Seriously cannot believe it has been 6 weeks. It literally blew by. I didn't think it would as I wasn't particularly busy and I had quite a few day offs as well (bank holidays, etc). My friends said that you cannot find a happier medical student on placement than me. I will admit, the placement started off quite slow...but once it got going...I truly truly truly did not want it to end. It's the first specialty where I could see myself work in as a career. Before starting, I was a bit hesitant as ever since I knew I wanted to do medicine, I wanted to do orthopaedics. I had very high hopes for it. Obviously I was very excited to start the placement, but there was a bit of doubt in the back of my mind. These 6 weeks could either make or break this specialty for me. I was actually scared that I will end up not liking orthopaedics...and actually hating it.
Luckily, orthopaedic surgery is just like how I imagined it to be. I was genuinely happy. It's the first placement where I enjoyed everything about the specialty. I enjoyed the surgeries. I enjoyed being on the ward (which was minimal to be fair). And I can't believe I am saying this but I enjoyed clinic. Everything clicked for me. I never struggled waking up to go to this placement. I had 8am meetings to go to (where I had to wake up at 6am) and I never struggled. If this was any other specialty and was told to go to an 8am meeting...I can guarantee you I would struggle and would probably turn up late or maybe even miss it. I was actually motivated to work hard in this placement. I didn't work hard because my supervisor was strict/I was scared of him...I actually worked hard because I enjoyed the specialty. I felt no pressure to work hard...actually my supervisor kept telling me to take it easy and made it very free. It was all down to me. There were times where I wished I was in more.
This was probably the most flexible and easy going placement I have had this year, but this is easily the one placement where I have learned the most. I had lots of fun, but also learned a lot of useful things. I am so lucky to have a supervisor who is really good with teaching and letting me progress. You all probably remember me having great praises for my last O&G placement and that it has set a very high bar. This orthopaedic placement just blew through that bar. I mean I knew it was going to be hard to have more fun and more responsibilities than my last placement, but wow this placement was fantastic. I have nothing but good things to say. I got to scrub in. I assisted in surgery. I learned how to suture and help close up. I saw patients in clinic on my own and got to examine them. I got to start and finish an audit project. I really could not ask for more. I don't even think I could do much more.
Today started out like any other day. Early meeting and then to morning clinic. Usual banter in the meeting...lots of good laughs and teasing. I took up my usual spot at the back of the room against the cabinet. Then off to clinic. Busy clinic as usual. Saw new patients on my own. Did the usual. I'm sure no one knew it was my last day because everything was going like it was just another day of my placement. Patient by patient...the note pile got smaller and smaller. Clinic was coming to an end. Next thing I knew my supervisor was signing my feedback form off. Had a bit of a chat about the placement and then a solid handshake. To be honest it was tough to leave. I wasn't sick of the placement yet. Just wasn't ready for it to end already. Every day when we finish and before I leave, I always crack a: "When am I seeing you next?" It was weird not to say that as I was heading for the door. I didn't even know what to say as I left. I think all I kept saying was "thank you" as I dragged my feet out the door. Even now...I'm absolutely gutted this placement is over. Feels like someone shot me out from cloud 9. Next week is going to be tough. Back to lectures. Back to reality. Then on to GP and being cooped up in a clinic from 9-5. No surgeries. Not in a hospital environment. Going to be out of my element. Hurts just to think about it. Should be a crime to enjoy a placement so much. Genuinely loved this placement. Entered placement as one of the happiest medical student you can find to probably the most gutted one at the moment. What a contrast. Just shows you how much I enjoyed this placement.
Showing posts with label highlight. Show all posts
Showing posts with label highlight. Show all posts
Friday, June 8, 2012
Thursday, May 31, 2012
What a Day.
So like I said in my last post, my placement is coming to an end and because my supervisor is really good with slowly giving me more responsibilities as the weeks go by, this week has been a lot of fun. My last placement, Obs and Gynae, could easily be the highlight of my medical school in terms of all-round great placement. Yesterday could have EASILY been the highlight day of my degree so far and by the looks of it - this placement will probably become the best placement of my degree.
Anyways yesterday was theatre day and was expecting to have 3 patients on the theatre list but I was actually disappointed in the morning to find out that one of the patients were cancelled so we only had two patients on the list. It was also going to be my last orthopaedic theatre list for this placement so I was a bit bummed out that we were most likely going to finish early. First patient was a simple straight forward one man job so I didn't scrub in and just observed. Afterwards we had a good break prior to the next and final patient for the day. Had some good banter with my supervisor and then I went to go see the patient in the anaesthetic room. It was a bit weird as the anaesthetist had quite a bit of difficulty putting in an epidural and other things just weren't going right/straight forward. The anaesthetist and I had a bit of a chat and we agreed that we have a feeling this surgery is going to be FAR from straightforward. Anyways after the patient was put to sleep my supervisor came in and told me that I will be scrubbing in and will be a first assistant. My eyes lit up. Last few weeks, I was scrubbed in, but I was more of an observer who did a bit of suction here and there, but nothing really special/that helpful.
