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.
Sunday, 25 May 2008
Feedback
At the end of every attachment we do we're supposed to have a feedback meeting with our tutor, and they tick and sign our sheets. There's room for comments. Most of the time they bother to write a few words, and ask us how we feel we're doing. That's about it.
This time my tutor did it properly. Individual meetings, discussion of our strengths and weaknesses. I'm really glad he did. Its rare on our course to be told how well you're doing compared to everyone else, and getting one-on-one time is almost unheard of.
He was very complimentary. I don't think I've ever had anyone be so nice. He told me that he thinks I'd be a great GP before I even told him that's what I'm leaning towards. He said that if I were to become a GP he'd want me to be his, as my smile and positive professional persona would make him feel better just by being in the same room. He filled in my feedback form with the words 'outstanding student' at the top.
I didn't really know how to take it to be honest. I assumed he was just a gushy kind of guy, but having seen the face of a very intelligent colleague who came out just before me I don't think he was as nice to everyone. I don't really know how I managed to deserve it.
I did have a moment of over-analysing, and got upset by the fact that I never get told my knowledge is strong, only my caring side. I often think I feel more comfortable as a home carer than a medical student, although I couldn't live comfortably on the income! I'm too lazy to do the reading, I seem to think I'll absorb what I need to know by turning up to seminars and sticking needles in people occasionally. So far it's working, but I doubt I'll get away with it for much longer. I don't really want to if I'm honest. Yet I've not had that kick up the arse moment yet. I'd half hoped he'd tell me I'm a slacker and to pull my finger out. Now I just know I can slack off for longer. Sigh.
Then I thought maybe he'd analysed me and realised I'm insecure, and that's why he was so nice to me. I need reassurance more than most.
Then I thought that I should just stop thinking about it and take the compliment. On my Mum's advice. She was very proud!
This time my tutor did it properly. Individual meetings, discussion of our strengths and weaknesses. I'm really glad he did. Its rare on our course to be told how well you're doing compared to everyone else, and getting one-on-one time is almost unheard of.
He was very complimentary. I don't think I've ever had anyone be so nice. He told me that he thinks I'd be a great GP before I even told him that's what I'm leaning towards. He said that if I were to become a GP he'd want me to be his, as my smile and positive professional persona would make him feel better just by being in the same room. He filled in my feedback form with the words 'outstanding student' at the top.
I didn't really know how to take it to be honest. I assumed he was just a gushy kind of guy, but having seen the face of a very intelligent colleague who came out just before me I don't think he was as nice to everyone. I don't really know how I managed to deserve it.
I did have a moment of over-analysing, and got upset by the fact that I never get told my knowledge is strong, only my caring side. I often think I feel more comfortable as a home carer than a medical student, although I couldn't live comfortably on the income! I'm too lazy to do the reading, I seem to think I'll absorb what I need to know by turning up to seminars and sticking needles in people occasionally. So far it's working, but I doubt I'll get away with it for much longer. I don't really want to if I'm honest. Yet I've not had that kick up the arse moment yet. I'd half hoped he'd tell me I'm a slacker and to pull my finger out. Now I just know I can slack off for longer. Sigh.
Then I thought maybe he'd analysed me and realised I'm insecure, and that's why he was so nice to me. I need reassurance more than most.
Then I thought that I should just stop thinking about it and take the compliment. On my Mum's advice. She was very proud!
Monday, 19 May 2008
All work and no play...
Why does everything pile up at once?
Not only do I have my OSCEs in 2 weeks time, all my added extras seem to have deadlines at the minute. I have so much on, and so little time. I had a fairly productive day today, in that I did a shift at work so I can afford to eat for another week, took back all my library books that have been gathering dust in the corner (this time before they cost me the earth in fines) and went into three banks in an attempt to sort out my finances. See, what with summer holidays so far away and no summer schools jobs this year I'm more than a little strapped for cash. I've maxed both my overdrafts (yes, that would be 3000 pounds) and haven't paid for my house deposit or my car repairs yet. My quote was 600 pounds. Joy of joys.
So I'm back to 15hr shifts and added extras here and there. Exactly what I need when everything else is mounting up.
I just don't see how I'm gonna fix this mess I've made.
Not only do I have my OSCEs in 2 weeks time, all my added extras seem to have deadlines at the minute. I have so much on, and so little time. I had a fairly productive day today, in that I did a shift at work so I can afford to eat for another week, took back all my library books that have been gathering dust in the corner (this time before they cost me the earth in fines) and went into three banks in an attempt to sort out my finances. See, what with summer holidays so far away and no summer schools jobs this year I'm more than a little strapped for cash. I've maxed both my overdrafts (yes, that would be 3000 pounds) and haven't paid for my house deposit or my car repairs yet. My quote was 600 pounds. Joy of joys.
So I'm back to 15hr shifts and added extras here and there. Exactly what I need when everything else is mounting up.
I just don't see how I'm gonna fix this mess I've made.
Monday, 12 May 2008
Exam stress?
I have my end of year written exam this afternoon.
