My week in Neurosurgery

I recently returned from a fantastic week at Addenbrooke’s Hospital, spent with the neurosurgical team. This was my first week spent in hospital accommodation (as it’s very far away from me!), which was surprisingly pleasant and made me feel more part of the hospital. Most of my time was spent on ward rounds with consultants and their teams. I really enjoyed being able to see CT and MRI scans, and I even found I could make sense of (some of) them! Most of the patients were post-surgical, having had tumours removed or craniectomiess, so the doctors spent a lot of time talking to patients about their recoveries and treatments. I also spent a day in the NCCU, which was my first time in this kind of intensive environment. It was fascinating, if very busy, mainly due to two extremely sick patients. Whilst the other patients all had significant care needs, the two patients had whole teams of doctors and nurses surrounding them. In addition, it showed me the difficulties of doing CT scans on patients who needed to be connected to IV drips and other machines as they had to be done in situ, meaning the machines had to be carefully manoeuvred through the ward and into position.  I was struck by the size of the team and the resources used on a single patient – the NHS is a service to be proud of. Unfortunately, the patient died despite the best efforts of the teams involved. All in all, I had a very enjoyable week and have learnt a lot about neurology and neurosurgery!

UKCAT

Just took my UKCAT and got my results as follows:

AR - 630
VR - 760
QR - 900
DA - 900

This has a total of 3190 and an average of 797.5!

My week in the Old School Surgery

I've just finished ( :( ) my week in the wonderful Old School Surgery, a GP surgery in Wiltshire. I had an incredible week, and managed to see some of the wide variety offered by the surgery. On Monday, I had my induction into the surgery, where I learnt how to use the computer system to book appointments and help order repeat presciptions and how to answer the phone (however putting people of hold was a skill that took me about 5 failed attempts of hanging up on people to master!).
I spent all of Monday and Thursday morning (as they are closed the afternoon) in Reception, for the most part scanning in letters to the GP surgery (e.g. from hospitals or A&E notifications) and adding patient, letter and sender details, and then filing them into the system and sending them to one of the doctors to read. This re-iterated the importance of proper notes, but also showed to me how important the services of reception are to the smooth running of the surgery and the importance of good teamwork.
On Tuesday, I spent the morning with the Nurse, watching her doing INRs, taking blood, measuring blood pressure, removing stitches, changing dressings and trying to remove a tick that seemed very insistent that it was not to be moved. In the afternoon, I sat in a GP clinic, where it was interesting to see the difference in the nurse/patient and GP/patient relationship, with the nurse/patient being a lot more jovial and relaxed than the GP/patient one.
On Wednesday, I spent the morning in a GP clinic, with a different GP, who had been at the surgery for longer, where it was fascinating to see the difference in the two GPs, as, while they had a similar, clinical yet friendly feel, the newer GP knew the patients less well, so had a slightly less personal, though equally friendly feel. I spend the afternoon in the dispensary, helping to find and check medicine. I started off needing about 5 minutes to find anything, although I progressively got quicker at finding things once I knew where to look! I learnt how everything that's done needs to be checked by another person, and about the drug tariff and dispensing fee.
On Friday, I spent the morning back in the GP clinic, where I saw some of the problems facing GPs, for example alcoholics and people with co-morbidities. I also saw the difference in how some patients treated their GPs, with some not seeming to pay any attention to the advice given to them, to one man saying "God bless you" (including to me, for some reason!) every minute. It was patients like these that showed me part of the rewarding side of being a GP, contrary to criticism in the media and what may be the popular belief that patients are all rude and come in with a cold. In the afternoon, I was back in Reception, continuing my vendetta against the pile of letters requiring scanning. It was nice to finish where I started, but it didn't make me any less sad to be leaving that afternoon. Just as I was about to leave (for the second time, after I had been delayed the first time with people at the desk and then a phone call!) I was presented with an envelope containing a £20 gift voucher! This was totally unexpected, because I felt I should be thanking them for the experience they gave me!
Overall I had a fantastic week, and really opened my eyes to the prospect of being a GP!

Medsim

A couple of weeks ago, I attended the Medsim course in Nottingham Uni. It was a fully packed weekend, filled with Clinical Skills (like Ultrasound, taking blood pressure, using stethosccopes) and practicing talking and diagnosing patients. In one session (claimed to be Clinical Analysis), one of the helpers ran in halfway through, shouting that there was an 'emergency' that we needed to help with. There were 3 different scenarios we worked our way through, including a car crash, a drug overdose and a woman who had had a heart attack. As a group we eventually got better at keeping calm and managing to keep the 'patients' alive. It was a very exciting evening, where I learnt a lot about the correct protocol and behaviour in an emergency. Overall I had a really great weekend (especially as I wore scrubs all weekend and got to take them home - guess who has some new pyjamas! :) ).

A very cold collection

Once again, we braved the elements to do a collection outside the local farm shop for CHSW. It rained. It was cold. And it was windy. After 6 hours collecting, we were very cold, but it was worthwhile as we raised just over £200 for CHSW.

Infection Prevention and Control

There's been a lot in the news about bacterial resistance to antibiotics - how this is increasing and new antibiotics aren't being developed quickly enough. I had the opportunity to spend some time this week with the Head of Infection Control at Musgrove Park Hospital. Big improvements have been made there in the number of MRSA infections, where they haven't had a case in over 700 days! Also, in C Difficile and Norovirus, there are decreasing numbers of cases. We talked about the importance of the right antibiotic prescribing in preventing C Diff and quick identification of patients with symptoms to allow early isolation. I read recently in New Scientist that it only takes 18 cells of Norovirus to cause an infection, so you can see why it is so contagious and difficult to control in hospital and care-home environments.

Easter Bonnets at Rowden House

Recently, I went to Rowden House (after being unable to the week before due to Norovirus) and we got there just in time to see their Easter Bonnet parade. The staff invited all of the residents to the dining room, where I was playing my saxophone, playing some hymns that I had been practising specifically for Easter. Whilst it took them a while to congregate in the dining room (about 45 minutes!), a quick quiz all about Frome began, which no-one seemed to know any of the answers to due to the ridiculousness of the questions! After the quiz, the judging of the Easter bonnets began! All of the residents had already made their bonnets with their entertainer, although some had to swap owing to the size of their hats. In the end, the best bonnet won first place, but we were unsure about the following ones! It was really nice to see the effort that had gone into it, and the fun that all of the residents seemed to be having.

One of my favourite residents (Doreen) and I

First and Fourth prize winners!

First Aid Qualification

I recently gained a qualification that allows me to be a first aider in the workplace. I have been training for it in my general studies lessons and took a 3-hour practical and multiple-choice exam. The practical skills side of the course entails: being able to assess a situation and decide the best course of action, the recovery position, chocking, CPR, using an AED and how to deal with cuts and bandaging (among other things). I really enjoyed learning about first aid and am glad that I now know what to do in case of an emergency!

The Haven

It’s been about 6 months since I started visiting a nursing home once a week – The Haven - in addition to my current residential home – Rowden House. Whilst both seem to be very good homes, they have some fundamental differences that I’ve noticed, probably due to one being a nursing home. Firstly, the people in The Haven all have severe dementia, which is less severe at Rowden, owing to the higher level of care that they require. This means that it is a lot harder to have a conversation with them (though we still try!), but they do still like the saxophone! Secondly, the security at The Haven seems to be a lot tighter, including an alarm going off whenever the door is opened and a keypad to open the door, in case people forget that they probably shouldn’t go outside, especially as it is near a road. Also, whilst Rowden is a lot bigger, both homes have about the same number of staff, again due to residents needing a higher level of care.