Not quite as exciting as the finals results that are out today, I thought I'd share something amazing that happened to me today.
I saw my first natural birth.
The medic in me wants to tell you all about the process, the fact she had a small amount of pethidine but mostly managed on gas and air, that Mum and Baby were both fine. It was her first baby and everything went to plan, apart from the fact they'd been told to expect a boy and a little girl popped out. She didn't need an episiotomy.
The girl in me just wants to grin, and say 'babybabybabybabybabybabybaby!!!!'
All of me wants to tell you what a wonderful experience it was, and how grateful I was to be allowed to observe something that personal and emotionally charged. The midwives on the ward are amazing and looked after Mum and me wonderfully. Mum, Dad and Grandma were all brilliant about me being there.
I don't think I'll ever forget today, Friday 13th, 1.56am, and I'm damn sure I can think of at least 3 more people that won't either :)
Friday 13 June 2008
Wigan woe
Originally drafted in a strop, in my new notebook (that irritatingly had neglected to tell me it was blank not ruled)...
Wigan has not made a good first impression on me.
I arrived on Sunday in a bad mood. This was partly due to the 15hr shift I'd just done, partly the fact I was feeling horribly ill and had lymph nodes sticking out my neck like golf balls, and partly down to crappy internet directions (and perhaps bad navigating by my friend) which had meant the journey had taken double the suggested time. It was almost midnight, which meant all obvious entrances to the hospital were locked. After what seemed like an age stood shivering outside (apparently it was warm, but I was awfully feverish) we decided to do the naughty thing and go in via A&E. Luckily a nice receptionist took pity on us and took us to switchboard to get our room keys. The man informed us our accommodation was on site, and that 'we couldn't miss it'.
We could. It took 3 circuits of the service road to locate it. It wasn't identifiably our block, but we tried our code and the door opened, so we breathed a sigh of relief and went in. My friend and I had been told we were in the same flat, me room X, her room Y. I opened the flat door and stumbled straight for my bed. My friend knocked on my door, whimpering, 'There is no room Y!'
I took some more paracetamol and tried not to cry. All I wanted to do was sleep. It took until the early hours to try her key in all the doors in the block and eventually find her a room in an entirely different flat. I passed out without unpacking and had an awful night's sleep.
I awoke early, still feeling ill. More paracetamol, then to the shower. Cold. Freezing cold. My bad mood escalated.
Our new consultant hadn't sent us the timetable he'd promised so we headed off to find someone that might know where he was. On locating him I was handed a page of pencil scrawl- my new timetable. A month of full-time, plus 2 on-calls a week. He suggested weekends, but as I'm still working long shifts at the agency to be able to eat/drink/drive (not all at the same time) I firmly declined. We have to get our timetable signed morning and afternoon to prove we've been in. I don't mind this (it stops me being lazy and makes sure I get the most) but towards the end of this attachment I have a 4000 word assignment to write, and I'd like to think I can be trusted to use the time wisely and decide when I'd be best off in my room at my laptop. Its not like there's internet access to distract me!
The rest of the morning was spent doing irritating admin tasks- ID badges, parking permits, computer logins. Then in the afternoon, still feeling ill, I headed off to another site to see some scans, and tried not to infect any pregnant mothers.
I got to leave a little early, so was back in my room (via a shop for more paracetamol, you apparently can't buy it in the hospital) by 5pm. I immediately fell asleep, and woke up a few hours later for long enough to be sick as I tried to take my next dose. I've not met my flatmates yet, but I'm pretty sure they'll have heard me retching into my sink. Joy.
Took Tuesday off. Now I'm missing two signatures on my timetable already, and have no way to contact my consultant and let him know why. I bet he thinks I'm a slacker. Really, I'm just scared of vomiting on small newborn babies.
I feel that's probably frowned upon.
Wigan has not made a good first impression on me.
I arrived on Sunday in a bad mood. This was partly due to the 15hr shift I'd just done, partly the fact I was feeling horribly ill and had lymph nodes sticking out my neck like golf balls, and partly down to crappy internet directions (and perhaps bad navigating by my friend) which had meant the journey had taken double the suggested time. It was almost midnight, which meant all obvious entrances to the hospital were locked. After what seemed like an age stood shivering outside (apparently it was warm, but I was awfully feverish) we decided to do the naughty thing and go in via A&E. Luckily a nice receptionist took pity on us and took us to switchboard to get our room keys. The man informed us our accommodation was on site, and that 'we couldn't miss it'.
We could. It took 3 circuits of the service road to locate it. It wasn't identifiably our block, but we tried our code and the door opened, so we breathed a sigh of relief and went in. My friend and I had been told we were in the same flat, me room X, her room Y. I opened the flat door and stumbled straight for my bed. My friend knocked on my door, whimpering, 'There is no room Y!'
