Perspective

Minimal words from me today - the video speaks for itself.

(Source: http://www.upworthy.com/this-kid-just-died-what-he-left-behind-is-wondtacular-rip)

Big Brother

Ever since reading George Orwell’s Nineteen Eighty-Four, aged 16, I've felt mildly on edge about the idea that we live in an society with an increasing amount of surveillance. Forgive me if my initial statement sounds incredibly cynical. In all honesty, I do agree that CCTV and other monitoring systems tend to serve a great purpose in the majority of circumstances. I must say, I'm less of a fan when 'cookies' on my browser ensure that I have continual adverts tempting me with that pair of shoes that I desperately want (but cannot afford) keep popping up on the side of my Facebook page. 

The important thing that I'm trying to say here is that I think that there are some circumstances in which surreptitiously 'keeping an eye' on people is simply inappropriate – particularly in a healthcare setting. On the few occasions in which it has been done before by healthcare professionals who felt that their concerns had been ignored by the appropriate parties, undercover filming has certainly worked. Take the damning scenes at Winterbourne View revealed to the public back in 2001, for example...watch the video below if you haven't seen it already (I should warn you that some of the imaging may upset you).

                                                             (Source: http://www.youtube.com/watch?v=subMgwyJOK8)

Despite this, the suggestion (albeit a few weeks back now, I'm behind with my blogging) that using hidden cameras could become part of the inspection regime in care homes next year still does not sit well with me. First and foremost, as the new adult social care chief inspector, Andrea Sutcliffe, rightly points out because of the need to respect the privacy and dignity of the residents of these homes. Perhaps we can justify filming ‘snapshots’ of poor care and retrospectively gaining consent from those who we have filmed in order to provide evidence to make a change. It might even be possible to say that doing so was necessary to get your voice heard in order to make positive changes for patient care.

I would argue that to condone undercover filming (and thus to make it a societal norm) seems to miss the point. Why don’t we deal with poor care before it happens, rather than try to catch truants out in a way which compromises the dignity of the vulnerable when it’s simply too late. Okay, rant over.

Pearls of wisdom

Source: http://www.spiritualistresources.com/cgi-bin/quotes/index.pl?read=131

If I had a penny, okay a pound, for every time a patient responded to the request to practice examining them said, 'Well, we all gotta learn', I would be a very rich medical student. (I'd like to add that this is said in a strong West-country accent, just so that you feel like you're really there.) I'm sure that the majority of my colleagues would agree.

Today has been no different except for the fact that one of the patients I met described themself as a 'whistleblower'. It was like my subconscious slapping me around the face and telling me to stop procrastinating. Why, you ask? Well I'm starting to get a little nervous actually, in exactly two weeks I'll be presenting my thoughts on whistleblowing (you might remember me going on about this during dissertation season) to a load of academics and healthcare professionals. My sphincters loosen up at the thought of it*

Within five minutes of meeting this patient, they had imparted their wise words on me 'Chantal, just remember when you become a doctor - if you're absolutely sure that you're right about something then never be afraid to speak up about it.' Like music to my ears. Well, until he told me that he was convinced that 'cannabis cures all ills.'

Each to their own.

*I sincerely apologise, poor medic joke. Yuck. 

'I wanna walk like you, talk like you, too.'

(Source: YouTube)

22 years old and content with being clueless as to what speciality I want to go into, I'm pretty easily swayed. If you: a) smile at me, b) try not to make me feel like I'm getting in your way and, c) make it look like you're loving what you do then I'll probably decide (at least for a day or two) that I want to do your job. It doesn't take much to convince me, clearly.

But my check-list works both ways, if you don't to any of the above then I probably can't think of anything worse than working in your speciality. I'm 99.9% sure that I'm not to the only medical student who has felt like a nuisance on the wards. Ward rounds can be a prime example of this - you follow a consultant, junior doctor and nurse around for a couple of hours and (sometimes) you are ignored by all of them.* But you're keen to learn, so you stay. Rumour has it one medical student got so attached on the ward round that he/she accidentally followed the consultant into the bathroom. Classic. 

Hospitals are busy places though, so I get it. Doctors, nurses and other professionals just don't always have the time to teach you. So I've changed tactic, those who know me well will know that I don't like to waste time. So rather than shuffling my feet uncomfortably, I've decided to find learning opportunities rather than wait for them to come my way. Why? Because my (limited) experience has informed me that teaching rarely comes to you. Thus far, it's working.

And in case you wondered why I've attached 'The Jungle Book' video, it's just a great song. It cheers me up. Go on, have a listen. 

*I would like to stress the fact that I've also been on a lot of great ward rounds where I've been taught by the staff, involved in the discussion and given the opportunity to present my own findings. I'm not 

Going back in time.

Walking into a cubicle, introducing myself and acquiring a patient's permission to ask them a few questions about what brought them into hospital and then to examine them. Sounds simple enough, until you're in A&E, the patient is seriously ill and you're the first person to see them. 

I learned the hard way this week, spending an hour with a patient only to realise that they were so confused (in the medical - not the academically challenged - sense) that the history that I had taken was essentially null & void. It was to be their partner and carer who would provide me with the history that would allow qualified members of the healthcare profession to attempt to make their loved one better.

Lesson 1. Sometimes the patient isn't the best person to tell you what's wrong with them.

Lesson 2. Sometimes they are.

On the flip side, some patients LOVE a good chinwag! They'll tell you everything about their health, family and day-to-day life without a moments pause. And it takes some guts to interrupt them mid-flow.. Despite the obvious time constraints, these are my favourite interactions. I often wonder how I find myself in such an honourable position. Why do people feel they can share so much of their life story with me? Some laugh, some cry, others just want to vent their frustrations. Either way I'm there, I'm listening, and most importantly I'm learning. 

Someone hang 'L' plates around my neck, please.

I have met four patients in my first week. Four. None of which seemed to realise that I was sweating profusely whilst practising my examination skills on them. Personally, I'm pretty pleased with that. I want to blame my body's reaction to the temperature in most of the hospital wards but that would be extremely dishonest. 

I need to take the positives from this week.

1. I managed to put on my stethoscope the right way around.
2. I have yet to get lost.
3. I am still smiling, even when inside I'm thinking 'WHY can't I remember the name of every cranial nerve?' (NB. Answer - because it's been a year since you've done any of this so chill out.)

There were moments when I've wanted to hide because I just can't comprehend how anyone could possibly remember the fountain of medical knowledge that exists. And then something happened that reminded me that there's more to this career than reeling off academic knowledge. My moment? Walking through a respiratory ward during visiting hours I spotted an elderly lady in one of the beds. She revealed a wide, toothy grin. She looked so happy, not because she was feeling 100% I'm sure but because someone had taken the time to come into hospital to wash and blowdry her hair for her. I'm not sure that my peers noticed her as we walked through the ward, and I know it seems like a small thing, but it was a gentle reminder that I'm embarking on a great journey and that it'll be worth it for grins just like that.

Just keep swimming

It's been a while and, admittedly, this is a short entry but reality seems to have just hit me. 10 days till I'm back at university. 10 days until I embark on the second and final half of medical school. 10 days until I realise that I'm going to need to have a browse through my colour co-ordinated notes so that I don't feel stupid when a consultant asks me the most basic of questions during bedside teaching.

Am I nervous? No. Apprehensive? Mildly. Excited? Most definitely. It feels like I've taken a sabbatical or something. Having had a year to gain an extra degree and learn a lot about myself in the process, I have absolutely no regrets. The highs and lows will also provide a lot of blogging material so watch this space...

I will need to purchase a bulk pack of four-way biros though.