Clinical examination of peers

[yazoo]

The way Belis sees it is the way most Drs do - it becomes about clinical priority and matching appropriate skills to the task. It simply isn't possible to be all about communication skills and rapport in medicine (and that includes with the patient and with other staff), but there is seldom a good excuse for poor communication either (but hey, nobody is perfect, and "sorry" works well).

The Drs role is to provide medical care. This includes appropriate explanations, eliciting concerns and caring, but not spending hours at the bedside (unless clinically warranted). Sure, if you are having a slow one and the nurses need a hand, many Drs will gladly give it (others go straight to the mess for a game of pool or put their feet up and have a few zzzzzzzzzzzs).

Cannulation and venepuncture become mundane. The interaction with patients should not. The two are quite different, but inter-related. I do get satisfaction out of cannulating difficult patients, or getting blood from stones (in the nicest possible way!). I also find it is an excellent time to establish rapport, elicit concerns etc. But if someone has e.g. become confused and aggressive following surgery ( a sign that complications exist) on the adjacent ward, I need to be there, not cannulating someone that the nurses can.

And nursing students can and do learn to cannulate and take blood in certain regions. It's just that they often loose these skills when they go to work on wards where they are not allowed to do these tasks (unless the senior nurses who made the rule are not on duty, but this tends only to be more experienced nurses who are confident in their skills - who go against the hierarchy, that is).

[rjm]

Originally Posted by Polldoll

If I ever get to the point that I dont want to spend time with patients, or do "mundane" tasks like taking their blood then its time to quit. Medicine is huge, yes doctors are busy and have loads to do, but you should always have time for patients, even if its just 5 mins whilst you are cannulating them. Thats my humble opinion anyway!!

All I can say is document that comment somewhere and look at it again once you have been a HO/F1/F2 and I'm sure you'll understand what we are saying. You are looking at something that is a like christmas day to you but like a relatively like a bog standard wednesday to us. I would definitely not say it is time to quite because I find cannulation/venepuncture boring. I regularly do them to keep my hand in, but my skills are better directed elsewhere that doing routine bloods and cannulas. And I would argue that there is no relationship between finding these tasks mundane and having time for your patients/bieng a good doctor - in fact I would argue that you have more time to spend with patients/relatives if you are not doing such things.

[Genevieve]

Originally Posted by charlie30

Totally off topic...but following the 'not being paid for doing extra stuff' thread...I work with midwives who perform venepuncture, cannulate and carry out the paediatric examination of the newborn etc...and still receive the same pay as midwives without these skills. Madness really.

I totally agree that nurses should be learning to take blood in their first year of training...why midwives and not nurses? When I am on surgical nursing placements I am not allowed to take blood!

Charlie x

Charlie....Just being nosey, are you a Student Midwife?

x

[charlie30]

Oooh how's this for a quick reply!

Yes, I'm a madwiggery student! I see from your sig that you are too! We kind of have the same career plan.

How are you finding the course? Bloody tiring, no?!

Charlie x

[Genevieve]

Yeah very tiring, got our last exam of 1st year in a week and i've just been to the Dr's today... kidney infection couldn't have come at a worse time.
Just hope I'm ok for placement next week, on community and it's really draining, much more than I expected but getting lots of venepuncture experience lol.

Where are you training if you don't mind me asking, is it in england?

x

[Dr Noodle]

Genevieve what do you mean by '6/40 babies delivered'? You've watched forty and delivered six? That must be an amazing experience Any machines there that go 'ping'?

[charlie30]

Eeek Genevieve, hope you feel better very soon. I couldn't handle an exam, community and a kidney infection all in the same week.

I'm training in NW England, whereabouts are you?

Are your med school plans common knowledge? I haven't really told anyone because I think I'd get stick for it! Can I ask...do you have sciencey type A Levels? I think I might need to study at least a chemistry A Level alongside my degree because I have nooo science background.

Charlie x

[Genevieve]

No haha 6/40 means 6 babies delivered out of 40 ( the amount needed to qualify) so I've 34 more to deliver, back in labour ward in about 4 weeks then gynae theatre... should be v.interesting !!!

[charlie30]

I'm on delivery suite from September...can't wait! Also on gynae ward...which I'm not really looking forward to.

I have managed to 'misplace' all of my EU directive sheets....all of the numbers and signatures for my A/N, P/N checks etc so far. I don't really know what to do...still hoping they'll turn up....what a nightmare if they don't!

Charlie x

[Genevieve]

Originally Posted by charlie30

Eeek Genevieve, hope you feel better very soon. I couldn't handle an exam, community and a kidney infection all in the same week.

I'm training in NW England, whereabouts are you?

Are your med school plans common knowledge? I haven't really told anyone because I think I'd get stick for it! Can I ask...do you have sciencey type A Levels? I think I might need to study at least a chemistry A Level alongside my degree because I have nooo science background.

Charlie x

I'm training in Scotland, is your course only 3 years including honours because up here its an extra year for the honours which is annoying, as its another year to wait for medicine!!!

I have kind of kept it quiet to my mentors as those who I have told said (nicely): why are you doing midwifery then? But really it was midwifery that made me want to do medicine even more.
Plus I need a degree so it might as well be in something I have a love and interest for!!! A lot of my classmates know about it as we are a close group and they all tell me to go for it.

I don't have a science background either... I have chemistry at standard grade (GCSE) but the teacher wasn't very good at explaining things I didn't understand and I couldn't grasp it enough to want to carry it on to Highers (A-level)

I emailed uni's up here for medicine asking if I needed a biology/chem Higher and they all said as long as its a BSc then I wouldn't need a science school qualification, however Aberdeen said it would help.

Are you thinking of going into Obs/Gynae or do you think you will take a different path for medicine? I have an interest in Anaesthetics but until I've seen other sides of medicine I'm staying open minded.

x