Dear diary,
I have so much to fill you in on but I've been busy.
Lately I've been waking up feeling so refreshed in the morning. It's the best feeling. Before, I used to drag myself out of bed and feel tired and couldn't wait for the day to be done to go back into bed but these days, I've been waking up early on my own, and waking feeling like I don't need more sleep.
The patients I had yesterday were fairly easy patients
I had 4 i think if I remember correctly.
Firstly can I just say I absolutely LOVE gp placement. I think it's solidified it for me that I want to work in a GP. Which is crazy because being a surgeon will always be my dream. Who knows, if I pass all my exams, and graduate inshAllah, maybe I'll work in a hospital and after a few years work in a GP, depending on job availability.
But I feel like a GP is where I belong for the time being. It also helps that our GP is so friendly, work environment makes a massive difference.
I saw 4 patients on my own, and my supervisor didn't even come in. Back in winter, they'd come in to double check but all I did was go to his room, discuss the patient, discuss medication, and he'd prescribe the medication and that was it.
My first one was a chest infection caused by asthma. He wasn't really using his asthma inhalers properly. For some reason, asthma is one topic I struggle wrapping my head around when it's actually quite easy, I learned it for the OSCEs and have a better understanding of which medication and steroid inhalers etc but idk, it's one of those easy topics that for some reason I need to spend more time on.
So we doubled his beclometasone dose from 2x a day to 4x puffs a day for only a week.
With any patient, you have to safety net. It's one of the first things they taught us when we first came into GP placement. So you always say, if your symptoms don't get better after the course of treatment, come back to the gp, or if you feel really bad during medication, come back to gp. So they can't use anything against you. It's a way to protect yourself and the patient. And you write it up in the patients notes after in the system, which I like doing lol.
I examined that patients chest and listened to it, I heard a wheeze on the upper part of the left lung I think.
Second patient was a 90 year old man. He came in also feeling unwell, normally we don't treat or give antibiotics if symptoms have literally just started, you typically gotta wait about 5-7 days before administrating antibiotics. But my supervisor gave him antibiotics because, idk. He said he knows this patient and whatever so he just gave it to him. Maybe cos he's old? I listened to his chest as well and heard a wheeze on the right lung, indicative of an infection but also at his age, it could be just that pulmonary function decreased as well so it may be expected.
Third patient was a 15 year old boy. Bloody hell teens can be moody. Was I like that?😂 I know my teen years weren't the best for my parents , I wasn't that bad but obviously mood changes and whatever. The teen wasn't rude or anything but could barely get answers from him or mumbled 😂 eventually his mum took over. 😂 I was friendly though, he was telling me has his GCSEs and I was like boy I do not miss those 😂 (actually I'd do anything to sit GCSEs for the rest of my life and not uni exam or "adult exams" lol)
This boy has a little bit of hearing loss in his right ear, and he came in with feeling his left ear is blocked. He said there's no pain, but it feels blocked and is affecting his hearing. He said he has a Spanish listening gcse exam tomorrow (so today, as I'm writing this the day after) and obviously that was their concern.
They taught us this in uni (and the GP told us as well) something called ICE: ideas, concerns and expectations . It's very important and I made sure to include it in my OSCE exam when talking to a patient.
