Loon Grinning

Be aware, the loon grinning has set it, and it won't go away for a while.  It may even be contagious.  You have been warned.  The loon grinning commenced last week on placement when the GP I was sat in with said, "Oooh, that's a nice mitral regurgitation murmur, do you mind if the student Doctor has a listen?"  (Don't worry, the patient has had it for a while and knew about it, that wasn't how the news was broken.)  I got to use my stethoscope on a real person for the first time ever! A real, sick, patient kind of person, not a medic friend I'm practising on.  Placement continued with listening to breath sounds for asthma, squeezing a huge sebaceous cyst (as big as a £2 coin), chatting to a Dr come in for a referral, and talking to a very charming lady who confirmed she ate a very good diet, elaborating that it consisted of no breakfast or lunch, a packet of Dolly Mixtures a day and a ready meal every evening.  It was really busy morning clinic and so interesting to see all the different types of cases.  The Dr was open to questions and at one stage even went out into the waiting room to see if she could drum up any more patients for us to see before we left.  I get the most from placement seeing the interaction between the patient and the Dr.  I like to see if there's any phrases or ways of handling and approaching things I can pick up in a monkey-see-monkey-do kind of way.  It really helps to put all the studying into perspective.  I'm studying for something.  One day this will be me.  It's like all access work experience and I'm still as excited as a little kid at al the opportunities I get.

In clinical skills we learnt how to do gastrointestinal exams.  Happy to say I have a liver, I have felt it. :)  We have competencies coming up after the Easter holidays where we have to do a combine cardiovascular, respiratory gastrointestinal exam - running them all together in the end of the bed, fingertips up to the head and down to the toes prescribed format.  This will be interesting because we have 10 minutes to do it and it took the demonstrator 15 when she showed us at full speed....

We only had one normal two week case block and now we have started another SSU.  I have been allocated  'The Impact of Eczema on Children and their Families'.  I've been attached to the dermatology ward and when I went for my contact session today she gave me a timetable for the rest of the week.  I'm in clinics everyday.  It's AMAZING!!!!!  There were a couple of optional sessions in there, like tomorrow morning.  She said "if you like you can come in tomorrow, get changed into some scrubs and observe some minor surgery.  It'll mainly be removing skin cancers and depending on where it is you can do some suturing if you like.  You don't have to come in though if you don't want, you can have a free morning."  Would I like to come and observe and do stitching? HELL YEAH!!!!!  Seriously, I am so excited.  I have not stopped grinning, and the little bean inside me is bouncing up and down like you wouldn't believe.  She had me at scrubs to be honest, I love a bit of dress up.  I've got some general clinics, some phototherapy, some patch testing and possibly a trip onto the wards to see some inpatients with skin complaints.  And this is just week 1!  I have 2 more weeks of this.

Stress Relief

I have been missing in action somewhat for the last week and a half.  The essay needed to be done after all, surprise surprise and I wrote an awesome one if I say so myself.  I was really proud of it - well researched, technically strong writing and a good conclusion.  Even my superior agreed when she saw the first draft.  And then I had to massacre it and cut 350 words.  That doesn't sound a lot but it only had to be 2000 in total and not a single word over.  It was so dry once I'd finished it I really didn't like it anymore which was really disappointing since I worked so hard on it.

As soon as that was submitted it was only a couple of days until the next AMK and I was feeling The Fear.  Between the first one and the second one we did a load of case units but between the second and third we did one unit on cardiology which I always just don't understand and a highly specialised SSU project.  I really wanted to keep making an improvement and stay in the top half of the class.  Late teens early twenties is my goal for this one.

I sat it this afternoon and it was horrible.  There were a load of gastro questions - ask me again at the end of next week when I've finished the gastro unit please, and a load of questions I recognised bits about from seeing them on patient records at work but don't know the specifics of to be able to answer.  And for once there were a few where I knew bits about what they were describing, but they hadn't asked the right question for me to be able to answer it.  For example they gave a perfect description of shingles without identifying it as such.  Fingers crossed the question is what is it....nope, how do you treat it.  I don't know, I didn't look at that bit.  Grr.  Can I have half a point for being clever and knowing it's shingles?  There were some I got down to a 50:50 and I honestly still can't say I got it right or not.  I'm afraid to look up the answer.  Oh, and diverticulitis.  It comes up every time and every time I think ooh, what on earth is that, must look that up and forget.  Gah.  Well, I know now.

