Categories
The Application

Application Timeline for 2022 Entry

Explaining the timeline for Graduate Entry Medicine can sometimes be confusing – a lot of work happens the year/s before!

As of now (March 2021) this will be my (rough based on last year) timeline:

May 2021 – GAMSAT registration opens for September 2021 testing.

June 2021 – UCAT registration opens for 2021 testing (July – October).

July 2021 – UCAT testing begins.

September 2021 – GAMSAT testing.

October 2021 – UCAS deadline for Medicine & Dentistry applicants. UCAT testing ends.

November 2021 – UCAT results sent to universities. GAMSAT results released to September candidates.

December 2021 – Communication from Universities – Interview invites, pre-interview rejections and work experience evidence.

January 2022 – Interviews begin. GAMSAT registration for March 2022 opens.

February 2022 – Student Finance applications open for new students. Deadline is roughly the end of May 2022.

March 2022 – Offers and waiting lists begin being allocated. GAMSAT testing.

July 2022 – Most offers/ rejections sent out. Waiting lists still operate.

September 2022 – Waiting lists close and courses start for 2022.

Exceptions or other time constraints – work experience must be completed by the October 2021 UCAS application deadline to be counted towards your application total (e.g. Warwick University).

Some universities send correspondence throughout the application cycle, others operate under radio silence.

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Uncategorized

Rebrand/ New Logo

I’ve now branched out onto just about all social media. It’s spurred me on to have a bit more of a professional image/ logo so, here it is!

Categories
Work Experience

HCA Interviews – What Will They Ask Me?

Recently, my temporary contract (from my redeployment) came to an end. My Trust and manager informed me that there would be permanent band 3 HCA posts being advertised shortly. In January, the posts were advertised on the NHS Jobs website. These were open to both internal and external applicants. They were also a different number of positions for all the wards, not only mine.

I filled in an application and sent it off. It took about 4 weeks before I was shortlisted and invited to interview.

There were some HR related issues and my interview was cancelled on the morning it was due and I was offered the permanent role by my manager instead. Which was very convenient for me.

However, I was able to find out some of the questions I would have been asked. All candidates that were going to be interviewed would have been asked the same questions and their interview performance assessed by people they did not know or work with. This meant there was a very real chance that if I had interviewed poorly, I might not have gotten the job I have been doing for the last 11 months. A really scary possibility and something my manager was not informed of either. (She was interviewing too but kept away from our interview panels. It would have been better for the ward managers to interview the candidates for their own wards, to know who would be a good fit for their team and patients.)

Regardless, HCA work is deemed the ‘gold-standard’ of work experience. It’s invaluable. It’s hands-on, patient care. It’s patient centred and the chance to work as part of a multi-disciplinary team. It really sets you up for all aspect of working within the NHS.

INTERVIEW:

Will I need one?

Yes, you will. Every band and role requires an interview.

Who will interview me?

This depends. For my interview it was a Clinical Lead Occupational Therapist, a Nurse Consultant from another ward, and a Ward Manager from another ward. Sometimes there will be HR involved or people who already do the job. Usually it will be a Ward Manager or Team Leader for the ward/ department.

Will the interview be in person or online?

I’ve know of interviews being held in both formats but mine was offered online via Microsoft Teams.

How long will it be?

Mine was scheduled for 30 minutes.

WHAT WILL THEY ASK/ LOOK FOR?

All the way through an NHS interview there will be questions that should allow you to showcase your skills and why you are best suited to the job.

WHY THIS ROLE/ DEMONSTRATE YOUR SKILLS?

For a HCA role, you’ll be prompted to draw on your precious experiences to demonstrate you’re a good fit and can do the job. For example: I had the experience from doing the job previously but they would still look for the aspects of being caring, compassionate and competent. Have you done a caring job before? Do you teach or mentor? All really transferable skills!

SCENARIO QUESTIONS:

So, the NHS/ Healthcare LOVE these. I find they’re often easier to answer as you can put yourself in that situation and explain what you’d do. You don’t have to necessarily find appropriate examples of previous skills.

