This week I am doing four days of work experience at a General Practice surgery, partly shadowing doctors in consultations, going out with a district nurse, and seeing what some of the administration is like. I did my first day today which started off with signing the confidentiality agreement, then I was invited to shadow one of the doctors for the morning.
I was struck straight away this morning by the massive variety of cases she was faced with in such a short space of time. As time went on I was amazed by how she adapted between patients. One moment she was comforting the depressed and mourning, the next laughing about her holidays with a patient with a throat infection. She explained to me a bit about each patient in between appointments, and from what she was saying I could tell that one very important thing about being a GP (and, I suppose any type of medical doctor) is that you can't always take things at face value. After a considerable number of patients she would tell me that the pain wasn't as bad as they made out, or that she had only referred the patient in order to reassure the patient that there was nothing wrong with them, despite knowing full well herself that physically, the patient didn't need it. So I could see how a doctor needs to look outside the obvious and read between the lines in order to treat the patient the best possible way.
Another thing that hit me from the first appointment was the intimacy that the patients trust the doctor with. Not just physically, but patients seem to open up their feelings to a GP in a way that one would never see anywhere else. This puts the doctor in such a responsible position; they have to be able to deal with this trust in the right way and uphold this unique relationship they have with the patient.
I also had the opportunity to ask the doctor what she thought the best and worst bits of the job were. She clearly loved her job and said the thing she most enjoyed about general practice was being able to get to know patients' stories and being able to follow their lives through a number of years. It seemed to me that for some patients, the GP was the only constant thing for them and so sometimes all they needed was a chat and an empathetic listening ear to offload their problems to.
The worst part of the job for her was having to give people bad news, especially when they didn't expect anything like it, and I can imagine this must be one of the hardest things for a GP to do. But she also said that she hates all the paperwork!
I hadn't realised before today how key teamwork is for a GP, as you don't really see this side of it from a patient's point of view; it all goes on 'behind the scenes'. But she was constantly phoning other people within the practice to organise different things for the patients which I suppose makes sense when I think about it. It was a surprise though seeing as from the outside, being a GP does seem to be quite a solitary job in comparison to for example a medic in an emergency department of a city hospital.
I spent the afternoon with two nurses doing routine immunisation injections for people going abroad, nerve impulse checks with diabetics, dressing leg ulcers and ear syringing. This too was interesting, seeing how the different jobs within the NHS vary and work so well together. Being able to see this contrast between doctors and nurses though has made me more sure that I want to be a doctor rather than a nurse. It's a very important job the nurses do and I know that their training is getting more and more scientifically based, but I would just love to be leading the diagnosis stage of treatment for more complex illnesses.
Today has been very interesting and tomorrow I am going back to the surgery before spending a day out with the district nurses. I'm looking forward to what tomorrow has in store!
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