final entry cardio

NATURE: The nature of our placement ended up being a bit all over the place! We were actually situated on MANY wards as during our 5 weeks as so many of the staff were either sick or on holidays...so Chris and I had to fill the gaps. It meant that we saw patients from gen med wards, hematology and oncology, ICU, Cariothoracics and rehab wards!! Even though going up and down the stairs so often was frustrating (and hard work on the legs!!), it meant we got to experience such a wide variety of patients and situations. I would now feel confident in any situation on a ward!

The peer-coaching model worked really well. Working with Chris in the first week really put me at ease. It meant I wasn't as nervous as I could have been seeing our first ever ward patients. We broke it down well, with one of us doing the subjective assessment and the other doing the objective assessment. This way the patient only had to listen to one person, and the other student could watch and then give very valuable feedback. This is great, because your supervisor can't be with you all the time, and getting feedback from a third party is often what you need to improve. In the second week, Chris and I saw our own patients and I felt much more confident after a week of peer work. And, we DID run the ward in our last week. It was flat out, exciting and a great learning curve. Your time management has to be PERFECT!

STRUCTURE: The structure was as I initially thought. Seeing patients on the ward daily who are flagged as needing physio reviews/treatments. It was difficult to fit in around the other health professionals. Patients constantly have procedures to go to etc. But having so many patients meant there was always someone else you could see. As long as I prioritised my patient list and didn't miss any urgent priorities, my day ran fairly smoothly.

ROLE: My role really was as a colleague to my supervisor. With all the staffing issues Chris and I were running a ward by the end of our placement. Without us there I think many patients would have missed and I feel like our help was really appreciated!

CONCERNS: There were many sick people on prac, and it was overwhelming. But I think I managed it well. In the acute stages of illness/recovery you do see rapid improvements, so there was a lot of hope involved with many of the patients. Also, knowing I was on such a strict time schedule helped. At Shenton Park I sometimes had up to 3 hours with people, which was emotionally draining. I think that at Freo, I managed my patient list well and didn't let myself become too emotionally involved.

Oh my god. The attachments were so daunting! I was right to be concerned! I couldn't believe how many tubes and lines could be in one person! We were very lucky in seeing some surgery patients with our tutor. She talked us through all the attachments, and when you have done it once, it is much less scary the next time! Also, if I was ever unsure, I just asked the nursing staff. They mobilise people to the bathroom etc daily and probably have the BEST understanding of attachments and what can be moved/unplugged etc. I've decided no question is too silly!

My take home message: I thoroughly enjoyed working at Freo, but I don’t know if it’s something I would want to do forever. I found that in ICU my time was really warranted and people really needed chest physio. However, up on the general med wards, I constantly found myself taking people for walks and going through deep breathing cycles. For all that we need to learn at uni, I was a bit disappointed at our limited scope in practice.

BUT…for the people that did really need me, it was very rewarding. I think that as a student you should take every opportunity in the hospital. I always jumped at any chance to go down to ICU/cardiothoraics and try and experience every facet of hospital life. It meant that I was exposed to suction, MHI/VHI and other techniques that are used less frequently on the ward. It also meant that I could really fine-tune my cardio assessment skills to every type of patient. It really is so important to have your assessment skills down pat. You use the same assessment for every patient and having it together perfectly means you can best come up with a problem list and justify your reasons for specific treatments. (Also, the same recipe won’t work for every one. Assessing correctly allows you to cater to the individual.)

Lastly, from the moment a patient is admitted, hospital becomes all about when they can leave and how we can best prepare them for this. I realized that discharge planning is often the most important aspect of our treatments, and it should be on your mind from the first assessment with your patient. It is so important, and good discharge planning should keep patients from being re-admitted. Thus, we should all do our best to familiarize ourselves with the services out there so as to provide the optimal care for our patients.