Getting the job as a HCA!

Prior to finishing this term, I had to complete some more hospital shifts as a healthcare assistant. During my week, I had the opportunity to work on the ward for complex needs. This allowed me to develop experience working with patients with high dependence and little or no independence at all. The majority of my shift involved taking observations and speaking with the patients and nurses, or helping patients feed or go to the toilet.

On break...with a disgusting cold cup of coffee...

I have recently really enjoyed working as a healthcare assistant so decided to apply for the job at the hospital as a Band 2 Healthcare Assistant - which I am happy to say I got the job! It could possibly mean I could stop commuting to my hometown to work in my retail store (where I have been working now for three years) and live permanently in my new city and work at the hospital there.

In this article, I'll describe some of the questions I was asked in my group interview regarding working at the hospital as a healthcare assistant...

• Why do you want to become a Healthcare Assistant? What are you currently doing?
• Have you had an experience which demonstrates your excellence in quality of care you deliver?
• Have you had an experience which demonstrates your respect for the patient and their dignity?
• What characteristics should a Healthcare Assistant have? What characteristics have you listed, do you demonstrate? (And provide some examples)

I also had to take part in a 30 minute numeracy paper and a 30 minute literacy paper in the assessment centre.

I got the results two days later, saying my job offer is conditional on a reference from my current line manager which was successful!

All of the nurses I have worked with have said that the perfect doctors have been healthcare assistants once in their life. Apparently, it creates great doctors who sympathise with the rest of the team and respect all the staff on the ward as you understand everyone's role, stresses and job role. This reduces the chance of a "pretentious doctor walking down the ward like they're better than everyone else."

Case-Based Learning

CBL = case-based learning; this is the type of teaching which my university is using to deliver its information to us medical students.

I find this such a great way of learning and it's very useful because it keeps all the information together. Each cycle is the same, just with a different system. So far for this year, we have studied the musculoskeletal system, cardiovascular system, respiratory system, gastrointestinal system and the urinary system. After the holiday, in term 3, we will be studying the neuro system and finally the endocrine system.

The cases are taught in two week cycles. These two weeks contain three facilitation sessions, one day of labs (and one session in the anatomy dissection room), one day of placement (GP or hospital, these are rotated) and ten lectures that deliver information on this section.

At the beginning of the cycle, we are given a case (of around 500 words) which will introduce us to a condition or complaint being presented by a patient regarding the cycle. So for cardiovascular, we had a patient with high blood pressure. In the musculoskeletal case, we looked at the use of anabolic steroids to develop muscle mass. In the urology case, we looked at two people who drank a certain amount of water before a marathon and the effects of dehydration etc. The problems described in the case will then be explored in our lectures for this case.

As an example, I will be using the respiratory case:

• Three facilitation sessions where we discuss the current case that has been presented to us. We sit and go through the learning objectives in the first facilitation session at the beginning of the cycle. We can identify parts of the case we don't understand that may not be or fully covered in lectures, so we will distribute and delegate presentations to each other and present them in the following facilitation session. We have another facilitation session mid-cycle to work out where we all are, and then a final session to conclude the case and clarify any final information we are struggling with or want help with (from the guidance of our facilitator who supervises us).
• 10 lectures - all delivered on the respiratory system but divided up across the two weeks. In these lectures, we learnt about the anatomy of the lung, how the lungs ventilate to provide gaseous exchange, what is gaseous exchange and the respiratory and metabolic responses within the body (at a cellular and organ level).
• One lab session in anatomy where we used cadavers to study the respiratory anatomy. In this session, we located the lungs, the pleura and other structures in the chest and mediastinum. But we also learnt about reading and interpreting x-rays of the chest and an introduction to taking a chest examination.
• I had placement in the GP, which meant I had the opportunity to do a home visit and meet a patient who had severe asthma. On the home visit, I was able to use my history taking skills to listen to the patient and understand the difficulties she experiences, but also apply the knowledge I had learnt in this cycle about the pathology and physiology causing her symptoms.
• People that had placement at the hospital for this cycle had the opportunity to practise percussion (banging your fingers on the chest to produce a sound which can signify hollowness [from air] or dullness [from a build-up of fluid]). There was also the chance to auscultate the chest (use a stethoscope to listen to the different lobes of the lung) and where to place the stethoscope.
• One lab session using the simulation patient to look at the effects of hyperventilation and climbing in altitude on the patient's respiratory rate, consciousness and oxygen saturation levels.
• One lab session on the effects of exercise on respiration (so doing an exercise activity and measuring the increase in respiratory rate etc).

This is the same structure for all of the cases.

Postmortem?!

I had an amazing opportunity to observe a postmortem this week! I am lucky that my facilitator is a pathologist who works in a coronary court to carry out postmortems on patients who have died 'suspiciously' (not like forensic murder!)

So what is a 'suspicious' death? According to my facilitator, this is where a patient has died unexpectedly, but hasn't seen a GP in the past two weeks before their death. This tends to be when a body has been found at home, and the death has come as a shock.

I was really shocked to how the postmortems are carried out. They are nothing like how they are portrayed in the media. The body is examined in a brightly lit lab - there is no small light dangling in a dark room with four people surrounding the body with their tools. In fact, there are four bodies being examined at the same time with one person doing it.

I won't go into the details in my blog, as I understand there is a line. But I would recommend you look at how they examine the body. They remove every organ from the body before examining each organ in detail. This is important to identify any health issues which may not be directly obvious from the outside as you are after all identifying the cause of death. For example, it is hard to look at a body that has been found, and see that the person died of a cardiac arrest. A postmortem will reveal hard crunchy coronary suggesting atherosclerosis that could've resulted in a myocardial infarction that killed the person. I would recommend you looking at the method they use to remove these body parts as I found it particularly fascinating.

This is an experience I was delighted to have the opportunity to take part in. I feel it endorsed my anatomy, as it was the most recent view I have seen of the internal anatomy of a human. Especially when the organs were removed, it was amazing to relate them to how close they appear in standard anatomy labelled diagrams! The liver is that red/purple colour in real life, despite it appearing greyer in the anatomy labs.