Portland Community Hopsital

[NikiEdwardsParticipant]

Week 1: 1st-5th August

Prior to my placement at Portland Community Hospital I was unsure of what to expect. Upon arrival I was greeted with the friendly faces of the staff who were more than happy to point me in the right direction. The hospital sister, my mentor for the entirety of my placement, gave me an in depth of tour of the hospital including the ward, minor injuries unit and physiotherapy suite.

I spent my first morning, and every morning after that, following one of the volunteers who had previously worked at the hospital before retiring as she made morning hot drinks for all the patients. Whilst doing this, I learnt the importance of a friendly face and a comforting smile alongside all of the medical work done by the nurses. I realised it can be difficult for the nurses to spend time with the patients and talk to them given how busy they are, but I noticed that each member of staff went out of their way to spend any spare moment talking to and reassuring the patients.

Every day the staff encourage the patients to get out of bed and into the communal lounge, which encourages them to socialise and partake in independent activities instead of sleeping the day away. The patients have a daily exercise class in the lunge, which I was invited to join. The exercises are chair based and are designed to help aid their rehabilitation by loosening muscles and improving movement. Some of them are also designed to reduce fluid build-up in the limbs which can occur when the patients are sat down for too long. From what I observed, the majority of the patients are more than willing to participate, which is most likely brought on by the keen and friendly nurse who hosts the exercises. During the activities, the nurse will ask the patients questions about their past which stimulates memories. Many of the patients here have dementia, so these visits into their past brighten their days and give some sort of relief from the confusion they may experience in the modern times. Two of my favourite stories have to be the lady who joined the land army as a young girl and the man who took a job as a telegram boy once he left school.

After lunch the patients are allowed back to bed, so the few hours after that which I was there for tended to be more slow as the patients started to retreat back to bed. During this time, I was allowed to shadow the ward clerk who was happy to provide information about the hospital. She told me that the hospital, previously the Royal Naval Hospital, was much larger during the second world war to cater for soldier casualties and that sections of the hospital had since been demolished as the requirement for beds decreased. The hospital now houses 16 inpatient beds, 8 rehabilitation beds and 8 assessment beds.

Since it was my first week, I was unable to do many hands on things and had to shadow a member of staff at all times. I really enjoyed this week, and any expectations I may have had were surpassed. I look forward to the rest of my time there.

• This topic was modified 10 years ago by  NikiEdwards.

[NikiEdwardsParticipant]

Week 2: 8th-12th August

One of the most exciting things to happen this week was being able to take a patient’s observations under the supervision of a nurse. Until this point I was only able to watch as the nurses preformed the observations, but this time I was able to take the patient’s blood pressure, temperature, pulse, blood saturation levels and count their respiration rate myself. I felt extremely privileged to be able to do this as I wasn’t expecting to be allowed to do this sort of thing whilst on my placement, and this skill will aid me in my future career in medicine.

The second most exciting thing was being able to see the joy in the patients faces at the arrival of the local reverend, who comes to the hospital every month to do bible readings, prayers and to sing hymns with the patients. The session is optional, but most of the patients join in. They are able to choose their own hymns and sing along with the reverend to the music of an accordion. From what I observed, this session was particularly enjoyed by the dementia patients who would have grown up in a time where religion was a big part of life. During this short session they are able to forget about their confusion at the modern world and where they are, and reminisce in the memory of their earlier years.

On Friday, the hospital’s longest residing patient was discharged. From my short time here, I was able to see the connection the patient had with the staff and other patients as he was a lovely man who always had a smile on his face. After being in the hospital for such a long time, it came as no surprise that during the days leading up to his discharge he became increasingly anxious about leaving. It was during this time that I realised that this profession isn’t always about the medicine, as the staff spent every available moment with this patient trying to ease his nerves and prepare him for his new life. As the time came for him to leave, there was a gathering where each member of staff on duty said their goodbyes. It was a very touching moment to be involved in, and I knew it would be moments like these that would make the long road to being a doctor worthwhile.

