Day 15: My last day
Well in the midst of rushing around trying to pack, do some last minute shopping, repack, catching a taxi and catching all 3 of my flights , I was able to spend some time reflecting on my 2 weeks in Gladstone.
Overall, my experience in Gladstone was excellent, I absolutely loved it. I cannot speak more highly of the town, the hospital and JFPP in general. I learnt so much in this placement, by watching- gastric, ortho and general surgery, obstetrics, ward rounds, anaesthetics, ED consults, fracture clinics, paeds clinics, antenatal clinics, postnatal clinics, baby checks, ambulance duty, plastering, medical imaging, handover meetings, phlebotomy, suturing, immunisations, history taking & med charts, physical examination, triaging, midwifery, nursing; and by doing- scrubbing in, assisting in surgery, listening to foetal heart sounds, taking bloods, cannulating, putting in LMAs, giving anaesthetic drugs, doing physical examinations on both adults and babies and much more.
Gladstone Hospital is a small but capable hospital, with friendly staff who took the time to explain things, answer my dumb questions, quiz us, show us procedures and watch over us as we practiced (and point me in the right direction when I was lost). No doubt this increased their workload, but the doctors, nurses, assisting staff, paramedics, midwives and receptionists were only too willing to give us a helping hand. If there was anything that we wanted to do, then all we had to do was as- and that environment is something I know is difficult to find in large city hospitals- there is no way that I would have been able to walk into a major city hospital, scrub in and assist in a c-section on my first day.
And 0f course I can’t go past the patients. I’m very grateful that they were so accommodating- letting me watch, poke,prod and stab them (maybe that’s why they’re called “patient”s- having to put up with us med students ;)) and all the while most of them were only too happy to chat with me about Gladstone, Tassie and whatever else. I can imagine that having a med student present in your time of distress/discomfort is not what most people want, but almost everyone seemed to understand that the only way we could learn was by being there.
Throughout the placement I’ve also become aware of the issues surrounding the GH. The GH is running on a minimum of staff with the staff shortages especially noticeable in January with people being sick and on leave. Almost all of the staff were from different countries, many were new and quite a few of the staff only stayed for short periods of time with the hospital having to rely on locums and one or 2 specialists. To their credit, the staff that were here were VERY dedicated- they gave up a lot of their time to be either at work or on call and on several occasions there was no choice as there just wasn’t anyone there as a backup- I watched as the only anaesthetist came off a 10 hour shift in surgery and ED only to get called in for an emergency caesar at 11 o’clock at night. The doctors there also did an amazing variety of work (and that was very appealing for me)- I saw my mentor, the head of the GH and a GP by training, working in surgery doing c-sections, in fracture clinic, doing anaethetic work, coming to ward rounds and helping out in HDU- he pretty much covered every specialty there was! I can really see why rural doctors have a wide range of skills and experience a wide variety of situations.
Because of the lack of some fixed staff, the GH is also limited in the services it can provide- e.g. a lack of full time specialised anaesthetists meant a limit to the patients they could treat and meant that there was no ICU and thus a lot of referring, a lack of some specialists (ortho surgeon, ophthalmologist, radiologist etc) meant that they had to rely on telemedicine, weekly visiting doctors from Rockie and more referrals. Surprisingly for me, the patients weren’t too fazed about having to go to Rockie or Brisbane to be treated. I never heard one patient complain about that- they just adapted to what the reality was.
And that seemed to be the attitude of most people- “this is what we have, how do we get around any problems” - an almost natural resolve and practicality. It’s going to be very interesting for me now to go back to a really large hospital, where distance isn’t so much of a problem, and resources are more easily available and see the similarities and differences.
Anyway that is about all I can think of atm (my brain is in desperate need of some sleep :O). I’ve really had a great experience in Gladstone, and I know everyone finishes off by saying this- but I truly cannot WAIT to go back for my second placement and subsequent placements and to see how much the town has changed!