I missed pancake day this year.  I was studying and couldn't take the time to make them.  I had suggested to my housemates before the workload became all encompassing we do a house pancake evening, because the only thing we've done together since we moved in was go to a disciplinary hearing.  They all said it was a good idea and we should do it.  Pancake day comes and they get some course mates over a pancakes for lunch.  Gee thanks guys, nah, don't worry I didn't want any  Thanks for asking... -_-

At the weekend I coxed the crew I'm supposed to be racing with at Women's Head of the River next weekend.  I can't go because I can't afford to get the membership and enter the race.  We had a new coach who's coached the New Zealand National team so he should be pretty good but he was pushing them so hard he almost broke them.  Race piece after race piece, more pressure, row faster, row for longer.  It was tough. For two hours I was in charge.  I was their on board coach, talking them through the pain, motivating them, getting them to row their best, keeping them strong, tweaking their technique, steering them.  I was responsible.  That's my stress relief.  Yelling at people to do their best at obscene times on a Sunday morning.  Dressed in so many layers you could push me over and I'd bounce up again.  Leaving work and study behind me focussing entirely on being what my crew need from me.  That is my stress relief.  That, and if you'd have been a fly on the wall of my kitchen a few hours ago I had the radio on full blast playing dance music and I was dancing round the kitchen like a loon cooking bolognese stuffed pancakes :)

Work, Work, Work, ?Study

"Do you like living your life at a maniacal pace?" Ha!  Obviously SSU was not going to be a nice chance to slow down.  My Practice Manager said this to me in the week as I was rushing from lectures to work.  I work as an administrator at a local GP's surgery and they must be pleased with me because I'm getting more responsibilities, more training and a pay rise, which is good.  Unfortunately I'm being thrown in the deep end some what as there are quiet a few sickness absences so since I seem to be a quick study I'm shown something once and left to do it.  Since my last post I've done a twelve hour shift which started with manning the appointment line (only my second time) for the Monday morning rush which was absolutely crazy busy but I managed it which I was so pleased with.  It ended with the late clinic and lock up where I was the only member of admin staff and there were two Doctors in and a full clinic.  The next day I was handed a pile of 41 dictations with 7 urgents to do since the girls that normally do them were off sick.  These are interesting, but involve a lot of sleuthing as the Dr's tend to say "letter to so and so" and you have to work out who that may be, what they do and how to contact them, whether it needs to go via choose and book so the patient can pick their hospital and slot if it's a speciality that it can be done for, or if you should be looking for an address for them or their secretary.  Google is a God-send!  Again the day ended with a solo shift on the front desk with the late clinic and the Dr running 30 minutes late.

I know that I'm probably saying yes to too many shifts at the surgery, and that I should be taking more breaks whilst I'm there.  But the work is so interesting, time slips by without me noticing and I'm not tired until I get home.  Equally, it's a viscous circle on the hours front.  I need to study so I can keep up to be able the knowledge to pass the tests to stay on the course. Although the work I do is related and I am learning bits whilst I'm there, it's not really the sort of knowledge that will help me at the moment.  I know my available time will get less and less as I go through the next five years, so I really need to make the most of the time I have now to work and save up so I can afford fees in the years to come.

What's not helping is the fact our SSU facilitator is off ill.  She has a different approach to everyone else, which is that she's setting us small questions to do for each session we see her, while everyone else just has an essay to write.  She told us to hang fire on the essay and not to start it yet and we'd go through some topics and discuss titles when we next see her.  She then cancelled that session because she was ill and sent us an email with some more questions to do for when we next see her which is next week, so now I don't know if she's expecting an essay or not.  I tend to be a bit of an ostrich about things I don't like and ignore them and get on with other stuff.  Since work is keeping me busy I don't want to think about essays and am happy to assume we don't need one, but I don't think life'd be that kind.

Ah well, time management - tick (sort of), multi tasking - tick, learning new skills - tick, being a responsible member of a team - tick, sleep - not really.  I'll be a Doctor yet :)