All about the Benjamins?

This week has been enough to blow my head off and splatter my frazzled brain over the ceiling.

It's our new semester and the seven new modules (Listed in last post), have already lost me. The membranes module on Monday was about "Flip Flop" (WTF?) and I learnt that lipids in a bilayer can flip flop, but proteins cannot (Please correct me if I am wrong). On Tuesday, I learnt that the chest has four pectoral muscles:

Pectoralis Major
Pectoralis Minor
Serratus Anterior
Subclavius

We have to learn the origins, insertions, blood supply, nerve supply and function for each one.

Today we have started on histology of the heart muscle and tomorrow we start reproduction (In the PowerPoint sense) On Friday we are doing something about disease mechanisms and today we went on to a ward for the first time and took a history off a patient.

That's the bugger you see - you learn so much in a week that remembering it all two weeks later is a massive problem. I am going to look for a memory textbook at the weekend to see if I can work out a strategy for learning all this stuff. I think there is a proven way of building long-term memory and I need some help. If any of you have some suggestions on how I can try to expand my brain power (Please don't suggest getting a bigger head) I would be very grateful.

I was thinking again today of why I really came into Medicine. Is it all about the Benjamin's? I have found that no one really speaks about coming into medicine for the money - it seems to be distasteful. I have to admit that, come graduation day, this is going to be me:



SHOW ME THE MONEY!!!

Yeah right - a junior doctor here is not on big bucks ( See here for our UK salary scale) but they do qualify on more money than many of my experienced nursing mates are now earning. What does cheer me up is that GPs are earning brilliant salaries, but if the Daily Mail has their way, they will have taken massive pay cuts by the time I get there.

The one thing I totally agree with is that there are easier professions to enter if money is your only goal. Even three months into the course, I can see how horrendous it can get and just doing it for the money wouldn't get you through. I have to be completely honest though - future earning potential is a large part of why I am putting myself through this purgatory.

OK, OK I might annoy people saying that and get emails saying that I should want to be a doctor so I can care for sick people and make them well. My reply to this is that if this were my only goal, I would carry on being a nurse. I would also argue that my old nursing job allowed to me to care for my patients to a far, far higher standard than I will be able to do as a doctor in the NHS. I worked as an Occupational health manager for a multi national American company, looking after 800 employees and I was fortunate enough to have the budget and time to be able to ensure that whatever they needed, they received. My patients were ruined!

I do daydream about being rich someday - on the way to Uni, I walk past some amazing houses (Oadby has some of the best I have ever seen) and they often have "MollyMaid" (Cleaning company) cars outside. I want a house and a cleaner - so shoot me! I have been in the health game for ten years and know many consultants who live in AMAZING houses, but work such long hours that they never get to see them in the light. At least their wives feel the benefit though. My husband will be more than happy to live in the executive house (With my mother, father and ten dogs in the attic) Perhaps I will become the family cash cow. I can live with that!

As a nurse, salary wise the ceiling was low and I hit it at the age of 27. At least as a doctor, there is scope for higher earnings.... I am rambling now. My last word is that there are now many nurses and physios going into medicine, but have you ever heard of a doctor coming into nursing or physio? I haven't and I am 100% sure that money plays a part in this.

I am a selfish git

Me after my genetics exam, (On finding out we were starting the Introductory clinical course three hours later)





OMG - I am SO tired.
After two weeks and seven exams, they finally finished at 1030 yesterday with the genetics module, which was absolutely horrible. The genetics module, for me, was a murky blott on the landscape, where the module leader decided that we were not to have any proper teaching or help during the group work sessions. This led to us sitting there going around and around in circles and when someone had the cheek to complain, they were told that these complaints are the same every year and we should trust the way the module was run. This resulted in a demoralised group of students and very little learning. Why does a little voice in my head cry out "If you have had the same pissing complaints, year after year, is it not time to start bloody listening to them? What do we know eh - we are only students.

Anyway - the exam was awful, with a big Hardy Weinberg claculation at the end. Don't ask me about Hardy Weinberg (Another group session where not only did the group tutor not help, but actually told us that he did not know the answers.....GREAT! All I do know about hardy Weinberg is that it's two blokes who were kind enough to create a maths calculation so that we can work out frequency of genetic disease - really handy thing to be able to do..... Not)

I think Leicester must want blood from us as we then started the introductory clinical course at 1330! We were like a big field of cabbages sitting there reeling. The five year course don't have to do it until next year so we joined the second year and although I moaned like a bugger, I am actually quite chuffed as we are doing a course that the five year cohort will have to wait a year for - and it brings it home that this course is so much faster.

