Day five

Bit of a slower day today. Started with a board round again, in which I had the opportunity to present the patient I saw yesterday. Went pretty well and didn't get questioned, so I'd call that a success! Quite nerve wracking trying to remember all the clinical details on the spot infront of the entire medical staff of the hospital (albeit not a huge number of people!). Then followed the ward rounds - I joined the medical one today and it was pretty good, saw a few patients and heard some good chest signs. Always nice when the whole group of 7 or 8 people wander to the foot of a patient's bed yet they smile and nod their head specifically at you, as happened when we saw the patient I presented earlier in the morning! Must feel like that with every patient when you're the F1.

Back to the doctors office and the jobs list informed me that my favourite patient needed a blood test. I promptly went and gathered the necessary equipment from the store before collecting the sample. I'm finally getting used to the equipment here - instead of vacutainers they use syringes that are actually themselves the blood bottles. Once they have been filled by pulling out the plunger you can just snap it off and they've turned into blood bottles! Quite neat really but needed a bit of getting used to. Once they were labelled up I took them up to the lab.

Then I saw another patient with some neurological signs - time to crack out the collateral histories, minimental state examination, full cranial nerve and upper/lower motor/sensory exams... Required a quick bit of swotting up from my phone before hand! Good revision though, as these are all things we learnt and were tested on in 3rd year OSCEs, so I know it but it's not very fresh. It's sometimes quite hard to self motivate to do things like this, as the doctors will say "Do you want to see this patient? They need a full neurological exam" and part of you wants to do it as it's a good learning opportunity but the other just can't be bothered as it's effort and you'll probably forget things as it's ages since you've done those examinations and wouldn't it be better to revise it first and then do it properly... Normally the former thought wins though, and it generally goes better than you'd anticipate and you learn way more than just glancing over it later.

Up to the teaching centre for an audit presentation on difficult airway equipment trolleys. There are 2 of these trolleys here, however there's only one fibreoptic scope due to budget restraints. After just 5 days here it's been really noticeable how many times budgets and finances have come into clinical discussions - the pressures of working in the NHS, a massive organisation fighting unlimited demand with limited supply, amplified in an isolated rural location. Lunch and back to the wards. Popped to CT scanner briefly to see a head scan and chat to the radiologists before an impromptu teaching session in the doctors office on the rather esoteric subject of scombroid fish poisoning!

The new camelbak bottle, great for car as no spillage!

That concluded the week and I headed home in sunshine and blue skies - brilliant I thought, might be able to get out climbing after all. Quick pop into Cotswolds to grab a new drinks bottle and some postcards and back home. No sooner had I arrived back though a torrential monsoon rain shower put paid to those dreams of craggin. After a quick couscous snack I headed over to Calluna, a bunkhouse about five minutes walk from the house where there's a small bouldering wall run by Alan Kimber. I signed the forms and paid for a month's pass (£20) before having a 1h30m session in the wall. It was pretty small and cramped, but surprisingly good once I got into it. Good music on the radio and the place to myself! The training board is a pretty nice angle, maybe 30 degrees? Possibly less. There's a good mixture of holds on it too. After an hour  of that I moved onto the campus board, just to do some fingerboarding hangs. Brutal! Really enjoyed the session though, and quite like training on my own anyway so think I might be down there quite a few times more before the placement finishes! And that's my wet evening plans sorted! Dinner consisted of baked potatoes, one with tuna/mayo/sweetcorn, the other with beans/cheese = lovely and hopefully quite nutritious/healthy! Skyped folks, watched a bit of TV and chilled out. Lie in tomorrow, especially as forecast for whole weekend is 'heavy rain'!

Nice training board

Brutal campus board - my foe for the next month!