NHS Frenchay Hospital 14/06/12

My fourth day at the Hand Centre was my favourite day. This was because there was a paediatrics clinic in the morning, but also because I heard a story from one of the most incredibly brave patients I have ever met.

From 9am-12:30pm I was able to sit in various different clinics with kids with hand injuries. I really enjoyed this experience because I get on with children very well and paediatrics it is an area of physiotherapy I would be keen to specialise in in the future. The most common problem with the kids was that they were not doing their stretches and exercises because they forget or are not reminded. This is why it is important for the physio to make sure the parent knew exactly when and what their child should be doing to improve the injury.

In the afternoon there was a private clinic for more severe injuries. I was really lucky to meet a woman who had been through a violent disease called Meningococcal Septicaemia. She explained to me that Meningococcal bacteria live naturally in the throat and back of the nose, and that around 20% of people will be carrying them at any one time without ever becoming ill. I found this shocking. It is deadly and can kill in a matter of hours, but luckily this woman had survived. However she had lost both of her legs and her hands apart from one finger. That finger was the reason she was at the hand physio clinic. She told me that she was offered prosthetic hands like she had for her legs. However she chose not to have them, instead she chosing  to improve the mobility of this one finger.

It was very hard for me not to well up a bit while she was telling me her story, as the things she loved most, like painting, she would probably never be able to do again, and the dreadful disease had changed her life completely. It had taken a long time for her to begin to be able to walk on her new legs and she said it was a really odd sensation. At this point she was still not able to walk great distances, and was in a wheelchair for most of the time. To me this seemed absolutely devastating and I was baffled by her positive attitude and smiley face.

After she had explained her story the physio began to stretch her last remaining finger and take measurements of the angles she could bend it in. It looked very painful, and there was very little movement in it. The physio explained that it would take a long time but stretches and exercises would hopefully get it more mobile, and then the patient said something to the physio which made me understand her cheeriness, ‘ Well, at least I’m alive. And you’re all helping me make my life even better! ’.

My experience of  meeting that woman has thoroughly inspired me to become a physiotherapist, as I have now seen for myself what a massive difference and impact they can have on the lives of people, just like the woman I met.

NHS Frenchay Hospital 13/06/12

On the third day in Frenchay Hospital, in the Hand Centre, I was able to observe more of the same rehabilitation techniques which enabled me to pick up the smaller and more intricate details about fractures, mallet injuries, dislocations, tendon and ligament damages, and many more injuries. Due to a broader range in my understanding I could then predict the possible treatments to the injuries of various different patients. I observed a general clinic in the hand centre in the morning from 9am-12:30pm. I then went to the trauma clinic in the afternoon from 1pm-4pm.

My favourite part of the 3^rd day of my placement was observing the work in the trauma clinic because the injuries there are much more recent and therefore generally more severe and the treatment required is more immediate. This meant that I saw a variation of types of splints they were using for hand injuries, and how to mould and fit them.

NHS Frenchay Hospital 12/06/12

On the second day I spent the day in the trauma clinic of Frenchay Hospital, shadowing one of the physiotherapists from the hand centre. This was really interesting as I was able to grasp more of an understanding of how the X-rays work, and that they make a correct diagnosis much easier. This is because it uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film, so the injury is accurately shown.

For example, in the trauma clinic the most common injury was dislocation of the bones and fractures, which I can now easily identify from a patient's X-ray. The treatments however always varied slightly due to the different severity of the injury. For example, a full dislocation, which occurs when extreme force is put on a ligament, allowing the ends of two connected bones to separate, will take a longer time to heal and possibly need a longer period of physiotherapy. Also nerves take up to 12 weeks to completely repair. Therefore, if any nerves are damaged in a particular injury then physiotherapy is likely to last up to 12 weeks. I spent the morning from 9am-12:30pm in one particular area of the trauma clinic (section 3), and then in the afternoon from 1pm-4pm I was able to wander around more and watch bits of almost every case that came into the trauma clinic.

It was amazing to see the variety of different types of injuries. For example, It was fascinating to see the progress from X-rays and pictures of before and after physiotherapy on a woman with a crocodile bite on her little finger. Another patient also had a pen lid stuck in his hand. I was incredibly lucky to be able to watch this being removed from the patient's hand, which was an amazingly interesting experience. They started by injecting an anaesthetic into the injured hand and then iodine was applied to the area the doctor needed to cut into. I then observed the procedure to get the pen lid out of the hand which was pretty horrific but I had never seen anything like that in my life and so I found it intriguing.

