Hospex Work Experience

Recently, I was lucky to get the opportunity to do work experience in my local hospital as part of a programme called Hospex. This consisted of three full days spent in various departments within the hospital, observing the many contrasting procedures and consultations that occur every day.

Upon arrival at the Education Centre in the hospital I met the other participants, who were other year 12 students from around the city. We were then given a map of the hospital (which turned out to be extremely useful!) and our timetable for the three days. As it was our first day we were escorted to our first sessions.

The area that I visited for the morning was the renal ward. Here, I sat in with one of the renal consultants to observe. During this time he saw several patients of a variety of ages and backgrounds with different problems. Most of them had come for a check up after having tests such as blood tests or scans and the consultation mainly consisted of the doctor telling the results, explaining the problems and then any further action that was to be taken. Despite the patients having similar issues, each appointment was different to the last. For example, the first one was simple and quick – where the patient, a middle aged man, was told his results, the problems were explained and he left content. In contrast, the following patient was a young woman in her early twenties. She was highly emotional and this appointment was much longer, as she required a lot more reassurance, in addition to more explaining to understand the problem. From this session, I learnt that doctors require a high level of patience, empathy and should also be good at breaking things down into simpler terms to help the patient understand. I also found out that renal is the kidney area, in addition to the sorts of kidney problems people suffer from.

It was then lunchtime, which involved navigating myself to the food hub; the Food Hall. This proved to be quite a challenge because of how enormous the hospital is but eventually I remembered that we had been given a map and not before long I was munching away at my lunch. Soon it was time for my next session which was in the Ophthalmology unit.

This was located in a separate building that was joined to the main hospital by an indoor walk bridge. Once I arrived, I was told to sit in the waiting area, which was bustling with elderly patients and a few medical students. I was then called for by the ophthalmology consultant. He was very kind and helpful – dishing out university advice and tips between appointments. Before we saw the first patient, one of the medical students who had also been in the waiting area came and joined us. This was very lucky for me because I also got the chance to discuss university life, studying medicine and the entry examinations with a student who had recently gone through the process. In addition to all of the talking, we also saw patients! The majority of them either had or were at risk of glaucoma. This is an eye condition where the optic nerve is damaged by the pressure of the fluids within the eye. As a result, the appointments were all very similar. However, there was a case where a man was allegedly faking his cross eye – most likely for benefits. Although from my work experiences so far this seems to be a surprisingly relatively common occurrence. Additionally, the final patient had a genetic disease which could even lead to blindness and sadly both of her children had also been passed on the disease. The doctor let me see into her eye and told me how the red colour was a blood vessel. After the last consultation it was the end of the day.

The first day showed me the importance of communication and social skills with patients. I also learnt about the value of patience which proved to be a necessity when explaining and discussing issues.

On the second day my morning session was in the Spinal Outpatients ward. This was a small section of the building attached to the main hospital with a few consultation rooms. Upon arrival I was taken to the consultant who I was to be shadowing for the morning. He was running between all of the rooms frantically discussing patients with other doctors and nurses. The morning session once again consisted of several consultations that mainly involved talking to the patient. One of the first patients who came through was bedridden and had come from a different part of the hospital. Luckily the hospital had been built in such a way that beds can be easily moved in the corridors and into the various rooms. One of the consultation rooms was larger than the rest, presumably to cater for bedridden patients, which made it easy for the consultant to see thm. The rest of the morning involved running between the consultation rooms and the office and soon the session finished.

After lunch on the second day I was supposed to be with a junior doctor. However, this was not to be… When I went to see the doctor he explained that there was little to do other than writing up patient reports. So instead he took me down to where endoscopy procedures are carried out. An endoscopy is where a long, thin, flexible tube with a light source and camera attached to one of the ends is inserted through either the mouth or bottom. I managed to see two procedures which were both through the bottom, this is called colonoscopy. Additionally, I saw the procedure consent carried out, which was surprisingly very thorough. It went through the procedure risks including ones which there was an extremely slim chance of occurring. The entire process was relatively short and the patients were put on anaesthetics to reduce the pain. The camera clearly showed the path from the bottom to the intestines as the image was portrayed on a screen in clear quality, colour live stream. In both cases the pathways were fortunately clear.

