Work experience st Marys Flashcards
. Shadowing Anaesthetist
. I had the opportunity to attend three surgeries in the orthopaedic ward, one of which was a hip replacement in an 83 year old woman with dementia
. I witnessed the kind and calming nature of the doctor, who talked her through each stage of putting her to sleep to ensure she wasn’t frightened.
Although she asked the same questions many times, the doctor stayed patient and gave thorough and answers to her. He made an effort to ask her about the weather or about the things she enjoyed, and it came across as being very genuine and she was evidently very relaxed going into the surgery. Her nerves were calmed.
What I learned:
Empathy
Communication
What is a difficult moment you witnessed at the hospital
. I had the opportunity to witness a brain stem test, where the consultant on ward was testing for brain activity of a young man in a coma.
. He had suffered a blot clot and it took too long to get him to hospital which unfortunately left him brain dead. It stopped oxygen reaching his brains so the cells died.
. Sadly the family were in the waiting room but I got to watch how the staff communicated this news with them and how gentle and patient they were.
Describe what you learnt from the tour of different jobs on intensive care unit
- The consultant on ward brought me around to speak with all the different healthcare professionals in the intensive care ward
For example critical care technologist who monitors all the life support equipment. This is incredibly important as without them ventilators and heart monitors could stop working which would seriously compromise patient safety.
Another role I looked at were dieticians who are in charge of providing nutritious meals for the patients. This is important because they aren’t able to exercise so it is vital to keep their health stable by giving them all the correct nutrients so their body can heal.
. Another role was Hospital porters who are in charge of moving patients around, for example bringing them to x- rays or to different rooms. I think this role is important because they keep everything moving correctly in the hospital system so everyone is where they should be
Explain sepsis fluids
Fluid is given because bacteria release toxins which trigger the body to release cytokines (small proteins that control growth of immune system) which cause inflammation which makes blood vessels dilate and become leaky so blood pressure decreases.
Low blood pressure is dangerous as not enough oxygen reaches organs so they could stop.
Fluids are given to raise this blood pressure, and also prevent dehydration.
Sometimes too many fluids are given which is bad as it can enter lungs which will fill with fluid and make it hard to breathe.
Charring cross work experience sepsis
Spent a day with a consultant who was coding an app to help doctors treat patients with sepsis.
He explained that it is quite difficult to know the correct amount of fluid to give to a patient with sepsis.
SepTIC work experience in clinical trials unit in St Marys
Currently when a patient comes into the ER with sepsis they are pumped with broad spectrum antibiotics because it takes too long to grow a sample and find out what the exact bacteria is.
It can lead to antibiotic resistance
This drug trial uses rapid microbiology tests to find out what the bacteria is quickly to give the patient the correct antibiotic and prevent antibiotic resistance
Why is a lack of communication bad
When i was doing work experience in the intensive care paediatrics ward, a young disabled girl with sickle cell disease was to be taken for a bone density scan.
However due to a miscommunication she was sent down by patient transporters without a nurse or doctor.
When we arrived at the room her oxygen monitor went off as her levels were getting too low but no one knew the password to it to stop the alarm, and to fix her levels of oxygen.
It was a very stressful situation and her mother got quite upset over it so I think a lack of communication can compromise patient care within a clinical setting.
What did you do in your time with the clinical trials team
What did you learn from it
I spent a day with a clinical trials team who were testing out something called Septic.
Basically when you have sepsis patients are pumped with all antibiotics so broad spectrum ones to hopefully kill whichever one is currently in the body.
However this can lead to antibiotic resistance, so this design was to make rapid testing kits for sepsis as it can take around a week to send off a sepsis sample to find out what bacteria it is so by that time the patient could be dead.
Hopefully these samples will be like covid tests so will tell you what bacteria it is so what antibiotic to give.
What did you learn from your calls with the SepTIC team
I attended a zoom call with many healthcare professionals discussing a clinical trial they had done where they gave vitamin C to covid 19 patients in the ICU but it didn’t work.
They were discussing together what went wrong in the trial and what they can improve on for next time.
They also had patients with them to make sure that what they’re talking about can be understood by people who aren’t in the medical field so it made doctors adjust their language so it could be understood.
This taught me about the importance of communicating with patients and how as a doctor you will learn abbreviations for words but you must not forget to adjust your language when speaking to patients. Especially when asking for consent to give a medication as it may not be informed consent if you’re using long and difficult words that the patient can’t understand.
