Sorted out a few things before heading down to the ED in the morning: paid my £200 odd accommodation fee, scanned in my elective attendance forms and picked up a letter from reception that had been there for a week without me knowing (one of the Aberdeen students had seen it while collecting their own post!) Quiet in the morning, chatted to Stephen the receptionist about GTA V that's just come out, definitely gonna have to get a copy, looks awesome. Although still need to get into Skyrim - bought that for cheap off Amazon just before exams so deliberately didn't play it too much. Turns out one of the students brothers got a copy of GTA V delivered to their house on Uist on Saturday!! It was officially released on Tuesday, but amazon sent out a few copies early by mistake and the publishers Rockstar weren't too happy. I guess they thought it might take longer to get to Uist so sent it out a few days early?
Saw a chap who had come in the previous week having fractured two bones in his hand, the xray was quite dramatic however they had the option of conservative management with just splinting/buddy strapping or surgery where they'd fix the fragments in place with K-wires, which would then have to stay in place for 6 weeks. Buddy strapping is quite a useful trick, where you strap the injured finger to a neighbouring healthy one, keeping it immobilised without any cumbersome splints. Patient went for the conservative option.
Lunch in the doctors office, burger/chips. Got admonished by one of the canteen staff who said I needed to be 'careful with my portion control' - her exact words. I wouldn't have minded if she said it was a large portion and was going to charge me a bit extra, that's cool. But was a bit annoyed being told I'd basically got too much - they should serve out the portions then! Also got me thinking, would it be unfair to just target 'portion control' to overweight/obese people? If a tall slim young person comes in with a massive plate of food is that a bad thing? I wouldn't have thought so. But they could be performing a decent public health intervention by helping overweight/obese reduce their portion sizes... Maybe they should weigh people at the till and titrate their portion size accordingly... !! Oh dear.
Stomach contented I went back to A&E. Patient came in, took the history and examined them, was obvious straight away that they needed catheterising- a procedure that's pretty simple but has lots of little steps along the way. Also catheters are one of the biggest sources of infection, so everything has to be done in as sterile a way as possible - King's drills this into everyone no end. I had a 'prepare a catherisation' OSCE station in 3rd year (practical exams we have to do), where I did not do very well, partly due to the equipment being different to what I was used to (no tweezers provided meaning hands couldn't remain sterile = confusion in the stress of an exam about how to move things around!) Sometime's it feels like we have to be mindreaders to work out what the examiner wants you to do, and that was definitely one of those stations. Infuriatingly too it was not testing the skill, just testing the preparation! I had some pretty crushing feedback on that station but seeing as on the other more 'worthwhile' stations such as heart/lung exams I did well I didn't pay too much attention to it. I can see what they're getting at but feels a bit pedantic at the same time.
Anyway, was supervised by one of the nurses in the ED whilst put it in. Useful to have another person to help open packets and give tips on what to do. As I said, it's a straightforward procedure but lots of stages. Got nearly half a litre out straight away, and the patient started feeling alot better! Nice thing to tick off aswell. I'd done them before but only on patients in theatre where everything is sterile and the patient's asleep = much less pressure! I remember one of my friends who's now qualified saying they had to do their first ever catheterisation on a patient who went into acute retention, on a night shift, on their own... They managed it and the best part was the patient thought they were a superhero as they went from unbearable discomfort to blissful ease as soon as the pressure was released. It's the kind of thing where you can't really go too wrong, you've just got to do it!
Headed back to the house before nipping down to the pool. Forgot my goggles but borrowed a pair from one of the lifeguards, kind of them. Front crawl massively improved, almost at the point where can just keep going now. Did 6 lengths without stopping at one point = success! Technique is probably awful, that's the next thing to work on. At least I'm breathing every 3 strokes on alternate sides, which I've heard is the thing that alot of people find tricky. Forgot to mention too that I've self-diagnosed myself with de Quervains tenosynovitis on my left hand - had pain over the thumb extensor muscles for a few days and then today had palpable crepitus when moving my thumb. People in A&E straight away thought it was tendonitis. Some mild swelling too. Not really sure what's caused it,possibly the swimming so tonight probably didn't help! Tesco to pick up some Ibuprofen and banana bread ingredients before house and spag bol dinner. Bit of 4OD online then baked the banana bread, incredibly straightforward recipe and the oven's not too bad (rare for hospital accommodation) so turned out pretty good! This one's for all the juniors tomorrow, then I'll bake another one for the A&E staff on my last day :)
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