In a follow up to this, tomorrow I start my SSM at DepCat hospital in ICU.
It is an audit, and now I have a title, a topic, and a pile of reading at tall as a house! I also have a questionnaire I composed to gather the data and now need to design a spreadsheet to put it all into. In some ways a database might be more useful, but I;m not sure how to extract data from that and this needs to be more about the data than the process. It is essentially a 'paper' audit with no actual changes to practice in the unit until we reach some conclusions, but could involve going back through 720 patient records (or 300 patient notes) hopefully though this might be nice and easy and come in a spreadsheet itself from the labs.
Although I did my ssm in ICU before christmas, thatw a s abig city ICU with tertiary centres, and high level professorial input. This next one is a much smaller unit, with more paper based recrds, so it may be something of a change. For a start not all the staff wear scrubs....and I might not get to either.
Showing posts with label ICU. Show all posts
Showing posts with label ICU. Show all posts
Monday, March 16, 2009
Wednesday, January 28, 2009
SSM(C) 2
I have another SSM / SSC coming up in March-April. After the fun of my last one at big city hospital in November, I am hoping to do the next one out at DepCat hospital. This one is looking to be an ICU Audit of some sort, and there will be two students doing it. The ICU there is much smaller so hopefully elss records to rake through!
Anyway the two of us students met last night, over coffee to plan our moves from here and brainstorm some ideas on what we could audit - any sugegstions? We have to meet the Consultant, plan the audit, sort out the practicalities, submit it to faculty, get a response to faculty from the consultant and have faculty approve it. All by next Friday.
Anyway the two of us students met last night, over coffee to plan our moves from here and brainstorm some ideas on what we could audit - any sugegstions? We have to meet the Consultant, plan the audit, sort out the practicalities, submit it to faculty, get a response to faculty from the consultant and have faculty approve it. All by next Friday.
Wednesday, December 31, 2008
2008/9
Well 2009 is now a little over 6 hours away and in common with my general state this year I made no plans for tonight and now end up with no actual evening as such. Most of my friends are quite apathetic for new year this year, with a large focus on 'staying in'; 'doing nothing'; 'got no money'; and 'meh'; when I surveyed them.
I have the car so could go to one of the gatherings I know are happening, but that involves going all the way down in Newcastle, or Reading, both of which are a long way. and would cost lots of patrol. I have my House series 3 from Christmas, a warm flat, lots of tea and wine, and a huge pile of ironing, so it could be that I have an interesting evening, unless I get a better offer by text soon. I also have a large street party and concert outside, which if I open the window I can hear perfectly, and should I want to, I could go to with the 2 free 'inconvenience' tickets I get from the organisers.
Looking ahead, 2009 should be a good year:- my last holiday as a student, elective, and SSM, my Child Health block and for the first time in (at least) 12 years......a summer with no exams!
Looking back 2008 was a year of some highs (passing 3rd year, my ICU SSM, my block at seaside hospital - including chicken sewing and fireworks, passing driving test, getting a Car, my Sister's wedding) and lows (death of close friends, death of grandfather).
I liked 2008, it was a good year, but I am looking forward to 2009 so much more.
I have the car so could go to one of the gatherings I know are happening, but that involves going all the way down in Newcastle, or Reading, both of which are a long way. and would cost lots of patrol. I have my House series 3 from Christmas, a warm flat, lots of tea and wine, and a huge pile of ironing, so it could be that I have an interesting evening, unless I get a better offer by text soon. I also have a large street party and concert outside, which if I open the window I can hear perfectly, and should I want to, I could go to with the 2 free 'inconvenience' tickets I get from the organisers.
Looking ahead, 2009 should be a good year:- my last holiday as a student, elective, and SSM, my Child Health block and for the first time in (at least) 12 years......a summer with no exams!
Looking back 2008 was a year of some highs (passing 3rd year, my ICU SSM, my block at seaside hospital - including chicken sewing and fireworks, passing driving test, getting a Car, my Sister's wedding) and lows (death of close friends, death of grandfather).