I really had my worries about the GEP. I heard some horror stories about it from other students and got worried enough to also apply for the five year course. If anyone is thinking of doing this (Applying to two courses at the same uni) get in touch as I have some views on it!

Having done three months of the course I would have to say that I think that the GEP is well worth doing. I live with three students on the five year course and there hasn't been a massive difference between the two courses so far. Basically you have no life regardless of whether you are doing it for five years or four, so why not work a little harder and get it over with! The only real difference in semester one was that we did an extra module during the week (Health Psychology) and an extra add-on module called "Health in the Community" (Not exactly an inspiring way of spending time, especially if you are over 25)

This semester, we are doing 6 modules:

Membranes and receptors
Musculo skeletal system
Reproduction
Cardiovascular
Health and society
Mechanisms of disease
There is also a clinical course (The one we stared yesterday) where we go on the ward every week and do history taking, system examination, problem solving etc.

I am SO glad that the exams are finished - the last three weeks have probably been the toughest I have ever known. What has become really clear to me is that you have to be a selfish git to study medicine. I really mean that. You have to put yourself first and blank out friends and family needs because at exam time, there is so much work that the only way of getting through is sitting in a room studying from when you get up until when you go to bed. A few people have commented that they have even felt guilty sleeping during the past few weeks. The Good news is that this only seems to happen around exams and the rest of the time, we get away with not having too much to do.

Anyway, back to being a selfish git - this has been hard for me and I am sure other mature students must feel the same way. If you are 18 with no husband, animals or homes to run, perhaps things would be easier, as you can get away with just sorting yourself out. When you have commitments, it really is hard ignoring them, but as I said, I found the only way was to blank everyone out and just be ....a selfish git!

So here I am at the end of exams with three dogs that stink (No time to clean their teeth) A deserted dad, a moaninh mum, a smelly husband (No time to remind him to wash and his knickers are all dirty because I just haven't had the time to wash them)a dirty house and an ironing basket that reaches the ceiling. In all this disarray, the new course starts Monday and the workload looks MASSIVE.

Here we go again.

Breakthrough!

So it's Monday and we are half way through exams. I have not left my room for three weeks and have no life or thoughts other than revision, panic, revision, panic.

The good news is that I had a breakthrough at the beginning of 2007. When I look back, I realise that I felt like I have been playing at being a medical student. I have never actually felt like I deserve to be here, and have felt unlikely to make it through the first year.

My reasons for this that my dad had a massive stroke on May 17th which left him unable to speak or look after himself. He was still in hospital when I started at medical school and it was horrendously hard to concentrate and learn, when he was faced with not having anywhere to go or anyone to look after him. He moved into a rehab flat in Mid November and then the fun really started because he decided he would get regular taxis to his bungalow. I would then get phone calls to say the rehab flat workers didn't know where he was and I would end up coming home from Leicester (Two hour drive) to find him and persuade him to go back. The stress of this has been indescribable and things got worse when, on December 23rd, social services decided he had been in the rehab flat for long enough and give him 48hrs notice that he was going into a care home. Nice Christmas present.

Christmas was awful - just a constant round of trying to keep his spirits up and travelling to and from his care home.

When I visit my dad, there doesn't seem to be any sense of him being glad to see me or that he is grateful for the effort I have made. I think he is gutted that I have not dumped medical school and looked after him full time and bitter as hell that this has happened to him in the first place. My guilt of having him in a care home is constant and my only way of coping is to block it out and not think about it.

Part of me is angry at him because he has abused himself into this stroke by drinking, smoking and eating crap for the past twenty years and has let his house get into such a state that social services have now deemed it unfit for living in. The other part of me knows that his dad also had a stoke at the age of 60 and so perhaps he would have had one without the extra risk factors.

I have been dragged down by all of this - I wouldn't be human if I hadn't.

My breakthrough occurred straight after New Year when I really started hammering the revision. I realised that I could do the work and that that more than anything, I really want to do the course. All I can do is hope for the best with these exams and then start afresh next week when we start semester two.

Where has the time gone!

Bloody hell! I finished uni on 15th December and am now 2 weeks into a four week holiday, before starting back on 15th January for two weeks of exams.

September - December was a 12 week semester, studying six modules (And some other "fascinating" extra modules) which will be examined when we go back in January. I am sitting here, completely overwhelmed with revision and wandering how on earth I can get through it all.

