Year 2 Day 8 - Clinical Day 1 (17/09/2018)

Today was our first day back on clinical placement. I was based on a stroke unit for the majority of the morning. The department seemed to have very little idea that we were coming or why we were there, but took it well all things considered. Took a very long history from one patient – need to work on keeping them on track, even under difficult circumstances. It was admittedly made more difficult by the fact that they could not hear very well at all so I could not interrupt them.

My kit case complete with tuning fork for neuro exams!

My kit case complete with tuning fork for neuro exams!

Had heart problems and mentioned having had a brain bleed – we followed this up by looking at the ECG afterwards and the consultant stroke physician took us through the head CT and quizzed us on our neuroanatomy – thankfully from having not been expecting us or knowing we had had any teaching he was fairly gentle.

I found lots of benefit in following up in the patient notes, being able to see ECGs and work through them, scroll through CTs and notice other pathologies or variants – this process helps build up the bigger clinical picture and explains some of the decisions that can be seen in the notes which may not be obvious or make sense at first glance.

In the afternoon I had one of my chosen CLOs (Clinical Learning Opportunities) on the tissue viability clinic shadowing a specialist nurse. It was a bit of a baptism of fire, examining heavily infected wounds in a patient with a very complicated history and a lot going on medically.

The patient claimed to recognise me from somewhere and kept wanting to talk to me, which I found difficult because I was stuck between the drive to listen to him and respect him for providing a learning opportunity for which he was having to experience pain as I palpated, and the need to indicate to the nurse leading the session that I was clearly paying attention. I did make a point of apologising afterwards to her and she thankfully replied that she thought what I did was actually helpful - it was distracting the patient while she carried out the painful procedure.

I’d definitely be interested in spending some more time with tissue viability staff in the future and wholeheartedly recommend the CLO for future Warwick AC1 students.