Thursday 4 December 2008

Survivor

I survived today. In fact I'd go as far as saying the whole day went pretty well. Not only did I feel a lot healthier than I did yesterday I also didn't burst into tears talking about that story. Tonight I even managed to cook dinner, whereas last night I sat crying into my bowl of cereal. Self pity is not a good thing.

The question of whether or not I'll survive tomorrow is a completely different story. I have the dreaded GP placement in the afternoon. As lovely as my GP tutor is I find the whole thing terribly boring. He criticises the 10-15 minute histories we take in the hospital and insists we spend at least half an hour. Although this is a nice opportunity to chat it goes against everything we've been taught. We're encouraged to allow the patients we see to wander off on to tangents...

Here is a little example to show you what I mean...

Me : "So can you tell me a little about the pain you say you had?"
Patient: "Well... I was on holiday in the Algarve, got a really good deal on teletext in fact, you should have seen the quality of the curtains in the hotel room I stayed in. So we were planning on a few days at the beach and a day looking at a museum but then one morning I got a really bad pain in my chest."


The GP loves this. He encourages us not to ask the when's and wheres of pain, or pretty much details of any symptoms but tells us just to use tactful silence to let them eventually tell us their problems. And in all fairness, a lot of the time, after half an hour, with only a few questions I do get a pretty complete history.

Now this is great as it makes the patients feel listened to. In the real world will we have the chance to do this? No. It also doesn't suit all patients. Take me for example. Whenever a doctor has said "What do you think the problem could be?", I've looked at them like they're insane. I'm not a doctor (yet). If I knew I'd go in there and ask for the right medication. As I'm always pretty busy when I go to the doctor I also like it when they ask everything they need to know, I tell them and I get my medication.

I realise that there is a time and place for longer history taking. However I don't think that a couple of weeks before we have an exam which includes a 6 minute history is the right time and place. At least it's a good practice for our mental health attachments which include much longer histories.

Lily xXx

1 comment:

Dragonfly said...

Don'tcha love it when if you do something different everyone assumes it is wrong, instead of the way you were taught to do it...

I have had similar experiences with the social history...some clinicians insist it comes first, others insist it goes last.

And the same goes for scrubbing in theatre and many other things...ah the joys of being a student. At least they take an interest in teaching I suppose...