The situation with my dad is going from bad to worse and having this in the background makes revision so much harder, if not impossible. Having refused (He still can't speak a word, but manages to get his opinion across perfectly well) all offers of help from his social worker, the worse scenario possible happened....on the Friday of Xmas weekend, he got moved into a residential care home. He is 61 and apart from not being able to speak and walking with a stick, he is pretty much OK. In his care home there are 30 residents, all in their 80's, 90's and 100's. Most need a lot of care and this place is completely wrong for him. It is horrendous visiting him there and the stress of having a young parent in a care home is always at the back of my head. I can't believe that all of this has happened.

And so back to the revision

When I go into hospital.......

If I ever go into hospital as a patient, I have decided that this is the dream team of people who I want to look after me. I admit that two of them are purely there for me to drool over.

I had to pick Karl Kennedy as he never leaves the hospital and Duffy and Charlie are the greatest nurses ever!

I should be looking at genetics rather than spending time doing this, but since my workload got so heavy, I love finding an excuse to not study and do anything else!

I couldn't have said it better!

I read this post tonight from 'topher's blog at "The Rumors were true". He is a medical student in the Carribean and I had to put a link to the post here, because it is describing exactly how I feel about trying, and failing to get on top of the workload.

I love reading some of the medical student blogs and this one and "That med school guy" are brilliant. It's strange to think that students in Canada and the Carribean are having the same problems as little old me, in the Midlands!

I am happy - it's the weekend and I am being a housewife.

Then Monday will come around and the merry go round starts again!

Men I would leave my husband for....1

I have been married for a long time and as lovely though he is, there are some men that would have me running for the hills.

Of course, these men are also unavailable, out of my league and unlikely to be interested in a little women from Wales. I have no doubt that my husband has a similar list which will contain really classy women like Jodi Marsh and Jenna Jameson.

This chap is just......beautiful!

A month in Medicine.....

.......Or five weeks in to be exact.

This week we have studied:

mRNA transcription
enzymes
DNA mutation, damage and cancer
Child psychology
Cognitive behaviour change
Histology - connective tissues
Examining the musculo skeletal system
Cohort studies

Phew and it's only Thursday!

I continue to be shocked with the volume of work that there is. I would say that this is the first week where I feel organised and as though I am keeping on top of the work given each day. This is a BIG problem as I am now 5 weeks into an eleven-week semester. My last five weeks worth of work is unorganised and I haven't a clue when I will be able to go through it, ready for revision. I feel like it has taken me a month to settle into the course, but the shitty thing is that we are half way through our first semester and I needed to be settled in from the beginning.

The message which I so wish I had taken on board is that you need to be organised from Day 1. I am in quite a mess because of this and I can't blame it on having going out on the beer every night. I haven't been anywhere but seem to have frittered the time away.

I have settled into my hall of residence, which is brand new and fine. The downpoint is that there are 730 people here and only two mature students! I haven't found this to be a problem but other mature students might want to avoid New Hall for this very reason. Nixon Court and Opal Court have many mature students and are very near to the medical school.

To make things more complicated my husband has just got a job down the road teaching. He's in digs in Coventry and between us we are paying £650 a month in rent. It makes sense to rent a house and live here together but I am not sure if I can get out of this Hall contract. We shall see!

I think I would quite miss living in Halls though - I have gotten used to not having to be a housewife in the week - no cooking and no cleaning his knickers from Monday-Friday. The upshot of this is that I have to bloody clean them all at the weekend, but I shouldn't moan as I love it really.

I have been tagged!

Thank you!

Charlie Brown from http://thatmedschoolguy.blogspot.com/ has tagged me.

I have to admit, I really didn't have a clue what this meant but I had a look around and it seems that I have to write down 20 things about me. I will post ten now and finish the rest off when I can. Great stuff!

1. I love hip hop music - especially Jay-Z. I am a real nerd (You can only guess how naff a white housewife from Wales looks trying to rap) and know the lyrics of most of his songs. The best thing I have heard lately was on the Radio One Westwood show on Tuesday night. It is a live piece where Tupac joined Notorious B.I.G on stage and it blew me away! I got to meet Tim Westwood last night and probably bored him senseless talking about it. All the other girls were hanging around him, trying to latch on to the aftershow party, and I just wanted to bend his ear about the music!

2. I am missing the "I want a baby" gene It has been replaced with the "I want a King Charles Spaniel" gene

3. I am developing claustrophobia and a bit of OCD. I never had this but now I do and I can't sit in the middle of rows. I have to sit on the end (Seems to work for me) I also have to keep my curtains open so I can see out of the window and make sure that my pens always have their tops on (Shit - I am scaring myself, admitting this stuff) I must be lots of fun to live with.

4. I used to be a classical ballet dancer. I danced in a group who toured around Amsterdam and when I got back home the Chinese whispers had gone around my town and I was now a stripper in the sex clubs of Amsterdam. I love this rumour!

