Volunteering at a Carehome

Having volunteered for a week last summer, I decided to go back to Anisha Grange Care Home for the elderly for another week this summer, having enjoyed the experience of helping the elderly, sometimes just by talking to them.

I learned a lot through this experience. One thing I in particular was the importance of treating each one as an individual and getting to know how to approach each person is important. I learned about the complexities of dementia which is becoming an increasing problem for the ageing population of Britain.   It was important to recognise that this illness is a very personal to the individual it affects. It can develop causing residents to be very different from how they would usually behave or magnify how they would normally act. All residents are at different stages of the illness. Taking all this into consideration, understanding and compassion are vital in how you should treat residents with dementia.

For example we were potting flowers whilst drinking tea when a resident confused a gardening shear for a spoon and began to stir her tea with it. Seeing this I explained I would get her a new cup of tea and a spoon, and upon prizing the shears away she was very angry and confused which was understandable. It is important not to run out of patience.

In addition last year I remember going on a ward round with the nurses on the dementia floor (called The Primrose Community). This was far more challenging than I thought it would be. They had to check some peoples blood pressure everyday and many of the residents were very resistant to it, as they didn't understand who/why/what was going on. It takes a lot of necessary patience and understanding. Some nurses had scratches and cuts up there arms and face from frightened residents, so it was a shocking eye opener to Alzheimer's disease.   

It can still be rewarding. A lovely moment with resident was when she was distressed as she kept muttering her husband's name and asking where he was. Music was playing in the background and having remembered that she liked dancing previously, I commented on the music and about how it is a great dance number. She immediately got distracted and broke out of her trance and talked about how she loved dancing. 

Another resident, who was brought into the home by the social services two days a week, talked for a long time about her situation at home with her son. She talked about how she wanted to stay at the care home and dreaded going back. She enjoyed her two days a week just by being able to talk to other residents, staff and volunteers. She told her me story over and over again but at least it helped her to have somebody to talk to. She was slow and frail but when it came to knitting, her speed was worthy of a gold at the olympics and she thoroughly enjoyed teaching me. 

I gained a lot from the week of volunteering and will organise to go back for a few hours every week, so I can continue to see the residents. 

It is perceived that most people send their elderly relatives to a carehome where they live the last few months of their life peacefully. However the main thing I learnt is that the residents do not go into the home to die, but rather, to live.

Tomorrow's Doctors

The General Medical Council's aim is to protect patients. They have published a number of documents which act as guidelines by which doctors should follow. 

The Tomorrow’s Doctors document created by the General Medical Council states the roles of the NHS, doctors, medical students and outcomes for graduates. The Good Medical Practice document expands on the duties of doctors that should be second nature to them.

It ensures that the "Tomorrow's Doctors" (Like me hopefully!) can enter and maintain a good healthcare service in the UK. 

A doctor's primary concern is the care of the patients, by keeping knowledge up to date with fast changing technology, creating good relationships with patients and colleagues, acting with integrity and being honest. They are required to offer leadership and work with others in changing systems to benefit patients. This forms the basis of patient-centred care that we have in the NHS.

From reading the documents you can see that the role of a doctor is also wide ranging from being willing and able to teach medical students and communicating effectively with patients and their families and working as a team with colleagues. At work experience I was able to see how crucial it was for doctors to have good relationships with nurses, as well as other doctors for a professional smooth running health service. I also shadowed an FY2 doctor who showed enthusiasm in fulfilling a teaching role, which I enjoyed, as he explained simple procedures to me, such as inserting cannulas and showed me CT scans.

Case study

From reading the document I observed that the doctor must deal with many wide-ranging complex and uncertain situations:

.      "If patients are at risk because of inadequate premises, equipment or other resources, policies or systems, you should put the matter right if that is possible."
"Good Medical Practice (2013)", paragraph 25b

At work experience at Broomfield Hospital I observed an issue regarding lack of resources, which is becoming a prevalent issue in the NHS. A patient who had travelled for 2 hours arrived at the gynecology ward with a lack of beds available. The nurses and doctors had to communicate considerately and effectively and explain the difficult situation at the hospital which means they must be sent home. Therefore some aspects of the job are frustrating when you want to help but some factors are limited beyond your control.

Challenges

Whilst prospective doctors just to help people, they must bear in mind that things can go wrong:

 "55  You must be open and honest with patients if things go wrong. If a patient under your care has suffered harm or distress, you should:

53. 1. a  put matters right (if that is possible)
       
    2. b  offer an apology
       
    3. c  explain fully and promptly what has happened and the likely short-term and long-term effects."
       "Good Medical Practice (2013)"
54. 
    
