Hello,
A week into my general medicine attachment, I've trailed round after a fair number of ward rounds and yesterday we had our first "take" of the year. All the general medicine firms of doctors take turns admitting new patients on-take in the Medical Addmissions Unit. Take is a great opportunity for us to clerk patients (take their history and examine them) because, provided a doctor has confirmed that they're well enough, we can be the first to see them and come to our own conclusions about what's wrong and what can be done. We're supposed to clerk 30 patients in the 6 week attachement, some on-take and some of which can be re-clerking patients already seen on the wards. It's suprisingly difficult to find patients on the wards to clerk, in a hospital full if them, because they have to be being looked after by our firm, be awake, not have visitors/nurses/occupational therapists/physios with them, not be so ill or demented that it's impossible to talk to them, and agree to being seen by a medical student. Take is therefore a great opportunity to top up the number of patients we've clerked.
We were on Day Take yesterday, seeing all the patients referred by GPs of coming through A&E between 8.30am and 4.30pm. Unfortunately they all came in a rush in the afternoon, which meant that I only got to clerk one (although I also got to watch a doctor clerking a man with catatonic depression, which was interesting). After clerking a patient, you have to present them to the consultant on a post-take ward round - telling him all the important points you've found and your analysis of the situation. Since consultants are supposed to be scary and critical (although all the ones I've come across have been perfectly civil and generally fairly indifferent to students) and so that the ward round goes quickly and smoothly, we can practise presenting our patients first to a senior house officer or registrar, during the take.
After we saw all our newly-admitted patients and looked at their X-ray and other investigations with the consultant, we went to the doctors mess to discuss their management, and then were finished by 8. This morning we have another consultant ward round, where we'll see the same patients plus those who were already under our firm.
A little added excitement yesterday was a cardiac arrest call, which it was my firms responsibility to respond to because they had the arrest bleep. It was actually a false alarm, with a patient collapsing after a gastrointestinal bleed but not actually arresting, so he was just topped up with blood and clotting factors. Running up from the medical admissions unit to general medicine on level 7 made a refreshing change from standing around waiting for patients to clerk though!