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Diary of a Postgraduate: Ward Rounds

Last time, when I wrote about what PA students do on GP placement, I mentioned that I was just about to begin my very first hospital placement.

Myself and my coursemates were allocated to different hospitals around the Swansea area to work in medical specialties including cardiology, respiratory medicine, gastrointestinal medicine and care of the elderly. At the end of each week, we met up to discuss how things were going and to present interesting cases we had seen on the wards. We looked at X-rays and blood test results and discussed the diagnosis and management with our lecturer.

This was a great learning opportunity, especially since patients do not present to hospital with a simple check list of symptoms that we might encounter in class; patients do not always know what information is relevant to tell us and they may have comorbid conditions which make diagnosing a new illness tricky.

seagull in swansea
Here is the resident seagull from the cardiac ward. The patients named him Sammy, and yes, they did feed him through their windows!

I spent three weeks on the cardiology ward at my local hospital where I shadowed two cardiology consultants who teach on my course, as well as a registrar and several junior doctors. I also spent a fair amount of time learning from the final year medical students who were placed on the cardiology ward at the same time as me.

I was able to attend ward rounds where I observed how the consultants talked to patients and the kind of questions they ask to find out the information relevant to diagnosing and managing their condition. I wrote in the patient notes while the consultant called out what they could hear, see and feel on examining the patient. I even observed bedside echocardiograms (an ultrasound scan of the heart) and I learned how to spot problems with a patient’s heart valves or heart muscle by watching the way they move on the screen.

Aimee
I'm no sonographer but I managed to capture my heart on the handheld echo machine

I also spent time getting some of my clinical skills signed off with the junior doctors, nurses and phlebotomists (a health care professional who specialises in taking blood from patients). I took bloods, inserted cannulas (a tube that goes into the vein so we can provide fluids and medications), performed ECGs, took observations and tested urine (yes, medicine is very glamorous).

This was quite scary to begin with, especially the more difficult skills like cannulation; doing these skills with real patients is very different to practising in the lab! The patient’s veins are not as easy to find as they are on the rubber arms in the lab. Patient veins do not stay still like the arms in the lab either – they like to dance around as soon as you feel like the needle is going into the right place.

The good thing about practising outside of the lab is that you get a feel for what you need to do with real patients: you learn the importance of anchoring the vein with one hand to stop it moving, you learn the importance of taking your time to find the right vein and you learn to do all of this while talking to your patient and making sure they’re comfortable.

aimee's postgraduate diary
The arms we use in the lab feel nothing like the real thing! (Photo by Laura McKeever)

Overall, my first hospital placement was a very rewarding experience, which made me realise that I have actually learned much more than I realised in the six months since the course started. I learned a lot about cardiology, reading X-rays and blood test results, how things run in the hospital and how doctors, nurses, physiotherapists, occupational therapists and social workers work together to provide the best possible care for patients. I gained confidence in my clinical skills and in my ability to communicate successfully with patients who might be unwell, confused and distressed. Most of all, I have learned that I really love medicine and I cannot wait to practice as a physician associate in the near future!

Until next time,

Aimee

 

Thinking of studying Physician Associate Studies too? These universities offer this very course! 

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