A Placement in Queensland's Beef Capital
I recently completed my first JFPP placement at Rockhampton (Rocky) Base Hospital under the mentorship of Dr. Khadri (Clinical Lead - Emergency Department). Rocky is a regional city in Central Queensland, 636 kilometres NW of Brisbane and fondly referred to as the Beef Capital.
I never could have imagined how many skills and experiences I would obtain and encounter during this 10 day period.
Being a first-year student, any placement was going to be a fast learning curve. However, nothing could have prepared me for this. Thankfully I have already worked in emergency of a tertiary hospital in Queensland as a pharmacist, so I was already familiar with the work flow and operation. If this hadn’t been the case I think ED would be quite a daunting environment for a first-year student and perhaps a difficult initial placement.
From my personal experience, learning in a tertiary hospital can be quite difficult. There are many clinicians above you and for some reason people just aren’t as friendly and down to earth. In Rocky all doctors, from SMO’s to interns were willing to teach and get me involved.
At the beginning of my placement, we implemented some great structure and I would recommend all students to do the same. I planned to rotate between the different areas of the Department daily. This would allow to me to see different presentations and work flows but also shadow many doctors at varying levels of training.
Secondly, I sat down with my mentor and set objectives for the first placement. On my first day I was asked to retrieve a patient from the waiting room and do the history. At first, I thought - me? I have never done this on a real person? But I quickly learnt how important it is to find confidence in the skills learned at university.
I also swiftly became comfortable with the uncomfortable. By the end of the week I was managing “simple” ED presentations under the guidance of the SMO. An example of such was a patient history, exam of a wound and suturing the wound or a patient history, examination and cannulation. Skills that I practiced during the week and became much more comfortable with included cannulation, intramuscular injection, suturing, many systems’ exams, histories, patient management from admission to discharge or transfer, investigation requests and the referral process. I also observed catheterisation, fracture reduction under sedation, foreign body removal from the eye, cardiac chest pain management and regional site management of CVA and MI.
Besides the medical skills acquired during the time, I learnt a lot about the challenges of regional/rural medicine. Rocky is a retrieval site, meaning many patients had travelled large distances to see a health care professional. Stressors affecting the lives of these patients were also greatly different to those of patients treated in urban medicine. All of this must be considered when taking a holistic approach to management. It was devastating to see and assist in the management of the current ICE epidemic affecting many parts of regional and rural Australia.
In this part of Queensland there are also many labourers, mine and farm workers. This means that many ED presentations are trauma or injury related. I learnt a lot from the people of Central Queensland and asked questions of my patients to allow myself to learn more. I spent the weekend visiting the local zoo, botanical gardens and visited the local beaches with my AirBnB hosts. I happened to be in Rocky during the ‘40 degrees Celsius for 4 days straight’ heat wave and catastrophic bushfires.
The lifestyle of being able to walk home through the quiet regional town, observing the beautiful sunset and enjoying the fresh air is definitely a lifestyle that all training medical professionals should strongly consider. The tight knit community was also impossible not to love!
Watch one, do one, teach one is the best motto to work by as a medical student. Often, I found myself feeling quite nervous at the thought of this but the only way to learn is to eventually do it yourself. I felt very supported in Rocky however it is vital that any students in a similar position are comfortable to just go for it and get used to feeling slightly uncomfortable. The doctors are there to help and support you, so just give it a go!!! I have already started planning objectives for next year and can’t wait to once again become involved with the Rocky community and work within the Emergency department.