During the Summer of 2010, I was lucky enough to be able to arrange a one week placement at Bedford Hospital. I wrote to the hospital asking for the work experience, accompanying the letter with a copy of my CV. For quite a while I thought that they had turned me down, as most of my friends received positive replies within just a couple weeks of having applied! Fortunately, after a few nervous months, a letter arrived saying that I had a post to shadow some doctors in late July. Hooray!
My week at the hospital was wide and varied, and I was given the opportunity to shadow doctors in many of the different departments and specialities. It was an excellent experience, and one that I would love to do again.
Day 1
On my first day, I was to report at the Major Injuries Clinic at the Accident and Emergency Department. at 8:00 am. I was slightly early, and was unsure of what I should do until the doctors who were working the day shift arrived. Luckily, a helpful registrar told me to sit down at the doctors’ station and reassured me that most people who came for work experience were a little nervous at first. She explained to me that working at A&E was stressful, and hours were long, but seeing a broad variety of patients and being able to make such a difference to them in a short period of time could be difficult at times, but always rewarding.
Throughout the day, I shadowed two of the FY1’s who were working on the department, both of which kept me on my toes, quizzing me over what I thought patients’ symptoms meant. Of course I couldn’t answer everything, and a lot of what I did come up with wasn’t entirely correct, but they did explain to me where I was going wrong and commended me on my efforts. I was particularly pleased when I worked out that one woman, who presented with abdominal pains, couldn’t have an x-ray to check for any abnormalities until she had a pregnancy text done as a precaution. Had she been pregnant then exposing her to radiation would have been harmful to the foetus.
As they treated patients, the two doctors taught me a lot about what they were doing. I observed that when taking blood, the blood appears to spurt out quite rapidly into the collection vial, which I know is due to the vials containing a vacuum. Also, each vial would have a different colour top on, so that the biochemists who analyse it know what they are testing it for. As far as I remember: blue was for testing for coagulants, light pink was used to determine blood type and grey was for measuring electrolyte concentration (I think). I saw so many different patients during the day that it would be impossible to list them all. There was such a wide spectrum of illnesses, including a lady with a pulmonary embolism, a blood clot in the lung; several patients with atrial fibrillation, arrhythmia of the heart; a man who had experienced an allergic reaction to a wasp sting, leading to an anaphylactic shock; someone who had taken an overdose of paracetamol and, of course, several broken bones.
As well as observing how busy A&E was, and how you were working non-stop from morning until evening, I noticed that the junior doctors had to spend more time than I had originally thought writing notes. I was told: “If it isn’t written down in the notes, then it never happened”. My day in the A&E Department had been an enlightening one. It was my first experience of what working in a hospital was like, and I thoroughly enjoyed it. I was lucky enough to get a true insight into how busy junior doctors are, and, to this day, Emergency Medicine remains the area of specialism that I would like to go into.
Day 2
My second day was an interesting one. This time I spent the morning in the Critical Care Unit and the afternoon in Cardiology. I wasn’t sure quite what to expect, but found the day very informative.
Upon my arrival in the Critical Care Unit I was made to change into scrubs as a precaution. I almost felt like a real doctor at this point! The team working on the ward went on a ward round, spending at least fifteen to twenty minutes discussing each patient in detail. I couldn’t understand a lot of what they were saying, so much of it went straight over me. The basics were explained to me at the back of the crowd by a kind consultant though. There were so many different medical professionals on the ward; dieticians, doctors, nurses and social workers were all present and working together to work out what plan of action was best for the patient. Shadowing doctors on this ward was quite shocking. I thought I had seen life saving medicine in A&E, but here I saw people that were on the brink of death. Everyone on the ward was giving the patients their complete and undivided attention to ensure that their lives were kept stable. I was fortunate enough to see a couple of procedures being carried out in the unit: the insertion of an arterial cannula and that of a subclavical cannula. They were carried out with such precision and skill, and the attention paid to detail was excellent to watch.
In the afternoon, up on the Cardiology Ward, there were no clinics for me to sit in on, and as such, I was given the opportunity to observe a series of cardiac angiograms and the fitting of a pacemaker. I sat, with a doctor, in the room that looked into the small theatre room. Unfortunately I wasn’t allowed into the room where the operation was taking place as I wasn’t 18. An unfair rule in my opinion. I was sat in a room which had all the monitoring equipment in, which the doctor was keeping an eye on while explaining what going on and pointing things out of the screen which showed the angiogram. The consultant performing the procedure was putting a long, thin, hollow wire into the right femoral artery, leading it up into the heart. Once the tube was in position, he squirted a small amount of radiopaque dye into the tube, which showed up black on the angiogram, highlighting the coronary arteries and vessels around the heart, indicating any blockages. When there was a blockage, the consultant manoeuvred the wire into the blocked vessel and dislodged it and break it down.
This day I had learned a lot about the teamwork involved in medical work. No doctor is working by himself, but is always part of a large, often multidisciplinary, team. In the CCU, the whole team deliberated over what the best path of treatment was for the patients, and on Cardiology one person was in charge of performing the actual operation, another kept an eye on the equipment, one looked after the patient, ensuring they were okay; and another monitored the screen for abnormalities. Teamwork is clearly a huge part of working as a doctor. If you aren’t able to cope in a team situation, then medicine isn’t for you. Without the close cooperation between people of different specialities, nothing would ever get done in a hospital!
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