I liked 2008, it was a good year, but I am looking forward to 2009 so much more.
Thursday, November 27, 2008
Should we get annoyed?
a.k.a. Why do good things happen to bad people.
Over the past few weeks, a common pattern seems to be emerging - often young, previously healthy patients with wives/husbands, young families, and who are working and contributing to society* are getting very sick, and or dying, whilst chronic alcoholic, IVDU's end up recovering from their alcoholic encephalopathy, seizures, and coronary events*.
*the above are composites of different patients.
It seems unfair that people who were doing good, and are only a little older than myself are dying, despoite all the treatment we can offer, and yet people who are on their second or third ICU visit are recovering, but not reforming and going back out to continue their downward spiral.
I am not suggesting that some lives are more important than others, but there does seem a fundermental unfairness about the fact that those who contribute to society are the ones to die, and those who sponge/take from socety are the ones who survive.
As one doctor put it today "those with a rough paper-round have just become so tough that it takes more than a bit of alcohol and an MI to kill them".
Over the past few weeks, a common pattern seems to be emerging - often young, previously healthy patients with wives/husbands, young families, and who are working and contributing to society* are getting very sick, and or dying, whilst chronic alcoholic, IVDU's end up recovering from their alcoholic encephalopathy, seizures, and coronary events*.
*the above are composites of different patients.
It seems unfair that people who were doing good, and are only a little older than myself are dying, despoite all the treatment we can offer, and yet people who are on their second or third ICU visit are recovering, but not reforming and going back out to continue their downward spiral.
I am not suggesting that some lives are more important than others, but there does seem a fundermental unfairness about the fact that those who contribute to society are the ones to die, and those who sponge/take from socety are the ones who survive.
As one doctor put it today "those with a rough paper-round have just become so tough that it takes more than a bit of alcohol and an MI to kill them".
Wednesday, November 26, 2008
Sorry
Sorry about the lack of posts recently, but I seem to be really tired after my SSM days, which is worrying as I now have to work on the essay etc!
Wednesday, August 8, 2007
Success!
Faculty have finally deigned to tell me that my year 4 (If I pass my exams as their emails remind me) will start with an SSM. I sent an email to the ICU ward where I have spent two mornings of my elective and got a reply next morning saying that they would love to have me and that they would see me on Tuesday 28th August (27th is, like the first day of each teaching block, an academic day on campus) at 0830 in ICU.
This will mean that (excluding 5 weeks holiday and 2 weeks of exam leave) I will have been at the same hospital from mid May- end of September. I was also there for clinical teaching 1.5 days a week from November '06 - February '07 in year 3. Thankfully it is also only a 15 minute walk from my flat. I'm sure such luxuries will end one day!
Friday, August 3, 2007
Elective - days 9& 10
Day 9
Today I was in vascular surgery. The anaesthetic stuff went quite well and I got to do a couple of venflons and intubations.
One of the registrars also told me a really simple way to look at blood gases and pH and work out whether a patient had an acidosis or alkalosis and whether it is respiratory or metabolic. If is a very simple 4 step approach which no text book has but it works very well. All in all it was a useful way to spend the 3 hours of the second operation; during the first one we had gone over ECG patterns and the pyramid of analgesia.
Day 10
Today I was back in ICU. This entailed following a ward round which was very interesting, as in the case of 4 of the 6 patients, the doctors had no idea what was actually wrong with the patients, nor why some of their biochemistry was so disordered. i also spoke to the ICU staff about the possibility of doing an SSM there - I need to send an email this weekend!
There is one day of my elective left, next Tuesday, as I have the Wednesday off for revision for the exams on Thursday and Friday.
Today I was in vascular surgery. The anaesthetic stuff went quite well and I got to do a couple of venflons and intubations.