55. This is especially important as a junior doctor where you will be carrying out new procedures under pressure and you must be prepared to make mistakes, respond appropriately, learn and move on. However things can even go wrong with a doctor having twenty years of experience so it is just part of the profession. It is something to bear in mind but not necessarily be discouraged by.

Three Outcomes of Graduates

In accordance with Good Medical Practice undergraduates are trained to provide and improve health and care of patients as scholars and scientists, practitioners and professionals. 

1) The Doctor as a Scholar and Scientist

This requires being able to apply knowledge gained to medical practice.

2) The Doctor as a Practitioner

This includes being able to carry out a consultation with a patient.
Difficulties in this include when doctors must assess patients capacity to make a particular decision in accordance with legal requirements (Gillick competence for under 16s)
You must provide an explanation, advice, reassurance, whilst staying honest.

3) The Doctor as a Professional 

This is behaving in accordance with ethical and legal principles. 

It includes reflecting, learning and teaching others: being a doctor includes lifelong learning academically and socially (something I would enjoy).


Finally...

Peter Rubin (chair of GMC) states that we will see huge changes in medical practice with continuing developments, new health priorities and rising expectations. Learning about the complexities and difficulties of being a doctor, whilst slightly daunting, makes me more excited to rise to the challenge in the ever-changing field of medicine.

New Years Day

This is a day I won't forget and has given me understanding of the homelessness in London. My family and I took to the streets around London on New Years Day, giving out bags with blankets, warm clothes and food to the homeless. The idea was to cheer up their news years and for us to start as we mean to go on. The weather was treacherous and initially I thought it was inconvenient for it to be so cold and rainy that day, but it made the experience more worthwhile, as we realised that we were helping the homeless in the conditions that they would need it the very most.

We purchased 20 meal deals and packed them into separate bags, ready to give out along with warm clothes. We would go up to them in a maximum of two and hand out a bag to them. I remember the first person I went up to was sleeping on some stairs under a narrow strip of shelter with a bottle of Malibu next to him. It's easy to judge but for me it was very hard not to feel compassion, as the alcohol was probably the only thing to keep him warm as half of his body was exposed to the rain. I covered him with a blanket and my partner gently woke him up just to let him know that the bag of food and clothes was now his. Anxious for his response at being tapped awake, he was very grateful and did not stop thanking us.

Although I admit was naturally nervous at first, by the end we realised that every single person showed gratitude towards us in one form or another. One thing I felt particularly touched by was a comment made, 'you have cold hands but a warm heart.' Another person said, 'It's bearable being homeless. We would survive. You don't have to help us, but what you do makes life worth living.' 

The second person we handed a bag to was from Greece escaping the economic climate there. He was surprisingly very articulate and keen to talk to us about his life and share his story. The eagerness for each person to talk to us and explain how they become homeless was a common trait amongst the people we helped. For example one man was found homeless after his long-term girlfriend had passed away six months previously. He became depressed, an alcoholic and lost his home. It gave me a great insight into how people find themselves in these positions, through a combination of unfortunate events that could happen to anyone including me. This is the main thought I have taken away from that day and to never discriminate, because you cannot judge how people land in the positions they are in. 

How You Can Help

Whilst we made the day of it, through this experience I realised just how easy it is to make a difference to someone day to day. If in london eating a meal, it doesn't take a lot buy an extra meal for a homeless person. Every time I go to London (in winter) I have committed to taking a blanket to give to a homeless person that looks cold- a small act of kindness that could make a huge difference to someones life. Above all, sometimes a small gesture such as a conversation or even a smile can brightens someones day.

Teen Constructs a Bionic Arm

I first came across this story briefly at Medlink and I was so intrigued that I had to do more research into this incredible story. 

Technology in medicine has come a long way and prices have sky rocketed along with that. A 17 year old teen, Easton LaChapelle,  managed to replace an $80 000 bionic arm that was limited in its functions, (only just being able to hold a can) with one which is of "extreme strength, functionality, costs under $500 and weighs less than a human arm." He still working on it and now each finger could hold 50 pounds of mass, surpassing human strength- almost dangerous! The low cost was made possible via 3D printing- a method with could help amputees of the third world. 3D printing has also allowed for changes and developments to be made easily through prototypes and adjustments. 

Easton LaChapelle at The White House 

This is a huge achievement for anyone, especially someone of this age. It is a huge inspiration to our generation, whatever their future aspirations. It all began when he saw a 7 year old girl with an $80,000 prosthetic arm, which is when he became determined to help lower the outrageous costs. His main motivation was clear and that was to contribute. A quote from his Ted talk, "It all started from boredom, into something that could change people's lives." This is just the start and his contributions are still continuing, as he is now building an exoskeleton for his friend who was paralysed from the waist down, so he can walk for his graduation. 

I think curiosity in the world today is key for progress and he says he challenges us to "look beyond the boundaries and be curious."