Thursday 27 April 2017

A typical Paeds day...

So on paediatric respiratory, like many areas of physio, our days have a specific structure. 

Our shifts start at 08:30 and finish at 18:15. We have a late shift that runs from 10:15-20:00.

At 0830 we split up and get handover, some of us will go up to the wards, check the patient list and then check with the nurses to see if anyone needs respiratory physio, and to get an update on any of our current patients. Others will go round each bed space on Paediatric intensive care (PICU) and ask about each patient to see if they need physio.

Let's pause here; for those of you who don't know physiotherapists don't just deal with bad backs! I turned up to a patient the other day who had a large volume of secretions and needed assistance clearing them, one of the parents asked me if I could assess their back whilst I was there, unfortunately I didn't have a plinth so I couldn't. But they were amazed that physiotherapy could help children clear phlegm from their lungs!

So back to the day! 

We then all meet together for handover and discuss all our patients and decide who is going to see them, this all takes about 45 minutes as we cover about 100 patients in total! 

Then we treat patients until about 12:30 which is lunch time and we aim to see all the patients once by then. After lunch we treat patients until the end of the day. We also get time for teaching and if a day is particularly quiet we get to do joint treatments with senior members of staff. 

Joint treatments are great because you can test your clinical reasoning talk it through with a senior and they can educate you in what to do better. I really enjoy working with them because they are all so knowledgable and all love sharing their knowledge. 

Our days can range from being really busy (7 patients each) to quite quiet (3-4 patients each +doubles) both days are great because you learn a lot on both types of days and they keep you on your toes. 

I have been here for approximately 2 months now and I can safely say that if I was to stay here for 20 years I would never stop learning! 

 I treated a patient today, they were very excited for physio and I spent about 5 minutes pushing them around the ward in a toy wooden cart, they were laughing a lot.....but it made them cough, treatment successful. 

Liam



Monday 24 April 2017

On-Call

So I have started my On-calls!

At the trust I am working at we have separate Rota's. As my current rotation is within paediatrics I am on the paediatric on-call rota. I only see paediatric patients and it's great because I know all the patients I could potentially see! This makes my on calls much less stressful and gives me a really nice start to on call life.

I actually don't mind on-calls, a lot of people I have spoken to have always disliked on-calls because you don't get an evening and you could be knackered the next day. For me, as we get a room to stay in, it means a much shorter commute, and I have been lucky and not had many call outs so I'm not that tired!

For my first on-call I was actually quite excited, I was someone who could be useful in the hospital. I start at 20:00 and I got called at 20:06, Started with a BANG! we had a new retrieval so I didn't know the patient and I was treating on and off until 00:00. First off I had to assess, they were an intubated asthmatic, the tube then had to be moved lower down because it was too high, then I did some standard chest clearing using manual techniques and Saline. Then I had to help instil a medication called DNAse (I didn't put it in, but it has a low dispersal factor so we have to shake it up and move it about for it to work) you then leave it for half and hour and it breaks down all the DNA in the secretions to make them looser and easier to clear out. I then came back cleared it all and wrote my notes. 

It was a long process.

But if I hadn't done all that the pH of their blood could dramatically change and they could have become very unwell, and I helped stop that. 

I then went back to my room and slept on and off for 7 and half hours, I woke up feeling refreshed and ready to go for the next day (I was working a long day).

How to summarise on-call....you are there to help change a situation, as a physiotherapist you can make a huge difference or sometimes you just can't, but you tried. 

Liam


Sunday 23 April 2017

Paediatrics

So I rotated at the end of February and have been rubbish at posting.

I have started on a paediatric respiratory rotation and I am absolutely loving it! It was my favorite placement as a student so I was concerned that I was getting overexcited but no, paediatric intensive care is where I want to be! 

More on paediatrics another time.

This was my first experience of seven day working. So I work 08:30 in the morning to 6:15 . It works really well for the patients and looking at our contact data we have reduced on-call call outs considerably, so that's good! I am enjoying seven day working, I have a 1 hour 30 minute commute so on 7 day working I work less days which means less commuting and more days off! The difficulty is my days off can be at any point in the week, so working at rugby and getting into a routine is more difficult. But I still prefer it to 9-5 mon - fri, and it makes a big difference to the patients! 

So far I am loving being a band 5 and I am really excited about the variety of areas I can work in. I'm really lucky that I am in a teaching hospital and have some amazing and knowledgable clinicians above me who take time to teach me. At the beginning of this rotation I had 3 weeks of training to prepare me for on-call. This made me confident in treating patients and allowed me to settle in well. 

More soon. 

Hopefully.

Liam