5. I am passionate about animal welfare. I despise modern farming methods and seeing animals carted around the roads when they are being transported makes me cry.

6. I have no life since September 20th this year when I started medical school. I am drowning - the work just keeps coming and I can't get on top of it.

7. I have been married for seven years to a very nice man. He used to be a footballer and played for Wales! I am now living 140 miles apart from him which is interesting. He didn't like dogs when we met but is now as bad as me and sleeps with our dogs between his legs, on his head and on his pillow.

8. I am a terrible cynic.

9. I despise bad manners, like when you hold a door open and they don't say thanks, or when you let a car pull out in front of you and they don't acknowledge it.

10. This is getting hard!

Studying at medical school

Hells Bells.

There really is a lot of work to get through and to learn. Where does one begin?!

I think for UK students, having A levels in Biology and Chemistry is a great (Perhaps vital) starting point for my course. My graduate group have mostly worked for the past few years and so although we have covered these subjects, the details can be rusty. I am quite lucky because I have spent the past three years studying chemistry to A level and I had the best teacher in the world (Brian Jones, I salute you!)

Each day, the five year students do one module in the morning, and the four year group do that, and an extra one in the afternoon. I have had an email off a fellow nurse asking about my timetable, so here it is:

Monday a.m Biological Molecules
Tuesday a.m Genetics and the basis of disease
p.m Health Psychology
Wed a.m Health and disease in populations (Epidemiology)
Thurs a.m Tissues of the body (Histology)
Friday a.m Metabolism

As well as this the four year course (GEP) have a clinical skills module. We started this last week (On our first day!) when a SHO came to show us how to do cardiovascular examination. This will be built on during the next four years. We also have other things like communication skills and multi-disciplinary team (MDT) skills. The latter went down like a lead balloon with many of us on the GEP. Having spent the last eleven years working in a MDT I would rather not have to do this, and could use the time trying to get my head around genetics. But there you go - I can't complain too loudly because this is the only problem I have with my course and I can't exactly roll up to the tutors’ door and say, "You can bugger orf. I am not coming to your MDT skills lectures because I am ahem......an expert" I am not an expert at MDT working, but I have done it to death and don't feel that this module will make me any more of an expert than I currently am. So there!

So that's basically what we have to do over the next eleven weeks. We then have four weeks off at Christmas, which will be taken up with revision, as our exams are first week back. We have exams on all the listed modules and have to pass the lots of them. Nice!

With all these modules, my innate worry is where do I bloody start? The uni boffins have told us that we can't learn it all and so have to form "structures" in our minds which we can "hang" our knowledge on. They mean that we have to understand what we are doing (Too much to learn, parrot fashion) and try to keep relating things to the bigger picture. Clear as mud then. I have read an excellent posting from "The haversian canal" on learning at medical school:

http://nielsolson.us/archives/2006/03/recent_thoughts_on_medical_education.php

This nice chap writes really well about learning at medical school and also wears a Navy lieutenant uniform, which is never a bad thing.

I have also taken heed of poor Charlie Brown at
http://thatmedschoolguy.blogspot.com/

He is a little further into his first months at medical school than me and is very stressed. His advice is to revise, revise, revise. Not sitting here writing my blog then!

This post is a bit long so I will go. I have to end by telling you about my Jay-Z experience. I LOVE Jay-Z and have seen every live show he has done in the UK over the past five years. I paid ....a.....fortune....on ebay for front row seats at Wembley. Like a weeks wages (In the good old days, when I worked for a living) All I can bear to say is that I got stuck in a 5 hour traffic jam (At the M5 at 1900 on a Sunday night - where the hell where you all going?) and got there for the last 10 minutes. This brings tears to my eyes. See how close we were:

I just about had time to take this photo and then he went. I can't put into words how gutted I am.

Half way though first week at medical school

Today was a good day! We had histology this morning followed by dissection and then cardio vascular examination this afternoon.

The histology was great - we looked at epithelial cells and the way the day was laid out was really well planned. We had a lecture first on the basics of simple and stratified epithelia. We then went into the dissection room (DR) and looked at bodily structures and epithelial linings.

I haven't mentioned the DR in my last two posts because I am a bit worried about how much I can say without causing trouble. I have to mention it though, because it is so integral to what we are doing. These words obviously represent my thoughts and not those of the university (Sorry about the formalities, but I know this is a sensitive area)

The dissection room is a strange place to be. Ours is superbly set up and in a big hall with around 40 Cadavers in there. We were introduced to it last week and despite eleven years of nursing, the shock factor for me was big.

