Sunday, 27 February 2011

Frozen Doctor Syndrome

I've seen a few examples of this in the last week and what with it being interview time, and me being in a contemplative mood again I thought I'd share.  There are people that 'do' and 'can' when the situation calls for it,  and there are people who 'can't' and 'don't' and I'm not sure you can really tell which category you fall into until the situation occurs and you are tested.  To put this into context, last week I watched Junior Doctors on BBC3 and it mentioned frozen doctor syndrome where the new F1's freeze and don't know what to do when faced with situations that require quick thinking and fast actions.  This is probably because of any number of very valid reasons - they don't want to be in the way, they don't know where things are, they haven't dealt with such an intense real life situation before or they are scared of getting something wrong.  A few weeks ago, one of my housemates tore a ligament in his ankle jumping off something.  The swelling hasn't really gone down and he was making do with strapping it and sort of keeping off it, but he's quite an active person and so has been going to the gym to do upper body work.  Whilst at the gym with our other housemate he met a load of medics and they were skipping (as you do, apparently).  For whatever reason, he thought he'd skip too to show off, and of course went straight over on his ankle and collapsed on the floor.  The medics all stood around staring at my friend screaming in pain on the floor.  One of them managed to mutter RICE, but by that time our other housemate had gotten some ice and a blanket and a bench and was coming back to pick our friend off the floor and ice his ankle.  Both of my housemates do sport science, so whilst he was an idiot to try and be a hard man and skip in the first place, I'm proud of their quick thinking, and wonder whether the medics were kicking themselves for not thinking to do that themselves.  I guess slightly on their side is the fact that they weren't in a setting they would be expected to use their skills and knowledge, but I think I'd still be a little embarrassed.  Even though we know nothing, we are perceived to be knowledgeable and capable, and RICE is kinda first aid basics, no?

I have been tested myself in the past, though thankfully not often and nothing too bad.  Back at Southampton my mentee had an epileptic fit on my driveway, sustaining a nasty head wound as he dropped.  Then earlier this week I had a knock on my door at 2 in the morning from my house mate, blind drunk, terrified and vomiting blood.  I'm happy to say that I appear to be a person who can and does, although inside I'm terrified and I have no idea where the strength  and calm I display in the outside comes from.  At least so far, with the situations I have been presented with, I am.

I think it's a difficult skill to interview for, because it's not about what you say, it's about what you do.  I have visions of one of the interviews going into pretend anaphylactic shock or something to see how the candidate reacts.  As if interviews weren't terrifying enough.  I'm sure that not all Dr's require these sorts of skills in their line of work, and that the more you are involved in situations like that the better you'll be at handling them, but it must be useful to be a person that 'can' and 'does' from the outset.  It gives you a base to work from and build in the actual knowledge of what to do to be useful.

If you can keep your head when all about you
Are losing'll be a Man my son!

If by Rudyard Kipling

Wednesday, 23 February 2011

Semi-Responsible Bean

I love Peninsula.  Just when I was starting to panic a little that everything was getting on top of me SSU comes along and I get a chance to breathe which is nice.  Other people seem to be stressing about coming up with a title for their essay so they can get started but my facilitator doesn't seem too bothered about us getting to the stage where we are ready to come up with a title yet.  So I have a few days to just relax and do what is for me, a bit of microbiology revision.  So today I had my first lie-in in ages :)  Awesome.

Also, today I had a little bit of a taste of proper medical decision making, which was a little weird to be honest.  I was at work at the GP's on the front desk for the second time ever, under supervision taking the phone calls.  I kept having phone calls from patients wanting appointments for the same day, of which there weren't any left.  From taking a description of the problem I had to decide if they needed a call from the Doctor which could turn into a home visit or late appointment if necessary, or an appointment later on in the week. I know that this is small fry compared to what I will be faced with, but having so little experience and faced with a crying mother on the phone because her toddler still has a fever from yesterday when the Dr saw them, I found it quite strange to try and strip away her emotion from what she wanted me to do, logically assess the situation and balance that with how annoyed the Dr might be with me if I keep adding appointments to the end of their clinic.  Luckily I had my boss next to me who was really patient with me as I consulted with her on every case like that, and the magic words "Sorry, I'm new to this, I'm in training, I'll just check" to brandish.  I honestly have no idea how the receptionists with no medical training at all handle those sorts of things, because it felt a bit like being a triage nurse.  I guess it just comes with time.