Brief summary of patient: 1st stage revision of total hip replacement. Reason: Infection
11.10 - first incision made
I am still a bit new to orthopaedic surgery, but I have seen a few now and I knew immediately that something wasn't right. Immediately after the first incision, the patient was bleeding a lot more than usual. As we went deeper, it was obvious that the bleeding is only going to get worse and by the time we got to the muscle layers...it was like the flood gates were opened. The patient was bleeding from all sides of the opening and it was difficult to find where the bleeding is coming from. I tried my best to keep up with the suction so we can identify where the bleed is coming from, but we couldn't find a specific source. At least we knew it wasn't an artery as the blood is darker in colour. Anyways it was just a big mess in there and slowly it became obvious that this surgery is going to take a lot longer than predicted. The anaesthetist was struggling to keep the patient's stats normal and eventually had to call in for blood. We took a break during the surgery to try and get the patient to clot by packing the wound with swabs and putting pressure. After a bit, we hoped the swabs did the trick and started removing the swabs (which also gave the anaesthetist time to catch up with the fluids) and 5 seconds after removing the swabs...the blood just came pouring out.
12.30 - removing the femoral stem component
This wasn't too hard and everything came out very easily as the bone was dead and very weak. The cement and the component came out without much difficulty...luckily. Then we had to remove the acetabular cup which proved very challenging...to the point we had to get creative. Anyways after a lot of creativity and trial and error we did get the cup out. Again the bleeding was still really bad and it was so hard to keep up with the suction and to keep the view clear. There were times where we were sloshing around blindly trying to feel for the anatomy instead of visualizing as it was far too difficult. At this point I was starting to lose track of time as I was completely focused on my job of suctioning and holding tissue out of the way, etc. As time went I could tell we were taking awhile as my feet were starting to hurt. My hands were starting to cramp up due to the gloves. My back was starting to stiffen up. Oh and I had to use the toilet...but guess what: too bad.
14.30 - making antibiotic cement beads
Essentially we leave these beads inside the patient to allow the antibiotics to work and to kill off the infection in the local area. After the patient has healed from this surgery...these beads will be taken out in the 2nd stage revision and a new joint would be put in.
14.50 - patient starting to really deteriorate
While we are operating...it is difficult to hear what is going on outside of the operating area as we are in a "tent" area with plastic walls, but you could hear the anaesthetist making a lot of calls for extra help. People were starting to come in and you know something isn't right.
15.00 - closing up the wound
We started closing up the wound and then I heard my supervisor tell the scrub nurse: "vicryl to the student as well please". I was a bit confused as to why my supervisor and I both each had sutures as usually only one person would close up while the other person uses the scissors to cut the stitch (which is usually my job). My supervisor told me to start on the bottom end of the wound and he went off and started closing up the top portion of the wound. Last time I sutured, my supervisor watched me and guided me. This being my 3rd (?) time suturing on a real person...no one is watching. Worst bit: I was also shaking like a leaf. No I wasn't nervous/scared...it was because the last time I ate was at 8.00am and was obviously starving. Anyways managed to close up the bottom of the wound and then proceeded to help my supervisor with cutting and pushing the skin closer together so he can close up properly. Other than the shaking...I didn't struggled with the knots or anything. It actually went fine and my supervisor said my sutures looked fine as well. Proud moment. Thank goodness for masks as I was probably smiling like an idiot.
15.30 - put dressing on the wound (which was leaking out with blood still) and clean up
As we took down the drapes and everything you really notice that the patient isn't doing well as hiding in the back were 4 other people helping the anaesthetist and the floor was covered with empty blood bags. At one point the patient's haemoglobin count dropped to 6 (normal is 12). Apparently the patient had no clotting factors as well and we suspected the patient had DIC (disseminated intravascular coagulation) as the patient was bleeding from the cannula sites and from her nose. By the end of surgery it was calculated that the patient had lost up to 10 litres of blood. Normal human has about 5 litres of blood. It wasn't good and the patient was obviously in a critical state. There was a student nurse watching the surgery so I went over to go talk to her. She initially thought I was also a surgeon and hadn't realized I was a medical student. I was a bit shocked as I thought it would be obvious as I'm the "clumsy" medical student that probably looked lost and clueless during the surgery. The student nurse quickly disagreed and said that she was amazed how it looked like I knew what I was doing and what needed to be done. She thought I was constantly on the same page with the consultant and I didn't need much direction. It was weird hearing that as I always though I looked like a clueless idiot when scrubbed in. Even the other theatre staff gave me a pat on the back and told me I did a good job. Definitely put a huge smile on my face and the surgery felt good. I really enjoyed it and it was exciting. The surgery was also definitely challenging so it was an interesting case for me.