From the second day, I learnt that doctors require enough stamina and drive to be able to rush around without having breaks to sit down for long. Additionally, I realised that to be a doctor you not only literally have to be on your feet but also metaphorically, in the sense that you should be able to think fast when necessary, like when the bedridden patient came. Once again the value of patience was shown because despite having an endless consent form it is still a must to go through even if some parts seemed unnecessary.

The next and final day proceeded to be the most thrilling. This is because I had the wonderful opportunity to go into theatre. This meant suiting up. After signing in I was shown to the changing room with some scrubs, shoes and a hair net. This was exciting because I got the chance to dress up like a real surgeon. After having suited up I was told about the procedure that was about to occur: a relatively old lady’s thyroid was getting to be large and was behind her sternum instead of the neck. This meant that the doctors needed to operate on her to remove the thyroid which could even turn cancerous. The doctor who would normally deal with such cases had already assessed the situation and realised that it was going to be a tough patient. He then accepted the fact that he needed help in the operation to ensure the best for the patient. Upon awareness of this he decided to ring up a consultant from Nottingham to assist as this just so happened to be this doctor’s speciality.

The process for the operation began in the anaesthetics room which conveniently opened up onto the operating theatre. In the first room, before the patient entered, the medics, nurses and students who were carrying out the procedure had a small meeting. Here they began by introducing themselves to each other and stating what each persons role was. This was because different people work on different cases and some people end up never having worked together. They then discussed the required equipment along with roles within this specific procedure. Once the gathering was complete the operating began.

The patient entered the room on a bed, prepared in a gown. In the first room there was a student, a nurse and the anaesthetics consultant, who was constantly explaining what he was doing to the patient. He inserted a needle into her wrist and then added the anaesthetics to the needle. Within no time the patient was lifeless. They were then wheeled into the operating theatre where the rest of the team were waiting. The patient was then placed onto the table and taped up leaving only the area that was to be operated on. To start with the patient’s chest was cut open using heat. Once they had past the flesh they had to use a saw to cut through the bone. This was dangerous because it was so close to the heart and if touched the patient would have died. After going passed the bone the team fished around to pick out the thyroid. Throughout the process there was a lot of blood coming out but this was safely being controlled by one of the nurses. Additionally, the patient had made an unusual request for a photograph of the thyroid lump. This meant the medical photographer had been called upon. So once the thyroid had been removed he began snapping away at it.

Whilst this was happening the rest of the team began closing the patient up. To do this they first had to wire up the sternum bones back together. This was a vital part because if they were not joined back tightly enough the patient would get into a lot of pain due to the bones rubbing against each other in the future. A metal wire was used to tie them back up and the skin was carefully sewed back together, completing the procedure. The team then disassembled and the patient was taken to ICU (Intensive Care Unit). Although the procedure may seem quick to describe it was actually a very lengthy one which meant there was sadly no time to see anymore.

From this session I learnt that to be a successful doctor it is necessary to know your limits and understand when you should call help, instead of trying to be a hero and do it all alone because everything should be done in the patient’s best interest not your own. If the consultant had decided he was too good and could do the procedure himself, there could have been several implications all at the patient’s risk. As a result this showed me how key knowing ones limits are. In addition to this I was once again shown the value of communication and teamwork. In order for an operation to work an entire team is needed to work cooperatively together. As well as this, I also realised that one should not be so stressed and panicked in situations. This is because within the operating theatre everyone was calm, relaxed and composed which made the procedure much easier to carry out.

Overall, this was absolutely one of the best experiences that I have had so far and managed to get so much out of. The skills that I have learnt will hopefully help me in the future, not just on my journey to medicine but in my general life path.

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