A PATIENT ASKS FOR FOOD/ DRINK OUTSIDE OF THEIR MEAL TIMES, WHAT DO YOU DO?

This is quite a common question. A patient makes a request for something that you don’t know what to do with. How do you handle not knowing something?

Refer to their care plan. It’ll detail if they’re on any restrictions or special dietary requirements.

Check their food and fluid chart – they may have missed a meal or been a significant amount of time since they’ve had a drink/ low on hydration.

Most importantly – ask your team. You’re not completely on your own. The staff you work with may be experienced and able to guide you, that’s why we work as a team. It’s all about support. Always ask if you’re unsure. It may seem really simple such as someone is thirsty and wants a drink but I have previously worked with a patient who is on restricted fluids. They may also be restricted for medical reasons e.g. an upcoming appointment or due to medication.

YOU’RE IN AN MDT AND THE CLINICAL TEAM ARE MAKING A CHANGE TO A PATIENT’S CARE THAT YOU BELIEVE IS NOT IN THEIR BEST INTEREST. WHAT DO YOU DO?

Again, really common scenario. Linked with professional disagreement/ how to challenge professionally. You may be applying for a band 2 position or a band 8b, it doesn’t matter. Everyone should be able to work and communicate what is both safely and in the patient’s best interests.

You can professionally challenge ensuring you explain why you believe this is not in the best interests of the patient. Give examples, if you’ve worked with them before then that helps.

Suggest that this change be made temporarily or on a trial basis. This will show that you’re open to change but aren’t fixed to a permanent care plan change should it not work.

HOW DO YOU KNOW A PATIENT HAS DETERIORATED?

Classic!

Deterioration is anything below the ‘normal’ or baseline presentation of your patient. If you have worked with them for a long time, you’ll know what is normal and what is not. How do you tell if you don’t work with them? PHYSICAL OBSERVATIONS/ PHYSICAL HEALTH! Check their BP, Pulse, O2, temperature. Make sure it’s written up in their NEWS chart and any scoring escalate to the NIC. If significant scoring, the on-call doctor will review, if life threatening, always call 999.

Little signs such as a patient not looking well – colour being off, sleeping a lot, not quite themselves are all signs of deterioration. THIS IS HOW I ESCALATED AND HELPED TO DIAGNOSE THAT MY PATIENT HAD COVID LAST YEAR.

HOW DO MAINTAIN PRIVACY/ DIGNITY AND/OR CONFIDENTIALITY?

A very common question.

Privacy and dignity can be anything from washing/ bathing/ dressing/ changing clothes or dressings and ensuring the patient is covered or kept away from an audience.

If breaking bad news to a patient, ensure they’re in a private or quiet area so that they can process this and display their emotions without fear of people watching.

In mental health, incidents requiring physical restraint are usually handled by ensuring the patient, staff and peers are safe, if this occurs somewhere communal/ busy, clear out the area of non-essential staff and patients that don’t need to observe someone at their worst.

These are only a few examples and not a complete copy and paste of the questions I was due to be asked but very similar.

Be sure of your skills, show how much you care, know the priorities and values of the NHS. Most of all RELAX AND BE YOU! If you don’t know something, be honest but explain what your steps would be to solve the situation, despite not knowing/ how you would expand your knowledge for next time. 30 minutes might seem like a long time but it’s definitely not long enough to sell yourself completely!

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Uncategorized

A Day in the Life of a Mental Health HCA

Recently I completed a story update which covered a day in the life of a mental health HCA/ my day at work. It wasn’t particularly eventful as our days go but it was nice to show what we do and how we handle situations and how much work we actually cover.

If you missed it or wanted a more detailed run down, here it is!

My working day starts at 7:30am for clinical handover. I’m usually at the hospital/ ward earlier so that I can get changed into my uniform and collect my keys and blick (personal alarm device).