Anyways first time being a first assistant for orthopaedic surgery and a good way to end my last theatre list for this placement. The patient ended up getting transferred to ICU, but she managed to recover so all was good. Definitely a very tiring day. By the time I got home it was around 1800 and I still had not eaten, but guess what...it was fine and I think it is something I have to get used to. My supervisor also hadn't eaten as well and he doesn't complain as I'm sure skipping lunch is a usual thing for him. What a day.
Anyways yesterday was theatre day and was expecting to have 3 patients on the theatre list but I was actually disappointed in the morning to find out that one of the patients were cancelled so we only had two patients on the list. It was also going to be my last orthopaedic theatre list for this placement so I was a bit bummed out that we were most likely going to finish early. First patient was a simple straight forward one man job so I didn't scrub in and just observed. Afterwards we had a good break prior to the next and final patient for the day. Had some good banter with my supervisor and then I went to go see the patient in the anaesthetic room. It was a bit weird as the anaesthetist had quite a bit of difficulty putting in an epidural and other things just weren't going right/straight forward. The anaesthetist and I had a bit of a chat and we agreed that we have a feeling this surgery is going to be FAR from straightforward. Anyways after the patient was put to sleep my supervisor came in and told me that I will be scrubbing in and will be a first assistant. My eyes lit up. Last few weeks, I was scrubbed in, but I was more of an observer who did a bit of suction here and there, but nothing really special/that helpful.
Brief summary of patient: 1st stage revision of total hip replacement. Reason: Infection
11.10 - first incision made
I am still a bit new to orthopaedic surgery, but I have seen a few now and I knew immediately that something wasn't right. Immediately after the first incision, the patient was bleeding a lot more than usual. As we went deeper, it was obvious that the bleeding is only going to get worse and by the time we got to the muscle layers...it was like the flood gates were opened. The patient was bleeding from all sides of the opening and it was difficult to find where the bleeding is coming from. I tried my best to keep up with the suction so we can identify where the bleed is coming from, but we couldn't find a specific source. At least we knew it wasn't an artery as the blood is darker in colour. Anyways it was just a big mess in there and slowly it became obvious that this surgery is going to take a lot longer than predicted. The anaesthetist was struggling to keep the patient's stats normal and eventually had to call in for blood. We took a break during the surgery to try and get the patient to clot by packing the wound with swabs and putting pressure. After a bit, we hoped the swabs did the trick and started removing the swabs (which also gave the anaesthetist time to catch up with the fluids) and 5 seconds after removing the swabs...the blood just came pouring out.
12.30 - removing the femoral stem component
This wasn't too hard and everything came out very easily as the bone was dead and very weak. The cement and the component came out without much difficulty...luckily. Then we had to remove the acetabular cup which proved very challenging...to the point we had to get creative. Anyways after a lot of creativity and trial and error we did get the cup out. Again the bleeding was still really bad and it was so hard to keep up with the suction and to keep the view clear. There were times where we were sloshing around blindly trying to feel for the anatomy instead of visualizing as it was far too difficult. At this point I was starting to lose track of time as I was completely focused on my job of suctioning and holding tissue out of the way, etc. As time went I could tell we were taking awhile as my feet were starting to hurt. My hands were starting to cramp up due to the gloves. My back was starting to stiffen up. Oh and I had to use the toilet...but guess what: too bad.
14.30 - making antibiotic cement beads
Essentially we leave these beads inside the patient to allow the antibiotics to work and to kill off the infection in the local area. After the patient has healed from this surgery...these beads will be taken out in the 2nd stage revision and a new joint would be put in.
14.50 - patient starting to really deteriorate
While we are operating...it is difficult to hear what is going on outside of the operating area as we are in a "tent" area with plastic walls, but you could hear the anaesthetist making a lot of calls for extra help. People were starting to come in and you know something isn't right.
