Term paper on Clinical Deplacement in a NHS Podiatry Clinic

Evaluating my experience as an observer, I should say that I accept all my experience as positive one. I think that it will contribute into my development as a specialist. I appreciate that I had an opportunity to observe different patients with different cases. I think that I benefitted much from communicating with the staff in the clinic. I think that being an observer of doctor’s work with the child patient did me a lot of good. I suppose that one more advantage of the practice was coming across the situation when my knowledge contradicted the actions of the practitioner. The only negative thing is that I had limited time with patients and I did not have an opportunity to study the history of disease of more patients in detail. Another bad thing was that I did not always could consult the practitioner as he was busy most of the time. However, my notes helped me and I managed to ask him most of the questions I wanted later.

Analysing my experience I should admit that it made me reconsider many things and think about the things I have never learnt at shcool. I appreciate that people who were busy with their routine work still could pay attention to me and could give me some of their time. I liked how the doctors in the clinic worked. They try to implement an individual approach to their patients. I suppose that the doctor used the right strategy in communication with the patient who had comorbid paranoid schizophrenia. He used both linguistic means of communication, gestures and mimic. The tone of his speech should be emphasized. This and other approaches are described as the most effective ones in such cases in France and Krame (2001: 352-357). The authors emphasize the necessity of combination of all the means of communication with this type of patients. I think that the doctor was right to spare some time to the patient and consulting her about the inheritance of her disease as she was anxious about her son’s health. The Leavitts (2011: 1-2) emphasize the importance of communication with the patient and his/her satisfaction for the treatment and improved outcomes. I think that the clinicians are right in trying to keep in contact with families and relatives of their patients In difficult cases and cases with children patients. I paid attention to the importance of considering comorbid diseases in the strategy and during the course of treatment. I knew that in cases of diabetes patients the clinic specialists had to decide whether to transfer them to a specialized clinic for patients with diabetes or to leave them to be admitted in the hospital. I was wondering how the decision making process was organized and what factors were considered in such cases. I was explained that every decision was taken on individual basis and that the specialists from the specialized clinic are often involved into the process of decision making. The most important factor is usually the level of risk to a patient’s life.

Summing up my experience, I would like to emphasize that I realized that practical experience develops our skills and makes us to look at routine situations which happen in our practice from different angles. It is important to consider different aspects of our profession. A doctor should not only demonstrate his health care skills but be a psychologist and develop an individual approach to each patient. I think that the specialists of the clinic follow the right strategy of working with the patients. I suppose that I should develop my skills in communication, increase my health care knowledge and train myself to be a good psychologist. I realized that interaction with your colleagues and with patients’ family and relatives may be rather beneficial for treatment. So, I should be able to use it in my professional activity. Decision making skills are very important in the profession as well. So, I think that I should develop myself in this direction. When I started my practice I intended to be concentrated more on the process of diagnosing, treatment and examination of the patients. However, now I think that communication with patients and some peculiarities of working with the patients were to be more important for me. I should have paid more attention to these aspects of my practical experience. My health care knowledge is not enough to go deep into diagnosing and treatment, still they are not less important. I think that such experience teach us to look holistically at different situations and see the deviations from what we study as students and what we observe in practice. Thus, we move from rule driven practice to gaining experience and relying less on rules as long as there is safe practice.

Speaking about the action plan, I think that I would pay more time to different aspects of clinicians’ work than to the process of treatment. I would still keep making notes about everything I observe. I would like to organize my time with patients in a different way. I would prefer studying the history of the disease first, having some time to boost my knowledge or to find more information about comorbid diseases and special needs of the patient and then starting my observation experience. It would be easier for me in such a way to be a more active participator of the process.



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