Turn on thread page Beta
    • Thread Starter
    Offline

    0
    ReputationRep:
    Second week in placement - and stuff is starting to fit together. I'm getting a grasp of how we refer people on and what we recommend for discharge - there are varying options according to how much support they need. This week my CE has got me speaking up in meetings about my patients (that still sounds weird), ringing round people, and apart from supervision, basically behaving as if I have a real caseload. She's still there to check I don't make a mistake,and give me feedback, but basically I'm leading and she's my assistant. Her judgement calls on when to stop pushign a patient are obviously far better, but it's all a great learning experience.

    The week started with poo central - one patient who'd been constipated for a week had been given laxatives shortly before we saw him, and sit to stand practice is a great way to trigger patients off. All part of getting vertical, squeezing the abdominal muscles etc. We didn't get a lot of rehab done! The same day saw another patient fall out of her chair. Unfortunately this can happen - patients can't be supervised constantly, and if they try and do something they could do before a stroke or whatever then accidents will happen. She wasn't my patient, but I was the first on the scene, alerted by the other people in that bay banging on their tables. Everyone rushed in to sort it out, but it was quite shocking at first to find someone lying on the floor.

    The rest of the week was fantastic - one lady discharged, who when I arrived was bedbound but can now manage stairs, plus several others up and walking in the parallel bars for the first time. Progress can be slow, but it's so rewarding when there's even a small sign of improvement. Sometimes relatives come in for practice sessions to encourage their husband/sibling/parent, and you really see then just how much it means to the family.

    The week ended with a creative moment - a patient who'd had a stroke - but was just about up to walking with a rollator frame holding on in the middle with one hand. Only trouble was - he was blind, so could never tell where the middle was. My solution - wrap a piece of tape aroudn his frame in the middle so he has a tactile cue as to where to hold. Result - instead of fumbling for the middle, and sometimes ending up way off, he got there quickly every time, and most importantly a lot safer.
    Offline

    2
    ReputationRep:
    (Original post by iainmacn)
    The same day saw another patient fall out of her chair. Unfortunately this can happen - patients can't be supervised constantly, and if they try and do something they could do before a stroke or whatever then accidents will happen. She wasn't my patient, but I was the first on the scene, alerted by the other people in that bay banging on their tables. Everyone rushed in to sort it out, but it was quite shocking at first to find someone lying on the floor.
    You wait till a patient of yours falls whilst you're doing something with them....thats quite scary. The first time you're a wreck, the seond time onwards its amazing how quickly you seem to bounce into action and know just what to do
    • Thread Starter
    Offline

    0
    ReputationRep:
    Half way in the placement tomorrow - and it's been a real roller coaster. Much more enjoyable than I expected, but tough all the same. I thought outpatients was busy but being on a ward is probably busier, in that you can have someone ask you a question at any time out of the blue, and there's an awful lot of info to take in and remember. This is an area I'm struggling with, and I'm going to try a new way to tackle it by doing myself a summary sheet to refer to. My CE just seems to be able to remember all the key facts about all the patients - I guess with practice I will too, or at least get attuned to which things I need to remember! Wards are less predictible - you can suddenly need to change plan if the medics are seeing a patient, or cope with notes (physio is now mixed in with medical notes) that can get rather chaotic, and different forms can be used for the same info. In many ways the old format where physio notes were spearate sounds like it would have been easier. Anyway - I'm stuck with it!

    There's also lots of little things I can improve on - handling fellow students in the spacious labs is different from handling really wobbly people in a crowded ward, and sometimes the furniture rearranging is like solving on of those puzzles where you slide the numbered squares aroudn to get them in order. Or a Rubik's cube, for those who remember those. My CE does it so smoothly! I guess that's experience though, and I am there to learn. She's very good at asking questions to make me think, so that I work out the solution myself. Sometimes I'll do dumb stuff, like forget to pull curtains when hoisting a patient. A lot of what I need to get better is I guess just "the craft" - polishing my skills so that I don't forget something when there's other things going on (such as the patient wanting to go to the toilet mid-rehab) and so on. Fellow students tend not to do that
    • Thread Starter
    Offline

    0
    ReputationRep:
    Half way assessment/feedback turned out pretty much as expected. I didn't disagree with any of the comments, but I was disappointed with the marks. The CE said that it was because although the past few days I'd been really good, she had to give the mark based on the whole three weeks, and she fully expected the final mark to be much improved, even if I didn't improve on where I'd been in the few days beforehand. I left happy, with plenty of ideas for what to work on.