One of the registrars also told me a really simple way to look at blood gases and pH and work out whether a patient had an acidosis or alkalosis and whether it is respiratory or metabolic. If is a very simple 4 step approach which no text book has but it works very well. All in all it was a useful way to spend the 3 hours of the second operation; during the first one we had gone over ECG patterns and the pyramid of analgesia.
Day 10
Today I was back in ICU. This entailed following a ward round which was very interesting, as in the case of 4 of the 6 patients, the doctors had no idea what was actually wrong with the patients, nor why some of their biochemistry was so disordered. i also spoke to the ICU staff about the possibility of doing an SSM there - I need to send an email this weekend!
There is one day of my elective left, next Tuesday, as I have the Wednesday off for revision for the exams on Thursday and Friday.
Saturday, July 21, 2007
Elective - days 3 & 4
Day 3
Today I was in a cardiac theatre where they were replacing a regurgitant aortic valve and doing a bypass graft using the saphenous vein from the leg. It was scheduled to be a 4-5 hour operation. The patient came down to theatre about 8.35am, and was in by about 9am, fully hooked up to all the monitoring machines, this operation was unusual, in that because the surgeon was going to be operating on the heart, they would need to stop the patient's heart and use a heart-lung machine to bypass the lungs.
The operation seemed to go ok - I saw a bit but not all, but the surgeon was very snappy and quite aggressive towards the other staff.
Day 4
Today (well the morning) was spent in ICU - intensive care. It was a kind of whistle-stop tour, where I also met some of the other emd students, who have done a full elective in the ICU. They were showing me what the equipoment does and also how the monitoring is done. I liked the visit to ICU and might consider an SSM at ICU this coming year. one of the other students also gave me some contact details for doing neonatal ICU, which might be a nice alternative.
It was one of the consultant's birthdays, so we had cake and stuff. All in all ICU is much calmer and fun than I had thought it would be, and involves a lot of the kind of detective work of managing patients to dow ith monitoring and correcting their blood results etc. They also seem to have good team working between the SHOs and consultants.
Today I was in a cardiac theatre where they were replacing a regurgitant aortic valve and doing a bypass graft using the saphenous vein from the leg. It was scheduled to be a 4-5 hour operation. The patient came down to theatre about 8.35am, and was in by about 9am, fully hooked up to all the monitoring machines, this operation was unusual, in that because the surgeon was going to be operating on the heart, they would need to stop the patient's heart and use a heart-lung machine to bypass the lungs.
The operation seemed to go ok - I saw a bit but not all, but the surgeon was very snappy and quite aggressive towards the other staff.
Day 4
Today (well the morning) was spent in ICU - intensive care. It was a kind of whistle-stop tour, where I also met some of the other emd students, who have done a full elective in the ICU. They were showing me what the equipoment does and also how the monitoring is done. I liked the visit to ICU and might consider an SSM at ICU this coming year. one of the other students also gave me some contact details for doing neonatal ICU, which might be a nice alternative.
It was one of the consultant's birthdays, so we had cake and stuff. All in all ICU is much calmer and fun than I had thought it would be, and involves a lot of the kind of detective work of managing patients to dow ith monitoring and correcting their blood results etc. They also seem to have good team working between the SHOs and consultants.
Friday, July 20, 2007
Dilema
On Friday night, should I go to meet up with people from work for a drink, or go and stand in a big queue at Borders for a certain book? Or should I just get up early on Saturday to get the book, or wait toil after my exams by which point lots of people will have told me what the crucial plot twists and ending is.
My current thought is to buy it on Saturday at some point. Or i could go after I have been to the pub. Of course going to the pub in the first place is dependent on when i finish in ICU today, and when I have done some revision and had tea without falling asleep, which has been my fate the last two nights!
My current thought is to buy it on Saturday at some point. Or i could go after I have been to the pub. Of course going to the pub in the first place is dependent on when i finish in ICU today, and when I have done some revision and had tea without falling asleep, which has been my fate the last two nights!
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