Islip Medical Practice

Last Monday, I went to Oxford to spend a day with Dr. Lisa Ibbs in the Islip Medical Practice. I started off by visiting the local nursing home, The Manor, which cared for elderly patients, mostly with severe dementia. The Islip Medical Practice provides regular medical support to The Manor and its residents. Having regularly visited Rowden House, a residential home, I could very easily notice the difference in the severity of the condition of the residents, most of whom were bedridden. Next, I sat in with the Practice Nurse, where I learnt the general role of the Practice Nurse and a lot about childhood immunisations. This showed me how much doctors rely on the nurses for a wide range of tasks, such as tests, vaccinations and chronic condition check-ups, e.g. diabetes. After lunch, I went to the dispensary where I helped find drugs for peoples’ prescriptions. After being repeatedly instructed to check the type of drug (e.g. capsules vs tablets) as well as the dosage, I further appreciated the importance of getting the medication right. I was also told that morphine was kept in a locked opaque cabinet, and had to be signed out by doctors due to its controlled drug status and addictive properties. I spent the rest of the day with Dr. Ibbs, mainly in her surgery. Firstly I watched Dr. Ibbs change a catheter which demonstrated a common complaint with an ageing population. Next, I saw the other end of the age spectrum – a baby’s 6-week check-up, where Dr. Ibbs checked the baby’s measurements, hips, skull and breathing. It was adorable! I then saw a large range of patients with conditions from conjunctivitis to ankle injuries to stomach pain. This taught me the large variety of illnesses that GPs have to know about, and that GPs have a very different relationship with the patient than most hospital doctors. Dr. Ibbs also told me that, whilst you do get a lot of people coming to their GPs for common ailments like coughs and colds, you also get a lot coming for chronic disease check-ups. Finally, I accompanied Dr. Ibbs (as duty doctor) on a home visit to an elderly patient with a suspected infection. Whilst I only had a day, it did give me a real snapshot of life as a GP. 

Pathway to Medicine

Back from another 2 days at Musgrove Park Hospital where I have spent the time on the Pathway to Medicine programme. This involved a general introduction to the NHS and a talk on infection control, which taught me what I needed to do to minimise the risk of spreading infections. Then came the fun bit! I met up with an F1 doctor who was working in the respiratory ward and who I would be shadowing for the next day and a half. It was really exciting to get closer to patients and the different types of treatment. Some of the things I enjoyed seeing were chest X-Rays, blood tests and a diagnostic lung tap, to see if any fluid in the lung was infected. I was also lucky enough to accompany a long consultant ward round and it was interesting to see how the consultant talked to both the patients and the other doctors who were in training. It also showed me that being a junior doctor involved moments that may not have been exciting (i.e. paperwork) but that they were still really important to patient care. These two days have made me even keener (if that's possible) on becoming a doctor.

The endocrinology clinic

So today was the day I learnt more about diabetes! I was invited to accompany Dr. Close (Medical Director) at Musgrove Park Hospital during his outpatient's endocrinology clinic. A number of these patients have had diabetes for many years and were suffering the side-effects such as kidney failure, circulation problems and eye problems. This taught me that for some conditions, treating the side-effects can be as difficult and as important as treating the main condition. What I found really interesting was how Dr. Close's communication style changed with each patient so that he and the patient got the most out of every consultation. It also further proved to me that not all patients can follow instructions and take their medication, even when they know there are significant risks.

Shadowing a matron

Monday 2^nd April started early for me! Leaving home before 6:30 to get to Musgrove Park Hospital in Taunton by 8 am proved ... a bit of a challenge, but by the end of the day, it was well worth while! I was lucky enough to be shadowing a matron (Sally Maltravers) who looks after Endocrinology amongst other wards. First of all, I toured the Endocrinology ward with the other nurses who were discussing changes that would be made to allow for two single sex recovery rooms. I was then given the opportunity to accompany a consultant ward round in the Neurology Unit which focused on rehabilitation. This was great, as this is an area that really interests me, and taught me that whilst doctors generally know what’s best for the patient, the patient isn’t always co-operative, so listening skills, having patience and staying calm are all very important. After that, I went to SAU, where I learnt the role of the ward sister and the need to balance time spent with patients and time managing staff. Towards the end of the day, I headed to a meeting to discuss the changes to the Endocrinology ward, which involved people from different functions in the hospital to talk about practicalities of the changes and to suggest alternative options. This showed to me the planning side of medicine and the number of things that nurses and doctors get involved in.

Battling Infections

2 weekends ago, I tried to visit Rowden House as normal. When I arrived there, there was a sign on the door informing visitors that they had had an outbreak of Norovirus in the home, and no visitors were allowed. The following weekend, all was back to normal, but some of my favourite residents were still suffering the after effects of this infection. I’m aware that Norovirus is common in the community but younger people usually recover quickly. At Rowden House, many of the residents are over 90 and it took them a long time to recover. This showed me how important it was to control any infections, especially in very communal areas. The residents were very pleased to see me, and enjoyed their sing-a-long to my saxophone playing even more than normal.

Over £5,000 for CHSW!

It’s been almost 5 years since I started fundraising for Children’s Hospice South West, and have just reached my £5,000 milestone (most recent total is £5,528.44)! As you can see from the photo, I was quite young (that explains the silly look!) when I started. I have visited one of the hospices – the one near Bristol – twice and it has never failed to impress me. It’s amazing how such a fundamentally sad place is kept very cheerful and homely, despite all of the specialised equipment. Just before Christmas I did another collection outside the local farm shop and raised £245.20, bringing my total for 2011 to over £1,000. Now I need to start planning my fundraising for 2012!

Visiting a Pathology Department

Over the Christmas holidays, I spent some time in the Pathology Department at Musgrove Park Hospital in Taunton. This is often an area of medicine that is forgotten, but most hospital patients and many who visit their GP will have tests done that find their way to a Path Lab. Getting quick and accurate results from these tests is a key part of quick and effective diagnosis. The team I met were very proud of some recent work they had done to dramatically speed up the cytology process. They had done a step-by-step assessment of their process and removed bottle-necks and delays, so that now, patients and their doctors can get their test results much faster. I was also given the opportunity to look down a microscope at some disease cells and compare them to healthy ones. The differences were often obvious, but some weren’t, showing the skill required to interpret the results. I’m looking forward to going back for a longer visit soon!