    Friday saw a visit to the intermediate care team - just to see what they did. This was interesting but in many ways unremarkable - just going to someone's house to see how they were doing, do a little walk with them, etc. All in all quite a slow place of life, and I'm not looking forward to that placement much!

    The start of the next week - and my CE stepped back a bit, giving me more room to organise my patients. While things didn't go disastrously wrong, I struggled a bit, and seemed to clash with the docs etc whenever I wanted to see patients, so all in all it was a bad patch. I had one critical moment when I realised my rehab ideas didn't tie up with the patient's pre-admission baseline, as he could already walk as far as then, so we just needed to work on transfers. Keeping on top of all the patient info was something I'd struggled with - and although I had a summary sheet I carried with me, it didn't have enough info.

    Tuesday I was doing a problem patient session - and hadn't gathered enough info for it, so when wquestionned I struggled. Part of that was because I didn't have enough idea of what was involved - I'd seen one the week before, but that took a more medical tack so didn't need as much social history. Anyway - I felt a bit of an idiot, and generally had a bit of a bad day. In my uni tutor visit, all went okay, but I confessed to be feelign a bit overwhelmed. My CE was fine and just said she'd step back in a bit, just for the odd nudge when I needed it, and not to take over. And she's been true to her word. I'd planned better for today, gathered lots more patient info, and generally got a lot more on top of how things worked. I think I've come out of my bad patch - today I got to see everyone it was possible to see, did some unexpected admin, and still fitted in a training session on falls. PLus I came up with some creative rehab ideas on the spot, and my CE kept sticking her head round the gym door to watch and was grinning, as was the head of department, so I think I was doing good stuff

    Hopefully that's me out of that slump. It's inevitable on a ward that you'll have days where things don't go to plan, and I'm sure I won't always know the answer to everything. Even the band 8 in charge has a super-physio consultant popping in to give her ideas, and she's working with the band 7's too - so everyone helps each other. As much as anything it's me being frustrated at myself - but hey, it's meant to be a learning experience!
    • Thread Starter
    Offline

    0
    ReputationRep:
    A few weeks since I last wrote! Placement's continued to go okay - in fact generally good. My CE has stepped back - but still been involved, and I'm managing my own caseload pretty well. There are still bad days, but generally I'm doing just fine and gettign through most of the stuff fine - but she's there if I need to ask her anything.

    We have weekly MDMs - Multi Disciplinary Meetings, when we plan discharges, update each other on progress, and so on. This is important, as the patient needs to not only be medically fit, but also physio fit and OT fit. If they're going back home then they need to be able to manage - even if not on their own then with the level of support they have. This can be from family or from an intermediate care team (ICT), or various other combinations such as Meals On Wheels, but it all needs to fit together so we feel the patient will be okay. Thus a medically well patient can stay on the ward as we need to rehab them a bit more. Having said that - if they're medically fit, but not physio fit, we might put them into a Bed ICT - which is like a hospital but without so much medical support. The idea is to clear medical beds. Having said that - they do need to fulfil certain criteria, so we have to rehab them to that level. Anyway - my educator had a training day, and basically said she was completely happy leaving me to work indpendently, which was greeat, and also to put our patients forward in the MDM. I'd done this a bit in the past but really had to step up to do this, but all went fine. Another piece of the jigsaw to make the complete physio.

    End of placement review went well - scored a first, although there were things to work on still which I totally agreed with. Working on a ward requires learning a lot quickly, and while I've worked damn hard I still have some way to go.

    Right - I'd better get off here - spent the morning interviewing for prospective students, and now got my portfolio to do - my reflections on what I learnt from placement.
    Offline

    13
    ReputationRep:
    (Original post by iainmacn)
    A few weeks since I last wrote! Placement's continued to go okay - in fact generally good. My CE has stepped back - but still been involved, and I'm managing my own caseload pretty well. There are still bad days, but generally I'm doing just fine and gettign through most of the stuff fine - but she's there if I need to ask her anything.