15.00 - closing up the wound
We started closing up the wound and then I heard my supervisor tell the scrub nurse: "vicryl to the student as well please". I was a bit confused as to why my supervisor and I both each had sutures as usually only one person would close up while the other person uses the scissors to cut the stitch (which is usually my job). My supervisor told me to start on the bottom end of the wound and he went off and started closing up the top portion of the wound. Last time I sutured, my supervisor watched me and guided me. This being my 3rd (?) time suturing on a real person...no one is watching. Worst bit: I was also shaking like a leaf. No I wasn't nervous/scared...it was because the last time I ate was at 8.00am and was obviously starving. Anyways managed to close up the bottom of the wound and then proceeded to help my supervisor with cutting and pushing the skin closer together so he can close up properly. Other than the shaking...I didn't struggled with the knots or anything. It actually went fine and my supervisor said my sutures looked fine as well. Proud moment. Thank goodness for masks as I was probably smiling like an idiot.
15.30 - put dressing on the wound (which was leaking out with blood still) and clean up
As we took down the drapes and everything you really notice that the patient isn't doing well as hiding in the back were 4 other people helping the anaesthetist and the floor was covered with empty blood bags. At one point the patient's haemoglobin count dropped to 6 (normal is 12). Apparently the patient had no clotting factors as well and we suspected the patient had DIC (disseminated intravascular coagulation) as the patient was bleeding from the cannula sites and from her nose. By the end of surgery it was calculated that the patient had lost up to 10 litres of blood. Normal human has about 5 litres of blood. It wasn't good and the patient was obviously in a critical state. There was a student nurse watching the surgery so I went over to go talk to her. She initially thought I was also a surgeon and hadn't realized I was a medical student. I was a bit shocked as I thought it would be obvious as I'm the "clumsy" medical student that probably looked lost and clueless during the surgery. The student nurse quickly disagreed and said that she was amazed how it looked like I knew what I was doing and what needed to be done. She thought I was constantly on the same page with the consultant and I didn't need much direction. It was weird hearing that as I always though I looked like a clueless idiot when scrubbed in. Even the other theatre staff gave me a pat on the back and told me I did a good job. Definitely put a huge smile on my face and the surgery felt good. I really enjoyed it and it was exciting. The surgery was also definitely challenging so it was an interesting case for me.
Anyways first time being a first assistant for orthopaedic surgery and a good way to end my last theatre list for this placement. The patient ended up getting transferred to ICU, but she managed to recover so all was good. Definitely a very tiring day. By the time I got home it was around 1800 and I still had not eaten, but guess what...it was fine and I think it is something I have to get used to. My supervisor also hadn't eaten as well and he doesn't complain as I'm sure skipping lunch is a usual thing for him. What a day.
Saturday, March 17, 2012
O&G Theatre Week
So far so good! I'm enjoying this placement 100% more than my paediatrics placement. I feel much more comfortable and it's a nice feeling to be looked after. Yes it is annoying that someone is keeping a hawk eye on your progress and your work, BUT at least someone cares. In my last placement I felt like I could get away with anything and there wasn't enough motivation/pressure for me to work hard. I'm working much harder in this placement and I am learning loads. This week was my theatre week and as you probably know - I'm a bit biased towards surgeries as I really enjoy surgery. If you tell me to stand in theatre from 9-5 and watch surgery all day...I will happily do that - no complaints. If you tell me to stand in the ward from 9-5...I'm pretty sure I won't be as happy about that. I don't know what draws me to surgery so much. It's just nice being able to fix things immediately right there and then.
Anyways all in all the week had its highs and lows. Monday and Thursday were my two highlight days of the week. Oddly enough these two days were the two days where I had theatre sessions with my supervisor (Mr R). Right before joining Mr R for theatre, I was told by his registrar that he enjoys quizzing his students in theatre. I found it quite weird as when I was in clinic with Mr R, he didn't seem to be the "quizzing" type of consultant. Before surgery even started, I was grilled about common gynaecological problems. Luckily the questions weren't too challenging and Mr R seemed fairly impressed with my knowledge. I was just lucky that I had clinic prior to theatre which covered the conditions that Mr R quizzed me about. Phew. After the grilling, Mr R invited me to scrub in and to assist in the surgery! I was obviously very excited and it was nice being right at the table and I got to actually assist. I felt a part of the team and I felt like I was helping out. Unfortunately, this gave Mr R the opportunity to quiz me on the pelvic anatomy (which was VERY rusty). My lack of knowledge in the pelvic anatomy was not exactly impressive and I was promptly told to review my anatomy. Oops. Other than that I was able to get my hands in and I learned quite a lot as I did not get a female cadaver dissection specimen during my 2nd year so it was nice to be able to actually see the organs. I was also lucky to help out in a total hysterectomy as it was an open surgery so I got to see the organs more clearly. As the days went by I realized this was the only open surgery I will be watching as the rest of the surgeries I saw were laparoscopic surgeries. Pretty lucky to be honest. When surgery finished I had a good time and had some good banter going on during the surgery. Got to know my supervisor and the registrar better. No joke I really felt welcomed and I didn't feel so much like a medical student. I didn't feel like a joke in the theatre. People were taking me seriously and the nurses were all very friendly to me and I got along with everyone. Definitely a good start.
