In Shadow

I've just finished my first clinical attachment of the final year. Otherwise known as 'Professional Work Experience', I shadowed a Pre-Registration House Officer in Respiratory Medicine. I loved it. Despite the huge amount of paperwork and the errand running, for the first time I really felt part of the team with whom I was attached.
I'm finding with increasing frequency this year that the approach to students, now in their final year, has changed. We are treated more as equals, and thanks to the fact we are more able ourselves, we can make a bigger contribution. Even small things like going for lunch with the Registrars - virtually unheard of in my past experience - happened every day.
The practical day-to-day things, such as writing up fluids, dealing with patient's electrolyte balances, writing up drug charts, ordering investigations and requesting a specialist's opinion may sound mundane, but bring an increasing confidence and provide the opportunity to even out the workloads on the ward doctors.
We were lucky to have a Physician's Assistant on our ward, which we shared with another team. Their role is to help with recording blood results and other investigations, which frees up the doctors to spend more time with the patients. It's that last half an hour of the day when one is keen to get home that gets freed up with this system.

Interestingly, I found I got further introducing myself as a Student Doctor rather than a Medical Student. This studentBMJ article looks at the differences in this approach. As the article points out, this can lead to patients believing you really are a doctor. I have to admit, many of our patients did think I was a doctor, and I did nothing to correct their mistake. It was nice to experience the position, and interesting to note any differences in the way I was treated by the patients. Obviously I didn't use this to do anything I shouldn't have (I'm allowed to write prescriptions, for example, but they must be checked and signed by a doctor) but I, for one, will continue to introduce myself as a student doctor.

I also learnt of a consultant's blog during my time. It seems fairly commonplace for healthcare proffesionals to document their experiences or have some form of outlet for the frustrations of work.

Finally, after my pleasant summer holiday and the haze of revision prior to that, it was strange to experience death again. I found myself totally unfazed by the two corpses I saw - one on the first morning, and one again on the last. Walking onto the ward, introducing myself to the House Officer and then certifying somebody dead a minute later was a strange experience, but I wasn't emotionally unaffected. I didn't know this patient, but I did know the lady who died on my last morning. She had terminal metastatic breast cancer, antibiotic-associated diarrhoea and a chest infection. She was not for resuscitation. She was isolated in a side room, and had requested to be 'allowed to let die'. I felt somehow my time was completed by her death, it provided some sort of closure. And I felt happier, knowing her suffering had ended.

Next I'm doing Anaesthetics and Pain Management. I'm looking forward to learning how to intubate somebody. I've always been intrigued by anaesthesia, and I'm keen to learn the skills necessary for basic life support. I'll keep you informed.