First Clinical Placement Reflection & Review

At the hospital ward, my patients were mostly liver transplant patients, IMCU, acute care, or AKI/dialysis patients. There were also the general surgery patients that occasionally dropped by in IMCU/ step down. I spent the first couple of weeks observing and taking in the many different procedures patients underwent, the process my preceptor used to see and prioritize her patients, and assisting a little bit in mobilizations of X3 assist patients.

During my placement, I familiarized myself with charting progress notes in the form of SOAP notes. I learned a lot about my treatment options and procedures.

For a day, I observed two surgical procedures; 1) a lateral thoracotomy for a mass removal of a benign tumour. I got to hold the tumour at the end, it was bigger than the size of my fists. It looked like an organ of its own as it had blood vessels growing all around it. It was a surreal experience, and at times, I did consider if a path as a surgeon. especially since the MCAT score has been lowered as a prerequisite. It made me feel rather gloomy for a bit, but then I looked at the facts. Doctor spend a lot of time behind paper work, much like physiotherapists, and they spend more than double the time studying and in debt prior to work. I can barely handle this two year program. 2) I witnessed a VATS procedure for a pneumocotomy. I then followed the tumour to the labs and watched the pathologist cross freeze sections of a metastasized tumour. I lowkey contaminated her office with the tumour too. yikes!

Over the six weeks, I went through a radiology tour to see how patients get cast fittings for radiology treatment and watched a couple of CAT scans. I also attended two weekly rounds, liver transplant rounds and patient ward rounds.

            I spent most of the time with patients who were assist X3 and later became competent enough to lead the mobilization of an assist X4 wheel chair to bed using a hoyer lift. I feel confident using the hoyer lift and organizing lines, drains, and tubed from the sheer volume of them I had worked with. I wrote new consults for new patients, and collaborated a lot with the staff in the hospital, specially the nurses in IMCU. I visited and worked four days in the ICU with acute care patients, respiratory failure patients, etc. I saw one patient progress from ICU to IMCU to a general ward room, and I saw a couple of patients regress due to deconditioning and multiple surgical procedures. For one day, I joined another physiotherapist in the thoracic and oncology units I set up goals with a demotivated patient, in which she followed afterwards. I sat in on my CI’s liver transplant outpatient meetings, in which I noted the effects liver failure has on patients such as jaundice, unfocussed eyes, muscle wasting, etc. I’ve been exposed to a wide variety of patients and cases, except paediatrics.

            I definitely feel confident and competent in mobilizing acute care patients from stand by assist to X4 assist. I did not, however, see or use enough breathing techniques, secretion techniques, or auscultations. Also, my subjective history taking skills have a lot of room for improvement. I was told by my preceptor that my soft skills are all there, communication, professionalism, compassion, etc. and that my hard skills will take some time as I gain more experience. I would definitely recommend this placement and my preceptor for future students, because I enjoyed this placement a lot. There were so many learning opportunities, but I feel that I learned the most I can by the end of it. I do wish I could have seen even more surgical procedures, they were the best.

It also worked out beautifully that I went at 8:20 am and left at 2 pm during Ramadan! I spent a lot of time sleeping, that's for sure.

Peace,

Peace,
M.D.