Tuesday I was with a different consultant for surgery and then realized to appreciate my supervisor as this consultant did not teach me at all. We were performing laparoscopic excisions of endometriosis and these were fairly complicated surgeries in general so the consultant was busy concentrating and I felt forgotten. I casually stood at the the back of the team as I was not offered to scrub in so I just observed. It was horrendously boring and I was getting fairly restless. After a fairly boring/dull Tuesday morning I went to look back at my schedule and realized I have the same consultant that I had in the morning on Thursday. I did a bit of snooping around and found out Mr R had a day theatre list Thursday morning so I decided to make amendments to my schedule and decided to follow Mr R. You would think why would I want to follow Mr R as he loves quizzing and it's quite a lot of pressure as this is my supervisor who will be assessing me at the end of my placement. After following a different consultant on Tuesday, I realized that despite all the quizzing, I learned a lot more with Mr R and in general had a lot more fun in theatre. Yes it's nice not needing to use your brain, but because I'm interested in surgery I rather get quizzed and learn things. On top of that Mr R lets me scrub in and help out so it really makes my experience a whole lot better. I guess it's a give and take situation.
Unfortunately I caught Mr R on a bad day on Wednesday and managed to "anger" him as I didn't know I was scheduled in for an audit in the afternoon as it wasn't on my schedule. Because I had my schedule in advance I decided to arrange a few meetings on that day in the afternoon as I assumed I had a half day. I had to explain to Mr R why I cannot attend the audit and he was not impressed whatsoever. I was properly pooping myself as we have been getting along and he's been pretty chill. I didn't think he would care that much about me missing an audit. I obviously felt really bad on Wednesday so I knew I had to redeem myself on Thursday. Wednesday night I decided to dust off my anatomy text books and revised my pelvic anatomy very well and read up on various gynaecological conditions. I also found out that Mr R consents his patients at 8am on Thursday prior to starting theatre so I decided to head in early and join him in his consent clinic. Let's just say he was pleasantly surprised that I was there so early and I managed to get consent from all the patients for the list in order to allow me to do examinations while she is under general anaesthesia. When in theatre I was promptly grilled on common gynaecological problems and because I had done my revision I was able to answer his questions with ease. To be honest...it was extremely satisfying. On the first patient I was told to put on a pair of gloves and to quickly do a vaginal examination. I was a bit disappointed I wasn't asked to scrub in, but I assumed Mr R was still annoyed with me from the previous day. Fair enough. I was essentially ignored for the rest of the procedure and then I guess Mr R remembered about me and then quizzed me on the pelvic anatomy. Again having revised anatomy the night before, I named all the parts with ease and Mr R was very impressed. He gave me the nod of approval and again I got that sense of satisfaction. It felt really good. Had a bit of banter in between patients and because I had "passed his test", I earned the right to scrub in for the rest of the list. It was amazing. I got to move the uterus into position for the procedures and the quizzing stopped. Yes it may sound daft "maneuvering the uterus"...big deal right? But something that small can make a huge difference to your experience in theatre. Yes I was doing a pretty dull job, but I knew I was making it easier for Mr R to perform the procedure with his registrar. I was then taught how to properly do a vaginal examination and was also taught how to do a speculum examination. I think this was the first time where Mr R took the time to teach and explain things thoroughly. Usually Mr R briefly explains things and is usually quite vague, but this time he was detailed and was really patient with me. He made sure I got a hang of it and made me do all of this with all the patients in the list. By the last patient I was doing the examinations with ease and was getting good at maneuvering the uterus. Haha. Was in a VERY good mood for the rest of the day. I was really proud of myself and it was nice getting praised by my supervisor. He seemed very impressed and I felt like I redeemed myself from the previous day's mishap. What a day.
At the same time I was a bit sad that it was my last proper theatre session for the rest of the placement. I will miss it a lot. My whole of next week are clinics and I'm not a huge fan of them. Will be a hard change and I'm sure I will be craving to go back into theatre. It was a shame I only got 2 sessions with Mr R in theatre as I learned so much. And with his quizzing, I realized I remember things much better. I guess in the end he ain't that bad of a teacher. I guess first impressions aren't always that accurate.
