Pennod 6 Doctoriaid Yfory

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-It's a new term and the cameras are

-back at the School of Medicine...

-..following young students...

-I don't know where I'm going.

-..on a unique course.

-I'm looking for scrubs.

-Stepping into the medical world

-for the first time.

-I'm opening the airway

-and tilting the head back.

-Facing the emergencies

-of our health service.

-Every bed is taken,

-especially after the bank holiday.

-People sitting in corridors,

-it's the reality of a busy hospital.

-That's alcohol free.

-The women's ward is full.

-One casualty patient is waiting.

-It's become so busy

-during the past 20 minutes.

-Treating life-threatening illnesses.

-Is this patient high risk?

-They assessed the patient and

-there's a high risk of fatality.

-Fragile lives.

-How long have I got?

-He's been worried about today

-since the scan three weeks ago.

-What's going to happen

-with my family?

-These are tomorrow's doctors.

-I want to help people.

-I want to help people.

-

-Thank you, Mos.

-In Newport's Gwent Hospital,

-some of the third-year students...

-..receive practical experience

-in different departments.

-Eben joins the surgery team.

-I'm on my way

-to the anaesthesia department.

-I'll be going to the theatre where

-they specialise in emergencies.

-I've never been to a theatre where

-I can watch the anaesthesia before.

-Today we'll see a patient with

-a femoral hernia in the groin.

-Mrs Haynes is in her 70s. This

-operation is not without its risks.

-To lessen the risk, she'll only

-receive a local anaesthetic.

-She'll stay awake

-during the operation.

-It's not a common hernia.

-Inguinal hernias are more common.

-They do happen and when they do,

-they're removed by surgery.

-Two teams work together -

-the surgeons and the anaesthetists.

-The patient receives a cannula

-into her hand.

-She'll receive

-the anaesthetic through her back.

-There'll be no pain from here down,

-in the legs.

-The patient will be awake

-during the surgery...

-..but they won't feel a thing.

-She doesn't have great bones

-in her back - she has arthritis.

-Her back isn't straight.

-There's more bone

-than there is in a normal person.

-It took quite a while

-to give her the injection.

-Can you feel this here?

-To test

-whether she feels pain at all...

-..they spray her

-with some water droplets.

-They do that because the

-spinothalamic tract in the body...

-..can detect pain and sensation.

-She can still feel the water.

-The doctors decide to administer

-a general anaesthetic...

-..to send her to sleep.

-Communication between all parties

-is now as important as ever.

-They have to get everything right.

-There's no room for error.

-They must get the right amount

-of medicine in the right place.

-It all looks very complicated.

-They'll burn her skin, then stretch

-it open to see the hernia.

-They've had to move the structures

-such as the femoral artery.

-They pushed the hernia

-under these structures...

-..to stop it re-emerging.

-After doing that, they'll put

-a mesh over it to keep it in place.

-What I find interesting is how many

-people from different departments...

-..in this hospital work together...

-..to provide the best care

-for the patient.

-I learnt a lot

-from the anaesthetic team.

-I didn't realise

-there was so much communication...

-..between the anaesthetists,

-surgeons and patient.

-I've learnt a lot.

-Surgery is over. We're moving

-the patient to recovery now.

-I was on telly!

-Bye.

-The patient was very buoyant

-which made it all so much easier.

-There was a relationship there

-from the start.

-It's so important to have a good

-relationship with the patient.

-No problem.

-It was lovely to meet you.

-You get better soon, alright?

-You're very, very welcome. Bye.

-How many children have you fostered?

-Between 60 and 70 but some

-were called supporting lodgings.

-I still called them my foster kids.

-That's amazing.

-This woman is incredible.

-She has 21 grandchildren too.

-21 grandchildren.

-She's 74 years old.

-She's done remarkably well.

-My grandchildren can talk Welsh.

-Better than their Welsh grandmother.

-As the academic year

-draws to a close...

-..Eleri completes her fifth year

-as a medical student...

-..on a placement near her home.

-It's strange being back

-in Ysbyty Gwynedd.

-When I had appointments as a child,

-I'd come to Ysbyty Gwynedd.

-It's nice to be close to home

-for the final block.

-Many patients speak Welsh

-which isn't the case down south.

-Good morning.

-How do you feel?

-How do you feel?

-

-Quite good, thanks.

-Today, Eleri is responsible

-for Mr Jenkins.

-He's having problems

-with his gall bladder...

-..which has caused

-a case of jaundice.

-You were meant to go home last week.

-I had the stents inserted last week

-to unblock the gall bladder.

-My blood hasn't recovered.