Handover will usually be rather quick. It’s a rundown of how the patients have been recently and any significant information that the nursing team need to know. As we’ve had our patients for a while, we know a lot of the information already e.g. Legal Status, Section, Observation levels and immediate health concerns.
We would be told if anyone’s obs levels have changed e.g. from 1:1 to general observations or if they’ve been increased and why.

On a day shift, we usually hear how the patients have been over night and the days before. If you’re on a night shift, you hear how they have been during the day and the previous nights.

Handover usually takes 5-15 minutes, afterwards, the team are allocated to their observations so that the staff team who are currently on obs can swap and go home.
On a day shift, this would usually mean that the patients are all still in bed. We have patients who enjoy a lie in, it doesn’t mean that they will be asleep when you come in but it’s usually the case.
On a nightshift, patients are all awake and you can swap to begin engaging with the patients.

Observations – If a patient is asleep, their observation levels may change e.g. 2:1 when awake but only 1:1 when asleep. You sit outside their room and note their breathing, any movement or use of the toilet. Basically anything of significance. On a nightshift when everyone is asleep, you swap around and spend most of the night doing this.

During the day, we usually spend 1hr observation periods with each patient. From the point of waking, we get patients organised and assist with personal care. All of our patients get up in the morning and either shower or take a bath. They’re very independant and don’t require a lot of help other that to wash their back or help with their hair washing. We have to ensure that patients do not remove or store their own toiletries and we also dispense shampoo/ shower gel for them. It’s not uncommon for our patients to ‘tip’ their toiletries or not use them at all.

Patients are given their medication and breakfast. HCAs are responsible for ensuring patients have adequate food and fluid throughout the day – this is also monitored and uploaded to their electronic records. We use plastic plates and cups and depending on the patient, they may not have access to metal cutlery e.g. they are risk assessed as being someone who may us a knife to harm staff.

In the hour we spend with the patient, we engage in activities they may enjoy. One patient enjoys colouring and so you can easily spend an hour colouring pictures together. Another patient has a stricter schedule for his day and certain activities are care planned for certain times e.g. walk at 10:30am. The day and activities are usually based on how the patient is presenting during the day and our staffing levels to complete these activities.

We used to eat with our patients at meal times as it’s a really successful and therapeutic activity, unfortunately COVID put a stop to this and we find it quite difficult to organise who gets breaks when and around the obs schedule.

Due to the nature of our patients we due often restrain. The ward has had a significant reduction in our restraints and I can’t remember the last time I was involved in full supine, PMVA holds. We are more likely (at the moment) to have to implement arm holds to escort a patient to a room for ‘time out’ or to secure them from attempting to harm staff.

We have a variety of jobs to do around the core job of patient care:
We complete temperature/ date and stock checks daily.
I try to attend the daily reviews – we have a daily meeting at 9am which discusses our patients with our team of clinicians. Any issues are raised and we get to discuss how we may move forward.
On Friday mornings, we have an MDT for one of our patients – this involves a full team, including clinicians and social care. We discuss possible care packages/ providers and their goal of discharge. Medication reviews are done and any alterations to their care e.g. obs level and S17 leave are discussed here.
We have a cleaning rota to complete (important due to COVID).
Laundry is completed – patients are encouraged to complete their own with the supervision of staff but staff have the overall responsibility.
We have to ensure that patients have sufficient funds/cash for the week and if needed, we withdraw this from the onsite bank facilities.

If a patient has S17 leave, this can either be for ground leave or area leave. We often take our patients out for walks around the site, to visit the hospital canteen or if care planned, they can be taken to a nearby supermarket or to visit nearby family. Each patient is unique in their leave plans. We have a ward car and this is utilised for patient transport. I’m usually driving!

We spend 12.5 hours a day with our patients and it’s long. We go to work in the dark and return in the dark. Dayshift is 7:30-20:00, nightshift is 19:30-8:00.