NHS Frenchay Hospital 11/06/12 (General Ward)

On the first day of my work experience in Frenchay Hospital I worked with the volunteers on Wards 201 and 202. From 8am-12:30pm I made tea and coffee for the patients on the ward and chatted to them while making sure they didn’t need anything else. I found this job highly rewarding as I was able to actually interact with the patients instead of just observing, I was really able to understand the hospital environment by talking to the patients and my understanding of the functioning of the wards became clearer. For example the wards I was in were all virtually full the whole day, which made the environment constantly busy, and there was always something to do.

Then from 1pm-2pm I gave the patients in the wards lunch, which was a very frantic process as everyone had to make sure they were giving each patient what they wanted and at the right time. This was rewarding as each patient seemed so grateful for our help and dedication to their needs. This was made possible by the patients ticking boxes of particular foods they wanted on a piece of paper, so they didnt need to move, which made the process far more efficient.

From 2pm-4pm I then helped move beds  around from different wards so new patients would be in the right places. After a while this began to be quite physically challenging, but it was not a problem as other nurses were helping and it was really enjoyable working with the nurses on the wards. They were able to make laborious jobs such as moving beds a fun experience.

The first day in Frenchay Hospital, although  hard work, was one of the most fulfilling because I was really able to understand how important the hospital's role is. I thoroughly enjoyed the experience, particularly coming to grips with how different roles such as nurses and doctors work in a hospital environment alongside physiotherapists. Due to the attitude of the people on the wards I have been inspired to work with this type positive attitude and bring a lively and joyful energy to a working hospital environment.

Clevedon Community Hospital North Somerset NHS (Midwifery Physiotherapy)

 

I spent the day at the Clevedon Community Hospital North Somerset NHS, where I shadowed a physiotherapy that specialised in midwifery physiotherapy. I was not sure at first what to expect, as I did not know much about pregnancy. However it became very clear to me that physiotherapy is key in the course of pregnancy as it can affect a woman’s body substantially, making movement inhibited sometimes, 

Firstly I sat in on the first class of the day which consisted of several heavily pregnant women. The physio went through various different breathing techniques which was fun to join in with, as they all practised together. The breathing techniques were important as when giving birth, it is vital to never stop breathing or you are depriving your body from oxygen. The physio then explained a variety of different birth positions; it is almost possible to give birth in any position that is most comfortable as long as the spine and head is controlled and in the correct position. I found this class incredibly enjoyable as it was interactive and thoroughly interesting, to discover how physiotherapy can be linked with such a fascinating thing such as child birth.

I then joined another group to observe and the physio was giving various tips and pointers for rehabilitation of the body after birth. The physio explained that their body’s would take a while to recover and then the physio showed them some exercises that would gently help them get back to being able to exercise, as it would be unhealthy and possibly dangerous to the body to go straight back into intense exercise after child birth.

I am incredibly lucky to have had this experience of observing such a specialised type of physiotherapy in a thoroughly enjoyable working environment. It has inspired me to discover and research different other types of physiotherapy that I could possibly specialise in, in the future.

NHS Bristol Royal Infirmary (Respiratory Unit)

The last physiotherapist I shadowed at the BRI worked in the respiratory unit of the hospital. I was most interested to hear about the rehabilitation of the patients and how a physio can help with this process.

One of her patients had recently undergone an operation and had been having physio to get him back on his feet. The physio explained to us that he was okay to walk now but it was extremely tiring for him and so he rarely walked more than once a day. The physio session we watched was helping him walk up and down stairs. This was something they had not tried yet with him and so he did not know if he could do it or not, but the physio’s were very encouraging which helped him have more confidence in himself.

He was much like the patient in the cardiac unit as he was also frustrated with himself for going at such a slow pace. However, he had a very good sense of humour and therefore was joking a lot, which made the physiotherapists job so enjoyable.. He used the hand rail on the right to stabilise himself and he was able to get up and down the stairs very well. There was such a positive atmosphere in the room, as everyone clapped when he had reached the top and the bottom. The patient seemed  grateful for the physios' help and it  was inspiring to see how important their work is to other people.

NHS Bristol Royal Infirmary (Cardiac Unit)

The second physiotherapist I shadowed at the BRI worked in the Cardiac Unit of the hospital. Before we entered I was slightly nervous as I didn’t know what to expect. However we did not see any operations but instead went into the rehabilitation part of the Unit. This is where we met a patient who had undergone a  heart operation about a week ago, so you could clearly see the scar across her chest, and she seemed to be very weak. Firstly we had  to talk to her to wake her up a bit more and therefore increase her awareness.

