My problem with the ward

I'm a mature student, 25 with currently pursuing Graduate Medicine. Whilst I have a strong clinical background with current work experience (community) as a HCA, and a number of years with patient contact, I have a particular fear of the ward environment. In particular, it's the sort of patients who despise the medical students that want to 'bother' the patient to reveal their history (again), or part-take in an abdominal examination. Most patients might be aware that a hospital is a teaching one, but I don't think that makes much of a difference to their cooperation with students.

Has anyone ever been shouted at, or been told to piss-off when approaching a poorly patient on an acute ward? ~~And as a result of the embarrassment, proceed to soil ones undergarments and reconsider the whole medicine thing as a career?~~

I admit that I may have a confidence issue (hopefully not one of incompetence), but I have heard a number of stories from the patients I work with and I've come to realise what 'bothersome little pests' some medical students are.

(And whilst this won't deter me from my application, it's always encouraging to work with patients that appreciate the learning caring/environment)

Reply 1

shiggydiggy

This is only ever really an issue when:

A. The patient is acutely unwell and your Hx/Ex won't add anything.
B. The patient has interesting signs and medical students come running in hordes.
C. You have poor bedside skills or the patient is grumpy regardless of what happens.

In my experience though, most patients are glad for the attention. Being an inpatient is boring as hell and it's nice having someone take an interest in you. I can only think of one or two instances when I've been turned away. I've certainly not had anyone tell me to piss off.

Reply 2

Democracy

Original post by J1mmy

Christ - I've never experienced anything like this. The patients I've spoken to so far have always been very keen to chat...a few of them have told me that it breaks up the monotony of being in bed all day, and I can see why.

I think on two occasions patients have requested that I not be present during a clinic appointment, but I've certainly never been shouted at by a patient :s-smilie:

I think as a student it's always worth asking the F1 or SHO which patients are good to talk to. Certainly you can have a go at talking to/examining random patients, but then you run the risk of talking to someone who doesn't particularly feel like chatting or who doesn't give a good history.

Reply 3

La_Chiquita

Original post by J1mmy

I'm not a med student, I'm a nurse, but I had the same kind of dilemma when I was a student nurse and I work around med students a lot. I've never experienced any negative reaction, most patients will say ''well, they've got to learn haven't they?''. In fact the only bad experience I've had was as a third year student with an F2. He ran over to me for help as an obese hyperventilating semi-mobile lady had somehow managed to half slide out of bed (over side rails) and was just kind of stuck there. I went over with the Dr and another student and we were all told to go away because ''we were just kids'' and to ''go and get a real doctor/nurse/an adult''. Once we'd sorted the patient out and she was back in bed breathing normally however she did apologize.

Overall the public are amazingly tolerant of students. They all seem to accept that people have to learn and I never, ever in three years was refused and never heard of a med student being refused either. Sometimes I have wished the patient would decline...for example when carrying out smear tests :-s doing icky dressings or (on my maternity placement) delivering a baby ( looooong story).

My only advice would be....to be fair to patients...get whoever is supervising you to ask the patient's consent well away from you out of earshot, so the patient feels under no obligation to agree to you examining them. Then be friendly, polite, introduce yourself thoroughly and try to appear confident, even if you're not. Confidence is key in medicine. The patient needs to feel safe and secure. Be like a duck....calm and serene on the surface water, paddling like crazy underneath the water. You'd be surprised how many medical students I've seen that are sullen, don't formally introduce themselves to patients, and talk to whoever is with them and not to the patient. Be friendly, explain that you've studied for X amount of years and are out in practice now you've had X amount of training and are quite competent in what you're doing. And please practice taking blood or citing a cannula before you torture some poor dehydrated elderly patient with no veins :-p

Bottom line - you will be fine.

(edited 9 years ago)

Reply 4

J1mmy

Thanks for the comments. I think they've dampened my fears for now.

Reply 5

Quilverine

From the other side of the fence, I have been an inpatient and the boredom is brutal. Practice on people that look like they could use some company! I was a student at the time and had to get patient consents for my portfolio so felt like I should help out fellow students but I think many patients who are suffering a lack of visitors would welcome the interaction.

Reply 6

J1mmy

Is it a bad idea to wake up sleeping patients (in the day) if someone suggests they might be a good case?

Reply 7

shiggydiggy

Original post by J1mmy

Is it a bad idea to wake up sleeping patients (in the day) if someone suggests they might be a good case?

Ask the nurses.

If they've been in pain and haven't been able to sleep in the last 48hrs - probably not so much.

Reply 8

QuestionableSam

The posters before have all given sound advice.

I just want to know how the hell you've avoided being shouted at or sworn at for so long? I've volunteered as ward volunteer at my local hospital and for various different charities for a couple of years now and I've lost track of how many times I've been sworn at or had food thrown at me. What's your secret?!

Reply 9

KimbyJayne

Original post by QuestionableSam

Step 1 - don't work with people with dementia.
Not sure if you do or not, but my experience as a HCA is that if someone will throw food you can almost guarantee that it will be someone with Dementia.
Definitely not saying that all people with dementia do however!!

Reply 10

opalescent

I have worked as a HCA in a dementia ward, an older adults' mental health ward (for functional mental health conditions such as bipolar disorder, not dementia), and an acute mental health admissions ward. I have been sworn at, bitten, and had things thrown at me a few times. In most cases I didn't take it personally. The dementia patients I worked with were living in an environment that was totally unsuitable (the ward was chronically understaffed and patients basically sat around with no meaningful activities, which sent their anxiety through the roof). I knew that they were also experiencing psychotic symptoms and having memory problems that made the whole experience very frightening and confusing for them. In that situation anyone would probably throw things, especially if they lack the speech to say what's wrong. I actually really enjoyed working on that ward - as a HCA I had the chance for more 1:1 contact with patients than a lot of nurses and doctors, and it was good to start building up relationships with people and trying to figure out what might trigger an outburst so that I could react in the most helpful way. It is challenging but try to remember that being unwell is not a pleasant experience and any aggressive behaviour probably says more about the illness than it does about you, or the patient.