Pennod 2 Doctoriaid Yfory

-Subtitles

-Subtitles

-

-Subtitles

-It's a new term and the cameras

-are back at the School of Medicine.

-We follow young students...

-We follow young students...

-

-I have no idea where I'm going!

-..on a unique course.

-..on a unique course.

-

-I'm looking for scrubs.

-Entering the medical world

-for the first time.

-I'm trying to make sure

-the airway is open.

-I tilt the head back

-to let air into the lungs.

-Facing the crisis

-in our health service.

-Every bed is taken.

-It's after the bank holiday.

-There are people in the corridor.

-It's the reality of a busy hospital.

-Is that alcohol free?!

-The female ward is full.

-There's one patient in casualty...

-..who can't be brought in

-because it's so busy.

-Treating fatal diseases.

-Is this patient high risk?

-After assessment, they've decided

-she's at a high risk of dying.

-Fragile lives.

-How long have I got?

-He's been worrying about today since

-having the scan a few weeks ago.

-What's going to happen

-with my family?

-These are the doctors of tomorrow.

-I can't wait to help people.

-I can't wait to help people.

-

-Thank you, boss.

-The University Hospital of Wales

-is nurturing the next generation...

-..of doctors and offers a pioneering

-course for enthusiastic students.

-From the early days, the emphasis

-is on practical experience.

-Trainee doctors meet real patients.

-Can you do this one?

-Bend your knee and bring

-your heel towards your bum.

-Can I have a quick look

-at your eyes?

-Can you pull down

-on your lower eyelids?

-They face years of studying.

-The journey for medical students

-is long.

-At the Princess of Wales Hospital

-in Bridgend...

-..third-year student Ffion

-is on a clinical placement.

-I arrived here

-as a shy girl from Porthmadog.

-I didn't know many people.

-My confidence has grown

-since then...

-..and I'm now friends

-with some wonderful people.

-On the first day of my placement,

-I was so nervous.

-I didn't know what I was doing.

-I had to ask people

-where I was supposed to go.

-I have a really busy morning today.

-I'm going straight to Cardiology.

-I have to do cannulas

-and I'm nervous about that.

-Then I'm going to see angiograms...

-..and I might have the chance

-to take some bloods.

-Excuse me!

-I feel really nervous

-about doing the cannulas.

-We'll see how they go.

-There we are, all done.

-It's such a different experience

-doing it on real people.

-The pressure of doing any skill

-for the first time...

-..is quite strange.

-You could have drawn blood in

-a fake situation countless times...

-..but taking blood

-from a real person...

-..pushing the needle into skin...

-..and possibly hurting someone,

-is very odd.

-I'm doing this one.

-We'll see how it goes. I hope

-he helps me if I get into trouble.

-Can you talk me through it?

-Can you talk me through it?

-

-Of course, of course.

-I'm worried I won't find the vein.

-With some older patients,

-the veins are smaller.

-They're difficult to find.

-I'm really sorry.

-I'm really sorry.

-

-Don't worry.

-People move, speak and complain.

-Mannequins don't complain.

-They don't feel pain.

-It was different

-coming in this year...

-..to do the skills on real people.

-I'm really worried

-about hurting the patient.

-When the needle goes in,

-that's the bit that hurts.

-After that, it shouldn't.

-If I do it properly,

-it shouldn't hurt.

-Ten out of ten.

-Ten out of ten.

-

-I wish it was ten out of ten.

-It was better than I expected.

-I successfully found the vein.

-I didn't press down firmly enough

-on the hand...

-..so some blood came out.

-I love cannulas now. I did one

-on my last day with the day team.

-It was a fantastic feeling.

-With the cannula in place...

-..the patient is ready

-for more tests.

-Over in the Royal Gwent Hospital,

-Newport...

-..third-year student Dafydd

-is on an anaesthetic placement.

-Dafydd will spend time

-in the surgery theatre...

-..dealing with general surgeries

-and emergencies.

-Anything can happen -

-that's what I like about CEPOD.

-You don't know what'll turn up

-on the day.

-You could have a whirlwind of a day

-and it's really incredible.

-An emergency case arrives

-and routine surgery is postponed.

-The emergency is the priority.

-She had an intestinal complaint.

-They didn't know

-what was wrong with it.

-We had to go in to check it.

-It was quite exciting

-to try and diagnose the problem...

-..but you could see the stress

-on the face of the surgeon...

-..because you don't know

-what you'll find.

-This lady has come in feeling ill.

-She's short of breath.

-She has a bloated stomach.

-They think her colon has ruptured.

-They think she might have

-an infection too.

-She has hypertension,

-high blood pressure.

-She's also diabetic.

-That complicates the problem.

-So, is this patient high risk

-to come into theatre?

-Yes, she is,

-she's got multiple factors...

-..which puts her

-in a high-risk category.

-She's in for an emergency,

-acute, abdominal surgery.

-Being elderly and she's diabetic,

-she's hypertensive...

-..she might have

-an ischemic heart disease...

-..poor functional tolerance -

-all that contribute as factors.

-After assessing the patient,

-they decided she was high risk.

