Thought I’d just have a little think back to the year just past. Here are my top 10 bits of 2011:

1. Ghana – top mates, interesting medicine, and a whole lotta memories
2. Running the half marathon with zilch training, the day after an all you can eat Chinese!!
3. Centre Parcs. Never been before, but a whole lotta fun with great company!
4. The amazing Uncaged Monkeys show the night I finished finals
5. Lake District. Plenty of walking and gatecrashed a stag do… ooops!
6. Barcelona…. strictly the end of the year before, but was wonderful…. Veggie tapas epicness!
7. Skeptics in the pub, my monthly nerdfest
8. National Trust. I am officially a member. How did that happen?
9. Weekend get-aways. The UK is beautiful, city, country, doesn’t matter! Managed a long weekend in Majorca too!
10. Magic shows: Derren Brown and Barry and Stuart

Here’s hoping 2012 is filled with as many laughs, new friends, and inspiration.. Would love to mention all those who have made the long days that little bit brighter, but I’d be here forever, and besides, I have a sneaking suspicion they know already!

Jxx

Unfortunately it all meant I was far to excited to work for most of the day… Probably a good thing, I’m exhausted !

Jx

At last, the exam season has begun for me. Treated myself to a massive burger (complete with onion rings and chips) for lunch to make up for all the nervous energy I *must* have burnt over the 3 hours!

Oh and this:

Nope, I didn’t go ker-azy with a cream egg and a cricket bat! This sort of…just…happened.

Oops, but still very yummy!

Jx

Jx

Finals start this week, but at least all will be over in a little over a week and a half! (Until resits…)

Cannot wait for lazy days, BBQ days, sand-between-the-toes beach days, pamper days, and learning to snowboard days. And I’m very excited that I seem to have bagged an interesting, relevant audit to do with a new friend, and a great placement with a truly fascinating department for some of my  post-exams private study time!

But until then, at least I’ve got these adorable “keep calm and…” badges to kep me smiling. That and a very full belly from the post-Easter-Sunday-pub-roast chocolate binge!

See you on the other side…

Jx

It’s now a month since I first heard about it, and thought it was time to reflect a little on my experience.

At a first glance, it seems kind of intuitive. Thie pieces of SBAR are:

S – Situation. Describing the current status/problem succinctly

B – Background. What has lead up to this? What are the salient points from the history?

A – Assessement. What have you done? What have you found? What does this tell you about what might be going on?

and finally

R – Reccomendations. SBAR as I’ve seen it has been used in handovers, so this is what the team handing over care recommend that the team taking over care should do.

There is a lot about this that I really get on with. It seems like a nice idea to begin with the key issue, sets the tone, allows the person you’re talking to to get a snapshot idea of what’s going on, particularly important in where patients have more complex histories or care issues. Often as I’ve come across patients being presented to colleages in the past, the order of the current situation and background may be flipped (as in “This is a x year old lady with a background of y and z, presenting with a”), so this has taken a little getting used to for me.

Another excellent aspect of the SBAR format is that it positively encourages doctors (in particular more juniour doctors) to engage in patient’s care more directly, by allowing them the opportunity (in fact, the format demands it) to make a management plan and vocalise it to others (the recommendation).

As well as handover, I have also been encouraged to use the format during an adrenaline fuelled simulation session, trying to get a registrar to come and see my increasingly sick (pretend) patient. Knowing that I was supposed to be using SBAR, and so was allowed to make firm recomendations to my senior (in this case, something along the lines of “drop what you’re doing and come help me NOW!!!!”) was very empowering!

However, even after amonth, something hasn’t quite gelled. I love the narrative of medicine. I love the descriptions patients use. I love engaging with people, and find it difficult to distill human interaction into a one line “neurology advised x”. Perhaps this is why I’ve always felt more of an affinity with the more narrative-based specialties (GP, psychiatry…) over the more ‘snapshot’ specialties. Without begining at the begining and working my way through, I know that I find it difficult to remember things. So SBAR can be something of a challenge.

In real life, we often come across several problems, and will solve some whilst still turning up new issues to be considered. This ‘disordering’, this natural chaos, is the environment my brain has learnt to cope with. To suddenly impose rigid barriers between the synthesising and exploration of theories feels artificial.

This is even more so in pressured situations. What I found with the simulated session was that my ability to synthesise the narrative of what was happening into an SBAR format felt nigh on impossible. Details bled away, my mind felt scrambled, and all I had to hang on to was “oh, I need to give my assessment now” rather than actually thinking about what information needed to be got across, what problems we’d encountered, and what steps we’d already taken to help the situation.

I am sure this is a tool that I will discover when it can be used well. I am sure I will also learn to use it at times I currently find difficult. But not today.

Jx

1) That yoghurt is really easy to make-although does require youghurt to make it.
2) That giving traditional birth attendents cranberry juice will not cure their social phobias.
3) Facebook is the best procrastination tool known to man (well, students anyway).
4) That vital websites will always be down, email inboxes full, library books MIA and coffee machines without any cups the night before a deadline.
5) The hilarity of geeky stats jokes is inversely proportional to the time (in hours) since last using SPSS.
6) That research karma is real – I blame not filling in all those 3rd year PHP questionnaires for my response rate.
7) That “statistics is just REALLY hard” (pearl of wisdom, apparently).
8) That medcaf will never be able to meet the brownie demand caused by intercalators!
9) Not to advertise sexual preferences on emails sent to staff.
10) “It’s a fork” (otherwise known as assume makes an ass of u and me)

Hungarian Gypsies may only drink brandy at 3 points during the day: First thing in the morning, in the middle of the night at a wake, or by women prior to going on a rubbish scavenging expedition.

From http://www.sirc.org/publik/drinking6.html

Referenced to Stewart M. (1992). I can’t drink beer, I’ve just drunk water: Alcohol, bodily substance and commensality among Hungarian Rom. In D. Gefou-Madianou (ed.), Alcohol, Gender and Culture. London: Routledge.

Armstrong and Miller = genius.