe so it had to be put back in immediately.  There were also rooms for families to sleep and live in if their relative was critically ill, so they could stay near them in their final days. I also learnt that all of the doctors in Critical Care were anaesthetists, because the patients there were so ill and relied on drugs to keep them alive. There were some alcoholic patients who were suffering withdrawal symptoms and needed full time care and supervision because they could be violent. Lastly, we had an interesting talk from a doctor there who told us about some different specialities and medicine in general.

 

Stafford Hospital – Day 1

Today I started my week on the Aspiring Doctors Programme at Stafford Hospital.

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I met up with the six other work experience students in the Postgraduate Centre and we had an introduction to the Programme from a surgeon. Then I went to the Acute Medical Unit (AMU) with four of the other work experience students and we split into two groups to go on ward rounds with the consultants. The first patient we saw had quite severe dementia and she was confused and was attacking the nurses who were cleaning her. When the doctor examined her she appeared quite reluctant to be seen and didn’t really seem to understand what was happening. She had also refused to eat or drink anything and had spat out the medication she’d been given at her care home. The doctor said afterwards that patients with such severe dementia probably wouldn’t be resuscitated if they suffered from a cardiac arrest.

We also saw another elderly patient who started crying when I asked her how long she’d been in hospital. She said she’d been having hallucinations and could see people around her, calling her names. First the doctor asked her some simple questions, which either she couldn’t answer or made her confused and then he examined her movements, which weren’t very good, so he decided to refer her to the mental health ward, and said she was probably developing dementia.

Many of the patients in the AMU ward were elderly (from 85 to 90+) and there were also a lot of patients who were alcoholics, which meant that some were quite violent and difficult to treat. The consultant examined all of the patients before making a list of possible causes (differential diagnosis). Then he arranged for tests such as CT scans to find out the diagnosis so that a plan for treatment could be made. He said that it was usually a very simple test, such as a urine dipstick test, that would diagnose a patient.

Unfortunately, one of the work experience students then fainted, so she was given a bed and her blood pressure was checked. It was very low, so she was taken down to A & E for an echocardiogram.

At the end of the ward round all of the doctors and the head nurse came together to review all of the patients and discuss what needed to be done. It was really interesting to see a typical morning for a doctor in AMU, and to gain an insight into some of the challenges that doctors face; patients who don’t want to go home; patients with dementia who won’t comply because they’re not competent; and violent patients who have problems with drugs or alcohol.

After lunch we had some paediatric basic life support training, where we learnt how to resuscitate babies and young children, by doing mouth-to-mouth resuscitation and compressions on dummies. We also learnt what to do if a child or baby is choking and had a chance to ask a nurse about what it’s like working in paediatrics.

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Later, we learnt some surgical skills from a surgeon who taught us how to tie together blood vessels and different ways to stitch up wounds, which I really enjoyed.

London School of Hygiene and Tropical Medicine Work Experience

This week I travelled down to London on the train and stayed there for a few days, visiting some of my old friends from Malawi. I’d never been by myself before, so it was a really good experience for me to learn how to use the buses and tubes to get around which I really enjoyed. 

A few weeks ago I got in touch with Alan Dangour, the head of nutrition at the London School of Hygiene and Tropical Medicine (LSHTM), and organised to spend a day there with him. I arrived this morning and I was amazed by how big the building was and how new and modern it looked inside. I met Alan and he explained a bit about what he does and what happens at the LSHTM. 

I told him I was interested in learning more about malaria so he gave me some malaria research papers and asked me to read through and summarise them. There was a systematic review and meta-analysis about socio-economic development as an intervention against malaria which I thought was really interesting. I went through and highlighted important points, then made a powerpoint presentation about the methods used, their findings and a conclusion. 

It taught me about the way research is carried out and about how to use papers. It was quite confusing to interpret the results at first because I’d never looked at odds ratios before, but I enjoyed learning how to use them. 

Later we watched people give presentations about a few different topics that groups had been researching which were really fascinating. They ranged from smoking, back pain and alcohol to how cycling fatalities are reported on by the media. After lunch I presented the powerpoint which I had put together about how socio-economic development can be an intervention against malaria, and answered some questions about what I’d learned, which was a really good chance to practice my public speaking and communication skills. 

I really enjoyed the whole day; it was such a great opportunity to gain an insight into medical research and into what it’s like to work at the LSHTM, and I’d like to thank Alan for  giving up his time for me.

Gold Duke of Edinburgh Expedition 28th June – 3rd July

A group of 12 of us set off on Friday morning, arriving at a campsite in Dartmoor in the afternoon. The first couple of days were acclimatisation days. On Saturday we went out for a walk with a couple of teachers to practice our compass work and navigation skills. After lunch we drove into Dartmoor town, past the prison and looked around the visitor’s centre to gain information for our group work about ‘Human Influences On Dartmoor Throughout The Ages’. That evening we had a barbeque and prepared for the four days ahead.

