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.
M.D.
