Diary of a Postgraduate: Ward Rounds

Physician Associate Studies student Aimee has been giving us a behind-the-scenes look at how her course at Swansea University has been progressing, letting you know expect should you want to undertake it yourself. Today, she’s showing us what happens when Physician Associate students are given their first hospital placements, what tasks are expected and what skills the placement can develop. 

Myself and my Physician Associate Studies coursemates were allocated to different hospitals around the Swansea area for our first hospital placements. We were going to be working in a variety of medical specialties, including cardiology, respiratory medicine, gastrointestinal medicine and care for the elderly. 

At the end of each week, we met up to discuss how things were going and to present interesting cases we had seen on the wards. We looked at X-rays and blood test results and discussed the diagnosis and management with our lecturer. 

This was a great learning opportunity, especially since patients won’t regularly present to hospital with a simple check list of symptoms that we might encounter in class. Patients don’t always know what information is relevant to tell us and they may have comorbid conditions which make diagnosing a new illness tricky. 

What is it like on a cardiology ward? 

I spent three weeks on the cardiology ward at my local hospital where I shadowed two cardiology consultants who teach on my course, as well as a registrar and several junior doctors. I also spent a fair amount of time learning from the final year medical students who were placed on the cardiology ward at the same time as me. 

I was able to attend ward rounds where I observed how the consultants talked to patients and the questions asked to find out the information relevant to diagnosing and managing their condition. I wrote in the patient notes while the consultant called out tests on what they could hear, see and feel on examining the patient. I even observed bedside echocardiograms (an ultrasound scan of the heart) and I learned how to spot problems with a patient’s heart valves or heart muscle by watching the way they move on the screen. 

Clinical skills 

I also spent time getting some of my clinical skills signed off with the junior doctors, nurses and phlebotomists (a health care professional who specialises in taking blood from patients). I took bloods, inserted cannulas (a tube that goes into the vein so we can provide fluids and medications), performed ECGs, took observations and tested urine. 

This was quite scary to begin with, especially the more difficult skills like cannulation. Doing these skills with real patients is very different than in the lab! The patient’s veins are not as easy to find as they are on the rubber arms we use to hone our technique. Patient veins do not stay still like the arms in the lab either – they like to dance around as soon as you feel like the needle is going into the right place. 

The good thing about working outside of the lab is that you get a feel for what you need to do with real patients. You learn the importance of anchoring the vein with one hand to stop it moving, you learn the importance of taking your time to find the right vein, and you learn to do all of this while talking to your patient to make sure they’re comfortable. 

The benefits of hospital placements 

Overall, my first hospital placement was a very rewarding experience, which made me acknowledge that I have learned much more than I realised in the six months since the course started.  

I learned a lot about cardiology, reading X-rays and blood test results, how things run in the hospital and how doctors, nurses, physiotherapists, occupational therapists and social workers work together to provide the best possible care for patients. I gained confidence in my clinical skills and in my ability to communicate successfully with patients who might be unwell, confused and distressed.  

Most of all, I have learned that I really love medicine and I cannot wait to practice as a Physician Associate in the near future! 

Next: Search for Physician Asoociate courses