Old life ending

Thursday, 26 July 2012

My second post! I'm not posting regularly yet as I don't begin med school until September and I don't really have much of interest to talk about at the moment.

I finish my current job tomorrow. I also get my exam results tomorrow (scary!). If I pass them it means that once I've sent off the paperwork I'll be a fully qualified Pharmacist! If I do pass (the exam's just pass/fail) it'll mean that I'll be able to work as a locum Pharmacist at the weekends/holidays whilst at med school which, seeing as I don't have any money, is kind of a necessity. If I don't pass though it's not the end of the world, just inconvienient, as I'll be able to re-take the exam in Septemeber. Some of the other trainee Pharmacists I'm working with have Pharmacist jobs due to begin in the next few weeks so they're a lot more nervous about the exam results than I am. I do hope I pass though, it's not nice to fail at things. Also, the results come out at midday (online so that everyone in the department can see them!) so if I don't pass everyone will know and I'll have to stay at work for the rest of the day which would be so humiliating.

Even though I'm not at med school yet, working on the wards in hospital I still get to see a lot of interesting and vaguely medical related things, so I thought I'd just write about a couple of interesting things I've seen so far:

~ Occasionally we actually get patients come into hospital with classic textbook drug interactions/ side effects. Most of the time patients aren't very straightforward and don't behave in the way textbooks say they should, so when a patient is very textbook it's a good learning opportunity. One such patient was an elderly woman on warfarin (blood thinning drug) who had been prescribed a week long course of metronidazole (an antibiotic). Textbooks tell you that metronidazole increases the antiplatlet effects of warfarin, and low and behold the patient presented into hospital with uncontrolled bleeding and a really high INR (a measure of how thin your blood is). I think the GP was aware of this interaction as he/she had made a note to take the patient's INR level a week after they'd started on the metronidazole, but maybe they weren't aware of how serious the interaction can be as they shouldn't have really left checking the INR for a week. Thankfully the patient got given some Vitamin K to reverse the effect of the Warfarin and is doing fine now.

~ An example of the type of doctor I don't want to be like: I was on the ward working on one of the portable ward computers. One of the consultants, with a team of mini doctors (students/F1's) strode onto the ward, and being the nearest computer to him, the consultant came up and stood next to me and loudly cleared his throat. I looked up at him and the consultant (obviously aggregated that I hadn't automatically jumped off the computer for him) snarled "I need the computer". Fortunately I was on one of the specific Pharmacy computers so I was able to just show him it was a Pharmacy computer and go back on with my work, and he flounced away. Though, even if I was just using one of the generic ward computers I probably wouldn't have given it up to him (obviously if it was an emergency I would have given up my computer in a heartbeat). Now, I understand that doctors/consultants are busy people, but in this case there was actually free computers not far away, clearly visable, a little further down the ward, and even if he is busy there's no excuse for rudeness and lack of manners. If he'd come up to me and said something like "Excuse me, would you mind if I used your computer for a ward round?" I would have gladly given it up, but the arrogant, rude way in which he just demanded the computer really rubbed me up the wrong way!

~ A patient who thought smoking was beneficial to health after badly explained stats: I was talking to a patient about smoking and he was talking about how he'd read on a heart disease leaflet a statistic along the lines of (can't remember the exact stat) 30% of smokers get heart disease, which the patient took to believe that as only 30% of smokers get heart disease and a large proportion of the country has heart disease, smoking must mean that you have a reduced chance of getting heart disease. As someone who's used to dealing with statistics it's easy to forget that other people aren't so familiar with, what to myself, are everyday terms. This was a good remainder of the importance of good explanation, pitching things at an appropriate level for patients and of ensuring patients understand what you've told them properly, things which I shall try to remember when at med school and working as a doctor.

~ I was working on the ward when an elderly patient who had half an hour previously been up and talking, suddenly crashed (their heart stopped beating). The doctors and nurses were all amazing, reacting really fast, but unfortunately the patient died. As the ward where I was working was quite open and where I was working was close to the patient's bed, I saw and heard a lot of the resusitation efforts. I found this quite upsetting and I was a bit emotional, even though I hadn't known the patient. As a med student and as a doctor I know that I will experience things like this quite a lot. I do tend to get emotional/upset about some things quite easily, so I know that I'm going to have to toughen up before I become a doctor.

I know that Pharmacy is very different to Medicine and obviously I have a lot to learn, but hopefully having worked as a Pre-reg Pharmacist on the wards alongside the doctors/ other healthcare professionals will give me a good grounding for med school. From my degree and reading patient's medical notes everyday I feel that I know the basics of common conditions (pathology, diagnosis, treatment etc), know quite a lot about drug treatments for conditions and drugs in general, and just things like knowing medical abbreviations, how wards work and I'm used to talking to patients and other healthcare professionals. Hopefully these things will help me at med school!