Week 2 Year 2

November 2nd, 2008

Journal

This week on placement I have had a few challenging situations, which I feel I have benefited from. I had a patient who suffers from tremors, so obtaining a good lumbar spine view was more difficult but ultimately successful. However the account I would like to reflect on is my experience with a nine year old patient who had Cerebral palsy. The patient arrived from the orthopaedics clinic with his lower leg in plaster, for a review on a fractured tibia and fibula, querying positioning and alignment of the fracture.

After speaking with his parents and explaining I was a second year student, I asked if they would be happy for me to perform the examination. After being given consent from the little boyâ€™s mother I then explained to her what I
needed to do. The situation was difficult due to the patient being frightened, and strong. His parents had adapted his push chair due to his lower leg being in plaster, and had used a sledge jammed in the chair so their son could sit comfortably. I decided to perform the projections with him sitting in his chair as he was very anxious due to his surroundings and all the new people around him. Once all the appropriate checks were done, i.e. name, address and date of birth, I managed to reassure him as much as possible by spending a bit of time speaking to him and letting him hold my hand, as well as, allowing him touch the cassette to reassure him it wasnâ€™t going to hurt him. This benefited the situation as it calmed his anxiety and he didnâ€™t seem to be as frightened. His mother had to stay with him during the procedures as he kept trying to push the cassettes away, but I was able to get two very good images, with all the detail needed. Although this was not a trauma I had to obtain the lateral projection using a horizontal beam. This situation was a great experience as I had to keep calm in a difficult situation and think outside the box due to the patientâ€™s circumstances.

Reflection

I feel I managed to cope with these situation well. I do feel it was due to being comfortable in my surroundings, due to
working in the department thoughout the summer.

I’m not sure if I would be able to cope so well if I were to be in new or strange surroundings.

I would like to think I would be able to cope in any situation where ever I am, but I have learnt very quickly things are not always that easy.

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Theatre Year 2

October 24th, 2008

Journal

This week on placement I have had a few challenging situations, which I feel I have benefited from. I had a patient who suffers from tremors, so obtaining a good lumbar spine view was more difficult but ultimately successful. However the account I would like to reflect on is my experience with a nine year old patient who had Cerebral palsy. The patient
arrived from the orthopaedics clinic with his lower leg in plaster, for a review on a fractured tibia and fibula, querying positioning and alignment of the fracture.

After speaking with his parents and explaining I was a second year student, I asked if they would be happy for me to perform the examination. After being given consent from the little boyâ€™s mother I then explained to her what I needed to do. The situation was difficult due to the patient being frightened, and strong. His parents had adapted his push chair due to his lower leg being in plaster, and had used a sledge jammed in the chair so their son could sit comfortably. I decided to perform the projections with him sitting in his chair as he was very anxious due to his surroundings and all the new people around him. Once all the appropriate checks were done, i.e. name, address and date of birth, I managed to reassure him as much as possible by spending a bit of time speaking to him and letting him hold my hand, as well as, allowing him touch the cassette to reassure him it wasnâ€™t going to hurt him. This benefited the situation as it calmed his anxiety and he didnâ€™t seem to be as frightened. His mother had to stay with him during the procedures as he kept trying to push the cassettes away, but I was able to get two very good images, with all the detail needed. Although this was not a trauma I had to obtain the lateral projection using a horizontal beam. This situation was a great experience as I had to keep calm in a difficult situation and think outside the box due to the patientâ€™s circumstances.

Reflection

This was a great learning curve for me. Learning not to always judge thing without having any experince. I now know its better to try something and then learn from the experience.

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Week 1 Year 2

October 24th, 2008

Journal

Osteomyelitis

On placement today, I assisted with a patient with severe ostepmyelitis. The patient had previously had his left leg amputated. The patient’s consultant had requested AP and Lateral from knee to foot.

Reflection

I found this a difficult situation, the patient was in extreme pain, with his leg in dressing. The patient was a lovely man, fully aware of the situation and under the circustances, very pleasant and co oprative. Manoeuvring this patient for the exposures we needed was extremely difficult, but it was beneficial for making you think outside the box, to enable you to get the best diagnostic images, without any unnecessary pain for the patient.

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Bank Assistant 08

June 9th, 2008

Working as a Bank Assistant

I have been working as an assistant at the ultrasound clinic with Dr Reid. Observing and assisting with patients who are attending for various clinical investigations.
Listing from, Thyroid investigation, Kidney, uthera and bladder, Liver.
He explains and points out the bile ducts, portal vein and arteries, explains the direction of the beam through the skin, and what is actually being seen. Subcutaneous fat and the colour differences within the tissues. He explained that some peoples liver shows up bright on the ultrasound due to high levels of fatty tissue, where as normally it should show up really dark. The degree of darkness varies as the outline of the kidneys show darker than the centre.

Reflection

I love these clinics, learn something new nearly every week, and enjoy meeting the different patients and finding out about why they have been refered.
Dr Reid makes these clinics enjoyable as well as adding some humor as he has different expressions for different body parts,
ie, gall bladder – tad pole
pancreas – guppy

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