[NikiEdwardsParticipant]

Week 3: 15th-19th August

This week, I learnt a lot about dementia and how it affects not only the patient but friends, relatives and their carers. There are four main types of dementia: Alzheimer’s, vascular dementia, Lewy bodies dementia and fronto-temporal dementia. Each of which effects the brain in different ways and can present different symptoms but the outcome is always the same. Dementia can be extremely distressing to the patient and those around them, especially in the later stages and can lead to the patient needing one to one care around the clock. The majority of patients at the hospital have some form of dementia in different stages, and often these patients are for assessment (where various care homes will assess the patient to determine whether their facilities will be able to cater for the patients individual and complex needs.) I spent a lot of my time this week sitting with a particularly agitated patient trying to calm them down and take their attention away from whatever turmoil is going on inside their head by taking to them about their early life and doing simple puzzles.

I was able to observe a small procedure conducted by the ward sister, where a cannula was inserted into a patient’s hand so an intravenous line could be attached. What would normally be an easy procedure in a younger patient turns out to be quite difficult in an older patient. Due to their age their veins tend to be collapsed which makes it more difficult for nurses to find a suitable vein. If the patient is agitated, the procedure may need to be repeated several times as a slight shift in position could mean that the fluids entering through the IV will not properly enter the blood stream.

Towards the end of the week I was reminded that life in the hospital isn’t always cups of teas and reminiscing with patients. I witnessed an emergency situation first hand which highlighted the necessity for the staff involved to be calm and collected despite the high stress situation. A calm demeanour means that the situation and patient can be assessed critically so every small detail, which may prove deadly if overlooked, is noticed. I realised that in this situation, you need to be able to cope well under pressure whilst maintaining a clear head to make appropriate decisions on the patients care to either save their life or respect their wishes of not being resuscitated.

[NikiEdwardsParticipant]

Week 4: 21st-26th August

The reason why I left it so long was so I could gather my thoughts and experiences to write one final post on the whole of my placement. From the beginning, all of the staff were friendly and more than willing to help me learn. They answered every single one of my questions as thoroughly as possible, despite how busy they were, and spent their free moments telling me about their experiences of working in the profession.

On my first day, I was told that I’d probably only be able to shadow the nurses and doctors, and speak to the patients whilst all the nurses were busy doing personal care. For the first week this was mostly true, but as time progressed I was trusted to do some observations on the patients myself with the guidance of the nurses. I was also able to witness a cannulation, and throughout the procedure the nurse explained every step to me.

During my time at the hospital I witnessed six discharges and four admissions. Each of which came hand in hand with a mountain of paperwork and planning to ensure the patients transfer was as smooth and easy as possible, and to ensure that those being discharged were going to get the care they needed in their new place. Every new admission was subject to a SALT (Speech and Language Therapy) assessment, which determined how well their swallowing action was to ensure they were able to eat solid food and regular fluids. If not, a dietary plan would be made up which detailed the type of food they were able to eat and if their fluids needed to be thickened. I was confused the first time I witnessed this, as it wouldn’t have been something I’d of thought needed to happen.

During my time at the hospital I learnt many valuable skills. The main ones are professionalism, empathy and friendliness. Whilst there, I was able to speak to all of their visiting doctors, which required an air of professionalism for them to take me seriously. Over time, I was able to gain valuable contacts given to me by these doctors to help me further my career, such as the opportunity to work in their GP surgery.

All of the patients were in there for various conditions, but dementia being the most prominent. Sometimes, to ease their thoughts, the best thing to do is just sit down and talk to them about their past. You could really notice the difference in the patient’s demeanour after someone took the time to sit down and chat with them. I realised that when you’re in hospital, all you have is time which can be distressing for some. The nurses always had jobs to do, but during my time there I noticed that every single one of them would make the effort to spend a little bit of time with each patient just talking to them, even if it meant staying after their shift.

This placement showed me that it wasn’t just the medicine and intelligence that made the doctors and nurses outstanding, it was also their interpersonal skills to reassure the patients and help not only their physical, but mental health too. By interacting with patients and staff I not only learnt some basic medicine, but also the personal skills that come hand in hand with it. The experience has made me more determined than ever to pursue a career in medicine, and has showed me that it’s not just grades and intelligence that matter, but also being able to relate and reassure vulnerable patients. My experience here was eye opening and I will always be thankful for this amazing opportunity.

• This reply was modified 9 years, 10 months ago by  NikiEdwards.

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