Sunday 26 June 2011

Holiday!

Tomorrow mr and I jet off to sunny Lanzarote.  It's currently 33 degrees over there; I am exstatic and mr shall just cook.  I was born to be in a hotter climate than this one.  Mr jokes I'm a little like a lizard: I need the sun to warm me up.  Apart from that, it will be lovely to have a whole week of me and mr being a normal couple.  I am currently typing this from his office on base whilst he finishes up some work.  It's just like we were back at uni again, most of our dates were spent sitting side by side in a computer room somewhere doing our work.  A little sad possibly but needs must and it works for us. 
Also tomorrow the results of the AMK and EoY1 exams are due out, so unless I can find WiFi I'm afraid I shall have to keep you in suspense over whether or not I passed.  It is a four hour flight and I anticipate going slightly nuts as the results are released just 20 minutes after we take off.  Rest assured the first thing I will be doing when we land is turning on my phone and praying for a text from Mum hopefull containing the magic word 'satisfactory'. 

Quite a few people I know have recently got their degree results, so well done to them.  I was waiting nervously for them to post their fate with everything crossed trying to summon some more cosmic good will their way.  Everyone I heard about did well, so I'm thrilled for them and hope they had fun celebrating.  I really hope the good will is extended my way, although to be honest, I'm not terribly stressed out.  I have a gut feeling everything will be all right.  Though that never worked out for me in Southampton, everything I thought went well did the opposite :-s  But, nowt to be donas was the about it now. 

After I made the decision to go back to my office job once I got back from holiday, I am now still waiting for them to confirm they actually have availability for me which is annoying.  I may have to make a call to the GP's when I'm back next week and work there after all.  As long as I'm working, I don't really mind where.  I'd kind of made up my mind about the office job and was sort of looking forward to the challenges they'd be asking me to fix.  In the last week at the GP's I spent two solid days coding diabetic retinopathy results and basic medical record stats like BMI and fixing telephone number data errors.  I spent a whole day on the front desk and telephone line and met my first patient that really, really annoyed me. 

They phoned in the morning and booked an appointment for the following week, which they were happy with.  I always sign off a call by confirming the date, day, time and Dr the appointment has been booked with, just to be clear.  A nurse from the hospital then called whilst sitting next to the patient to book an INR blood test for the same time, only she thought the appointment was tomorrow, not the next week.  She was getting really angry at me, as was the patient.  The hospital wanted to hand care over to the GP now, but we physically couldn't fit them in until the following week, we were all booked up.  The nurse was trying to say that since the INR would only take a couple of minutes, did it have to have a nurses appointment, couldn't the GP do it in their consultation.  Firstly, the patient DOESN'T HAVE AN APPOINTMENT, and telling me they do isn't going to make their name magically appear on my screen.  Secondly, no, that's not how it works.  GPs don't do INR's, nurses or HCA's do, and as we are a busy practice and the types of appointment are grouped so all the bloods and all the imms are done together, ringing me the day before an expecting an appointment is a little unreasonable.  I thought they were all fine with it, grumpy, but they understood there was nothing I could do.  That afternoon, the patient in quetion turned up at the desk 'to confirm their appointment time tomorrow.  I spoke to someone this morning'.  Nice try, it was me you spoke to, and surprise surprise we still don't have spaces since you called 2 hours ago.  They got their appointment in the end.  They came in the next day for the appointment they didn't have and made so much fuss the nurse and a GP fit them in in between patients, and were subsequently running over 30 minutes late.  It's fine for the patient, they got to be seen and to feel like they got one over on the mean receptionist keeping them from medical attention.  They didn't have to be receptionist sitting there fielding evil glares and queries about when they would be seen from the waiting patients because morning clinic over ran.  They did it again the next day, again turning up for an appointment they didn't have and again the day after because, despite being given a clean bill of health from us, they'd gone to the Emergency Department anyway that evening for the same complaint and been sent home fine.  They'd had blood tests, so came in to use the following day because they wanted to know what the blood tests had said.  Cue the GP asking me to contact the ED and find out why the patient went in and what the bloods showed.  That was fun, because obviously everyone who had been there had since gone off shift.  Did it though.  The Dr was very pleased.  The bloods were clear. 