-She's in danger of dying.

-When an emergency operation

-is carried out...

-..it's very different.

-They haven't had enough time

-to prepare for that patient.

-Often, you'll see more people

-in the theatre.

-The radio's off.

-They check everything.

-People come and go and it's like a

-whirlwind happening in front of you.

-Any surgery like that is high risk.

-There's a huge risk

-of there being an infection.

-If the colon is ruptured...

-..it's not nice seeing

-what goes into the stomach.

-The body responds quickly

-and it becomes serious.

-The surgery involved

-is a laparotomy.

-They cut straight down

-the middle of the stomach...

-..and open everything up

-to see what's gone wrong.

-If you're seeing this for

-the first time, get yourself ready!

-In North Wales, an A&E department

-is straining under the pressure.

-Jess is a third-year student.

-Going on a placement

-is the best thing about the course.

-I just love it. This is why

-I wanted to do the course.

-The first is sepsis.

-Every single patient, you should

-ask yourself is this sepsis?

-Under Dr Subbe's guidance,

-Jess feels the pressure...

-..of a real medical emergency

-and the reality of the work.

-I had an operation in January.

-I had my appendix out

-and a piece of bowel.

-They thought it could be

-something to do with that.

-There's some trial and error

-when you're on a placement.

-You go with your gut feeling

-and learn as much as you can.

-Have you had chest infections

-before? Have you travelled recently?

-No.

-It's so important

-that they can see the reality...

-..and see different illnesses.

-We think that this is a pneumonia

-of your right lung.

-It's a significant pneumonia

-from the blood test and the X-ray.

-We'd expect it to get slowly better

-over the next few days.

-We've got you on drip antibiotics.

-After 48 hours, we'll switch you

-to tablet antibiotics...

-..and hope you continue to improve.

-Thank you very much.

-Back in Newport, Dafydd's patient

-is ready for the emergency surgery.

-The tension in the theatre

-is evident to everyone.

-The patient is asleep.

-They're about to do the first cut.

-They hope her breathing

-will improve...

-..because the pressure

-from the abdomen...

-..prevents her

-from breathing properly.

-When they relieve that pressure

-from the lung....

-..they hope to see an improvement

-in her breathing.

-They've just burnt the skin

-to gain access to the abdomen...

-..to stem the flow of blood

-more than anything else.

-You can smell it.

-It's a smell

-I've never experienced before.

-There are so many team members

-in the theatre.

-You have the surgeons,

-the anaesthetists, the nurses.

-They all have individual jobs.

-The anaesthetists make sure

-that the patient is OK...

-..to take the pressure

-off the surgeons.

-They concentrate on the surgery.

-After entering the abdomen...

-..they've discovered

-that part of the small bowel...

-..has died because of ischemia.

-Ischemia is caused by the organ not

-being supplied with enough blood.

-They'll cut that part out...

-..and re-join both parts together.

-I think that when we watch patients

-during surgery...

-..it's important to remember

-that they're actually there.

-Sometimes you forget, especially

-when they're covered by a sheet...

-..and you can only see

-the surgical area.

-Sometimes you forget

-that the patient's there.

-If you're going to open

-someone up...

-..it's going to be a huge risk.

-It doesn't always work out.

-The dangers for this patient

-are high...

-..and the surgery is far from over.

-.

-Subtitles

-Subtitles

-

-Subtitles

-In Bridgend,

-third-year student Ffion...

-..is on a work placement

-at the Princess of Wales Hospital.

-We're going to follow some of

-the patients we've already seen...

-..who had the cannulas.

-They'll have angiograms where

-we put a dye through the cannula.

-We're going to take a photo

-of the heart.

-The dye will show

-the blood vessels...

-..and highlight any problems

-with the heart.

-Everyone's here because they have

-symptoms relating to the heart.

-The angiogram test

-will show any illnesses...

-..that cause the symptoms.

-To enter that room...

-..I have to wear these scrubs.

-The test is crucial for a diagnosis

-but it can be dangerous.

-It's a worrying time

-for the patient.

-How are you feeling about going in?

-How are you feeling about going in?

-

-Really nervous.

-What are you nervous about?

-What are you nervous about?

-

-Needles.

-Do you not like needles?

-Have you got your cannula in?

-Yes.

-Lead-filled clothing

-protects staff from the radiation.

-That goes around your neck

-to protect your thyroid.

-We wear these to protect

-any vital organs from radiation.

-Thank you.

-It's really heavy.

-Very fashionable. You could be

-on the catwalk like that.

-They are quite heavy, actually.

-Angiograms measure blood flow

-around the heart.

-A tube is fed into a vein

-in the arm...

-..straight to the patient's heart.

-They do around 100 a week

-which is quite a lot.

-The risks can be quite serious.

-It's not a high risk,

-only one in a thousand...

-..but patients can experience

-a heart attack or a stroke...

-..and they can die on the table.

-The staff are very aware

-of the risks.

-There's a defibrillator

-in the corner.

-They're always ready in case

-something serious happens.

-They've looked at the blood vessels

-to the heart.