Anyways all in all the week had its highs and lows. Monday and Thursday were my two highlight days of the week. Oddly enough these two days were the two days where I had theatre sessions with my supervisor (Mr R). Right before joining Mr R for theatre, I was told by his registrar that he enjoys quizzing his students in theatre. I found it quite weird as when I was in clinic with Mr R, he didn't seem to be the "quizzing" type of consultant. Before surgery even started, I was grilled about common gynaecological problems. Luckily the questions weren't too challenging and Mr R seemed fairly impressed with my knowledge. I was just lucky that I had clinic prior to theatre which covered the conditions that Mr R quizzed me about. Phew. After the grilling, Mr R invited me to scrub in and to assist in the surgery! I was obviously very excited and it was nice being right at the table and I got to actually assist. I felt a part of the team and I felt like I was helping out. Unfortunately, this gave Mr R the opportunity to quiz me on the pelvic anatomy (which was VERY rusty). My lack of knowledge in the pelvic anatomy was not exactly impressive and I was promptly told to review my anatomy. Oops. Other than that I was able to get my hands in and I learned quite a lot as I did not get a female cadaver dissection specimen during my 2nd year so it was nice to be able to actually see the organs. I was also lucky to help out in a total hysterectomy as it was an open surgery so I got to see the organs more clearly. As the days went by I realized this was the only open surgery I will be watching as the rest of the surgeries I saw were laparoscopic surgeries. Pretty lucky to be honest. When surgery finished I had a good time and had some good banter going on during the surgery. Got to know my supervisor and the registrar better. No joke I really felt welcomed and I didn't feel so much like a medical student. I didn't feel like a joke in the theatre. People were taking me seriously and the nurses were all very friendly to me and I got along with everyone. Definitely a good start.
Tuesday I was with a different consultant for surgery and then realized to appreciate my supervisor as this consultant did not teach me at all. We were performing laparoscopic excisions of endometriosis and these were fairly complicated surgeries in general so the consultant was busy concentrating and I felt forgotten. I casually stood at the the back of the team as I was not offered to scrub in so I just observed. It was horrendously boring and I was getting fairly restless. After a fairly boring/dull Tuesday morning I went to look back at my schedule and realized I have the same consultant that I had in the morning on Thursday. I did a bit of snooping around and found out Mr R had a day theatre list Thursday morning so I decided to make amendments to my schedule and decided to follow Mr R. You would think why would I want to follow Mr R as he loves quizzing and it's quite a lot of pressure as this is my supervisor who will be assessing me at the end of my placement. After following a different consultant on Tuesday, I realized that despite all the quizzing, I learned a lot more with Mr R and in general had a lot more fun in theatre. Yes it's nice not needing to use your brain, but because I'm interested in surgery I rather get quizzed and learn things. On top of that Mr R lets me scrub in and help out so it really makes my experience a whole lot better. I guess it's a give and take situation.
Unfortunately I caught Mr R on a bad day on Wednesday and managed to "anger" him as I didn't know I was scheduled in for an audit in the afternoon as it wasn't on my schedule. Because I had my schedule in advance I decided to arrange a few meetings on that day in the afternoon as I assumed I had a half day. I had to explain to Mr R why I cannot attend the audit and he was not impressed whatsoever. I was properly pooping myself as we have been getting along and he's been pretty chill. I didn't think he would care that much about me missing an audit. I obviously felt really bad on Wednesday so I knew I had to redeem myself on Thursday. Wednesday night I decided to dust off my anatomy text books and revised my pelvic anatomy very well and read up on various gynaecological conditions. I also found out that Mr R consents his patients at 8am on Thursday prior to starting theatre so I decided to head in early and join him in his consent clinic. Let's just say he was pleasantly surprised that I was there so early and I managed to get consent from all the patients for the list in order to allow me to do examinations while she is under general anaesthesia. When in theatre I was promptly grilled on common gynaecological problems and because I had done my revision I was able to answer his questions with ease. To be honest...it was extremely satisfying. On the first patient I was told to put on a pair of gloves and to quickly do a vaginal examination. I was a bit disappointed I wasn't asked to scrub in, but I assumed Mr R was still annoyed with me from the previous day. Fair enough. I was essentially ignored for the rest of the procedure and then I guess Mr R remembered about me and then quizzed me on the pelvic anatomy. Again having revised anatomy the night before, I named all the parts with ease and Mr R was very impressed. He gave me the nod of approval and again I got that sense of satisfaction. It felt really good. Had a bit of banter in between patients and because I had "passed his test", I earned the right to scrub in for the rest of the list. It was amazing. I got to move the uterus into position for the procedures and the quizzing stopped. Yes it may sound daft "maneuvering the uterus"...big deal right? But something that small can make a huge difference to your experience in theatre. Yes I was doing a pretty dull job, but I knew I was making it easier for Mr R to perform the procedure with his registrar. I was then taught how to properly do a vaginal examination and was also taught how to do a speculum examination. I think this was the first time where Mr R took the time to teach and explain things thoroughly. Usually Mr R briefly explains things and is usually quite vague, but this time he was detailed and was really patient with me. He made sure I got a hang of it and made me do all of this with all the patients in the list. By the last patient I was doing the examinations with ease and was getting good at maneuvering the uterus. Haha. Was in a VERY good mood for the rest of the day. I was really proud of myself and it was nice getting praised by my supervisor. He seemed very impressed and I felt like I redeemed myself from the previous day's mishap. What a day.