It just seems so strange to walk into a room where there are so many dead people. We were in groups of around 15 people and our demonstrator peeled back the sheet.... and there was our body. I am not sure if ours was a man or a women because we could only see from the chest up. I didn't pass out or anything like that but just felt very odd and a bit sad. We had been given an intro to the DR during intro week and apparently, dissection is becoming less and less common in UK medical schools because of the huge cost associated with it and also because less people are donating their bodies. I wander whether Gunther von Hagens has a lot to do with this.

We Will Cut you up in front of a live studio audience!

For me personally, I think it will be of massive value to be able to see structures and where everything fits in. One of the speakers last week (A professor of surgery) said that he has found anatomy to be lacking in many junior doctors and my medical school seem very focused on ensuring we know our stuff. Once I get over the queasy feeling in my stomach, I will love it!

During histology today, we looked at a human head and I was very, very unnerved. I tried to concentrate on the tissues we were supposed to be looking at, but I couldn't help looking around to see if anyone else was thinking "Shit - This is someone's head!" I couldn't help thinking that this was someone (Again, not sure if was a male or a female head - I am going to make a fantastic doctor) who had perhaps been speaking to their family a few weeks or months ago, or walking down the street. Very strange experience.

Phase One - week one! Thought of the day.....90% of our DNA matches that of a banana!

Bloody hell! It is day two of the course and there is so much work to do already.

Yesterday we had two modules: Biological molecules in the morning and clinical skills in the afternoon. Both were very good and I am SO glad that I have just done the years of chemistry, because I would absolutely have a real struggle on my hands without it. We never did any chemistry as a student nurse and in one three hour session yesterday, we touched on loads of principles from the AS chemistry course.

First note to any nurses thinking of doing medicine = go and do a chemistry course - I would recommend AS level at least .

The clinical skills session was on examination of the cardio vascular system and was an introduction to basic clinical skills - all good stuff. My nursing covered perhaps 50% of it but there was plenty of new stuff such as listening to the apex beat and other heart sounds that will be completely new to me.

Day two, we had genetics all morning and Health Psychology all afternoon. The genetics is going to be, erm.. challenging to me because it is all new, but the psychology was pretty much what I have spent the past ten years doing.

I am living in a really nice hall which is 100% improvement on last week. It is small but clean and now i have my internet and TV set up, I am fine. It is costing me around £3700 per year which includes food.

I am not as homesick this week but still feel like I have wandered in to an 18-30 holiday and am waiting to go back home and get back to normal. It is only today that I am starting to feel like a medical student - last week I felt like an intruder who had crept in to the back of class. It is a massive, massive change for me and I am giving myself time to settle down. The one thing that is crystal clear is that the pace of work is so fast that I need to work for a good few hours each night, right from the beginning. I remember starting my nurse course and having to give a 2,000 word essay in after three months on the course. With this course, I have at least 6 exams in 12 weeks time and need to pass all (They only allow you to fail one module in the whole year in order to go to year two. If you fail more than one module, you have to sit a qualifying exam in the summer which looks horrendously stressful)

Induction week at medical school

Many apologies for the lack of posts but I have not had an internet connection until now. I haven't spent the whole week sozzled - honest!

Well - I am finally here. I really never thought that I would make it, but I did and here I am in D halls on my induction week. The medical students arrived on Sunday and are all staying in halls so we can "Bond" .There are around 270 five year students and 60 of us older, graduate students. The week has been very well organised with daily "Welcome" lectures, uni familiarisation and nightly organised socials in the town centre.

I have found this week very, very hard. As an older student, I suppose that I am stuck in my ways and I have given up an awful lot to come here.

When I arrived in my room in D Hall on Sunday, my heart sank. What a dive! My room had disgusting brown dirty carpet tiles which had lots of silverfish crawling in them and squashed mosquitoes on the walls. I could see the mattress springs though the sheets and when I got in bed, the mattress was so saggy that I had to sleep in a boomerang shape. The others on my corridor thought it was fine to come in at 1,2 and 3 am and shout as loud as they could.....Ok you get the idea - I hated the place!

I wanna go HOME!!!

As well as the accommodation, I found it very overwhelming being around so many new people, although they all seem a nice bunch. I have never, in my life, been homesick and thought that I was much too old for that kind of thing now, but I have missed my old life and just wanted to come home, put my uniform on and go to my nice normal job with people I know and then come home to my nice house and eat nice food with my nice husband!
I suppose the good thing with being a bit older is that I know I am likely to be much happier next week when I move into my proper accommodation and get started on the course. What I can safely say is that the medical school seems excellent and the four years are likely to be quite a slog!

