Tuesday, 11 December 2012

Long days full of sniffles

Week 7 of acute care was my favourite yet.  It was called thirst, but was actually just a week on the paediatric ward.  After an induction session watching a video about how to examine children and a supervised practice examining a 3 month old we shadowed the ward round and were then let loose to clerk all the patients being sent up from A&E.  They have a very low threshold for admitting patients down there, so they tend to send them up to be triaged and dealt with by paediatricians just to be sure nothing important is missed.  We had to check the board to see who was due to be seen next, collect them from the waiting room and take them to a side room, take a history, do an examination, send them back to the waiting room, write up our notes and find a Doctor to present them to.  It wasn’t terribly difficult though, as most of the patients were toddlers or below with bronchiolitis, a respiratory infection caused by RSV.  The treatment is pretty much just monitoring. 

We were encouraged to stay for the afternoon handover at 5 and continue clerking until about 7 when it started to get less busy.  It was intense, but it was really nice because you really got to know all the patients on the ward and really feel useful and a part of the team.  It made for long days though, especially as Thursday I had an evening placement with Devon Doctors.  On that day I was in for 8am and the ward round and I didn’t get back home again until 11pm, taking 30 minutes for lunch and 30 minutes for tea. 
We weren’t actually timetabled for that much, but our facilitator was a little disgusted with how little paeds we did and politely suggested that we spend all the time we can clerking patients to improve our confidence with examining children.  You could also be cynical and say we were helping to keep the department running smoothly by adding free man power to the clerking side.  But I had a blast, so I’m not complaining!  Also, since he had to write a professionalism judgement on me, I wanted to be seen to be heeding his advice and on the wards as much as possible. 

Devon Docs is our out of hours system now that it is no longer compulsory for individual GP practices to be responsible for out of hours cover for their own population of patients.  Local GP’s sign up and according to a rota they are either based at the hospital triaging calls and seeing patients that are well enough to come to hospital, or they go out in a chauffeur driven car to see patients in their own home.  I was lucky enough to go out in the car with Devon Doctors.  It was great seeing the Doctor trying to work out if the problem was severe enough to be admitted overnight.  It’s quite intense as you are on your own in another person’s house with no back up if anything goes wrong or to support your diagnosis.  

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