Sunday, 25 July 2010

Stroke week

Week 5 of my 12-week placement was supposed to be Stroke Week with an emphasis on Peer-Assisted Learning. Except it didn't work out entirely as planned, for two reasons: my peer was off sick on Monday, and on Wednesday we didn't do anything about stroke. The other issue was that all of the dietitians qualified to work on the wards were away on Thursday and Friday except for the one who was supposed to supervise us students, making her job a completely impossible one.

On Monday, then, instead of working with my peer I went off to some other (non-stroke) wards to see new patients. I have started, very carefully, to be allowed to talk to the patient and ward staff. It is more difficult than it sounds, believe me, and almost harder than writing in the dietetic and clinical records.

I so much prefer the controlled atmosphere of an outpatient or community consultation, where the absolute maximum amount of distraction might be from one or two family members. There is so much going on in the wards, I can hardly think straight. Part of the difficulty lies in continually switching between wards and patients so that there is no continuity or familiarity - when I am ultimately given more responsibility, I should be able to get a bit of routine into the work, which should make it all easier and less stressful.

Alongside the practical experience there are some 'tutorials' which take the form of worksheets covering the specialist area of the week. In the stroke tutorial, apart from revising some aspects of stroke incidence and care, we had to invent a 'feed regimen' for someone who initially needed to be fed through a tube, and then moved on to start eating again. It was a lot harder than it looked, but we both came up with something that wasn't too bad.

Because of the structure of the training this week, and the shortage of staff, J and I have spent a lot of the week together on the stroke ward. We observed some of the work that the physiotherapists do to help people become more mobile following a stroke, at breakfast time and in the 'gym'. We watched a couple of swallowing assessments with a Speech and Language Therapist (SALT), which was fascinating. SALTs seem to have two quite distinct areas of specialism, communication and swallowing, but they are clearly related by the requirement for coordination of brain impulses, tongue and oesophageal muscle control.

On Thursday and Friday we started this Peer-Assisted Learning thing in earnest. It involved going through a dietetic record card and clinical records for both new and existing patients, then writing our hypothetical entries in the records. We didn't do too badly, but it brought home how much we still have to learn. Quite a lot of the proposed treatment plan has to be based on experience, which we obviously don't have yet. It's getting better with practice, though.

1 comment:

aims said...

You continue to amaze me and you always spark an interest in what you are learning and doing.

Keep it up Lola. I am one proud follower of Lola life.