Saturday, October 20, 2012

Care of the Elderly.

So I've started yet another placement (5 placements down, 2 more to go) and this placement is "Care of the Elderly". Out of coincidence and sheer luck I've been placed in Orthogeriatrics. Majority of the patients on the ward are patients who broke their hips (neck of femur (NOF) fracture (#)). Because this placement is only 2 weeks, it's a really quick taster and for me it's a bit of time to get my sanity back as I really enjoy orthopaedics so it's nice to just go back to something I'm quite familiar with.

Essentially I've got 10 days to learn and see everything I need to know to care for the elderly...great. Pretty rushed. And on top of that, get to know the staff on the ward which in general takes a bit of time to warm up to. First day - I met my consultant who is really nice so that was good news. The junior doctors are also really nice and chilled out as well and very understanding as they know we've got exams coming up so they aren't too bothered. They are also quite keen to get us involved in terms of helping them do jobs and getting involved in ward rounds (taking notes, looking at obs charts, drug card, etc.). To be honest, I've never been so involved on the ward...ever. It's also a bonus as I can get my clinical skills logbook signed off as I'm getting lots of opportunities to do clinical skills like venepuncture, cannulas, catheters, ABGs, etc. Really enjoying that and it's good practice. On top of that, I've been quizzed on osteoporosis and surgical management of NOF #s, but having done and attachment in orthopaedics (hips), for once I can actually answer questions with ease and confidence. It's actually quite a nice feeling to be able to answer questions...wish my knowledge was that sound with everything else in medicine...

Because I'm on Orthogeriatrics, the team works closely with the orthopods so we have to attend trauma meetings. Actually we don't have to attend trauma meetings (completely up to us as it starts quite early in the morning). I didn't get a chance to attend any trauma meetings during my attachment in orthopaedics, so I was quite keen to check them out as it does have a bit of a reputation. The benefit of having done my attachment in orthopaedics, is that the consultants recognize me so they don't question my presence in the meeting (students tend to avoid trauma meetings). In terms of education value - these meetings aren't great, but you get to hear about some interesting trauma cases that have been admitted...some fairly amusing and crazy stories as well. It's also a bit of a shooting gallery as well as consultants do "fire at will" if a trainee says something wrong or doesn't present a patient well. It's all a bit of a laugh/leg pulling, so it's fairly amusing at the expense of a junior doctor/SHO/registrar. Despite the earlier than usual wake up for placement, I don't mind attending. Again this is something I noticed in my orthopaedics attachment. I didn't struggle to wake up for placement during orthopaedics and was never late. I actually looked forward to going to placement - something to wake up to in the morning. If you follow my blog closely, I struggled quite a bit in GP and waking up was a huge struggle. Now in orthogeriatrics and early morning trauma meetings - I'm finding it easy to wake up again. Just feel like there's something to look forward to in the day. It's a nice breath of fresh air especially after two placements that were mediocre (well poor and mediocre).

I also quite like talking to the elderly as they've always got a great story to tell. One patient that stuck out for me this week was an 80 year old gentleman who was in for a left NOF #. He was a very talkative man and I met him the day before his discharge. He's gotten to know the staff on the wards quite well as he's been in hospital much longer than he should have been due to some complications. When the doctors were speaking to the man, he seemed like a genuinely funny and animated guy. He's obviously fed up with being in hospital and very much looking forward to leaving. He's apparently known to be getting quite critical with the doctors as he is sick of getting prescribed more and more medications as he stays longer and gives the juniors a bit of a tough time (in a joking manner though). After telling the patient he will be leaving the next day, and after quite a bit of joking around, he suddenly turned very thankful and grateful. He shook the doctors' hands and thanked each of them for taking care of him and "putting up" with him. It's quite nice to see as these days some patients don't give doctors enough credit and give doctors quite a tough time. It was a small gesture but it definitely put a smile on my face. It's nice to see the appreciation and I think the staff is happy to see him finally able to leave the hospital.

All in all, this week has been a great week, which is a good change as I've always had slow first weeks/things don't go my way in the first week. It's a good start to a very short placement and I'm getting along with the junior doctors so it's definitely making my placement a lot more enjoyable. It's also nice to see some familiar faces as well in the orthopaedics department. Even the secretaries are recognizing me as I've been popping around. Like one secretary said: "It's almost like you never left!". Funny enough it's actually been almost 4 months since my orthopaedics attachment (seems longer than that though!). It's been a good week and I've been getting some good news as well which I'll talk about at a later time.

Sorry for the long post - it just feels like it's been a long time since I've had a good time at placement and fairly happy. Dreading the fact it's only 2 weeks, but I think it's a good motivation booster - in time for exams. Happy reading!


  1. Really enjoyed this post - thanks for sharing your experience!

  2. When the doctors were speaking to the man, he seemed like a genuinely funny and animated guy.