Despite finishing my university time for year 2 back in June, it wasn’t time to kick back and relax for the summer holiday until last week. On successful completion of all the academic components of the second year, each of us had to complete a fortnight’s placement in a hospital operating theatre, followed by the remaining 2 weeks of the driving course.
The aim of this hospital placement was practical consolidation of the skills we had learnt in our second year skills module, most notably cannulation and intubation, but also placement of LMAs (another type of airway, generally easier to insert than the tube used during intubation), and the running through of fluids if we hadn’t done many of these during our placements on the ambulance throughout the year. We needed to do the cannulations and intubations in hospital before we are given the opportunity to do them with our PPEds out on the road next year. Paramedics used to have to achieve a specific number of each skill before they could be let loose on the public on their own, but this wasn’t the case for us. Our LAS tutors recognised that when in theatre, lots of the patients are candidates for LMAs as opposed to being intubated, which dramatically decreases the number of ‘tubes’ (intubations) available for us to try. Furthermore, in many hospitals, there are medical students competing for the same skills as we are, and preference is generally given to them.
The night before my placement started I was really nervous; the thought of going to a place completely different to anywhere I had ever worked before, with a whole set of new people I had never met before was incredibly daunting. Our year group had also heard horror stories of scary anaesthetists at other hospitals who shouted at students for no reason and didn’t let them assist with the procedures they were there to do. I decided to get an early night rather than ponder on such thoughts; I had been informed I needed to get there early on my first day anyway so I could be shown around and told where to work, so the sleep would do me good.
When I arrived on the Monday morning I introduced myself to the staff on reception and told them why I was there. It wasn’t difficult to guess who I was as I stood in front of them in my obvious green uniform. They directed me to the changing room and showed me where the scrubs were that I would need to wear. It took me ages to find a size that fitted me, they were all either too small or ridiculously big and baggy, making me look like a bit of a clown. As if I didn’t feel silly enough, I also had to wear a surgical cap! Once I was all dressed up, I got a guided tour of the department, invaluable to me as my sense of direction is generally pretty poor. The lady showing me around pointed out each operating theatre and advised I go round to meet the Operating Department Practitioners to find out which patients would need intubating that day, or whether I could assist with the cannulations. All patients required this skill as the intravenous route was used to give the drugs to put them to sleep.
I spent most of my first day trying to be in the right place at the right time. I kept going from theatre to theatre to see if there was anything I could do, but I had either just missed an opportunity or the patient wasn’t appropriate for my skill level for one reason or another. It wasn’t until very late in the afternoon that I finally got the chance to do something; one of the anaesthetists had seen my wandering around the department and said she had two intubations coming up next. There was a medical student who needed the practice too, so she said we could do one intubation each. I asked to watch the other student’s attempt; unfortunately for him he the intubated the oesophagus rather than the trachea, and rather than give him another chance, the anaesthetist took over. I was really nervous about having a go as the other student asked to watch my attempt, but I was lucky enough to get a very good view of the vocal cords, ideally where we want to be able to watch the tube passing through, and intubated the trachea correctly. I got this first skill signed off in my paperwork and decided to go home for the day, leaving on a high.
Come back next week to read part 2 of my summer theatre placement.