I learnt a secret the other day I'll let you in on.  When I first got my stethoscope, obviously the first thing I did with it is put it round my neck.  Poking around on some other blogs I've seen some of the older medics and Dr's laughing at the young ones wearing the steths round their necks.  However, no one will ever tell you why it looks silly, or where you're supposed to put it.  The secret apparently is that if you keep it round your neck it gets warm, and if the tubing gets warm repeatedly it gets stiff and may even snap.

Sunday, 20 February 2011

Sniff, again

Well, I'm ill again so now is as good a time as any to give you an update.  Since the last post I have learnt respiratory exams and cardiac exams.  I have signed up to be part of a new society called Save a Baby's Life that will aim to teach basic life support in GP's surgeries and parent/child groups.  I taught a lesson on HIV to a class of year 11's at a local school.  I have done more hours at the GP's surgery than I thought could fit into my time table.  I found out I was successful at applying for another job that I entered in for ages ago and have completed on-line training to be... a census collector :)  I have struggled through a PBL case unit on the heart - the first topic that I really don't understand.  I know it's not hard, it's just that the heart has never seemed to 'click' and make sense with me.  I have received peer feedback forms from my new PBL group and discovered that while the last group thought I was too loud, this one thinks I'm too quiet, half think my sources are great and half think they aren't and one appears to want me to put all my sources on the group discussion board  on-line before the session  thereby giving them all my answers 0_o  I have come to the conclusion you can't please all the people all the time and perhaps I really shouldn't care about what my peer feedback forms say.  This has been compounded by the actor in my clinical skills communications class telling me to my face that my history taking was fantastic, I covered everything and did everything really well...and then scoring me as 'poor' on his feedback form.  Grrrrrr.  I have also been called to a disciplinary meeting with the rest of my flat because our fridges have some damage to them. Namely the door fell off one of them and one of the plastic bits has broken in the other because they get so much use.  It has escalated to this stage because when they came round to get one of us to sign a form to claim the damage and pay for it none of us would because we believe it is wear and tear which we are covered for and don't have to pay for according to our contracts.  I have had training at work on how to man the front desk and how to carry out carer medicals to check that people who care for others are getting all the support they need and are fit an healthy themselves.  I have been a tea lady again.  I have been rubbish and haven't replied to emails I got  (sorry :( ).  I have been nostalgic as a round of GAMSAT interviews took place.  I have accompanied Mr to a wedding of one of his best friends at Sandhurst and had a lovely day and met really wonderful group of people which I really don't think I'd have had the courage to do a year ago; to go to an event where I only know one person and not stay sat in the corner of the room and observe quietly, but to actually talk to people and be brave.  I am starting to understand what it is to be part of the army family.  I found out I'm mushy to the core and I cry at weddings, but it's their fault for having such beautiful readings.  I watched Never Let Me Go for free at the cinema the day before it premièred as part of the Slackers Club run by E4 and the Picturehouse and found it to be very plain, simple, clever and so sad.  I rowed in the first ever Peninsula Women's 8.  I have laughed until I cried and I have danced until my feet ached.  For two weeks I did not go to bed before 3am and then got up at 8am everyday.  I found out that Mr loves me even when I'm snotty, covered in tissue fluff and snoring like train /mush.

I now have a streaming cold and feel like pants.  It is entirely my own fault, sort of.  The stuff that I planned to do wasn't supposed to all come at once, with a load of other stuff cropping up that had to be done immediately.  So, I guess I've also found out that I'm pretty good at running on autopilot, ish.  I haven't done all the stuff I should have done, or wanted to and have now made my life more difficult by catching this cold when I still have a lot to do.   Fingers crossed for me please because Glandular Fever is currently going round and I really couldn't handle it if my cold turned into that.  But, I also have my fingers crossed for you and I hope you interviews are all going well.  Believe in yourself that you can do it, because if you don't believe you'll never convince the interview panel you're right for the place either.

