Wow! Another 5 weeks already!
This prac has probably been the most difficult prac to get ‘into the swing of things’. Whether or not this was due to my sickness during weeks 2 and 3 or if every student finds neurosurgery hard to get their head around in the first couple of weeks, I don’t know. It was only after my head cleared from the virus at the beginning of week 4 that I really started enjoying this prac and everything started to smooth out. By the end of this prac though, I can honestly say I really had a great time in neurosurgery! It was a lot different than I imagined 5 weeks ago.
Dealing with patients in this acute state was a bit daunting – especially those whose GCS wasn’t 15/15. However, I found the most rewarding and inspiring cases to my physio career so far – getting people to move again. One specific case was working with a patient who had a very complicated SAH and various failed surgeries to deal with it. When I first met her, she had no movement anywhere, had a trachy insitu and struggled to keep eyes open during treatment let alone actively participate. By the end of this prac we were in the process of weaning her off her trachy, she had active movement in the right upper and lower limbs, I had heard her voice through a speaking valve and we were planning to decannulate her on Monday. This may seem not much to some people, especially coming from a musculoskeletal placement, but seeing the little yet functional improvement and joy in the patient’s eyes really made me appreciate my work as a physio.
Dealing with patient’s co-morbidities were slightly more complex than any other placement I have been on as with the risk of vasospasm and other acute surgical issues, we had to tread carefully around some patients and outright not see them for the first few days until they had the all clear.
Communication was something I worked on a great deal as I was presented with a couple of dysphasic patients. Using tactics from each case I dealt with helped me from getting frustrated with the inability to communicate properly.
Working within a multidisciplinary team again was lovely! Let me just say I have a new appreciation for speech therapists with this whole trachy business! During this prac, I was able to observe one of the SP work with one of my patients and I found out that they’re not only about correcting a stutter or lisp!
Another one of my concerns was my assessment abilities but after going over it with my tutor, supervisor and also practicing it on various patients I think I am confident with my technique and timing! – this was a personal goal for myself and every placement I’ve been on this year.
Working in this big tertiary hospital was a bit scary and I felt so lost so many times! Also as the hospital was so big and there were so many physios and students I never felt at home there like I have in other placements. This is what I expected anyway but I do prefer smaller hospitals and the ‘closeness’ of it all.
My tutor was possibly the most useful person in the last 5 weeks! I got so much out of her and the techniques I learnt I will be putting into practice forever! Although this placement and my tutor was very Bobath purest and this was slightly frustrating as at uni we have been taught if they can do the movement with compensatory techniques then let them do it! Unlike the Bobath theory where they have to be able to perform the movement with perfect technique before being allowed to do the task.
I learnt a great deal from this placement and wish I could’ve spent another few weeks there just to fine tune everything. It’s a shame it took until week 4 to really get into the prac but I’ve had amazing experiences here which have made me appreciate our profession a lot more! Suctioning a patient was a highlight of this placement and I look forward to using this technique a lot more in my cardio placement next!
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