Crummy Handovers

I started my elective on Monday morning, and so far it has been fantastic! I've spent the last 2 days with a lovely critical care paramedic and a paramedic who've gone above and beyond to make me feel welcome and to teach me stuff.

We haven't been that busy, but we have had some interesting jobs that I'm sure I'll mention in the future. However the most important thing that I've learnt so far is about a good handover.

A good handover seems to be a mysterious thing for ambulance crews. This isn't their fault.

Over the past few days I've witnessed many incidents of nurses and doctors not really listening or not allowing paramedics to handover properly.

A prime example of this was yesterday. We brought in a lady with a serious neurological condition. We did this because we witnessed her change conciousness levels, black out and switch between aggressive and just simply away with the faeries. To put it into context one minute she'd be thrashing around, shouting abuse and trying to get out of the ambulance, the next she'd be slumped and not even flinch while having a wide bore cannula shoved in her arm.

Turns out she'd self discharged against medical advice the day before. She'd also been aggressive towards the hospital staff. As you can imagine they weren't happy bunnies. In fact, the hospital staff were so rude while handing over that the patient tried to get up and leave. Great. Making her more aggressive. They then kept interrupting while not listening. The handover could have been 30 seconds long and if they'd have listened they'd have understood that we'd seen some worrying clinical signs. Annoyingly it took us about 4 minutes to get someone to listen to these clinical signs because they were too busy interrupting and basically saying that they didn't want the patient because the patient had been trouble before.

So next time you're in a&e listening to a handover, do just that. Listen. You might learn something new about the patient even if you've known them before.

Once you've listened and got the full story, then start asking questions or making comments. If you do so before you just look stupid and grumpy.

Lily xXx

Bye-Bye...

No not me. I'm staying here for until the end of next month.

Facebook is filled with everyone's status updates. "Flying in 3 hours" or "Just landed in Tanzania". It's exciting just reading it.

I hope everyone has a safe journey and an amazing time. I know that I can't wait until I'm jetting off on a plane to Samoa! I'm also already looking forward to coming home and seeing everyone's pictures and hearing their stories from elective. Thank goodness we're all in London for the first couple of weeks after we get back.

If there's one piece of advice I can give to everyone is pack a spare pair of pants and t-shirt in your hand luggage. It's bound to go missing if you don't!

Lily xXx

Time Flies

This time next week will be the night before my elective starts.

That means that this time last week will be my last night of "real" holiday before 5th year. Something tells me that elective should be even better than having holiday time though.

Over this week I've got lots planned. The first part of the week will be taken up helping a friend revise for her OSCE exams and dinner with a friend before they jet off to America. The middle part cooking an amazing meal for my Dad's birthday. Then the weekend at Farnborough Air Show with my Dad and some of his friends. It will really be non-stop.

The first 4 weeks of my elective are still in drizzly, windy and recently gloomy England. I'm spending time with an ambulance service. Soooooo excited. Fingers crossed early next week the guy who's organised it for me will email me with what I'm doing and where to go. I also need to ask him what I should wear. Sounds like a pointless girly question... but really... What should I wear?!

I then have a week to recover from the excitement and long days of the ambulance service before I have to hop on a plane for 25 hours. Well 2 planes actually, and 3 of those hours are at an airport. Then I'll be landing in Samoa. It sounds cheeky but I'm hoping that Samoa will be quite laid back. I definitely want to learn medical things, but I also want to get a chance to explore the islands and the culture. I haven't really decided what to pack yet except 4 bikinis, a couple of pairs of linen trousers and a pile of T-shirts.

Lily xXx

Finally a Final Year

It's official, I passed my OSCE!

That now means that I'm a final year medic.

On one hand it doesn't feel like I've been at university for 5 years, on the other hand I'm starting to get a little fed up of student living.

It's incredibly scary to think that I have 1 year left at university. 1 year left living near the vast majority of my friends, 1 year left where we have relatively little responsibility, 1 year until I am expected to know what I'm doing...

By the time I get back from elective I have a sneaky suspicion that it will all zoom by in a flash. There will be foundation applications, then christmas, then we find out jobs, then easter, then exams, then graduation.... then the real world starts!

I am planning to celebrate today by cleaning my flat. I am so rock 'n roll.

Lily xXx

Graduate Tax

Another thing for us students to moan about.

I can't quite decide whether I think graduate tax would be a good or a bad thing. On one hand the money for universities has to come from somewhere, on the other hand it would be nice not to be paying out for university all the time.

What really bothers me about paying for university is the fact that for the next 10 + years of my life I'm pretty much tied to the NHS. So I'm paying lots of money, to learn how to do a job, to then work for a government organisation.

This isn't too bad in itself.

What makes this bad is the fact that I'm starting to feel hard done by. I have more than 1 friend who hasn't gone to university and has had a baby. Now that these friends are single parents to young children they can't afford childcare so instead stay home on benefits. These friends live in nicer houses and flats than me, can afford sky TV and seem to spend a couple of nights a week either getting takeaways or out drinking.