-They're checking every day,

-fair play to them.

-It's nice speaking Welsh

-to the patients.

-It's so important to get a community

-of Welsh-speaking doctors...

-..who can speak

-and treat patients in Welsh.

-The hope is that the stent can make

-the blood tests on the liver easier.

-That's right.

-It makes the treatment

-more personal.

-Thank you very much.

-They can speak Welsh to the team,

-the doctors and nurses.

-That makes such a difference.

-We want more students

-from Wales...

-..to study medicine in Wales

-and then stay in Wales...

-..to work as doctors.

-That's the course.

-Mr Jenkins has seen a few changes

-in his blood tests over the weekend.

-They've been deteriorating.

-He's going to have another stent

-inserted.

-He had one last week.

-They think the stent has moved.

-The plan is to insert another

-to see if it works...

-..in the hope of getting him home

-soon because he's been here so long.

-We're going down

-to the X-ray department...

-..where the procedure will happen.

-It's tight in here.

-I hope it doesn't break down and

-we're stuck here for half an hour.

-You're on a bed if we do get stuck!

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-On a placement in Ysbyty Gwynedd...

-..Jess can practise

-her blood-taking skills.

-Are you happy for me

-to take your blood?

-Yes. It'll be the second time today.

-Have you had your blood

-taken already?

-Make sure you leave some behind.

-I'll try my best. I need a lot.

-Oh, yes?

-Not too painful?

-No, it's fine.

-I definitely want to stay in Wales

-when I start working.

-I grew up here,

-it's where I come from.

-It's a wonderful place to work.

-I'm bleeding you dry!

-The opportunity to speak Welsh

-in work is a great help.

-That's alcohol-free.

-That's one of the main reasons

-I want to stay in Wales.

-Thank you.

-Thanks for letting me do that.

-Not many people like having students

-doing that.

-You have to learn.

-It's a great feeling when

-you're doing it for the first time.

-You've seen a doctor doing it,

-you've seen it on TV. It looks easy.

-When you're there for the first

-time, you forget everything.

-I managed to get some blood.

-I needed quite a lot, four bottles.

-It's a good feeling when you get it.

-These are going to the lab.

-I'm very nervous thinking

-that in two years' time...

-..I won't be able to hide behind

-my student lanyard.

-People will look up to me

-as a real doctor.

-I'll be treating patients

-and making decisions.

-I've grown so much this year

-and learnt so much.

-Within two years, I hope I'll be

-ready to go out into the world...

-..to treat people as a doctor.

-Every single patient, you should

-ask yourself, "Is this sepsis?"

-I want you to spot it.

-It will not get through.

-As the third year

-draws to a close...

-..Rhodri also feels

-the pressure mounting.

-During my time in medical school...

-..the expectations rise every year.

-By this time of year, we've almost

-completed the third year...

-..we're expected...

-..to be able to diagnose a patient.

-What could be causing

-these symptoms?

-While taking

-a patient's medical history...

-..students should spot significant

-changes in their condition.

-Do you have any family history

-of medical conditions?

-A heart murmur when I was born.

-With Mrs Hodgson, there's concern

-about her recent weight loss.

-How long has that weight loss

-gone on for?

-Since January.

-How much do you think you've lost?

-About 50kgs.

-50? Gosh, that is a lot, isn't it?

-That's serious.

-I've got no clothes that fit me.

-I put things on and they hang.

-The rings don't fit your fingers?

-No wedding ring, no engagement ring.

-There's a history of reflux.

-Every time she ate,

-she gets a reflux.

-She also has a pain in her chest.

-Right now,

-sometimes she starts gagging...

-..which causes her a lot of pain

-and she can't eat a thing.

-How much are you managing to eat?

-How much are you managing to eat?

-

-Just about nothing.

-Just about nothing.

-You mentioned about the crackers.

-How many of them

-would you have in a day?

-Maybe one.

-Have you had the camera tests?

-How were they?

-Everything came back fine.

-Any other medical conditions?

-Do you have diabetes?

-I have had diabetes but my doctor

-says I've lost so much weight...

-..there's no way

-I've got diabetes now.

-Do you drink any alcohol?

-Do you drink any alcohol?

-

-I do but not much.

-How much alcohol do you drink?

-Brandy diluted in a glass like that.

-Every night?

-Every night.

-It's the only way I can sleep.

-OK.

-When you're in so much pain,

-you need something.

-It's apparent that Mrs Hodgson's

-problems are complex...

-..and she requires more tests.

-There are simple tests you can do.

-I'm going to write everything up

-about everything we discussed.

