Facing little fears

Wow i am staring to feel like half a doctor!! Its day 3 of our first week back and our practical training sessions have been so interesting learning basic skills for the hospitals! Our first morning consisted of a few talks from coordinators about the year ahead. My stomach gave a little churn of excitement and nerves when they talked about the hospitals, 'as fourth year medical students entering the hospitals you are basically at the bottom of the food chain, but patients will look at you and see you as 'almost doctors' and ask you many questions and may expect certain things from you', in this situation we would explain to them our position and advise them to consult their actual doctor or nurse, but still the prospect of being treated as an 'almost doctor' gives me goosebumps!

That afternoon as we started our practical training sessions i had urinary catheterisation, we had 2 lovely Plasticine models Willy and Regina who were our 'victims'. The actual process was quite straight forward, the tricky part was opening the bag of equipment and keeping everyt

hing sterile, there is certainly an art to it! It was good to see they are very pedantic about reading and checking the dates and concentration of the solutions which were to be used and recording them and the batch numbers down, patients are certainly in safe hands there! They covered all areas of concern, one included what happens when you are catheterising a male and they have an erection, in that case it would be more embarrassing for the male then us doing the procedure, so we just pretend we are oblivious to the fact, and wait a few

minutes for it to pass whilst talking to the patient, then continuing with the procedure, simple.

My next one was patient handling, basically a 2 week course combined into 2 hours! It was so useful though, how to move patients from beds, get them to sit up and down and all in a way which doesn't strain our back, one thing i learn (and loved!) was the fact that tai chi is extremely useful as it is basically how you move your legs and arms in a flowing motion that transfers your weight and the weight of the patient in swift motions. We were giving a manual which i was so happy about to read over and remember how to do all the

moves, definitely useful for the future!! Being a medical student a lot of our training relies on us to use our initiative, they teach us the basic procedures in limited time and it is up to us to then apply them to different situations, even with something simple with patient movements, hence why we had a 2 week course crammed into 2 hours!!

My third class was resuscitation.... wow!! It went over the basics of our first aid course but further expanded this to the hospital situation. We were given many scenarios with the manikkin which the instructor told us. It was exciting to learn all the different roles each person who arrives at the scene of a cardiac arrest follows, and interesting to have the scenarios with different ways a cardiac arrest could happen. We had the hospital type defibrillators out and used them, assessing the manikkans rhythm which changed at the press of a button from the nurse (Nick) who was instructing us and we were guided what to do

in the different situations. It was very handy that the defibrillator would assess the rhythm of the heart and would advise us to shock based on whether there was a shockable rhythm (e.g. asystole, ventricular fibrillation or a pulseless Ventricular tachycardia) or non-shockable. We also learnt how to put in a guedel to open up the airways and use a mask for breathing for the patient. We were advised to get our own patient mask to carry around with us where ever we go in case it is needed. One thing of note is DR ABC has become DRS ABCD - Danger, Response, SEND FOR HELP, Airway, Breathing and Circulation. I am going to make up a flow chart with scenarios for myself and certain situations to go over what you do in each one. The room set out was sort of like this internet picture i found but we had a different hospital defibrillator and unfortunately we weren't wearing scrubs!

And today... i finally took blood!!! it has been one thing i have been nervous and a little scared about and i have finally done it! We were divided into groups of 4 surrounding a dentistry chair as we were learning at the Oral Health Centre of WA otherwise known as OHCWA (OC-WA). Of course first we were taken through the process step by step, patient identification and hand hygiene is emphasised many times and we learnt the order of 4 tubes - orange/yellow first (anticoagulant tube), the blue (Citrate tube), then green (Heparin?) and Purple last with EDTA in it. I was wondering how i would go taking blood from someone, i have had an episode of fainting a few years ago and am not too good with needles in me but that is a rashional fear most people have, i will not let it hinder me from becoming a doctor! but like most things exposure to what you fear is what helps you overcome that fear and the first few times are the hardest but it will get easier. Taking blood today i found it so much better than having blood taken from me, i felt clearer in my mind on the process unlike in the chair as a patient, i was focused on the job at hand and it is so much better not waiting for the prick! The four people i was with were amazing, yes they did well taking blood but amazing in terms of how we all talked to each other to calm one another down. Our theme turned out to be the Hokey Pokey of all things! But it is such a catchy song to sing so long as the one in the chair doesn't shake their arms and legs while being bled! But it is something i will remember and use when i take blood from patients, if not the hokey pokey i will find a nursery rhyme everyone generally knows so we can sing and take the persons mind off the actual process at hand. My first time i tried, my 'patient' had smaller veins which made the first time harder but i missed the vein and felt a little deflated when no blood came into the tube, but the second time i had a guy with nice big veins and i was so happy to actually get blood out!! The instructor was so good and assisted us to ensure we did not harm each other or move the needle around too much which we were all grateful for. Apparently i have text book veins, not sure if that is an advantage or not but i'll take any help when people are taking my blood. So the next step is to go to the hospitals and book in for some sessions with phlebotomists around the hospital... and ASAP before the year gets too busy. I am keen to practice so i can become good at taking blood!

We have Australia Day off tomorrow which is a nice break, then my last practical session for this week is asepsis, injections and cannulation, thankfully we are using models :)