At the same time I was a bit sad that it was my last proper theatre session for the rest of the placement. I will miss it a lot. My whole of next week are clinics and I'm not a huge fan of them. Will be a hard change and I'm sure I will be craving to go back into theatre. It was a shame I only got 2 sessions with Mr R in theatre as I learned so much. And with his quizzing, I realized I remember things much better. I guess in the end he ain't that bad of a teacher. I guess first impressions aren't always that accurate.
Saturday, February 4, 2012
Highlight of my Placement.
It is now the end of week 4 of my placement. 3 more weeks to go. To be honest...these last few weeks have been going by quite quickly. Even the doctors on the ward agree that these last few weeks have blown by. Now 4 weeks in....I'm really feeling a part of the team. We are all starting to get to know each other better so there's a lot more banter going on and joking around, which I really enjoy. Despite this, there are still a lot of up and downs during this placement. There are days where there's a lot going on, and then there are days where you start asking yourself why did you even come in.
Wednesday could have been easily the highlight day of my entire placement. This day also came at a perfect time as it's halfway into the placement and it really gave me a good boost. Every one noticed that I was in a very good mood on Wednesday and actually had a bit of spark in me. Found out that there was some paediatric surgery going on in the morning and I decided I needed a change of scenery. Heard the consultant surgeon apparently looks fairly stern (cue heart sinking) and no one could pronounce his name. Got changed into greens (oh I missed them soooooo much) and heard that surgery is delayed as the patient hasn't arrived yet. Sat in the coffee room and there was only one doctor in there (who looked kind of stern) and I figured he was the surgeon I will be following in the morning. It was fairly awkward in the room as we just sat in silence and watched a tv show. Few minutes later he got up and I shortly followed behind him and hope it didn't seem like I was stalking him. Saw the surgical list before going in and to my delight I found out he is a Paediatric Orthopaedic Surgeon. Pretty sure I was smiling like an idiot at the list. Walked into the anaesthetic room and we did introductions and after the consultant introduced himself, I knew immediately he's a really nice guy. He asked me to help him out with setting up equipment and he seemed really keen to get me involved. Slowly my mood was picking up and I was really getting excited. He then allowed me to scrub in for one his surgeries (in grown toe nail). It was a really quick surgery but when a consultant asks you to scrub in, it makes you feel involved and you start to feel more included/less useless. You feel like you're actually helping. It's a hard feeling to describe. Like during placement, especially early on, you feel unwanted and useless so when a doctor asks you to help even in a tiny little task, you get this good feeling/sense of satisfaction.
Anyways during a break in between surgeries, the consultant and I had a chat and he noticed that I seemed quite keen about surgery. It was cool having a casual chat with the surgeon and I told him I'm interested in orthopaedics. We had a really good talk about the specialty and then he told me to go to the Trauma list in the afternoon. Saw a fracture reduction + internal fixation and it was easily the bloodiest surgery I have ever seen, yet oddly enough, the one I enjoyed the most...ever. Even a few times I questioned myself as I caught myself smiling during surgery. I was really interested and I found the surgery pretty cool. There was a surgical trainee who was observing and he talked me through the surgery. The surgery was fairly complicated, but I was genuinely absorbing everything the trainee was saying. I was following along without difficulty and I just had this good feeling inside me. I think the hardest part about the surgery was wearing the lead aprons for 2.5 hours as there was a mobile xray machine in the room. Xrays were periodically taken to make sure the plate was in the right position and if the screws were placed properly. My back was killing me by the end of surgery (as I've been in surgery all day and almost all the procedures I had to wear a lead apron). But the aching legs and back was totally worth it. I could easily say it has been the best time I've had in surgery. The morning procedures were fairly simple, yet I still really enjoyed my time. It's quite weird.
"Be back by 4pm" said the registrar when I stopped by the ward to grab my bag for lunch. It was now 5:30pm and I was still in surgery watching the surgeon close up. He made stitching seem so effortless and simple, but I guess if you've been doing it for 20 something years, it'll become second nature. I was in no hurry to leave theatre. To be honest, I didn't want to leave. My bleep went off twice and I knew I should get going. The consultant and I had a chat after surgery and he said throughout the surgery he noticed me looking very interested/keen. I don't think I have ever really heard any doctor tell me I look keen. To be honest, most of the time I probably look like I'm not even there. The consultant also said he was fairly impressed that I didn't get sick as he agreed it was a very bloody/gruesome surgery. He asked when will I join him again in theatre or pop by his clinic as he said he wouldn't mind me around, especially if I'm interested in the specialty. Again I got this weird feeling of actually being wanted. Usually consultants don't want to deal with students, but this consultant seemed interested/keen to teach me.
