From the Trainer
Assistant Director (GP), South East Scotland, UK
E-mail: richardson.judith{at}googlemail.com
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A day in the life of a trainer |
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 TOP A day in the... |
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The alarm goes off and I roll over trying to ignore it; my husband brings me a cup of tea, my two small children jump on me forcing me to get up and face the day. The pace of the day picks up as I hurry to get out of the house in time to beat the morning rush hour and deposit the children at nursery.
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I arrive at work at 8:30 clutching a coffee, which I drink while waiting for the computer to load the increasing number of software programmes that we need to function as GPs. The first thing I check is the ePortfolio of my GP Specialist Registrar (GPStR) 3 in preparation for this morning's tutorial. He has obviously been busy preparing for this morning as well; there are 9 unread shared items for me to review including an out-of-hours session, a couple of new Consultations Observation Tools filled in by one of the other trainers in and a Direct Observation of Procedural Skills filled in by one of the practice nurses on taking a cervical smear. I read through these making comments, marking as read and validating against the competencies. I make a note to discuss the out-of-hours session as part of our tutorial, in particular, the certification of death in a nursing home and the issues surrounding palliative care in an out-of-hours setting. Next, I log into my GPStR 2 ePortfolio to catch up with what he has been doing; a couple of shared items and a Mini-CEX await, again I read through these validating, commenting and marking as read as I go. I send him a message reminding him that he needs to arrange his attachments with us and suggesting that as he is doing paediatrics to come on days we have the baby clinic.
Its 9:00 and I have not even looked at the mail and test results awaiting me in DOCMAN (our computerized document management system) or the 40 e-mails awaiting my attention. No time now as the computer goes ‘ping’ to announce the arrival of the first patient! Nine patients later, its time for a quick cup of coffee and to catch up with the practice gossip—how was such and such holiday and what everyone has done at the weekend. All too soon and its back to the consulting room, the computer and the final 6 patients of the morning, one patient has guttate psoriasis and I ask them if they would mind the GPStR 3 coming in to have a look at her rash. He comes through and we discuss the diagnosis with the patient.
12:00 should have finished surgery but running late. I finish consulting and do the mail, repeat prescriptions and referral letters while eating my lunch.
13:00 I go down to the GPStR's consulting room, we close the door and shut ourselves off from the hussle and bussle of the practice. The time of the week that I most look forward to; time to stop and think about the complexities of General Practice; to reflect not only on the GPStR's patient management but my own and to both teach and learn from the GPStR. We catch up on what has been happening for the past week including discussing his out-of-hours session and a couple of patients who have complex management issues. This week we do not have any Workplace-based Assessments to do but have agreed to look at videos of consultations with a particular aim of helping him to find ways to explore patients’ health beliefs and incorporate them into the explanation of their problems. We watch a couple of videos and discuss ways of changing the consultation to address these issues and agree that he will try to use these in future consultations. We also discuss how the structure of the consultation is improving and that as a result timekeeping is better following a similar video session looking at this the previous month. All too quickly 2 hours has passed and its time to emerge from his room and re-enter the practice.
15:00 I grab a cup of coffee as I pass the tearoom, pick up the paper mail (mostly junk and journals) and head back to the computer and an afternoon of Quality and Outcomes Framework administration. With my head spinning with targets, numbers and invites to screening I do a final check of the mail and log out of the computer.
17:30 I pick up the doctor’s bag and palm computer with our mobile clinical software on and say goodnight to the receptionists as I head out of the door to visit a patient in a nursing home with the GPStR on the way home. He is a 94-year-old retired professor whom I have known for years but sadly no longer recognizes me. As a result of his dementia, he is becoming increasingly difficult for the nursing staff to care for and we have a case conference arranged for the following week with his son, nursing home, and psychogeriatrician. We are just visiting to see how things are prior to the review.
18:30 arrive home in time to bath the children, read a story and put them to bed.
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