    We have weekly MDMs - Multi Disciplinary Meetings, when we plan discharges, update each other on progress, and so on. This is important, as the patient needs to not only be medically fit, but also physio fit and OT fit. If they're going back home then they need to be able to manage - even if not on their own then with the level of support they have. This can be from family or from an intermediate care team (ICT), or various other combinations such as Meals On Wheels, but it all needs to fit together so we feel the patient will be okay. Thus a medically well patient can stay on the ward as we need to rehab them a bit more. Having said that - if they're medically fit, but not physio fit, we might put them into a Bed ICT - which is like a hospital but without so much medical support. The idea is to clear medical beds. Having said that - they do need to fulfil certain criteria, so we have to rehab them to that level. Anyway - my educator had a training day, and basically said she was completely happy leaving me to work indpendently, which was greeat, and also to put our patients forward in the MDM. I'd done this a bit in the past but really had to step up to do this, but all went fine. Another piece of the jigsaw to make the complete physio.

    End of placement review went well - scored a first, although there were things to work on still which I totally agreed with. Working on a ward requires learning a lot quickly, and while I've worked damn hard I still have some way to go.

    Right - I'd better get off here - spent the morning interviewing for prospective students, and now got my portfolio to do - my reflections on what I learnt from placement.
    I know it's a long shot, but you don't know when we hear do you??? They said to us by the end of March, and that's tomorrow!! I'm so far on the edge of my seat that I'm about to fall off!
    Good blog btw, very helpful in giving an insight
    Offline

    0
    ReputationRep:
    Well done on the first Iain, brill - send me some of the magic dust will ya!
    • Thread Starter
    Offline

    0
    ReputationRep:
    Thanks Cassius - good luck with it

    DJK - I don't have any inside knowledge, AFAIK it's within two weeks, although some people have said they've heard via UCAS track earlier. My impression is that there's several interview days over the next couple of weeks, so Lynda is a bit busy adn so you might have to wait most of the two weeks. Do check though!

    When's your interview?
    Offline

    9
    ReputationRep:
    Good to chat to you again (briefly) today Ian. DJK, lynda told us during the morning that we will not be hearing whether we have been accepted/rejected until 15th April at the earliest as she is off for Easter holidays. I will join you in the nervous checking of UCAS every day for the next fortnight then :-)
    • Thread Starter
    Offline

    0
    ReputationRep:
    Hope it went well Mike - we had some good applicants today. This year there's been more good people than last year - so I think getting in is going to need a better performance than last year. Doesn't mean you didn't though of course, I know we decided to accept quite few today, I just don't know who they were, other than the ones in my room.

    ANyone else at interview today?
    Offline

    9
    ReputationRep:
    I was happy with how it went, but you just never know with interviews. I did my best, so whatever will be will be. Hope I was one of the ones accepted - was impressed with the setup.
    Offline

    9
    ReputationRep:
    Just by means of an update - UCAS just got updated and I got into St Georges :-)
    Offline

    2
    ReputationRep:
    (Original post by Ironmike)
    Just by means of an update - UCAS just got updated and I got into St Georges :-)
    congrats - best uni for Physio although I am slightly biased lol
    • Thread Starter
    Offline

    0
    ReputationRep:
    Right - back to the blog. There's been very little ler up. We had three weeks scheduled holiday, but I spent most of that working, as did many. First week was spent getting my portfolio up to scratch (hopefully). I do think the portfolio is useful, but the format is pretty strict and it takes a lot of rather tedious donkey work to get it right. I got mine in with half an hour to spare, then went for a coffee to chill out - and it was rather amusing in a not gloaty way watchign everyone move past the coffee shop outside towards the hand in point at ever increasing speeds and ever increasing looks of panic as the 4pm deadline approached. I think everyone got it in, and we then hit the pub - for a well earned few beers and daft banter.

    That was the first week of the holiday done - I know I could have done portfolio while on placement but tbh I got home tired pretty much every night and wanted to do some reading up. I took the next week off completely, then got stuck into my neuro group presentation and annotated bibliography. Ann. Bib, as it became known, is rather a clever assignemnt in that you have to pick five journal articles, critique them, and then summarise them and build an argument to answer a question, which is basically part of what you do in the final year research project. It's tricky to find the irght literature, as even seemingly broad topics get cut down quite quickly once you try to get the same outcome measures, get reliable studies without major design flaws, etc etc. I intermingled that with neuro presentation. We'd met before the break to divvy up the work and had a topic each, or rather the group had a topic (use of aerobic exercise in neuro rehab) and my pathology was MS.

