Acute Medical Unit - Hospital Placement Reviews

Hello everyone! Over the past couple of weeks, I have been flapping like a fish out of water; and this is why! We are on our 'out of ambulance placements', ie our hospital placements. We have five weeks of hospital placements in both Year 2 and Year 3, and the Acute Medical Unit was my first one! I am going to give you an account of these placements so you know what to expect on your degree. I had no idea what to expect but all in all, it was not too bad!

Background
We have 5 different placements in 5 weeks of hospital placements, each week is different. This week was arranged as my Assessment Unit placement, where patients are assessed, examined and begin their pathway. It is arranged by the university and I know that all of my fellow students have been placed all over the county with up to 2 hour travelling times and expensive car parking. We have to make up 37.5 hours each week and we have a POD (Practice Observation Document) which is a bit like a PAD but more observation, less participation and much more vague to fill out.

Day 1
My day starts at 5.45am which is quite a lie in for me when I am working or on placement. My bag is already packed from the night before (which is a must do), I have a cup of tea, put my food in my bag, put my uniform on and get on my motorbike. I ride to my placement and get changed before I try to find my way to the unit. I have already given myself a rough idea beforehand by looking on the hospital map and making sure I know the unit and number I am going to. I get to the ward entrance ready to start at 8am and ring the buzzer to be let in.
'Hello, my name is Danii and I am a student paramedic who is based on this ward for a week. Please could you show me where I can put my bag and point me to the direction of the handover room?' Find a member of staff, smile and be polite. Two things about hospital placements, get rid of your bag but keep out your POD, a pen and waterbottle, and there will probably always be a handover, so get yourself in there as all the staff will meet there. You will stick out like a sore thumb which is great because no one will expect you to have any idea what you are doing.
At the end of handover, try and find someone who looks important. Either look at name badges for their ranking or judge by how nice the uniform is. Tell people you are a student para and say you have no idea what you are meant to be doing, generally people are always happy to help you out. Hopefully you should be given someone to follow around, so ask lots of questions and make sure they orientate you.
In my first day in AMU, I shadowed a Band 5 nurse for a while who was triaging walking patients, but she had very few patients (a grand total of 2) so she suggested I went to Ambulatory Care (just down the corridor) as there were more skills going on there. Ambulatory care is a hospital version of a walk in centre. Patients have to be referred by a healthcare professional and they have obs and bloods done before assessment. This was quite cool. The healthcare assistant I ended up with let me take bloods using a butterfly (pretty sure that is against hospital policy but oh well) and I cannulated a few patients. By lunchtime, I had practised obs and needle skills and was seeking more.
By this point, the doctors have already done their rounds, pharmacists, physiotherapists and occupational therapists have all disappeared, and the ward is quieter. I followed the guys around in Ambulatory Care for the rest of the day and vowed not to be encouraged back here again.
The day was good, I got bits signed off in my POD, my timesheet signed for 12.5 hours and I took my break 30 minutes before my shift was due to end, and got home early. Time for dinner and bed.

Day 2
I feel a bit more prepared this morning. I met some wonderful people yesterday and I am excited to see them again. I get into the ward, put my bits away and wait in the handover room. I talk to some of the healthcare assistants I met yesterday, and the day is already more relaxing. After the handover, I get asked if I want to practice my skills again in Ambulatory Care... I decline and ask to follow the nurse again who is doing the drug round for patients who stayed on the ward. Again, the day was not as busy, but I had time to discuss cannulation with an amazing nurse (who swears by greens) and chats to the nurses about different topics. Quite the education experience.

Day 3
Today I am meant to be in Ambulatory Care not Acute Medical Unit, but I decided the previous day that I really wanted to watch a drug round and the doctors rounds. This was really interesting. In the drug round, I checked every medication I could not remember (basically all of them) on the BNF to make myself more familiar with them and wrote them all down so I could revise them. There is no better way of remembering common patient medication than checking them and writing them down. I then followed the consultant who has three doctors, all taking it in turns, to discuss their patients and coming up with a treatment and medication plan. This was incredible because the consultant was so knowledgeable and confident to try and discharge them. Apparently he is amazing in the eyes of the other doctors and nurses, and I think more hospitals need people like him.
Once that was done, I went and found a pharmacist to discuss how they go through the medication and what they look for. We discussed conflicting medication and toxic doses, sometimes using blood results to measure this. This was also really interesting and they liked to test me on my pharmacology (again I do not know any so better get learning). Finally, I harassed the lovely physiotherapist and occupational therapist who work together to assess their patients. They discussed so much with me regarding what happens at hospital and at home, and how paramedics can help - for example, writing how they mobilise at home and when we found them. The ambulance notes stay in their file so it really helps the team know how the patient actually mobilises when they are not in hospital (lots get hospital syndrome where apparently their legs stop working whilst on a hospital bed... Please feel my sarcasm when I say this).
To finish off the day, I head to Ambulatory Care as there is less happening on the Acute Medical Unit. I made sure I had things signed off and my hours were signed. I finished a bit early (as I was off to Scout Camp), and that concluded my week!

Conclusion
I had a very eventful week. On my first day my patient collapsed on me (I will tell that story another time) and the rest of the week was full of people happy to talk to me and answer my questions. Everyone was busy, but they tried to squeeze me in. I generally followed people round if possible, and people were happy for me to cannulate them as I have actually been cannulating for longer than some of the nurses, as this is not included in their training. I did find some of the placement a bit repetitive, but I understand now that it is important for you to find your own experiences and education. Overall, it was a good placement! My next placement is Labour Ward, so keep your eyes peeled for that!

Read the others in this Hospital Placement series!
Acute Medical Unit
Maternity
Community Mental Health Placement - Prosthetics
Cardiac Intensive Care
Paediatrics



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