I feel that I'm being penalised for wanting to do a job that will help people. If I'd decided to have a baby and stay home I could be curling up on my new sofa, watching sky on my 37" TV.

I know it's controversial to say this, and I'm sure that there are people on benefits who not only deserve them, but spend them wisely... but the more people I talk to the less that seems true.

I'd be happy to pay a graduate tax if I didn't see other people get handouts without having to put any effort into life.

Perhaps if the government only gave benefits to those who needed it, and then made sure they weren't giving money out to be spent on sky TV and nights out clubbing, then they'd have more money for education.

Lily xXx

What to do?!

I had to pop to the shops today in my revision break.

I was wandering past the place where madsadgirl and I often go for a cup of tea when I noticed something. Someone had collapsed on the floor and was surrounded by people trying to help.

I slowed down and thought "hmmm... maybe I should go and help..."

I walked over to the entrance next to where the lady was collapsed and was told by a security guard to go away as the situation was under control. There seemed to be a fair few people helping so I left.

Now I feel incredibly guilty.

Should I have pushed a little bit more? Insisted I was a medical student so I could help. I certainly know my basic life support and emergency management very well after this week's revision.

Do I realistically know more than your average first aider? Had anyone there even done a first aid course?

I'm 100% positive that if this happened in a year's time and I was officially a doctor I would have barged in to help regardless of what the shopping centre's security staff thought. Maybe I should have a little more confidence in my abilities now?

All in all I hope that the lady had just fainted with the heat and is now back on form, sipping a cup of tea and nursing her bruises from falling down.

Lily xXx

Temptations

For the first time ever I have my OSCE towards the end of the 2 weeks of OSCE exams. In the past I've always had my exams near the beginning.

This leaves me with a moral dilemma.

Should I ask people who've already done the exam what they've had? The majority of my year group seem to think this is definitely the way forward. I'm not so sure.

Firstly there's guilt. How would I feel getting a mark that I know might only be better than a friend's because I was more prepared for a certain station?

Secondly, OSCEs change. surely over the space of 2 weeks they will change the stations they examine us on. We're lucky to pretty much know every station that is going to come up, so regardless of what a friend has had I'm still going to have to make sure I'm safe and learn every station just in case in come up.

Thirdly, what if I get myself in a muddle? It's all too easy to listen to what other people found in exams. "My patient had a kidney transplant..." Would this make me just go into an abdo exam focusing on looking for a transplanted kidney? Would I forget to check other things? What if it wasn't the person with the kidney after all? Surely if I just examined properly I would be able to find out what's wrong for myself.

So because of this I am going to buck the trend and avoid everyone who's already done their exams talking about it. I don't want to know the stations and I don't want to know what patients they had. I'm just going to spend my time learning what to do for the stations and making sure I do it properly.

Lily xXx

Surprise, Surprise

Believe it or not, admin messed up again.

I have a feeling this is starting to turn me into a bitter person.

On the plus side when written exam results were due out on Friday, although we didn't get our marks they did let us know whether or not we passed or failed. I passed thank goodness!

Fingers crossed today I shall get to find out my actual mark.

The uni has also claimed that next years GP placements are being released today. I'm a little miffed as due to being short on time they've missed a whole stage of ranking placements. Originally we were supposed to rank the areas of London, then we'd get allocated an area and we could rank much smaller areas within that large area. As it stands I've pretty much chosen an area which is about 1/4 of London. I could end up with a pretty big commute next year.

I'm finding it very hard to concentrate on OSCE revision. I have a week to go... Does anyone have any tips on the best way to revise OSCEs?! Tomorrow I'm meeting up with a friend to practice some examinations, but otherwise I'm pretty much reading the book and taking histories off Teddy C.

Lily xXx

Levels of Panic

Going into uni in the run up to practical exams always raises my panic levels.

It seems that the vast majority of people are hysterical about them.

What I don't understand is why?

Yes they're nerve wracking, yes there is a small chance we might fail... surely getting hysterical just makes this all worse.

We're lucky in the way that we're told quite specifically what we can expect, yet people still ask stupid questions.

"Do I have to take the pulse in a cardio exam?" ... erm, well yes.

"Should I do a PR once I've done this child's abdo exam" ... have you ever PRed an actual patient in an OSCE. No. Do what you did last time and say "to complete my exam I would like to examine the hernial orifices, do a PR and get a urine dipstick."

"Will they test me on this really obscure minor bit of a limb exam? OMG.... If I miss it am I going to fail?" .... no, they've just said that nothing is instant fail.

"I know you said nothing is instant fail, but if we fail XYZ is THAT instant fail?"

ARGH!

The next person to ask a stupid question is liable to get headbutted by me.

My other pet hate at the moment are those people who say how amazing being last in the OSCEs is as they'll know all the stations. We already know what we're being examined on. Just learn it all. Doesn't matter if your friend a week ago said they had gout/heart failure/cerebral palsy... it could change. Stop trying to guess things and just learn the stuff.

Less than 2 weeks to go now. Thank goodness.

Lily xXx