She talked about how she loved to walk with her sons on the mountains and that she missed walking as these were her best memories. It was obvious that she was a very active person and she was becoming more and more frustrated about being unable to get out to bed. When she was asked how she felt she replied saying ‘never get old, it’s such a pain’. I felt an immediate reaction that we must get her back on her feet, and I wanted to help. The physiotherapist suggested we take her for her first walk after her operation, which she was nervous about. She found it extremely difficult to get out of bed and it was a very slow start. I was really intrigued to see how she would cope with walking for the first time.

Once we had helped her get on her feet she smiled, which was such an amazing thing to experience because it showed me how fundamentally important the work of a physiotherapist is - just being out of bed made her so much more happy. She walked very slowly down the corridor for about 50 meters and then she rested and we went back up. She was proud of herself but still frustrated because she wanted to recover more quickly, but the physio told her she would have to be patient as things like this take time. However when he told her she would be able to walk again with her sons she seemed completely reassured and when we left the room she seemed a dozen times happier than when we entered it.

I only played a tiny role in helping her and yet I experienced such a strong feeling that I had assisted in improving somebody’s life, which felt utterly rewarding. If I were to become a physiotherapist I could play a bigger role in situations such as these and therefore my ultimate goal is to help with the recovery and rehabilitation of as many people as I possibly can. I want to help someone like this every day because I feel that improving someone’s life is the most important thing. I am so grateful I had the opportunity to be involved in the hospital to gain such an understanding.

Sport Medicine Clinic Bristol University

21/02/12 Today I went to the Sport Medicine Clinic at Bristol University on Tyndalls Avenue. I shadowed Penny Porter, who is a physio who works there. Firstly she showed me through to the office, where three of the physio’s desks were and it was a really nice atmosphere, because they were all helping each other with everything they needed to get done, such as filling out notes on their patients. Penny showed me her typical daily schedule. She had around 6 patients from 8am to 2p . I found it really exciting as with each patient it was a surprise to see how we could help with the problem they were having. For example, Penny had 2 patients in the day that she had never seen before. This meant that once they had told her the symptoms and she had a look at the problematic area, she would quickly have to make a diagnosis of what she thought was wrong. It seemed completely evident  to her and she made it look easy which I thought was extremely inspiring.

The most common types of injuries Penny had to deal with were  weak knees and the overuse of certain muscles, so a lot of similar stretches were used to loosen the hamstrings, quads, glutes, gastrocnemius and any other muscles around the problem area. Because a lot of the patients were students they lacked time to do the stretches they were supposed to be doing. Penny said that it was obvious if they hadn’t done them as there would be no improvement from the last time she had seen them.

In our break Penny showed me around the building, which I thought was surprisingly nice. The top floor had an indoor track and the gym on the lower floors was huge. Penny said she could use it whenever she wanted to.

Today has further inspired me to want to be a physiotherapist because it has shown me that every day will bring something completely different, and the people you can meet along the way make the job rewarding and thoroughly enjoyable.

NHS Bristol Royal Infirmary (Hydrotherapy)

The first physiotherapist I shadowed, worked in hydrotherapy. I was really looking forward to seeing the type of facilities she worked in, and the sort of exercises she used, as I had never seen any hydrotherapy in practice before.

The pool was smaller than I imagined but  it  was explained to me that this was because hydrotherapy rarely includes any exercises that need a large space or any intensive exercising. Another thing which surprised me was the temperature of the pool - it was like bath water. This was so the muscles are warm when they are stretched and so  the patients are less prone to injury. The physio said that it seems nice and relaxing,  but actually, staying in a hot pool all day is extremely tiring, and it’s important to keep hydrated.

I loved the atmosphere in the hydrotherapy unit. There were different coloured lights on the ceiling like stars, which were used for relaxation sessions, when the lights were turned off. The pool had 3 different levels of depth to it. The deeper the water the less weight you will be bearing on your muscles.

I watched a group, all of whom suffered from arthritis. It was interesting that there was a range of severity of the arthritis, and this made it even more clear to me why the different depths were so important, as patients with the most severe cases of arthritis were most often in the deeper level of the pool. The physio began with easy stretches to increase the patient’s heart rate and the exercises became more and more challenging. By using floats, which they pressed down or pushed  to the side, the waters' resistance acted really efficiently to get the correct muscles working. This technique is also effective because I noticed that if the physio ever saw any of the patients having problems, or finding it too hard, she could either replace the float with a smaller one or move the float so the area pushing against the water was reduced and the pressure the patient would have to put on the float lessened.

The atmosphere in the pool was wonderful. They all got on really well because they have the same class every week and I expect the physio felt rewarded as she has helped these friendships form. Not only had she done this but the patients were also telling me how useful the lesson was, and that they found themselves much more physically able after it,  and as a result were  able to get more done in the day. Although I wasn’t in the water I thought I would get up and try the exercises myself. This was really fun and I felt like I was a part of the group.