I took some more paracetamol and tried not to cry. All I wanted to do was sleep. It took until the early hours to try her key in all the doors in the block and eventually find her a room in an entirely different flat. I passed out without unpacking and had an awful night's sleep.
I awoke early, still feeling ill. More paracetamol, then to the shower. Cold. Freezing cold. My bad mood escalated.
Our new consultant hadn't sent us the timetable he'd promised so we headed off to find someone that might know where he was. On locating him I was handed a page of pencil scrawl- my new timetable. A month of full-time, plus 2 on-calls a week. He suggested weekends, but as I'm still working long shifts at the agency to be able to eat/drink/drive (not all at the same time) I firmly declined. We have to get our timetable signed morning and afternoon to prove we've been in. I don't mind this (it stops me being lazy and makes sure I get the most) but towards the end of this attachment I have a 4000 word assignment to write, and I'd like to think I can be trusted to use the time wisely and decide when I'd be best off in my room at my laptop. Its not like there's internet access to distract me!
The rest of the morning was spent doing irritating admin tasks- ID badges, parking permits, computer logins. Then in the afternoon, still feeling ill, I headed off to another site to see some scans, and tried not to infect any pregnant mothers.
I got to leave a little early, so was back in my room (via a shop for more paracetamol, you apparently can't buy it in the hospital) by 5pm. I immediately fell asleep, and woke up a few hours later for long enough to be sick as I tried to take my next dose. I've not met my flatmates yet, but I'm pretty sure they'll have heard me retching into my sink. Joy.
Took Tuesday off. Now I'm missing two signatures on my timetable already, and have no way to contact my consultant and let him know why. I bet he thinks I'm a slacker. Really, I'm just scared of vomiting on small newborn babies.
I feel that's probably frowned upon.
Sunday 8 June 2008
OSCEs and post-alcohol-post-OSCE syndrome
I am poorly again.
I've been ill on and off for a couple of months, mostly due to the fact that I never get enough rest. I'm on placement all week, then work ridiculously long shifts at the weekend, and when I have the opportunity to go out I make it a big one. Entirely my own fault. Doesn't stop me feeling sorry for myself.
I had my OSCE on Thursday. I worried myself sick before it, and drank myself into the floor afterwards. It went surprisingly ok. Station breakdown as follows:
Setting up an IV infusion- not done it since week 1 in September. Regret that now. My particular favourite moment was me struggling to get the damn line to run through, and the examiner saying 'perhaps you might want to take the cap off'. Joy. I'd expected this to go badly though after hearing the people the day before had had it. Picked myself up and moved on.
Examine pt for hepatosplenomegaly- went really well. Looked confident, simulated patient looked happy (they're worse than the examiners for keeping a straight face). Finished early and the examiner didn't do that really annoying 'and what else?' thing that makes you know you've forgotten something really obvious.
Hx no 1- Heart failure- barn door diagnosis. Was polite and confident. Only error I can pick out is that I was too quick to decide that's what it was. Otherwise, happy.
Cannulation- was ok. Got the plaster stuck to my gloves and a bit tangled. Think it was alright.
Examine pt for thyrotoxicosis- have practised this examination loads so was quite confident. Examiner suggested one or two little extras afterwards, and pointed out I should use the equipment available (water for swallowing, instead of just asking to swallow). Happy.
Hx no 2- Bladder cancer- another barn door diagnosis. Didn't tell pt she had cancer, which is good. Calmed her anxieties about cystoscopy. Think it was quite good actually.
Explain new diagnosis of iron deficiency anaemia to a vegetarian- I am an anaemic vegetarian. I totally rocked this one.
Rest station- supposedly to calm down, took me out my swing and made me hyperventilate again. Ah well.
Examine pt for DVT- took the whole of 1 minute. Missed something obvious. Did however take the hint and use the tape measure. Came up with some good differentials, didn't however know what a Baker's cyst was. Hopefully haematoma, cellulitis and bursitis are enough to get the mark.
Consent pt for colonoscopy- had the external examiner in with me on this one. It was all he could do to not give me a double thumbs up afterwards, I could see him twitching. Was really happy. Heard from others afterwards that the simulated patient had sat there and said 'I'm not having it done. No, never, not having it' to them, so I must have done something right.
Examine for R sided pneumonia- didn't do tracheal deviation, decided it wasn't relevant, examiner made me go back to it- it was. Otherwise did a really competent respiratory exam, concluded well and knew exactly what I'd expect. Bolton did good things for my chest medicine knowledge.
Consent for ABG for 'education and training'- this one was interesting, mostly because I'd never actually ask someone if I could stick a needle in their wrist for practice when it's of no benefit to them. I misread the card at first (so did most) and went in thinking it was a test she needed. I don't know how well that went to be honest.
Urinalysis- another thing I've not done since September. I think I did ok, one of my questions I got wring but the examiner seemed pleased otherwise. They're well practised at not giving too much away.