I like to think I'm a resonable person, certainly I've had many other patients compliment me on empathy and going above and beyond for them.  This is the first that has acted like I have purposefully been difficult.  If there is an emergency, or you are a green flag patient so you have open access (generally for the really sick) I can make a space for you whenever, but just because the hospital have decided they don't want to treat you anymore and your GP can deal, or because you turn up and yell at the receptionist, don't be surprised we can't see you immediatley.  That's what Walk in Centres and ED's are for, and even there you have to wait. 

That's probably enough from me for now.  I shall go and finishing combining my bag with mr's and prepare for the horrible early start required to drive to the airport and catch the flight.  Have a great week. 

Friday 17 June 2011

Holiday?

The end of year exam went well. I hope anyway.  It felt like it went well.  It was certainly a lot better than I expected.  There was a lot of anatomy - along the lines of " if you were to inject someone here, what would you have to careful not to hit?".  Probably about 60-75% I could answer without thinking and the rest I could make educated guesses on.  There were only about 4 out of the 100 I couldn't answer at all.  It takes the standard AMK format, so a wrong answer is -0.25 and a correct answer is 1 mark, with a blank being 0.  Results for the End of Year and the final AMK are out on the 27th.  There was a question about what movement a lady found painful when shutting drawers and when people got to that question you could see them all going through the motions.  It was quite funny to watch.  I'm fairly happy.  I wouldn't go so far as to say I'm not nervous about the results, but the butterflies in my tummy aren't pterodactyls (as the lovely madsadgirl would put it). 

I am currently working at the GP's and in a bit or a battle with hours.  I would like to do full time but they can't afford me full time.  Bearing in mind their full time is 42.5 hours a week, I asked for 33 hours and have been told they can definitely give me 28 but can't confirm more than that however they really don't want to lose me.  The problem is, my old job have asked me back.. sort of.  One of my old bosses has a project he wants doing, and he thinks if he goes to the board and says I'm free I'll do it, they will allow it.  Then there's other bits I can do whilst there for the rest of summer.  They pay more than the GP does.  I will earn £800 more at the office job than doing the 33 hours at the GP, and £1100 more than the 28 hours at the GPs.  Now sneaky BIS have re-written the rules to exclude the loophole they had previously been ignoring, and all the campaiging that is being done to save GEM is ignoring us grads on five year courses, it's looking less and less like I will get the fee loan money after all, so anything I earn now is important. 

I worked out I am covered for year 2, I can afford fees and rent there, and I have year 3's fees sat in an ISA, so it's rent and fees and rent for 4 and 5 I'm saving for now.  So, head says go for the more money.  Heart says I want to do a job I love, a job that is relevant, where everyday I'm learning new bits that help my degree.  I'm not coming home shattered like I do at the office job even though it's longer hours and more repetitive 'boring' work (that acctually I really enjoy).  I'm not using my brain to problem solve as much as I get to in the office job, I don't have autonomy, lunch time cards or the responsibilty my office job gives me, but still....  I can't be pleased.  Those that tell me to do the one I love I tell the money side to, and those that say do the money job I tell the enjoyment side to.  I am completely stuck.  They say you should flip a coin and in the split second it's in the air you'll know the one you really want to do, but even that doesn't work.  I didn't get the job at the hospital to boost the GP job money and do the two part time, and I don't think the office job will let me be part time.  I am hoping the decision will be taken out of my hands.  I've told the GP's my final offer of 33 hours a week and if they don't meet it I will have to go back to the office job.  It's the sensible, grown up thing to do.  You can't have what you want all the time.  And it won't be for very long.  People who read my blog who are further up the course than me, how do you find balancing a job with being a 3rd, 4th or 5th year?  Is it possible?

If we ever get around to booking it Mr and I are going to Lanzarote in a couple of weeks for a cheap week in the sun together.  Looking at the horrible rain we've had today I cannot wait.  I have a to do list that is ridiculously long with work to do, rooms to tidy, stuff to sort out and cull, christmas presents to start making, baby clothes to finish knitting, I have to decide what if any rowing or coxing I'm doing this summer.  And summer doesn't really seem to be that long to get it all done.  I tell you what though, I can't wait for it to be over :)  I want to see what the next case unit is, and where my placements will be.  :)