Must have been a lack of competition

Well bugger me! I got the job.

I checked my mobile yesterday and realised that the nice lady who interviewed me had left a message a few hours after I left. This message had been there for two days (More cringing) so I don't know what they must think of me.

Of course, I now can't imagine how I am going to manage it because I have also agreed to do some hours in the tampon factory too (I don't actually make the tampons, I help to look after the people that do) and also to do a few hours a week in my lovely welding factory (Demoted to doing the filing, in a room with no windows)

Am still very calm and wandering why I am not hysterical and running around the factory, beating my chest in anguish. Still time though.......

I start on the medicine course in four days time and from them on this blog is going to be a barrel of laughs as I winge and moan my way though the course. With this in mind, I am going to tell you a bit about myself so if you are not interested, come back next week and I promise the posts will then be about life at medical school.

I have realised that in my last post, I placed my husband under my dogs in my list of important things. This is not good, but can you blame me - look at them:




Kings Charles Cavaliers come in four shades and I have three of them. I really want the fourth (A Blenheim) but my husband has banned me (He is far enough down my list as it is)

We have had cavaliers since I was five years old and I love them so much that every time one has died, we have been so cut up that we have sworn never to have another one again. Then a few weeks have gone by and we have gotten so depressed that we have gone out and bought another one. I lost my last two from heart failure (Very close to each other) seven years ago and three weeks later we ended up buying three more. My husband was never a dog person but is now just as bad as me and I can safely say that we have the three happiest dogs I have ever met. They are our babies and are clever enough to realise that if real babies were to come along their reign would end. To ensure that this never happens, they like to come to bed and three dogs and two people do not, a happy bed, make.

We alternate through the night between two beds, trying to get away from them, but they are never far behind - Victoria would be horrified

A Strange Week......

This is my last full week of work and it feels very strange. I am one of those boring people who hates trying new things and loves routine and I have got up the same time, gone to the same job and got home the same time every working day for ten years. Although my title still has the word "Nurse" in it somewhere, my job is office based in a large manufacturing mill which makes toilet rolls and tampons (Rock and Roll)

My new life is going to be a challenge (Hmmm - Understatement) and I just can't imagine not having to go to my two jobs anymore. In fact, I would have thought that I would be a hysterical wreck this week, but I have been strangely calm. I think this is denial! Wait for the weeping, wailing post next week.





GOODBYE OFFICE MATES!




I have told very few people that I am leaving so I'm happily wandering along telling everyone that I will see them next week. My reasons for not telling people is the denial thing but also that I am worried about what people will think of me. I have this horrible feeling that I am not going to belong anywhere - the nurses will think I have decided I am too good for nursing (Absolutely untrue) and the doctors will think I am this nurse who has ideas above her station. I also think that what I am doing is quite unusual ( I don't know any nurses who became doctors) and so as people are finding out, I am finding that they all have a viewpoint. I have so many doubts about what I am doing (Leaving my sick dad, dogs, husband, secure job) that I don't need to hear anyone else's doubts. Phew - getting a bit deep and meaningful there!

On a lighter note, I am looking for a little job to help out the money side of things and went for an interview yesterday with a local GP "Out of hours" centre. WHAT A NIGHTMARE! I got lost and so arrived a little late. As soon as I arrived, they gave me a card and told me to sit down for ten minutes and read it through. The card read:

"Mr Jones 72 rings you up at 1145 on a Friday night to say he has had abdo pain for 72 hours which is now getting worse"

1. What clinical history would you take?
2. What treatment would you recommend i.e. Does he need to be seen?

Looking at this now, it looks very straightforward but after trawling in my car for an hour and a half, my head was spinning. My first thought was "They think I am coming for the doctors job, not the nurses job" My second was to bolt for the door but it had a keypad lock on it so there was no escaping! (I had an Ally McBeal moment, imagining me smashing the door down with a fire extinguisher)

You know sometimes when you have had a cringeworthy experience and you get flashes of what you said, coming back over the next few days? That is where I am at now. I absolutely sucked!

They asked me what my differential diagnosis would be (I bit my lip to stop myself from saying that I would ask the nearest doctor) They then asked me what I knew about the medical centre where I wanted to work - which is called "Flintdoc". I had not done my homework and so actually knew very little apart from that this was where you telephoned when your GP had gone home for the day. Instead of smiling sweetly and admitting this, I came up with the answer of all answers....."The centre supports the community of Flint" CRINGE.....

What should a mature medical student worry about? Bloody everything!