-It looks normal.

-They've noticed a problem

-with one of the valves.

-They're inserting another wire

-to check the valve.

-The doctor said that serious

-problems happen very rarely.

-It's better for the patients

-to have the test...

-..to make sure there are

-no problems with the heart.

-I didn't think it would be that easy

-but it was very straightforward.

-Her coronary arteries are normal.

-The chest discomfort is not angina,

-which is good.

-The arteries are all clear.

-She's also diabetic.

-That can lead to clogged arteries.

-It looks as if they're clear.

-It's good news for the patient.

-In Ysbyty Gwynedd, Jess experiences

-the reality of the A&E Department.

-When people are admitted

-to the A&E Department...

-..people don't see

-behind closed doors.

-It can be manic trying to get the

-right people to the right places.

-If you're in the waiting room,

-you might think everything was calm.

-With many patients waiting,

-Jess deals with James...

-..the young pneumonia patient.

-He's already moved from the main

-ward to the quarantine department.

-He has a history of MRSA...

-..from surgery he'd previously had.

-He's in his own cubicle.

-It puts you on edge when you face

-a situation like this...

-..when you have to wear gloves.

-The possibility of transferring

-the infection between patients...

-..is quite high.

-A little bit nerve-wracking.

-Hiya, are you alright?

-I'm Jessica, I'm a medical student.

-Do you mind if I just have

-a quick chat with you?

-How are you feeling today?

-Exactly the same.

-Exactly the same, still none

-the wiser what's up with me.

-Is your biggest frustration

-that you don't know what's going on?

-I've been left in this room

-and no-one wants to come in to me.

-I've told them eight times

-about this bell.

-You had MRSA before

-and they put you in here in case.

-When they took my staples out,

-they were a bit weeping.

-And then a little section...

-I can see it there.

-That didn't heal

-for what must have been five weeks.

-It was open.

-That's where they got the MRSA.

-It was really interesting.

-I didn't expect the patient

-to say what he did.

-He was frustrated that he

-didn't know what was going on...

-..with his treatment.

-He doesn't know

-what medicine he's taking.

-He doesn't know what's happening.

-We have to shut the door

-because of infections...

-..but he feels as though

-he's being ignored.

-He's noticed a lump

-on the scar he had after surgery.

-Nobody's picked up on this before.

-When he coughs, it gets worse.

-We're not sure if it's a hernia.

-When you're busy, you don't have

-time to go to the toilet or eat...

-..but you still want to make

-your patient feel...

-..that they're the focus

-of your attention right then.

-Sometimes, that can't happen.

-I've had people shouting at me

-and calling me numerous names...

-..when it seems to them

-that we're doing nothing.

-After starting on a course

-of strong antibiotics...

-..James' situation

-starts to improve...

-..and he's on the road to recovery.

-Since this morning,

-the patient's NEW score...

-..has dropped from five to two

-which shows he's recovering.

-This will be down to

-the antibiotics.

-The plan now is to start

-cutting down on his antibiotics.

-In the Royal Gwent Hospital...

-..an emergency operation

-is carried out on a dead colon.

-The patient is diabetic

-and has high blood pressure.

-This is a problematic procedure...

-..and the team is concerned

-about her deteriorating health.

-The anaesthetist

-is inserting a central line.

-The line is inserted

-in the patient's neck...

-..and that allows them

-to administer medication...

-..that can access

-the heart directly.

-It's important to get the line

-directly to the heart...

-..to administer drugs

-directly to the body...

-..and to place a monitor.

-That's important for the anaesthetic

-team to keep the patient stable.

-He's using ultrasound

-to localise the line in the neck.

-It's important not to hit

-the other structures in the neck...

-..such as the arteries.

-The patient is rather unstable.

-It's crucial to get

-the central line in...

-..to get quick access to the heart

-and administer drugs quickly...

-..to prevent any changes

-in her body.

-The situation

-can remain quite tense.

-The anaesthetist and surgeon

-are talking constantly...

-..about blood supply,

-blood pressure, the heart...

-..whether the patient is stable.

-You have to stop the surgery to make

-sure the anaesthetist is happy...

-..with the blood pressure and pulse.

-As you can see, there's loads

-happening at the same time.

-The surgeons are working there.

-The anaesthetist team is up here

-inserting a line.

-I've had the chance to see many

-things happening at the same time.

-It is exciting.

-This is so amazing to watch.

-Seeing the reality of surgery

-is challenging but crucial...

-..in the education

-of our young doctors.

-I enjoy the intense situations.

-I feel I work better under pressure.

-I enjoy the speed of thought...

-..and making quick decisions.

-It's a lot more exciting.

-At the moment,

-it all feels hands-on.

-We're having the opportunity

-to use all the skills we practised.

-We're doing it in hospital.

-It's great.

-The surgery has just finished. The

-patient will come out on a new bed.

-She'll go up to Resus or ITU.

-People will look after her.

-The next patient will then come down

-and we'll prepare for surgery.

-For tomorrow's doctors,

-it's going to be a long day.

-S4C Subtitles by Testun Cyf.

-.