On Sunday we were driven to our starting point and we set off. There were lots of wild horses wandering around but we couldn’t see much more wildlife in the mist. We were going along well until we reached a split in the path where we got a bit confused, so three others went a little ahead and checked one route by taking a bearing but it was wrong so we carried on straight. I was the photographer so I took lots of pictures of the stone ruins and other points of human influence as we walked along. We reached a stream that we needed to cross and met a different D of E group there, so we waited for them to cross before carrying on. Adam went first but the rocks were quite loose and he dropped his bag into the stream and it got very wet. There was another disaster when I wanted to take a picture of a windmill and realised I’d lost my camera. Katherine, Diya and I ran back a short way down the hill and luckily I found it, but then we had to climb back up to the others. Amazingly, we reached the first checkpoint on time after trudging up a marshy hill and soaking our boots. We were happy to fill up our water bottles and have a short rest because it was getting very hot.

We carried on walking and stopped for lunch later, on the top of a hill with a great view. We topped up our sun cream because by then the mist had gone and it was really sunny. The route on day one was fairly easy and enjoyable. We met a couple of the teachers again at a checkpoint near to the old tin mines and then kept walking. We lay in the sun for a short while on a hill before meeting two other teachers by a rock and we headed down to set up our wild camp. It was about half past five when we put up our tents next to Black Ford and then started cooking our dinner on a meths stove. It was quite warm so we ate outside and then washed up our plates in the stream before going inside our tents, although it was hard to get to sleep after discovering a dead sheep right outside our tent.

On Monday we had packed up and eaten breakfast by seven so we set off again, over the moorland. We got quite lost early on trying to find a wall, which was on the map but not actually there at all. Eventually we found the large lake next to some old clay works and got back on track. From then on it was hard work as we kept sinking in the wet and muddy marsh and we had to leap from one lump of dry grass to another to try and avoid getting our boots any wetter. We got through the moorland eventually and out of Dartmoor then carried on walking. We reached the top of a large hill and waded through spiky plants until we could see the reservoir and we made our way down. It was late afternoon when we arrived at the checkpoint by the reservoir and topped up water and used the proper toilet. I realised I was very sunburnt, so I covered myself in sun cream and had to put on a fleece to cover my red arms despite the boiling temperature! We made our way through a village and then walked along the river. We realised we’d taken a wrong turn so we planned to re-join the route after crossing some stepping-stones and corrected ourselves quite quickly. There was a short stretch of road leading to our camp but it seemed to go on forever. We arrived and went to sleep almost immediately after putting up the tents and cooking some tasty hot rice.

When we woke up on Tuesday there were swarms of flies, which filled the tent as soon as we zipped it open. We packed up quickly and set off by seven. The third day was the least enjoyable with frequent showers, mist and lots of hills. We started off in the morning with our waterproofs and woolly hats, as we climbed the first Tor. Later on at the top of another Tor we saw the other group from our school but waited for them to go ahead before we carried on. A while later, we saw a couple of teachers, from a different school, and they filled our water bottles then headed off. We made our way down to the valley and crossed a bridge when the mist suddenly came over and so we could no longer see. We decided to wait there and let it clear, but it started to rain heavily so we changed our minds and headed up the hill. The mist was so thick we couldn’t see the valley or anything else once we reached the top and the path disappeared. We set our compasses for Manga Rock, the next point and started walking in that direction. We decided that three people should go a little way ahead and the others wait until we whistled. We kept checking the compass and counted our steps to work out how far we’d come. The weather was worsening and we weren’t sure if it was the right direction. Some of the group wanted to use the emergency phone but we tried to stay positive and we encouraged each other so we carried on. The ground was very uneven and there were lots of holes, which we kept falling into. Finally, we reached the rock and we could see the Tors we needed to get to in the distance. We took bearings then carried on walking until we stopped by a wall that gave us a bit of shelter from the rain and strong wind, where we ate lunch.

We walked on, more confident that we were on the right track because the mist had lifted slightly and we were able to see certain checkpoints. We walked past the stone ruins and hut circle on the top of a Tor, but we weren’t sure where to turn off and head down to the valley so we left the path and went down too early.

Luckily the teachers were waiting at a checkpoint below and spotted Katherine’s neon yellow rucksack cover. We found them and they helped us to find out where we were and we reached the checkpoint by the stream. We then had to go through a village and carried on a bit further to our second wild camp at Gulliver’s Steps. It was so windy when we arrived that it took all of us to put up one tent at a time so that they didn’t blow away. Katherine and I started cooking and ate our dinner outside, while the others stayed in their tents because it was freezing cold and really wet.

We got up at about six in the morning and started our last day of walking. We found quite a lot of army debris around the campsite and on our route, which was very close to the army’s shooting range. We began to follow our planned route but the track was closed because there was shooting and we saw a large army truck drive past with lots of soldiers. We had to turn back and use a different path to get back on route. Later on we found ourselves in the middle of an army camp and there were hundreds of soldiers asleep in tents all around us, so we crept quietly past. We had to climb some more hills and I took some pictures of the wild horses we passed. We reached the reservoir quite early, at about 10:30, as it started to rain. We had a short break and saw the teachers before setting off again for the last leg. I had hurt my ankle which was quite painful but we carried on at a slower pace. We sat down in a field for a rest but had to get up quickly when we saw people on horses coming towards us, who were herding cows into a field further up. Eventually we found the river Lyd in Lydford and knew that we had just about reached the end. It was such a relief to see the school minibuses and the teachers waiting for us at the end. We arrived just past lunchtime and evaluated our expedition with our assessor. We were all happy that we passed, and it felt so good to get on to the bus and sit down!