I am worrying about everything this week. My top ten worries are:

1. Where is the money going to come from?
2. Am I mad, leaving my jobs? (Will I regret giving them up and leaving my lovely boss?)
3. Will my husband be able to put up with my new life? I am going to be away for at least three nights a week.
4. Where is the money going to come from?
5. Am I clever enough to do this course? (I am not a boffin)
6. Will my dad be OK? (See earlier posts)
7. Will I hate living in halls of residence and find it hard to live with 17yr olds?
8. Will I be accepted by doctors? (I have already had some comments from doctors along the lines of "GEP medicine isn't as rigorous as normal medicine" "The training isn't what it used to be" "You must be bloody mad - go and be a dentist" and the comment of all comments from a consultant who has worked with me for ten years....."Aren't you a bit thick to be going into medicine?" Cheers mate!
9. Will nurses hate me? I worry about this so much that I have hardly told a soul that I am going to do medicine!
10. Where is the money going to come from?!!

"We used to have a doctor, but now the Nurse IS the doctor!"

Occupational health is a lovely area to work in.

At least it used to be in the old days when nurses did their work and doctors did theirs. Somewhere along the way, the managers realised that OH nurses could do much more of the doctor's role than they had previously realised.

I remember one of my first jobs in 1996 in Bromborough. I was sent to do a days work performing lung function tests on employees exposed to flour dust. When I arrived, a lovely old GP (He was 76 years old) met me and had a bit of a moan that I hadn't got there a bit earlier so that I could make him a cup of tea before the patients arrived.

As the day progressed I did the lung function tests and sent the employees through to the doctor with the results. I wasn't allowed to interpret the results (God forbid that a nurse could do this!)

Ok...I know this is very old fashioned and that most of the employees did not need to see the doc with their lung function results. Around 90% of them were normal and I could have dealt with these perfectly well. However, the employees went back to work pleased as punch that they had seen a doc and the managers were happy that their money had been well spent.

Fast forward 10 years and we have gone from one extreme to the other. I did a shift in the Midlands a few weeks ago. When I arrived I was given a list of people on sickness absence to contact. I called them at home and spent a long time on the phone with each of them. Many had complex illnesses, the details of which I struggled with. I had to use the Internet to look some of the details up whilst I was on the phone to the employees so as not to sound as though I didn't have a clue, and to be able to advise whether the new drugs they had been prescribed would render them unable to drive and affect their ability to do their job.

By the end of the day, the managers wanted a report from me, detailing how long these people were going to be off, if they were likely to come under the DDA etc:

I found this difficult because in my other jobs, this is the doctors’ role, not mine. As a nurse I was never taught these disease processes in such depth as to be able to now estimate likely times of recovery. I am good at my job - I have a degree in OH nursing and eleven years full time experience, but I have always worked with a doctor. I asked the company if they had a doctor and they looked blank and said that they used to have a doctor, but "The nurse is now the doctor"

I am lucky in that I have worked with an excellent OH consultant during the past ten years and when I was writing my reports to the managers, I visualised what he would have said in the same situation. I managed to complete the reports and did a reasonably good job. The off shoot of this is that the penny pinching managers have won! They saved hundreds of pounds by using me rather than a doc and I was stupid enough to do the work that they wanted to a good enough standard for what they needed. I should have looked at them like they had two heads and said "Actually mate, this is the docs job"

I know that many of my OH colleagues would criticize my views on this, but I am appalled that we are now doing the doctor's jobs. If for one minute I thought that we were being given these new roles because they thought we were an amazing group of nurses I would perhaps put a sock in it, but lets be honest here - IT'S ALL ABOUT MONEY!!

I cost £25 per hour. The doc costs £150 per hour. Easy maths. I agree that we can do much of the OH role but I also know where my competency ends and when to look to a doctor for advice.

My big worry is that when I have qualified as a doctor, I might well want to come back to occupational health. By then though, there is a good chance that all the docs will have been replaced by nurses.

I'm back!

It's been a strange few months and I managed to lose all of my access details to here, so have not been able to get on to my blog.

I am starting medicine in three weeks time - it definitely has not sank in. I gave my notice in to work last week and the girl who is taking over my job has given her notice in too, so there is no going back for me. If the other nurse had not given her notice in, I know 100% that i would have changed my mind this week - I am so worried that I am doing the wrong thing. I earn good money and work part time days - I LOVE my job and am giving it up to go and sell my soul to the NHS. I think I am mad at the moment - absolutely mad. I am trying to cheer myself up by buying a pink stethoscope - it's not working though!