    One week back - and everyone's been so busy finishing off annbib that we've done very little on neuro, and one member of the group has been off sick too. Anyway - we've got a couple of days off - i.e. no timetabled classes, so we're meeting up then to pull the whole thing together. It's got great potential to be good I think.

    We've had classes this week - mainly musculoskeletal which I love - interesting stuff on the sacro-iliac joint, MWM's and taping which was great fun until you tried to peel the damn stuff off! Ow!

    We've also got a respiratory exam coming up - we've got four topics to read up about and piece together stuff to use in potential essays. Whiel we've got is a broad topic and then the question could ask about one area within that. The entire mark for the module counts on that, so I want to do well. Should be interesting too. Having the weekend off to see a friend and watch the marathon - this year has been one hell of a slog without a huge amoutn of time out - so this weekend I'm having it
    Offline

    2
    ReputationRep:
    (Original post by iainmacn)
    We've had classes this week - mainly musculoskeletal which I love - interesting stuff on the sacro-iliac joint, MWM's and taping which was great fun until you tried to peel the damn stuff off! Ow!
    Count yourself lucky - our session on the SIJ was cancelled for some reason and never rearranged. Only for us to be to "don't worry, you'll learn it as a junior" lol

    Cue my first outpatients pt as a junior being a 28wk pregnant lady with pelvic girdle pain..................good times lol
    • Thread Starter
    Offline

    0
    ReputationRep:
    Right - well this week we have mostly been poring over journals looking at stuff for our respiratory exam. We get four toipics that we have to research, and be prepared to quote literature on them. It's actually really interesting taking the stuff from the framework lectures we were given, and looking into it further, and finding other relevant papers. My biggest fear is beign able to remember all those facts and figures, and not get papers mixed up. Had a very useful session with one of the resp tutors, who also happened to mark the neuro (she worked at the National Neuro hospital and did resp as well as neuro rehab there, so she knows both areas very well).

    I hadn't realised that the neuro marks were out, but she congratulated me on doing a really good job, so I went and looked - and I got 80/100 Very pleased with that! I'm sure my teachign background helped, but she said the content was exceptionally good for all my group. I'd thought we'd done a good job, but I was particularly pleased with that - so happy days!

    Busy drawing mind maps for the resp - the topics all interlink so while that means less work, it also makes it all the more potetnially confusing! The neuro mark has brought my average up into first territory, but the resp module mark is totally dependent on this exam - so I really don't want to stuff it all up and score 45% on it or something! Jackie's been great and given me a few tips as well, which is great

    Weird seeing the first years around preparing for their exams. Amazing to think that that was us only a year ago - we've come so far in a year! Odd too to think that there's only a year until we start applyign for jobs, and that three months of that will be spent on summer hols. We start placement ten days from now, and if ther rumoured change of another placement straight after we get back is true too - we won't be back until mid October - meaning a lot of the next six months we won't be learnign stuff at George's - we'll either be on a break or on placement.

    Eeek! :woo:
    • Thread Starter
    Offline

    0
    ReputationRep:
    morning spent looking up journal articles, during which time I happened upon a paper which explains why Rolf Harris doesn't snore (allegedly):

    "Didgeridoo playing as alternative treatment for obstructive sleep apnoea syndrome: randomised controlled trial"

    Now this wasn't the paper I wanted, I wanted another one on pulmonary rehab and breathing exercises by the same author, but it did make me laugh. Being serious I guess it would mean you learnt better control of breathing, possibly got some positive end pressure or something similar? More research is needed! Could similar effects be achieved with the more manageable recorder perhaps? My PhD research topic is taking shape!

