研修感悟-柯医生2

May,7th , 2019 cloudy

All doctors that work with patients in the UK must be registered with the GMC(general medical council) to undertake clinical practice. Since 2009,they are also required to have a medical licence to practice that gives a doctor the legal authority to undertake certain activities in the UK. For example prescribing medication and working in the NHS. Doctors are described by the specialist area that they practice in, for example cardiology, and by the level of training and experience they have ,which is called their grade.

All medical doctors start as medical students and typically continue training until they become a consultant ,GP(general practitioner) or SAS (staff grade, associate specialist and specialty) doctor.

May,8th , 2019 cloudy

Types of doctors:

The following is an overview of medical students and different types of doctors. Other than for medical students, all doctors listed are all medically qualified and will usually use the title “Dr” before their name. Doctors who perform surgery may, due to historical reasons, use the titles “Mr”, “Mrs”, “Miss” or “Ms” instead. A doctor that is a university professor may also use the title “Professor” instead of “Dr”.The title “Dr”.It is important to be aware that the title “Dr” is also used by dentists or people who have a PhD(doctor of philosophy) degree, although they may not be a medically qualified doctor.

May,9th , 2019 cloudy

How the NHS works and its structure and funding

NHS established in 1948

The founding principles:

Services should be comprehensive, universal and free at the point of delivery except Dental Treatment and Optical Care.

NHS structure:

Initially: 

1. Hospital Services (in regions)

2. Primary Care (GPs, Dentists, Opticians worked as independent contractors not salaried employees)

3. Community Services (including Maternity, Child Welfare, Vaccination and Ambulance Services)

May,10th , 2019 cloudy

My daily work is to follow my consultant Suba to work in the clinic or perform surgery in the theatre in the morning and deal with related matters in the afternoon in IVF studio.

They do not wear white coat as the work jacket.

Every operating room has a player playing music, which helps to relieve the tension in the operating room and relieve the pressure of patients.

In terms of country or theatre, London is a melting pot. Today, I have observed five operations in Croydon university hospital with the anesthesiologist from Singapore, the itinerant nurses from Poland, the instrument nurses from South Africa, and the students from Korea.

May,13th , 2019 cloudy

Multi-disciplinary care occurs when professionals from a range of disciplines and specialities with different but complementary skills, knowledge and experience work together to deliver comprehensive healthcare aimed at providing the best possible outcome for the physical and psychosocial needs of a patient in their care. Multi-disciplinary care are an important part of daily work in every hospital. Members included in Multi-disciplinary Team are as follows:

Doctors、Nurses、Healthcare Assistant、Pharmacists、Physiotherapist、Occupational、Therapist、Radiographer、Dietitian、Psychologist 、Behavioral Therapist、Dentist

May,14th , 2019 rainy

The daily work of the reproductive center is the controlled ovulation induction. The only operation is egg collection. After collecting the eggs, the eggs are packed in a special incubator and transported by their husbands to a laboratory in London.

May,15th , 2019 cloudy

Doctors and patients have different perceptions of China. On the first day of Ali’ clinic, a patient was so interested in China and Chinese doctors that he put consultant on hold. He asked: Is the reason why I came to Britain to study is that China is underdeveloped? In the 1960s and 1970s, China had only bicycles, but now they have cars, Ali said. I say: we have not only cars,our transportation, such as the subway, is much more developed. So from then on, I began to consciously convey the good image of China and Chinese medicine. For example, a nurse from South Africa asked me this morning: How is the IVF in China? I said: in the leading position in the world. Then she said, "So if I want to do IVF, I should go to China, right?" I said: “Yes”.

May,16th , 2019 cloudy

The first operation: Oocyte retrieval, using a disposable puncture stand, with a rubber band tied to it, because there is no laboratory, they use double chambers, each follicle was checked through blood flow signal to select puncture point, the patient obtained 15 eggs. Using a special BOX to transport the gamete. Generally speaking, for example, 17 eggs result in 12 embryos, most people will choose to culture the blastocysts and get 6-7 blastocysts. The anesthesiologist asked us if we were going to pick eggs under the condition of anesthesia. I said no anesthesia, only sedation. They do not use Durantine. It seemed that because they were in google, they had either general anesthesia or lidocaine on vaginal anesthesia.  

May,17th , 2019 cloudy

The evaluation of the operation: 1. Before the operation, the surgeon will wear ordinary clothes to enter the preparation room and sign the consent form with the patient. 2. Content of the form is very concise, complications will always be bleeding and infection, patients have a high degree of trust in doctors. Most of operations do not wear masks, only wear hats. 2. Simple surgical instruments are put in place. Instrument nurses step down to do other things. The surgeon takes what he needs. 3. Operating room is not very serious, no matter doctors or patients feel relax. 4. TiME-OUT was checked strictly before and after the operation. All the medical staffs were gathered together and asked questions by the itinerant nurses. 5. Operating room washroom were in the same room. The operating bed was not fixed in the theatre, it' was pushed in when operation began and pushed out again when operation finished. 6. It was very safe to use their special surgical bottle opener to open the fluid bottle.

May,20th , 2019 cloudy

In the UK, previous NICE guidelines defined infertility as failure to conceive after regular unprotected sexual intercourse for two years in the absence of known reproductive pathology.  Updated NICE guidelines do not include a specific definition, but recommend that "A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility, should be offered further clinical assessment and investigation along with her partner, with earlier referral to a specialist if the woman is over 36 years of age.

May,21th , 2019 cloudy

GP plays an important role in the whole medical system. Consultant feeds patient information back to the secretary in the walkie-talkie and then secretary feeds back it to GP after recording it. They attach great importance to training, such as two classes a week for the infection control, covering every employee.

Pay attention to any details to guide the healthy life of patients.Emphasize team work.

May,22th , 2019 cloudy

Guidance for patients can be divided into informed consent guidance and general post-operative guidance. In Britain, all surgical procedures require the consent of the patient himself. But healthcare professionals may provide emergency treatment to patients without consent provided that the treatment is necessary to preserve life or to prevent a serious deterioration in the patient’s condition. Some post-operative instructions are very thoughtful and meticulous.

Remember that at any time the patient has the right to refuse consent!

Valid consent to treatment is absolutely central in all forms of healthcare. Patients must be informed about risks, benefits and consequences of proposed treatment. 

May,23th , 2019 cloudy

All patients should be treated equally regardless of gender, race, sexual orientation, age and religion. 

Pay more attention to patients' feelings.Encourage patients to ask questions–this makes patients feeling control of their care and health.Bed design is very ingenious and takes full account of patient comfort.

May,24th , 2019 cloudy

Human-oriented concept:

Color recognition is used in every corner of the hospital. For example, different colors guide patients to different areas of treatment,;  The size of surgical gowns are distinguished by color, yellow represents small clothes; The type of operating room are distinguished by color, orange represents daytime surgery.