It's been a busy week in university-land. All the students that have had to resit exams have been given their results. It must have been a pretty tough week for an unfortunate few as they have to decide whether they can face repeating a year or they may even be looking at an entirely different career to medicine.I did some sessions as an OSCE examiner this year. OSCEs are Objective Structured Clinical Examinations and are now accepted as a fairly standard method for assessing the clinical skills of students.
It is interesting to watch students show off skills that I, along with generations of doctors, had to learn on the job, at ungodly hours, with no supervision and scant training. I am young enough to have done a rudimentary OSCE as a student but old enough to remember the squeaky bum terror (apologies to Alex Ferguson) of doing a lumbar puncture after reading it up in the ever-faithful and well-thumbed Oxford Handbook of Medicine. Our first years can do all sorts of practical procedures that I have never been taught formally. The old and bold may moan about the molly-coddling of students but I like to think we are now molly-coddling the patients rather than the junior doctors.
Our Trust has imposed a 'bare below the elbows' policy. No rings, no watches, no ties, no nothing. At the OSCEs it was quite striking how all the students wear their wristwatches on their belt loops or some of the females have a nurse-style upside down watch thing (do they have a name?). They all practice perfect Ayliffe technique handwashing and (again, I have never been taught that either - you can see it here) are quite the little infection control wallahs.
How many GPs do you know that follow this policy? I gladly gave up my bug-ridden tie on the slightest sniff of evidence of a problem but I feel some reticence to give up my watch and wedding band. I have yet to examine the evidence for this policy but I can't find any mention it on the Health Protection Agency site. However, it is one of those policies that it is tough to rail against at first glance. A second glance may be merited but the benefits of handwashing are pretty clear cut.
Still, I am trying to be positive and I am considering indulging myself with a pocket watch as I feel sure they could be due for a revival in the medical profession. I am not sure if I will be able to pull off a waistcoat to match but potentially I could look quite the dapper country GP gent.
4 comments:
Our infection control crowd did look for evidence on ties etc. They didn't find any.
Removing a wedding ring to safe a life? I expect it's a bit like the life jackets stowed under your seat in airplanes . . . it's protocol that it's done, but it's not an action that's saving lives.
The only thing I can think of re the wedding ring is not the ring itself which is highly unlikely (this sounds like good statistical evidence!) to be a source of infection, but what about the cleansing agent that collects underneath it, and how long does some of it lurk there.
"nurse style upside down watch thing" - well, when I was a girl (!!!) they were called "fob" watches. My daughter (who is training as a nurse) has one. I always used to think it might be a bit of comfort as you held it up with one hand to see the second hand going round whilst holding the patient's wrist with the other to take the pulse and made you concentrate that bit harder on counting. Who knows, but they certainly had a LARGE second hand that you couldn't miss - and, really, digital watches aren't much use for taking a pulse or breathing rate accurately, are they?
You will need to get a nice portly belly to hang the watch and chain on and then be able to ask if "t' patient is feelin' reet poorly".
Sorry, my brother in law is from Yorkshire and will probably punch me for that.
Anonymous, it is amazing the number of patients who have a pulse rate of 60 when you count with a digital watch.
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