Since I didn't do so well in my A Levels, and consequently had a horrifically awful results day involving rejection, clearing, and eventually Manchester changing their mind a few days later, you'd expect me to be quite bothered by exams. I'm not. I'm far too laid back. I usually get mildly panicky for the few days before, but never enough to actually do too much revision. When we had semester tests in the pre-clinical years my friend and I did 3 15hr days revision before every test and passed comfortably. I'm lucky, I seem to manage it somehow.
My professor the other day made the huge error of telling us that the progress test (the exam I have in less than 4hrs time) is designed to be cram-proof. If I don't know it already, I won't know it. This relaxed me even more than normal, and made me feel much less guilty about the fact I had a holiday booked the weekend before a Monday exam.
I've been away the past 3 days with 6 other girls to a cottage in the middle of nowhere. With the beautiful weather, we spent most of the weekend in the garden, in and out the hot tub, with a glass of something sparkly in our hands. Any fluids I lost through sunbathing were quickly replaced by champagne, gin and cider. Lots of fun was had. The books came out for an hour on Saturday afternoon.
Yesterday we intended to get back in time to do some practise questions, learn some of the common topics. Unfortunately after a weekend of problems, my car finally gave in as we tried to leave, and whilst awaiting AA men and tow trucks we ended up back in the sunshine in a beer garden, accompanied by a few more beverages of the alcoholic variety. I finally got back to Manchester at bedtime, and couldn't make myself do any work.
This morning, revision has started. 5hrs before my exam. And an hour later, I'm writing this.
I only hope my confidence pays off, that the work I've done throughout the year will be enough. I enjoy medicine, I pick it up fairly quickly when I try. I just don't seem to do that often enough.
Since I didn't do so well in my A Levels, and consequently had a horrifically awful results day involving rejection, clearing, and eventually Manchester changing their mind a few days later, you'd expect me to be quite bothered by exams. I'm not. I'm far too laid back. I usually get mildly panicky for the few days before, but never enough to actually do too much revision. When we had semester tests in the pre-clinical years my friend and I did 3 15hr days revision before every test and passed comfortably. I'm lucky, I seem to manage it somehow.
My professor the other day made the huge error of telling us that the progress test (the exam I have in less than 4hrs time) is designed to be cram-proof. If I don't know it already, I won't know it. This relaxed me even more than normal, and made me feel much less guilty about the fact I had a holiday booked the weekend before a Monday exam.
I've been away the past 3 days with 6 other girls to a cottage in the middle of nowhere. With the beautiful weather, we spent most of the weekend in the garden, in and out the hot tub, with a glass of something sparkly in our hands. Any fluids I lost through sunbathing were quickly replaced by champagne, gin and cider. Lots of fun was had. The books came out for an hour on Saturday afternoon.
Yesterday we intended to get back in time to do some practise questions, learn some of the common topics. Unfortunately after a weekend of problems, my car finally gave in as we tried to leave, and whilst awaiting AA men and tow trucks we ended up back in the sunshine in a beer garden, accompanied by a few more beverages of the alcoholic variety. I finally got back to Manchester at bedtime, and couldn't make myself do any work.
This morning, revision has started. 5hrs before my exam. And an hour later, I'm writing this.
I only hope my confidence pays off, that the work I've done throughout the year will be enough. I enjoy medicine, I pick it up fairly quickly when I try. I just don't seem to do that often enough.
Wednesday, 30 April 2008
Livers and lookers
Well, I finally learnt the liver. Had a really good PBL session yesterday where we blitzed the whole thing, and with me having made the decision to stay in the night before and do some work for a change, I understood it. It's a big relief!
Have moved back onto a diabetic/endocrinology ward, which is alright. I was taking a history from a patient who was my age yesterday. It was really odd, I'm used to patients being significantly older than me. Getting the balance right between professional and human is more difficult with younger patients I think.
Our junior doctors are really great. Both have offered us teaching every day, and are sympathetic to our upcoming exam pressures. A few months ago I was embarrassed to have a guess or ask silly questions when I didn't know the answers, now I am comfortable enough to throw out random words and say when I'm not sure, and nice teachers really help that and mean I get much more out of it. It helps as well that one of them is quite hot. Lol.
All in all, I've had a really good few days. I only hope this good mood sticks with me during the next fortnight before my written exam...
Have moved back onto a diabetic/endocrinology ward, which is alright. I was taking a history from a patient who was my age yesterday. It was really odd, I'm used to patients being significantly older than me. Getting the balance right between professional and human is more difficult with younger patients I think.
Our junior doctors are really great. Both have offered us teaching every day, and are sympathetic to our upcoming exam pressures. A few months ago I was embarrassed to have a guess or ask silly questions when I didn't know the answers, now I am comfortable enough to throw out random words and say when I'm not sure, and nice teachers really help that and mean I get much more out of it. It helps as well that one of them is quite hot. Lol.
All in all, I've had a really good few days. I only hope this good mood sticks with me during the next fortnight before my written exam...
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