Wednesday 8 June 2011

Medically Racist

Well I've had my placement at the Chiropractors.  I'm probably a little more pro-chiro now than I was but I'm not sure I'd ever go myself.  He said there were two types, the traditional that believe they can fix any problem because the spine is the centre and needs realigning to restore flow to the nerve roots that come from the spinal cord.  Then there's the mechanical type like the one I saw that manipulate the spine to fix back pain but refer on for anything else.  He did get quite hands on and jump all over the patients, contorting them in strange positions and hugging them tight, jerking them to extend the stretch until the joints cracked.  There was one patient who was finding it really uncomfortable and seemed to be in a fair amount of pain but he was just ignoring it.  He berated her somewhat afterwards by saying that if he could move her neck there was no reason she shouldn't be able to which I thought was a bit harsh.  It's only natural that if something hurts you don't do it.  He might very well be right, I just felt there were probably more sensitive ways to say it.  He seems to have gone the opposite way - where Peninsula teach us to treat the whole patient including their thoughts and feelings, he treats spines, and just spines.  I did like how he explained to the mechanic about his back comparing it to a car engine, but he didn't treat all his patients equally.  We got into discussions about where GPs refer to.  He was upset that many will refer to a physio but not to a chiro.  He called it being medically racist, which is a novel idea.  The GPs I've spoken to say they won't refer to chiros because they aren't NHS; they aren't in the 'toolbox'.  He sort of understood this at the time, but then later referred back to GPs being medically racist, as though he was willing to accept my input, but had already made up his mind and that was what he thought.  What made me laugh was how he said he wanted tighter regulation and didn't want to be associated with the traditional chiros who do all sorts of strange treatments, but then said he uses a blend of physio, osteopath and chiropractic moves.  How is that better? He's still going outside his remit to treat how he feels works best.

Exam prep is still going pants.  I'm more on the 'I've got so much to learn and I'll never get it all done in time' mindset now.  I found out I passed my last assessment essay, so passing through to year 2 is all riding on the AMK or EoY1 test now.  As a class we've taken to accosting members of staff to see if anyonehas any knowledge of our AMK scores.  No joy yet.  I also found out I'm going to Truro for my fifth year which I'm pleased with.  I've collected the set now with years spent at Exeter, Plymouth and Truro.  Mr and Mum aren't too thrilled as it means I'll be really far away.  The way I see it, I'll be too busy to have the time to just pop home.  Plus it's no further from home than when I was in Southampton and Mum didn't have a problem then.  I'm happy because it's pretty, I've heard good things about the teaching as people have the time to teach you and they are friendly.  I'm not fussed about the lack of nightlife, and I'm pleased I have the opportunity to go to Cornwall as a local and not a grockle.  If the foundation school applications change to reflect the proposals I was emailed about earlier in the year, it'll mean I do F1 there as well.  See you on the other side of the dreaded end of year :-|

Saturday 4 June 2011

Nearly

I am about to start the last week of being a fresher.  It's quite a scary thought.  I'm not really ready for it to be the end of the year.  Not because I'm not looking forward to the exam at the end, rather I'm having a blast!  I've worked so hard to get here, and it's amazing.  The placements I get to go on, the skills I'm learning, the science.  I'm having such a good time, I don't want a break for 3 months.  As for the exam, well I really don't have the motivation.  I seem to swing wildly between thinking "I'll be fine, I can do it", to "I don't need to do it because I've passed the AMK, so I don't need to work too much for it", to "OMG I have no idea what I'm doing about anything, all the work I've done has been focussing on the wrong things and I've now run out of time to cover it all properly and I don't even know where to begin".

I'm getting rather fed up with Peninsula keep changing our timetables.  I organise meetings and work and then have a double check and it's all changed! Not useful.  It's been a pretty quiet week otherwise.  Placement is next week because of the bank holiday.  It's at a chiropractors which should be interesting.  I have an open mind, but I'm not the biggest fan of alternative medicine to be fair.  Although there are two chiropractors we get sent to on placement, I don't think this is the one where the guy doesn't believe in DNA.... (I wish I was kidding)

I'm getting married next week :)  To my medsoc wife and we shall have fresher babies in September :p  My wife-to-be and medsoc mum and a friend went out last night for pizza and sangria to celebrate my birthday.  I'm 23 tomorrow.  I had a really good night.  There was a lot of sangria and I bumped into a friend I hadn't seen for about 8 years.  It was a shame more people didn't come, but I guess that's what I get for not socialising with them that often, and spending my nights with my head in the books.  Maybe I'll see what I can do to try harder next year.