Dragged my feet back to the ward and everyone was commenting how I look alive for once and happy. To be fair, I was very happy. I was definitely motivated. I can't wait to go back to theatre next week/hopefully I'll be able to escape to theatre. What a great day. Will never forget the last surgery of the day.
Wednesday could have been easily the highlight day of my entire placement. This day also came at a perfect time as it's halfway into the placement and it really gave me a good boost. Every one noticed that I was in a very good mood on Wednesday and actually had a bit of spark in me. Found out that there was some paediatric surgery going on in the morning and I decided I needed a change of scenery. Heard the consultant surgeon apparently looks fairly stern (cue heart sinking) and no one could pronounce his name. Got changed into greens (oh I missed them soooooo much) and heard that surgery is delayed as the patient hasn't arrived yet. Sat in the coffee room and there was only one doctor in there (who looked kind of stern) and I figured he was the surgeon I will be following in the morning. It was fairly awkward in the room as we just sat in silence and watched a tv show. Few minutes later he got up and I shortly followed behind him and hope it didn't seem like I was stalking him. Saw the surgical list before going in and to my delight I found out he is a Paediatric Orthopaedic Surgeon. Pretty sure I was smiling like an idiot at the list. Walked into the anaesthetic room and we did introductions and after the consultant introduced himself, I knew immediately he's a really nice guy. He asked me to help him out with setting up equipment and he seemed really keen to get me involved. Slowly my mood was picking up and I was really getting excited. He then allowed me to scrub in for one his surgeries (in grown toe nail). It was a really quick surgery but when a consultant asks you to scrub in, it makes you feel involved and you start to feel more included/less useless. You feel like you're actually helping. It's a hard feeling to describe. Like during placement, especially early on, you feel unwanted and useless so when a doctor asks you to help even in a tiny little task, you get this good feeling/sense of satisfaction.
Anyways during a break in between surgeries, the consultant and I had a chat and he noticed that I seemed quite keen about surgery. It was cool having a casual chat with the surgeon and I told him I'm interested in orthopaedics. We had a really good talk about the specialty and then he told me to go to the Trauma list in the afternoon. Saw a fracture reduction + internal fixation and it was easily the bloodiest surgery I have ever seen, yet oddly enough, the one I enjoyed the most...ever. Even a few times I questioned myself as I caught myself smiling during surgery. I was really interested and I found the surgery pretty cool. There was a surgical trainee who was observing and he talked me through the surgery. The surgery was fairly complicated, but I was genuinely absorbing everything the trainee was saying. I was following along without difficulty and I just had this good feeling inside me. I think the hardest part about the surgery was wearing the lead aprons for 2.5 hours as there was a mobile xray machine in the room. Xrays were periodically taken to make sure the plate was in the right position and if the screws were placed properly. My back was killing me by the end of surgery (as I've been in surgery all day and almost all the procedures I had to wear a lead apron). But the aching legs and back was totally worth it. I could easily say it has been the best time I've had in surgery. The morning procedures were fairly simple, yet I still really enjoyed my time. It's quite weird.
"Be back by 4pm" said the registrar when I stopped by the ward to grab my bag for lunch. It was now 5:30pm and I was still in surgery watching the surgeon close up. He made stitching seem so effortless and simple, but I guess if you've been doing it for 20 something years, it'll become second nature. I was in no hurry to leave theatre. To be honest, I didn't want to leave. My bleep went off twice and I knew I should get going. The consultant and I had a chat after surgery and he said throughout the surgery he noticed me looking very interested/keen. I don't think I have ever really heard any doctor tell me I look keen. To be honest, most of the time I probably look like I'm not even there. The consultant also said he was fairly impressed that I didn't get sick as he agreed it was a very bloody/gruesome surgery. He asked when will I join him again in theatre or pop by his clinic as he said he wouldn't mind me around, especially if I'm interested in the specialty. Again I got this weird feeling of actually being wanted. Usually consultants don't want to deal with students, but this consultant seemed interested/keen to teach me.
Dragged my feet back to the ward and everyone was commenting how I look alive for once and happy. To be fair, I was very happy. I was definitely motivated. I can't wait to go back to theatre next week/hopefully I'll be able to escape to theatre. What a great day. Will never forget the last surgery of the day.
Subscribe to:
Posts (Atom)
Posts
