Yesterday was the last day of my Orthogeriatric placement. Was a bit bummed out as I've gotten to know the junior doctors quite well and I enjoyed my placement (despite it being only 2 weeks). By being on the Geriatric ward, you realize all the ethical problems and how cost of care can be so high for these patients. For example - hip fractures cost the NHS 1.7 million pounds per year. The problem is that when these patients turn up, they don't just get an operation and then get discharged after a few days. Older people require a bit more care as they tend to suffer from other medical conditions such as vascular disease (MI, stroke, etc), diabetes, etc. Along with needing to continue treating their co-morbidities, these patients are more susceptible to hospital acquired infections (eg. pneumonia) so essentially it becomes a vicious cycle for these patients. Majority of the patients on the ward stay in hospital for a month which is quite a long time. Care 24/7 for 4+ weeks...the costs do add up.
I was probably most involved with ward rounds in this placement than any other placement I've had so far. I was quite keen to actually help out as I know I do get bored quite easily if I just stand around. I got to write in the patient notes and you just feel a slight bit more responsible while on placement. It sounds a bit sad, but it's quite satisfying signing off on something. I mean as a medical student, we never really get to sign off on anything so it's nice being able to sign off the notes you made in the patient notes during ward round. You also feel a sense of contribution as well, which is a nice bonus. Also good practice for the future as well - will be doing lots of paperwork in the near future...
I think the main problem about being on a geriatric ward is that the turnover rate is quite low so the ward round usually consists of a quick check-up and if there are any new concerns/changes. This made me find this week a slight bit more dull than my first week. The only thing is that now I know the patients, but there isn't anything new to see. Their improvement is also quite slow so I must admit this week's ward round was a bit less interesting.
I mean overall it was nice to be back on a proper medical ward and doing "medical things" as I've spent the whole year in very specific specialties. There was a lot of general medicine and it made me realize how much I have already forgotten (quite scary especially when exams are just around the corner too!). All in all these 2 weeks helped me get my sanity back and I managed to grab some motivation back - well enough to take me through to exams. Now I've got 2 weeks off before my next and final placement - Neurology. Neuro will be tough but I'm quite lucky that I've had an attachment in Stroke medicine last year so I shouldn't be too lost on the ward.
2 weeks to dig my head into my books and do some proper revision. Procrastination mode - on. Need to focus!