I Do Sometimes Go To Work.

Ardnamurchan From Ganavan

Lest I create the impression that all I ever do is ride my bike or go walking, I felt I should probably write a bit about the job at Oban and why it is a good for a GPST1 year.

 I did my foundation jobs in the two enormo-hospitals in Sheffield, Englandshire.  As a result, my exposure to lots of really common medical and surgical presentations was limited to what I saw when carrying an out of hours on-call bleep.  I have therefore, prescribed IV fluids and chased serum rhubarb for patients with everything from epistaxis to epididymitis, without learning much about the management of these conditions. 

Happily for me, the relatively small number of patients and the non-specialist nature of care at Oban means things are very different here.  In my first six months, I had really good start-to-finish exposure to all the commonly presenting medical conditions and I am finding the same, now that I have moved over to surgery (or the dark side as the medical nurses refer to it). 

The same is true of my experience in A+E.  I have never done an A+E job before, so I am finding the smattering of A+E that you do whilst on call here a great experience.  It presents situations where I don't have a clue what I am doing (otherwise known as learning opportunities) every day.  This has really brought my knowledge and confidence on.  This is also true with very unwell patients in A+E.  Out of hours, for at least a short while, when a sick patient comes in, you are it.  When I have called consultants in at night (which has NEVER been a problem),  I have never been pushed out, rather I have supported and guided through management of the unwell patient.  It is rather like being thrown in at the deep end, but with a good lifeguard on the poolside. 

I made a film last year about training here, in which some of the consultants and juniors talk about why they think this is a good place to train.  Have a look.  It's a bit long, but I hope it gets the message over that if you are looking to get a very broad base of exposure and some experience of being under pressure, then you could do a lot worse than Oban.

MAMIL sighting on Mull

Hello and sorry it's been a while since I last posted anything.  Just got back from an excellent weekend off cycling.  The first whiff of spring has brought everything back to life and there have been sightings of a rare mamil on the Isle of Mull.  For those who do not know, mamil is not a spelling mistake but an acronym, standing for 'middle aged man in lycra'.  Rather than tell you how lovely it was, I have made a little film for you to look at.  Tried to upload it directly to the blog but it didn't like it so here's a youtube link to it.  Bye for now, 

Mike.

 

 

Dog Bites and Nurse Practitioners.

Was awoken from my post night shift unconsciousness (I won't call it sleep) by my wife Janet this morning, as she had been bitten by a small, terrier whilst out running.  Although it would be very fitting if it had been a West Highland, but the description sounded more like one of those yappy brillo pad type dogs who's name I can't remember.  Happily, beneath the fairly alarming streak of dried blood lay only a very minor wound.  Unpleasant though this incident was for her, it gave me an opportunity to do two things; firstly to breach patient confidentiality without being sued (she knows I have no money), and secondly to talk a bit about nurse practitioners and how indispensable they are to the workings of the hospital here at Oban.

Janet's Leg; after dressing.

West Highland terrier; not guilty.

I wondered about her tetanus status as she had her last booster over three years ago after another running mishap.  Living 30 seconds from A+E does occasionally have its benefits and I suggested we go over and get a more informed opinion on the matter.  On arrival, Jenny one of the ENPs was on hand.  Whilst cleaning and dressing the wound, she reminded me that 5 tetanus toxoid injections are regarded as giving lifelong cover and additional cover would only be required for highly contaminated or devitalised wounds. " Of course", I said, "how could I forget". 

Perhaps because I have mostly been in big city settings prior to moving to Highland Region I have never worked in a hospital which was so reliant on nurse practitioners to run the show.  As a new junior here, the nurse practitioners in A+E keep you on the right track.  Never having done an A+E job before, I find that they are way more knowledgeable than I, especially on things like minor trauma.  I used to think I didn't like nurses telling me what to do, but now I have discovered that I love it.

There is also a ward based advanced nurse practitioner on every shift.  In addition to participating in ward rounds, helping with admissions, coordinating beds, liaising with ward staff, keeping an eye on patients with potential to deteriorate, spotting any problems which have gone unrecognized by others (sometimes me) and generally helping wherever needed, the ANPs also carry an arrest bleep and attend all resus calls to A+E.  On a hectic day on call or a busy night shift, they make a massive difference to how your day goes and they come and have a cup of tea and a chat when it is quiet.  Here is Jilly, the ANP who is on call with me tonight talking about what they do. Bye for now.


Mike.

 
 

Hello from Mike In Oban.

My name is Mike McIver and I am on the first year of the four year Caledonian GP training programme base in Oban for my GPST1 year. I did Medical School and foundation jobs in Sheffield, South Yorkshire. When I was thinking about what to do after foundation jobs, I organised a week-long taster at Ullapool GP practice. If there was any doubt in my mind, this helped to settle it; I wanted to be a rural GP, somewhere in the North of Scotland. I feel that General Practice in rural locations provides the opportunity to do very varied and interesting medicine and to feel that you really work within a community. I also love this part of the country; the peace and quiet, the mountains, the empty roads for cycling, the beautiful beaches. I opted for the four year course as it offers a years experience in a rural hospital setting and I chose Oban mainly on the basis of location, but I had also heard from friend of friends that the training here was good. I have not been disappointed on either score.

I suppose for a lot of people, the down side of working somewhere like Oban on a temporary basis is either having a long distance relationship or dragging their partner around the country, picking up whatever work they can. Fortunately for me, my wife Janet also loves Scotland and has found a job as a Youth Worker based in Oban, so she lives with me here in the hospital accommodation, along with most of the other junior doctors. ‘Living in’ is a new experience which is mostly good and makes for a closer relationship with my colleagues than I have had in previous jobs. Since I started in August, we have had some fantastic weekends off. With Glencoe, Ben Nevis, the Mountains of Central Scotland around an hours drive away, we are spoilt for choice. Also the boat to Mull for walking and cycling and there are some really nice beaches close enough to go to in the evening after work in the summer.

I've just got back from a 10 days of annual leave, which were fantastic, but back on nights now. It is after 7am so I am going to risk saying it has been a quiet night without jinxing myself. Anyway, I have to go and see a patient so I will write no more this time.