    Just been in for a hydrotherapy session. The timign was a wee bit irritating, but it obvioulsy has to be squeezed in around classes for the physio staff who normally use the hydro pool and things. Really fascinating how water could be used both as support and to make exercises easier, or as resistance, and with a bit of creative thinking and various gadgets such as flippers, swim gloves and floats, you could do exercises in all sorts of fun positions to achieve lots of differents effects. It's one benefit of George's uni being part of the hospital, as we get easy access to stuff such as that, and I suspect a lot of courses don't.
    • Thread Starter
    Offline

    0
    ReputationRep:
    Resp exam done - and while one section was great, the other was a *****! There was a question on pulmonary rehab, which I'd revised, and one on physio post thoracic surgery, which I had only skimped over. SO what's the problem? Pulmonary rehab was on non-COPD patients - and COPD patients make up the bulk of the pumponary rehab people, as well as the bulk of the literature. WHile I had a few articles in my head I could use, the majority was for COPD. I decided this was a better option then the surgery, and tried to argue that much of the COPD literature would apply, and also used some of the breathing techniques that I hadn't used (it was a separate topic in itself). Fingers crossed!

    Now onto placement - and I've done well with my CE again - we seem to get on great, really feel like it's a good working relationship that'll be productive. I've got community this time - which has a reputation for being slow, but I get a really good mix as we do visits to people's houses, some assessment in A+E, and also some neuro rehab at a local nursing home. It's a tough mixture to do as there'ss so many different paperwork systems and I keep getting them confused. Getting some fabulous experience though and relaly enjoying it.

    The thord year's have just handed in their final piece of work - hard to believe that in a year that'll be me! The course has flown by
    • Thread Starter
    Offline

    0
    ReputationRep:
    oops - once again it's been way too long since I've posted - I said when I saw Jackie's posts drop off that I wouldn't do that, but I've just been sooooo busy! I passed the exam and the accompanying essay thing on musculoskeletal literature, both with decent grades.

    Placement went well - continued to love the variety but found it all a bit tough, and in A&E in particular (the falls assessment bit) I struggled with the more complex cases. I could get the answers when prompted, but still needed the prompting. My educator told me to have more confidence, as I got it right a lot of the time, but why would I be confident when I honestly wasn't sure. Maybe I'm just a bit too honest - I'm not that comfortable with pretending I know when I don't, I'd rather say that I'm not 100% sure but I think...... Just seems more honest.

    Final mark was okay - a highish 2:1. Not the first I was hoping for as the placement seemed to follow on nicely from the previous one, but then again it didn't as much as I'd expected. I think it's partly learning what educators want, plus some of them I think expect rather a lot for a second year, and in spite of loads of positive comments - really praising me madly, I was still only given 73%. I did ask what I'd have to do to get the other 27% as this was a quarter of the marks, only to be told to get 80% I'd have to be absolutely outstanding - does make you wonder what standard was expected. The other sections were fair enough, there were some things I never quite got to grips with, and I could still freeze when there was a lot of different stuff to take in at once.

    End of term - and back for a de-brief day. Some stuff on next year's assessments, and the next placement, which is now just after we get back rather than six weeks in. We're judged to a higher standard too, and the thought that I have a resp placement to come and will be judged from early on, when as yet I don't have much resp experience is worrying. I do wonder if it wouldn't have been better to have resp this year, and then have the more general stuff in the third year. Still - it's pot luck, and I have some useful neuro in the bag that should help with the neuro placement. There's a lot of group assessments, which worries me. So far I've done well with the groups, but I could get one where the people aren't after top marks and so don't work as well. We'll see.

    The day ended with a big booze-up at a local Vodka Revs, and walking home at 5 in the morning. My head was somewhat fuzzy the next day.
    Offline

    13
    ReputationRep:
    thanks so much Iainmach for sharing this with us all.I do like to read your thread and see how you coping on your physiotherapy degree.I am giving some serious consideration at this moment to applying to St Georges next year myself as i heard such good reviews about it:yep:
 
 
 
Reply
Submit reply
Turn on thread page Beta
Updated: July 9, 2009

University open days

  • University of Bradford
    All faculties Undergraduate
    Wed, 21 Nov '18
  • Buckinghamshire New University
    All Faculties Postgraduate
    Wed, 21 Nov '18
  • Heriot-Watt University
    All Schools Postgraduate
    Wed, 21 Nov '18
Poll
Black Friday: Yay or Nay?

The Student Room, Get Revising and Marked by Teachers are trading names of The Student Room Group Ltd.

Register Number: 04666380 (England and Wales), VAT No. 806 8067 22 Registered Office: International House, Queens Road, Brighton, BN1 3XE

Write a reply...
Reply
Hide
Reputation gems: You get these gems as you gain rep from other members for making good contributions and giving helpful advice.