Whilst there are obvious challenges of the job – physical aggression and violence to staff, property and environmental damage, violence and aggression to peers, verbal abuse and the risk of absconding. I have been kicked, I’ve had a patient attempt to strangle me and grab at my throat, I’ve been hit and scratched but.. we also have some really enjoyable and rewarding work with our patients. As our longest patient has been with us for 2 years (nearly 3) we can build really good relationships with them. They know your name, what you’re like as a person, ask you if you’ve had your hair done and will remember when you’re next on shift. I can remember walking on to the ward and having a patient stood right at the doors to greet me, as I entered the patient cheered. They were cheering all the staff onto the ward!

We dance with our patients, we laugh, we feel their pain and frustrations, we are their family when theirs can’t be there.

I should be sad that I’m working all of Christmas but to be honest, I feel really lucky to spend it with those that need me. I truly love my job and the personalities of those I work with. It’s not for everyone but it’s definitely for me.

Categories
Work Experience

GP Placement – Tuesday

Today we were at a different practice and completing minor surgical procedures. There was my Dr, myself and a qualified Nurse present for this.

We saw a total of 5 patients; 4 of which we completed procedures on.

Patient 1:

A male presents with a cyst on his back. Took him through and lying on the bed. The cyst was marked to show the margins and incision line (this was checked as the patient was standing – the cyst is pushed by two fingers either from the left and right or up and down to see which shows the most elasticity. The elasticity allows for suturing and minimises the risk of sutures bursting or the wound reopening and not healing.) Local anaesthetic was dawn and injected into the site, around the margins. The amount of anaesthetic used was as minimal as 0.5mls.

The site was checked to make sure there was no sensation and that the anaesthetic had kicked in. The initial incision was made with a round-bladed scalpel. This cyst was very superficial and could be seen very quickly from the first incision. With a bit of patience and retraction the skin was cleaned from the surface of the cyst. Forceps were used to help ensure the cyst was fully unattached before removal. This cyst was attached quite well and on removal, the base still remained attached. After a careful extraction of the base of the cyst, the sample was bottled and the would sutured with 4 sutures and dressed.

Patient 2:

Patient 2 was a male who had a mole on his back that he wanted removed. Again, it was inspected and found to be benign. We took him though and injected the local anaesthetic. Moles don’t need to be marked up as they have clear margins due to their colour and the procedure. Once anaesthetic has kicked in, the mole was literally scrapped away from the skin. Moles often will do this although it is not recommended that patients do this themselves! Once removed the sample is bottled and the wound is burned to prevent bleeding. (People mention the smell of burning skin and it doesn’t/ didn’t bother me but I can imagine some would be put off by this! It reminds me of when a big fly/ wasp gets zapped by the big killers!😂) The site was then dressed.

Patient 3:

Patient consulted for a mole. Mole was very ‘squidgy’, no colour changes or other features of malignancy. The patient was happy and so it was decided not to remove it.

Patient 4:

A lady came in with a skin tag on her neck. She was having problems with it getting caught on clothing or when she brushed her long hair. We agreed to remove it although had informed her that if she could manage with it, removal wasn’t necessary. Due to the location she was adamant that she would like to part with it.

We took her through and injected anaesthetic. The tag was removed using a flat ended scalpel, the area was then burned to prevent bleeding and dressed.

Patient 5:

This gentleman had been to have a cyst removed previously. Unfortunately, he hadn’t eaten breakfast, had been up all night with his young child and generally felt unwell. He told me how he had seen the instruments being prepped, eyed the scalpel and felt very unwell. He did the right thing and informed the GP and nurse who both discontinued the procedure. He assures us that he was well rested, had eaten and was feeling very well.

He was a very nervous patient and was oversharing and very chatty as a way of coping with his nerves. We took him through and marked out his cyst which was on his scalp. Again, injected local and once anaesthetised, the initial cut was made. This cyst had been present for a while and proved to be a bit trickier to separate from the superficial layer. It also presented as being deeper than the first. It took time and patience to get it to the position of removing it, although once there, it was removed easily and came out all intact.