Wednesday, 9 February 2011


Probably not a surprise, but things got busy again, hence the long delay in posting.  Sorry!  I had the best intentions....

Placement was with a charity called Headway who offer support following brain injuries.  I went to a morning group session where people can drop by and meet with others in similar circumstances.  It was all very informal and people can take whatever they want from the sessions.  One person was there talking through with a staff member difficulties he was having.  He had told his case worker that he didn't need them any more because he could do his own washing and cooking, and the staff member was trying to explain that this wasn't what they were there for.  He'd been having trouble filling in his benefit forms so the group were trying to convince him to let someone help him with them.  Others were there to use the computer, some were setting personal goals with another staff member to help them address difficulties and work out what they wanted from their Headway sessions, one man was bombing around in his wheelchair whose task for the morning was supposedly drawing pictures of birds, but actually he was having a great time bombing round getting into what everyone else was doing.  He spent some time complaining to me about how long he was having to wait to get his wheelchair fixed since it was so poorly designed - he slumped badly to the left and the controls were positioned so that he couldn't do anything on his lap because they got in the way of his dominant hand.  It seemed like such a simple thing to sort out for him and really important too, there was just so much bureaucracy in the way.  Another group of people were playing Scrabble, my buddy was playing Frustration with someone and I was sat with someone working on a project about the brain - apparently he'd remarked that the picture of the brain on the wall was good but it didn't tell you what each of the different bits did, so they told him why doesn't he research it.  He'd gone to his Mother's who'd printed him out some information from the internet but he'd decided since it was his project he should handwrite the information and so was meticulously copying it out.

Before the people arrived the staff member were telling us that it might look like they are just playing Scrabble but they are also developing their vocabulary, learning about dealing with a social setting, about fair play and fine motor skills.  They also told us that some people don't have a clue as to the scale of their injuries - they may just think they had a bump on the head and not realise its impact.  I didn't entirely understand this at the time, but I I was chatting to this man who was telling me about his life: his father had died, he'd been in two car accidents neither of which were his fault, his wife had spent all his inheritance and left him for someone else but it would be all right because he had this project on the brain to do now.  o_0  This poor man had so many terrible things happen to him, but because he had something to focus on he was fine.  Inspiring and heartbreaking all at once.  His injury had caused him short term memory problems and he was having trouble recognising where he'd already copied bits from and would start to write something but then forget where it was coming from, even though it was right in front of him.  Sat across from me was my buddy playing frustration and the guy he was with seemed 'normal' enough - there was no physical disability and he was fairly quiet but happy playing his game with a wicked sense of humour, getting my friend to feel his hand because his hand hurt and then laughing because you can't feel pain like that.  The staff had told us that he likes to steal things like keys and phones so he can give them back to you later and tell you he found them because he likes to be helpful.  He had another quirk that was every now and then he'd quack like a duck.  Totally bizarre!

It was an amazing placement.  It was challenging to my views, a fantastic experience and a lot of fun, but equally really upsetting and quite uncomfortable.  I really didn't know how to approach these people. Most of them didn't have any outward signs that they had anything wrong with them so it was hard to know what level to pitch your conversation to them, whether you were just being patronising, what they needed help with and what they were just being lazy about and  whether it was my place to correct them if they got something wrong.  It's great for developing communication skills as they made need things explaining in many different ways to them, and in some cases it was like talking to a child.  They all stared at us when they first got there, some coming over to chat because we were new and others completely ignoring us. I sort of felt like I was in a zoo, although I guess they've had plenty of people staring at them in their time.

If you're looking for work experience or extra curricular brownie points I'd definitely recommend looking to see if you have a local Headway branch.  They can always do with volunteers, it's really different in terms of normal work experience and it will certainly broaden you and your skills and challenge you whilst still being fun.