Reflection on my first clinical attachment

So, I’ve finished my first clinical attachment- 10 weeks in a hospital, split between Care of the Elderly and Respiratory. So, it’s reflection time.

Things I’ve learnt:

Go for it. Stop worrying if the patient is going to say no to you examining them and just ask them. The worse they can say is no. At the start, and even a bit now, I would get too shy or nervous to go up to patients, which is why I would always go with someone else so they could do the initial talking.

Fake complete confidence in your fledgling clinical abilities because it puts the patient at ease, even if you’re not. This piece of advice was given to me by an elegant older lady that I was taking blood from. Reading between her lines: girl, stand up straight and stop stammering, you are making me nervous.

Ask. Ask questions. It gives you answers and makes the ward round or clinic a bit more fruitful.

 

Things I need to improve on:

-Reading up on things that I see in hospital. There is no point keeping a list if I don’t look back on it.

-My practical skills. Clearly. See below for anecdotal evidence. I’m just not the most dexterous person in the world. It can only be helped by practice.

-Waking up and going in for firms. This hasn’t previously been a problem for me when I was just going in for lectures. But it has actually become very tempting to just wake up, have breakfast, go back to bed, wake up, have a second breakfast, go in late. It’s because, clinical learning is a very self-directed thing. Apart from scheduled teaching, it’s pretty much up to you, and no one really cares if you come in or not. Next placement after Christmas break, I’m on surgery which means an hour earlier start, so this is going to be a real struggle, especially as I don’t really understand the concept of an early night.

 

Clumsy moments:

-Spilt a patient’s jug of water all over her table whilst taking a history, and spilt a cup of water all over another patient’s table whilst leaving his bed on the ward round. Now, I just need to spill something smaller and then I’ll probably stop doing it.

-I was setting up IV infusions with the nurses and I pierced the bag, which we had set up with a pretty expensive drug. Ooops. Luckily, the nurse’s problem solving skills were a tad greater than mine.

-I was in A & E getting ready to put in my first cannula. I had this great mental block when it came to cannulas. I was alright doing it on the fake model arms but when it came to human arms, I was terrified of getting it wrong. So, I was preparing the cannula, hyping myself up mentally. Come on, you can do it, this is it– and so I take the cover off and I push into her arm and it’s not going in. Why isn’t this going in? It’s not even breaking skin?? Turns out, during my extensive preparation phase, I had pulled the needle out of the cannula, so I was literally just trying to push a small plastic tube into her arm, rather than a needle (the tube then goes over the needle and into the arm and then the needle comes out, leaving the tube in the arm). Sigh. A doctor ended up doing what should have been my first cannula.

-This one’s not mine- but my firm partner was filling up a syringe of saline for a cannula, pulled out the plunger and squirted saline all over me….why is it always me

-I could go on, but some things I just block out.

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