With the position of the cyst being on his scalp, the sutures don’t follow the same rule as the previous and stitches were thrown from front to back of the scalp. My GP took the time to explain that throwing a vertical mattress stitch in the middle of the incision meant that the edges of the wound would close together, evenly. This would prevent the edges of the wound overlapping, healing unevenly and taking longer to heal. Two more stitches were thrown either side to close the incision nicely.

Afternoon:

We spent the afternoon in surgery, again, a variety of patients and ailments. We managed to see 7 patients in our short session.

First patient was a gentleman who had a ?UTI. He had booked the appointment however, had previously seen a nurse practitioner who had prescribed some medication and things seemed to have settled. He described himself as being well. He had brought a urine sample and it was dip tested. The strip lit up like a Christmas tree! He had proteins present, blood present, the whole works. Despite his reluctance due to feeling back to normal, he was strongly advised to finish his medication and to hand in another urine sample after the course of treatment to rule out any other possibility.

A women with knee pain and had a history of neoplasia. She was advised to have bloods taken as a precaution before further treatment/ investigation.

An 11 month old presenting with chronic pain up to 20 minutes after feeding, up to 3 times a day. The baby would go rigid and arch his back whilst screaming out in pain. Mum had brought baby in and seen a Dr who had prescribed lactulose for constipation and mum had not been convinced so requested a second opinion. Baby’s chest, ears and throat were examined. His temperature was within normal limits. He was examined, abdomen was soft and non-tender. He was stripped completely and check for any signs of construction or lack of circulation. He was extremely happy and smiley all the way through. No signs of any other cause of pain and it was explained that we weren’t siding with a colleagues opinion and that we would always welcome any patient or parent to do the same, however on this occasion we would recommend taking the lactulose, even splitting feeding up with cooled boiled water to help as breastfeeding. Any more problems and come back to the surgery.

A gentleman who’s forehead was quite scaly and red. He was given some moisturising cream and steroid cream to treat. He also had some moles he wanted checked. Happy to report all were benign and posed no problems so are happy to be left alone.

Another young child with a viral infection. Temp was high, breathing a little laboured, ears red. Prescribed a course of antibiotics and again, if not seeing improvements, to return to surgery.

A man had a cyst on his neck. He previously had one on his face, was booked to see Dermatology at the hospital however, before the appointment it resolved itself. We both inspected the cyst and were happy it was benign however, due to its location, it would be removed by Dermatology. Referral completed.

An interesting one! A gentleman came in after having a punch biopsy performed for malignancy. The area where the biopsy was completed wouldn’t heal. It was inspected and pathology results consulted. He was referred back to his hospital consultant. It appears that the clinic letter stated that the punch biopsy was completed and malignancy was removed successfully. However, the pathology results showed that there was only the punch biopsy completed. The malignancy was never removed, hence why the wound would not heal.

What I learned:

  • Always eat breakfast before minor surgery.
  • How to throw a vertical mattress suture.
  • That cysts can smell.. badly.
  • Patients won’t tell you when they’re nervous.
  • A qualified nurse isn’t always required in minor surgery but it’s really refreshing to have a fellow healthcare professional assisting.
  • Parents feel extremely guilty when they are ill and then their child becomes ill. It can be emotional.
  • Consultants and GP’s can often get things wrong/ make mistakes, we are human. It’s important to check your work (or that of your secretaries).
  • A second opinion is never a bad thing or a question of someone’s ability to diagnose.
  • The importance of taking a full dose of antibiotics/ medication. You may feel better or normal but infection can still remain.

Overall:

I thoroughly enjoyed the minor surgery experience. I’m not squeamish and it was great to see that a GP still has the opportunities to use some finesse and surgical skills should they want to. I enjoyed having the opportunity to talk with a qualified nurse. Claire was lovely! We discussed the importance of asthma checkups (she runs an afternoon asthma clinic) and how asthma isn’t always a 100% foolproof diagnosis. It’s all a learning curve.