I have been reading an excellent blog from http://thatmedschoolguy.blogspot.com/2006/08/orientation-day-5-6.html

Jason has just started med school in canada and is making some great comments about his first days. I am going to do the same thing and hopefully this blog will be useful for would be medics who want to know what they are letting themselves in for.

It is 13 weeks now since my 60 yr old dad had his stroke. He is walking with a stick but still has no use in his right arm and no ability to speak. It is saddest thing I have seen and I don't think he will ever be able to speak again. He is limping up and down, wandering why people aren't able to understand him. It breaks my heart and I am sure you can understand the guilt i have, flying off to do medicine when he is going to be heading for warden controlled accomodation.

Oh bugger - this is turning into another depressed post - please bear with me as i promise to get happier

Doing medicine as an oldie

For the first time, I have butterlies in my stomach today! I am excited about having the chance to go to do medicine. I have my fingers crossed that things will work out with my dad and am going to keep planning with a view to being able to take my place in September.

Money is a big factor - have been looking at a professional studies loan from the HSBC so that I can pay off my debts before starting. These loans allow you to defer payments until back in the world of work but the cost is massive. If you borrow the maximum of £25,000, the repayments work out around 400 per month for eight years. Scary!

I have had a few emails from people who have read my blog (It's a nice feeling to think that someone would want to plough through these posts) asking how an oldie gets into medicine. If any of you have been watching the recent ITV programme "Vital Signs", you will be under the assumption that one day you can wake up, decide to be a doctor, walk into the nearest medical school and ask for a place!




Hmmmmm.....today I am going to be a doctor!



If only this were the case.....getting into medicine as an oldie in a labour of love and much jumping through hoops is needed, although there certainly more opportunites than there were ten years ago. I qualified as a nurse in the mid nineties and went to Kings College to complete my nursing degree. One day, I knocked on the dean's door to speak to him about becoming a medical student. He laughed at me - no joke! His words were along the line that in his experience, nurses struggled to do medicine and so he would not be happy to consider me (He was eating an egg sandwich as he said this and at one point he spat some egg onto my sleeve)
I remember walking out feeling like shite on his shoe and pretty much come back to Wales with my tail between my legs.

Anyway, then it was unusual for schools to look at non-traditional students but now things have changed. There are opportunites for older students from non-traditional backgrounds, but the competition is fierce. I found out most of my information on two helpful internet forums:

http://www.admissionsforum.co.uk/

http://www.newmediamedicine.com/forum/

There are two options for the oldie wanting to study medicine:

• Applying to medical school for a traditional five year course (Will need A Levels or degree or access course)
• Applying to one of the newer Graduate entry programmes (GEPs) A 2:1 degree is normally needed, unless it is one of the schools that use the dreaded GAMSAT test - you can apply for these schools with a 2:2. Georges and Notts use GAMSAT - not sure if any others do

Both of these courses have the same outcome, but GEPs attract an NHS bursary in years 2,3 and 4 and allow you to start work as a doctor a year earlier. For a traditional five year course, graduates will not be able to get a student loan to cover course fees and so will need to find £3000 each year from 1-4, and then an NHS bursary in year 5.

Either way, a massive amount of debt seems to be the only way of getting through medical school as an oldie!

Fluid Balance charts

Back to my dad.

His swallow has been assessed (After ten days in hospital, where he had been drinking normal fluids) and they have decided that he should drink "thickened fluids" as he does not have a cough reflex. This means that if fluid starts going down "The wrong way" i.e. into the trachea, he will not cough and so he could aspirate (The fluid go into the lungs, with chance of causing pneumonia) :

"The cough reflex is a protective physiological mechanism that defends against aspiration of harmful substances into the respiratory tree." The stroke association

On hearing this, I gave him a drink of tea, with a teaspoon of "Thick and easy" in it and he looked at me as if another head had sprouted out of my neck. Thickened fluids are pretty grim things. They are so grim that he has stopped drinking them and so the nurses have had to get a venflon re-sited and put him on IV fluids. When a patient is on these, they need to have a fluid balance chart to record what is being put in and what is coming out. If nursing care is at a good standard and the charts are filled in correctly, they are a great help.

The problem is that the charts are not being filled in. For the past four nights, my mother and I have given him drinks and filled the charts in accordingly. My mother (Ex nurse of 27 years) and myself are the only ones filling them in. The nurses are not recording things going in or things coming out.

This is so hard to deal with: My father is likely to be on this ward for a long time and antagonising the ward staff is not a good way to go, but filling in fluid balance charts is just such a basic, basic task of nursing care. As they are empty of information, it is assumed that he is not drinking. My mother and I know that he is drinking, but as long as the charts are empty, he will remain on IV fluids.