I was lucky enough to get another placement at a different GP Surgery this week! It was only for one day (revising for mocks/a show meant I couldn't do much more), but certainly a long one (10 hours) and was well worthwhile! I saw lots of variation in patients and the conditions I met seemed to be completely different to the ones I saw at my other placement. I spent part of the day with one GP, another GP, the District Nurse and the Practice Nurse, so certainly saw a range of people!
GP - Dr Robins
I spent the morning with Dr Robins. He was really friendly and helpful towards me, giving me a quick briefing on patients just before they came in. Obviously as before, we had to ask their permission for me to sit in, and most said they were fine with it. In the morning, I mostly saw acute problems, which contrasted with the chronic problems, such as Depression, COPD and Heart Disease I saw at my other placement.
One of the first patients I saw was a mother concerned about her baby, who had had a nappy rash for 2 weeks, which had "angry spots" and hadn't gone away, despite the persistent application of Sudacrem. Dr Robins examined the baby's bottom and diagnosed a Thrush infection, caused by the bacteria called Candida. There are many other types of Thrush, such as oral and vaginal thrush, which are caused by the same bacteria.
Another patient was a boy called George, whose mother had noticed a lump on his back. Dr Robins examined the lump, firstly by looking and feeling it, then looking at with with a magnifying glass. He concluded it was a Sebaceous Cyst. Sebaceous Cysts are closed "sacs" beneath the skin which usually contain Sebum. Although mostly harmless, they tend to increase in size and can get infected. Dr Robins recommended that if George wanted to have it removed, or if the cyst became infected he should come back to the Surgery. Sebaceous Cysts can be removed in two main ways: Advanced Electrolysis, where a current is put through to the cyst to kill it before it's ingested naturally by the body, or by surgery. One type of surgery removes the cyst whole and results in scarring, but a more modern method drains the fluid from the cyst before removing the wall. This results in less scarring, and so for this reason many patients prefer this. Advanced Electrolysis results in virtually no scarring, however it can only be used on small cysts that have not been recurrently infected.
District Nurse - Susie Collins
After that, visits with the District Nurse. Firstly: an elderly woman who had been previously diagnosed with Hypertension. Susie checked her blood pressure, which wasn't at extreme levels and so we shortly left.
The next stop was less medical, but still very interesting and involved a patient, called Mrs Gale. Mrs Gale refused support from Social Services and denied needing it. However, her friend had been looking after her and her house for her, especially since she'd been ill with a chest infection. She was sometimes incontinent, incapable of washing her clothes, sheets and herself and also incapable of preparing food for herself. Susie spoke to Social Services to arrange 2 weeks of free care for Mrs Gale, who was ensured it was just to help her while she was ill. An assessment was arranged for that evening.
Being with the District Nurse was an entirely different scenario to sitting in or even accompanying GPs on visits. It seemed less science-based and included more social and care issues than being a GP. Susie repeatedly told me that the sole purpose of the District Nurses, who are employed by the Health Authority, not the surgery, was to keep patients out of hospital. They never see patients in the surgery.
Practice Nurse - Megan Johnson
I spent the next few hours with the Practice Nurse. Once again, this was less scientific than when I sat in with the GP. The Practice Nurse dealt with a range of patients, but another key difference was that patients booked appointments with the Nurse and stated what for - the Practice Nurse knows what she has to do before the patient comes through the door. The first patient I saw was travelling to South Africa and Zambia and wanted to ensure she was up to date with all her jabs, which due to her interest in travelling abroad, she was. To name a few of the vaccines required for the travelling the patient wished to do: Yellow Fever, Hepatitis A and Hepatitis B.
The next patient had been routinely coming to the Practice Nurse for about 6 years. He had severe leg ulcers, which had been exacerbated by obesity and hypertension. The ulcers had become infected multiple times, which had resulted in very slow healing. Megan dressed the ulcers with compression bandages, which aim to control the blood pressure in the leg.
GP - Dr Carter
Dr Carter saw acute and chronic problems. These mostly took the form of injuries, such as sprains (acute) and various aches (chronic), usually arisen from activities such as going to the gym and weightlifting, running and cycling. For most of these, Dr Carter recommended rest and in some cases swimming to help alleviate the pain (this was for more chronic pains though).
I really enjoyed my placement - being with the Practice and District Nurses was definitely another worthwhile experience and being with more GPs was also extremely valuable! Dr Robins said he often performed minor surgery on Thursdays, however when I went unfortunately it was cancelled. I'd love to go back (if I can fit it in with my school timetable!) one Thursday afternoon to see this! It sounded really interesting!
No comments:
Post a Comment