Thursday, 25 November 2010

Diagnosing Death

It's strange to think of death as a diagnosis... but apparently it is. It's a diagnosis that I'm sure most people wouldn't like to be given, but each of us will be given one day.

Today I certified my first patient. It was a bit of a strange experience. For a start the patient had been dead 3 days. Although a fair few patients die on my geriatrics firm, they all seem to die out of hours so I've never been around when someone passed away. This meant as I went with the doctor to check whether or not a patient we needed to fill out a cremation form for had a pacemaker or not, the doctor let me run through diagnosing death.

To be quite honest I felt like a bit of a prat. I knew he was dead, the doctor knew he was dead, the mortician knew he was dead. He'd been in a fridge for 2 days! You'll be relieved to know there was neither a pulse or a heart beat.

Afterwards I got into a conversation about dead people. It's strange how as doctors (or even medical students) we get used to dead people. It's also strange that no matter how used you are to dead people, there's always the odd situation where handling it is that much different. Sometimes it's if you knew a patient well, other times it's when surrounded by the patient's family and sometimes you just can't put your finger on it.

Surprisingly the mortician wasn't as much of a weirdo as I'd imagined him to be. Someone who locks himself in a room with dead people all day lends themselves to getting a reputation. I'd almost imagined him to be some kind of social outcast who couldn't string a sentence together. He was a very nice man. If it wasn't for all the dead people in the fridges I'd be happy to go back and visit.

Lily xXx

Tuesday, 23 November 2010

Treading Water

For once the reason I haven't blogged is not because I have nothing to say, but because I've been so busy! So busy in fact that I feel like I'm constantly running around doing stuff, but not really getting anywhere... especially with sign ups!

Regardless of that feeling I'm in a pretty chirpy mood. This may have something to do with the sunshine, or something to do with the fact Christmas is coming... but is more likely to do with the nice young man I've been spending my free time with. Enough about him for now... I'm sure I'll bore you all with lots of details at some other point, you probably want to know what else has been keeping me busy.

End of last week I spent some time in the admitting ward of the hospital I'm placed at. Clerking in patients, managing them and then attending the post take ward round. It's reminded me of why I want to be a doctor, even though it was geriatrics, it was pretty fun. There was a steep learning curve, mainly to do with ordering tests and bits and bobs but the other junior doctors and the nurses were all really helpful. I love seeing everyone work as a team, as seems to happen with this geriatrics firm and the nurses on all the wards.

At the end of a full day of clerking in patients I was exhausted. I didn't even know how I was going to get up to attend ward round the next morning. I'm glad I did though. All the hard work paid off. The notoriously difficult to please consultant not only complimented me on my hard work, but then went and showed me off to the other consultants as "the really hard-working medical student who clerked and managed more patients than the sho's"

Part of me wanted to die with embarrassment and the other part of me wanted to have a t-shirt printed with it written on in HUGE letters.

Annoyingly even with all this hard work I still haven't got that many sign ups compared to other people because I just don't have time to trawl the wards to get things observed. I'm hoping on my night shift this weekend (yes exam Saturday, night shift Sunday, social life... gone.) I'll be able to sweet talk some friendly nurses into helping me get some bits signed off. I really really really want at least 20/30 sign ups done this term.

Lily xXx

Monday, 15 November 2010

Chugging Along

Sorry I've been a bit lax at blogging over the last week, but as I've really just been chugging along I didn't see much point in boring you with what I was having for breakfast (an apple today, sometimes musli... quite often mini rolls), or something equally as dull.

Today I changed placement. I am now doing geris. Those of you who've been reading this for a while will know that there is no love lost between geriatrics and myself.

In fact I detest it.

This is no critacism of geriatricians. In fact I really admire them. They have to be good general physicians, patient, able to work effectively within a multi disciplinary team, they have to see the bigger picture with regards to patient's social as well as medical needs and they have to deal with lots of really sad stuff. It's the sad stuff that gets me down. The nutty old people are OK.

First day has been OK. I've sorted out when I'm clerking for my case study. I did a few really scutty errands that have hopefully earned me some brownie points and I managed not to fall asleep. This was so mean feat as I was up pretty late last night with a friend.

During this week I'm also going to get to experience the acute admissions ward. I'm excited about being able to go back to clerking patients in properly and examining people. It will also help with revising for my mock OSCE I'm guessing. Not that I'm planning to do much work. Seriously... an exam on a Saturday 6 months before the real things. I'm still waiting for them to say they're having a laugh.

Lily xXx

Tuesday, 9 November 2010

Making The Most of It...

I've been telling myself since summer that hardcore revision starts from January. That means that I have less than 2 months of revision-free time to enjoy!!

Although I'm stressing about sign ups (yes... I realise, I'm always stressing about little things for no particular reason!), and my elective poster (Hmmmm... probably should start that soon!), I'm also going to make the most of the next few weeks.

I have weddings, birthday parties and Christmas parties all lined up. Yay!!

What is not exciting is my impending mock practical exam. On a Saturday. 6 months before the real thing. Did I mention that it's on a Saturday? Unimpressed. So that'll be a 6-day week for me then. Fabulous.

Lily xXx

Friday, 5 November 2010


Yet again I've promised myself a weekend of relaxation and getting some work done, and yet again, by 3pm on Friday afternoon I have organised a weekend of complete madness. Fabulous.