Hx no 3- GORD/ulcer- Not so pleased with this one. Started well, but pt was deliberately talkative and pressing me to tell him whether something was up with his heart. Eventually I said I suspected it was more to do with his stomach and acid reflux. I'm not sure how well I did this, bearing in mind we're not actually able to tell patients their diagnosis. Everyone else seemed to go with the 'I'm a medical student, I don't know' option. We'll see when the marks come out, but I have a feeling I may fail on that one.
Overall, a mixed bag. I'm confident that I've passed, but I doubt it's a high mark. Nerves got the better of me in the end.
The post-exam celebrations however were much more successful. Made a fool of myself by drinking too much cider, as ever. After two days of drinking (and over 40 units) I spent most of yesterday in bed, and missed my housemate moving out for good. Felt really crap about that one.
Today I'm back at work. 7am-10pm. Two hours off in the afternoon. Then afterwards off to Wigan to start my SSC in Obs and Gynae in the morning.
I really just want to sleep.
I've been ill on and off for a couple of months, mostly due to the fact that I never get enough rest. I'm on placement all week, then work ridiculously long shifts at the weekend, and when I have the opportunity to go out I make it a big one. Entirely my own fault. Doesn't stop me feeling sorry for myself.
I had my OSCE on Thursday. I worried myself sick before it, and drank myself into the floor afterwards. It went surprisingly ok. Station breakdown as follows:
Setting up an IV infusion- not done it since week 1 in September. Regret that now. My particular favourite moment was me struggling to get the damn line to run through, and the examiner saying 'perhaps you might want to take the cap off'. Joy. I'd expected this to go badly though after hearing the people the day before had had it. Picked myself up and moved on.
Examine pt for hepatosplenomegaly- went really well. Looked confident, simulated patient looked happy (they're worse than the examiners for keeping a straight face). Finished early and the examiner didn't do that really annoying 'and what else?' thing that makes you know you've forgotten something really obvious.
Hx no 1- Heart failure- barn door diagnosis. Was polite and confident. Only error I can pick out is that I was too quick to decide that's what it was. Otherwise, happy.
Cannulation- was ok. Got the plaster stuck to my gloves and a bit tangled. Think it was alright.
Examine pt for thyrotoxicosis- have practised this examination loads so was quite confident. Examiner suggested one or two little extras afterwards, and pointed out I should use the equipment available (water for swallowing, instead of just asking to swallow). Happy.
Hx no 2- Bladder cancer- another barn door diagnosis. Didn't tell pt she had cancer, which is good. Calmed her anxieties about cystoscopy. Think it was quite good actually.
Explain new diagnosis of iron deficiency anaemia to a vegetarian- I am an anaemic vegetarian. I totally rocked this one.
Rest station- supposedly to calm down, took me out my swing and made me hyperventilate again. Ah well.
Examine pt for DVT- took the whole of 1 minute. Missed something obvious. Did however take the hint and use the tape measure. Came up with some good differentials, didn't however know what a Baker's cyst was. Hopefully haematoma, cellulitis and bursitis are enough to get the mark.
Consent pt for colonoscopy- had the external examiner in with me on this one. It was all he could do to not give me a double thumbs up afterwards, I could see him twitching. Was really happy. Heard from others afterwards that the simulated patient had sat there and said 'I'm not having it done. No, never, not having it' to them, so I must have done something right.
Examine for R sided pneumonia- didn't do tracheal deviation, decided it wasn't relevant, examiner made me go back to it- it was. Otherwise did a really competent respiratory exam, concluded well and knew exactly what I'd expect. Bolton did good things for my chest medicine knowledge.
Consent for ABG for 'education and training'- this one was interesting, mostly because I'd never actually ask someone if I could stick a needle in their wrist for practice when it's of no benefit to them. I misread the card at first (so did most) and went in thinking it was a test she needed. I don't know how well that went to be honest.
Urinalysis- another thing I've not done since September. I think I did ok, one of my questions I got wring but the examiner seemed pleased otherwise. They're well practised at not giving too much away.
Hx no 3- GORD/ulcer- Not so pleased with this one. Started well, but pt was deliberately talkative and pressing me to tell him whether something was up with his heart. Eventually I said I suspected it was more to do with his stomach and acid reflux. I'm not sure how well I did this, bearing in mind we're not actually able to tell patients their diagnosis. Everyone else seemed to go with the 'I'm a medical student, I don't know' option. We'll see when the marks come out, but I have a feeling I may fail on that one.
Overall, a mixed bag. I'm confident that I've passed, but I doubt it's a high mark. Nerves got the better of me in the end.
The post-exam celebrations however were much more successful. Made a fool of myself by drinking too much cider, as ever. After two days of drinking (and over 40 units) I spent most of yesterday in bed, and missed my housemate moving out for good. Felt really crap about that one.
Today I'm back at work. 7am-10pm. Two hours off in the afternoon. Then afterwards off to Wigan to start my SSC in Obs and Gynae in the morning.
I really just want to sleep.
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