Back On The Wards

I have just completed my second hospital placement on a respiratory ward at Northwick Park Hospital. This placement felt night and day from my first placement I did in December in the hepatology department at St. Mary’s Hospital. In December, I felt very awkward and always in the staff’s way and I felt nervous to ask questions. I always felt I was not bringing everything I needed or maybe I was not dressed right. Now, it felt a little more familiar and comfortable. I felt more confident asking for help and answering questions. It also didn’t hurt that I luckily had a very short commute, this time it was only 15 minutes, but it took me over an hour to get to St. Mary’s.

I spent the past two weeks taking and presenting patient histories, doing basic observations, interpreting imaging, observing the morning handover and shadowing the ward round. Another task we had to complete during the placement was reflecting on an interesting clinical encounter.

At first, it was intimidating being tested on clinical knowledge by consultants, but they are there to help you further your knowledge and to push you. Better to mistakes now early on in your studies while you are unexperienced. A quick tip is to brush up on the relevant content for your placement, revising lung failure, pharmacology, common respiratory disorders and chest x-rays and CT scans would have helped me be a lot more confident when following patient cases. I would also recommend keeping a reflective log to look back on and to keep note of key words and concepts you don’t understand on or want to do deeper research on once you get home.

Observing the morning handover was more difficult that I expected. At around 9am, nurses, doctors, physiotherapists and other staff would come together to discuss each patient and what had occurred since the previous handover yesterday including observations, imaging, testing, mobility, and the plan for the patient moving forward. The staff would throw around unfamiliar terms that was a little difficult to keep up with but got easier as the placement went on. It highlighted what a multidisciplinary team is like in action.

This placement really taught me to be more proactive about my learning, all the staff still have their regular tasks to complete so unless you ask questions, you might miss valuable learning opportunities. It also gave me a chance to put my skills to the test in terms of taking basic observations by asking healthcare assistants and examinations like auscultations and percussion when on the ward round with doctors.

My placement at Northwick Park and St. Mary’s were both in medical departments, so I am looking forward to the opportunity to be on a surgical rotation next year. Clinical contact does start early on at Imperial but I am still hungry for more time in clinical settings which I definitely will get in 3rd year.

It was difficult to see so many patients seriously unwell, with some of them being ITU step downs for COVID infection and the majority of others that were dealing with chronic conditions that were getting progressively worse. We saw a lot of patients with COPD, lung cancers and other pathologies.

This placement really highlighted how important reflection is. Reflection is where a lot of learning happens, it is also a good emotional check in with how you are handling clinical experiences. All clinical contact we have had so far has a required reflection component which I think is so helpful especially early on in the degree.

I’m really excited for next year, I wonder what specialities I will end up in?

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