As well as going to the middle of nowhere to watch fireworks tonight, I'm also planning to hit the nightclub. Then Saturday I am being offically "the-best-friend-in-the-whole-world". A friend of mine has nowhere to live for a short while and as my flat is completely empty I'm running the keys up to London for him. Haven't decided if I'm going to stay in London Saturday night, or if I'm going to go home, but either way I think it'll be a late night with a few drinks.

Sunday I'm going to be chillaxing and recovering.

What does everyone else have planned for this weekend?! Hope you all have a good one!

Lily xXx

Wednesday, 3 November 2010

Smile and Smooze

I started this morning with the obligatory consultant ward round, followed by a cup of Earl Grey in the mess. As we haven't been on take for a few days our patient list is rapidly dwindling (thank goodness as it seems like half the firm is on annual leave). Because of this there weren't that many jobs to be done, so with my FY1s permission off I trotted to get some sign ups.

This year as well as sign ups for skills we have to perform there is a long list of different procedures we need to observe, so that we can better explain them to patients in the future. This is why I ended up trawling the hospital sweet talking pretty much every healthcare professional I came across.

Apparently us medical students have a reputation for being demanding, bolshy and rude. I'm aiming to turn that around. It is for this reason that I have perfected the smile and smooze.

The smile and smooze works best if you are genuinely a nice person. It is quite obvious if you're just putting it on.

The technique is simple. When asking if a different healthcare professional will show you something you have to be nice to them. Remember that explaining things to you will probably slow down their already busy day. I always start with introducing myself and giving a big smile. I then ask nicely about what I would like to do or see. It's important at this point to emphasize that they will be doing you a favour so timings are completely flexable. If they frown it's important to keep smiling. This disarms mean people so even they say yes. The smoozing then continues with a very big thank you once they've agreed to what you want.

To perfect the smooze when you return to observe the other healthcare professional at work, bring something for them. A sweetie pilfered from somewhere is enough. Then remember to say thank you at the end. A couple of comments on how interesting/difficult/skillful their job is also doesn't go amiss. Everyone likes to hear when they're doing a good job.

The smile and smooze has yet to fail me. Fingers crossed!

Lily xXx

Tuesday, 2 November 2010

Muddled Head

I don't feel quite right today. I've had a headache since yesterday afternoon and my brain just feels all mixed up. I gave up on being in the hospital after ward round today and went for a nap, which hasn't really changed or improved matters.

I really don't want to be ill!! Noooo

I've been feeling too grotty to even add anything more to my Nanowrimo, which is a pathetic 772 words long.

Fingers crossed I'll wake up tomorrow feeling like a new person. I want to make a game plan to get more sign ups this week. I managed to get another 2 today... hurrah! Some of the sign ups we have are really stupid though, whereas others seem near impossible. "Watch a barium enema" - Well I would if the hospital trust I was at did them anymore.

I've decided to be sensible this weekend and give up partying to instead do my Elective Poster. No more last minute rushing around for me this year. No no no. This year I'm going to be organised and calm (or at least as calm as I can be with finals looming!).

Lily xXx

Monday, 1 November 2010

A Week In The Life of a Final Year Medical Student - Friday

Sorry this is late... I had such a busy day on Friday that I just left my laptop and went home for the weekend to recover!

7am - Get up, get sorted out to go in to the hospital.

7.50am - Realise the other students on my firm are too hungover to come in. Consider going back to bed, but decide I might as well make the most of being the only student for the day so trek in.

8am - Get to the hospital. See the huuuuge list of patients. Wish I'd stayed in bed.

9.30am - As its so busy I get to write my first discharge completely on my own. Get it double checked by a doctor... one sign off in my log book!! Woo hooo!

9.45am - Ward round moved from the Clinical Decision Unit to the wards. We have a new SHO with us (borrowed from another firm), she's really lovely and keen for me to get lots of experience. She lets me write drug charts and double checks them. I'm glad I went to the prescribing sessions we had a couple of weeks ago. Sign off number two...

The ward round is huge so this takes all morning. I get to write in the notes, fill out more drug charts and even examine some patients.

1.01pm - The SHO and I rock up 1 minute late for a presentation we all have to attend because we're so busy. We were worried there would be no good left but I manage to get a nice combination of colslaw and a chocolate chip muffin.

2.10pm - Leave the talk and hot foot it to the wards to get jobs done.

2.15pm - Try my first ABG. I was so nervous that my hands were shaking. Surprisingly to me I got it. That means I have a 100% success rate so far! I then had to run the sample to the machine on the other side of the hospital and work out how to use it. Not fun and noone in A&E would show me. Eventually got it working and had to run the results back up to the ward,.

3.00pm - Go through all the patients on the list and work out what blood tests they need over the weekend and print out the forms on the right wards. This is the disadvantage of not being ward based. The advantage is all the free exercise.

3.40pm - Spent time chasing a haematology referral as they haven't made it clear if they want to take on the patient or not. Try and find out what we're supposed to be doing. Succeed only after actually turning up to the haem clinic and sitting outside the room.

4.20pm - Chat to microbiology on the phone about a couple of patients. Get drilled on antibiotics once the consultant realises he's speaking to a medical student. Realise that I have a lot to learn.

4.30pm - Run around 4 wards trying to find the FY1s to tell them about the microbiology results. Noone's answering bleeps!!

5.05pm - Finish for the day. Legs throbbing from walking around so much.

5.30pm - Get in the car home to visit my Dad. Wonder how I'll survive a night out...

Lily xXx