-Then I'll research some

-of the conditions or illnesses...

-..she could have.

-I'll then start thinking

-about a plan for her...

-..and get her home

-as quickly as I can.

-After a month of tests and treatment

-in hospital...

-..Mrs Hodgson gained enough weight

-to return home.

-Jess has taken

-Mr Jones' medical history...

-..after he was admitted

-to the emergency department...

-..short of breath.

-She will present the information

-to the consultant...

-..Dr Subbe.

-He has left-sided chest pain

-but I think that's more muscular...

-..because he's had several rib

-fractures after falling from a tree!

-You fell out of a tree?

-You fell out of a tree?

-

-Yes.

-That's good enough, yeah.

-Given that we know he climbs

-into trees, he's normally very fit.

-I'm 72, my brother is 74.

-They can't stop him.

-The other one is 76.

-They can't stop him.

-Not everybody over the age of 70

-is still in trees.

-I was a patient in A&E a few times

-when I was younger.

-I was just clumsy, I broke bones.

-These haven't disconnected.

-They're really free.

-Family members

-have attended hospital.

-It has changed how I see patients.

-That's a good perspective to have

-when you're on a placement.

-You're looking for lung markings,

-those lines going to the periphery.

-In most areas, I can see that.

-We're happy there's no obvious cause

-of breathlessness.

-Two minutes.

-Two minutes.

-

-You're getting Welsh on me now!

-We'll have a look at your tracing

-of the heart to see what's going on.

-You have a slow pulse.

-There's a beat that looks different.

-It could be a ventricular ectopic.

-That would give you also

-different morphology, wouldn't it?

-The heart has got a pump

-and it's got electricity.

-The electricity normally starts

-at the top bit of the heart.

-The normal is always like this.

-So now, that only works

-when all the electricity is proper.

-What happens in your case is...

-Pop, pop, pop.

-Occasionally you miss a beat there.

-That means your heart is much slower

-than it would otherwise be.

-If you would run up a tree,

-the pulse should go faster.

-The heart needs to pump more oxygen.

-In your case, it drops a few beats.

-Then you start getting short

-of breath. That's what happens.

-Would a clock thing sort that out?

-If you would have a pacemaker...

-..then it might do extra beats...

-..and you might have better function

-and more oxygen delivered...

-..and you might be

-less short of breath.

-Is that alright? OK.

-Thank you.

-Thank you.

-Thank you.

-

-Thank you.

-On the Tryfan ward, on her

-final placement on the course...

-..fifth-year student Eleri

-is treating Mr Jenkins.

-I'm expecting

-I'll get another camera.

-Another camera?

-He has stomach problems

-and jaundice.

-My blood isn't recovering.

-He feels OK himself. He doesn't have

-the symptoms he had when he came in.

-He just wants to get

-his blood back...

-..to the base line it was

-before these symptoms started.

-OK, great.

-He's on his way to theatre...

-..to have a small camera

-inserted down his throat.

-At the moment,

-they're just sedating Mr Jenkins.

-I haven't seen

-this procedure before.

-Last week, the doctors

-inserted a stent in his stomach.

-There seems to be

-some kind of blockage there.

-We're looking for

-the bilirubin level.

-That's created in the gall bladder.

-The bile can't travel out.

-That's blocked right now.

-We're trying to insert a stent

-to release it.

-When the bile is released, hopefully

-the bilirubin will come down.

-The bilirubin

-has caused his jaundice.

-The blood tests will improve,

-as will his skin colour.

-They've inserted the stent

-to help release the bile.

-It looks as if it's working.

-That was really interesting.

-It's the first time

-I've witnessed that treatment.

-It was uncomfortable to watch...

-..since they inserted a tube

-while he was still awake.

-He was sedated but not too much.

-I could see the stent

-they'd inserted last week.

-They've stretched the stent

-with another balloon...

-..to help release more bile.

-As her fifth year

-draws to a close...

-..Mr Jenkins will be one

-of the final patients...

-..Eleri will treat as a student.

-The next step is to start work

-next month.

-It's huge.

-Taking that step, taking this

-lanyard off and starting work...

-..I don't think one person can

-say that without feeling some fear.

-Hello, how do you feel now?

-Hello, how do you feel now?

-

-Better, thanks.

-We have more responsibility

-when we start work...

-..but we've learnt to work

-as a team.

-We don't work alone. There are

-so many people around us to help.

-I'll see you tomorrow.

-That makes me feel more comfortable

-about starting the job.

-From their first lecture...

-From their first lecture...

-

-I'll introduce something else...

-..to the graduation ceremony

-at the end of the course...

-..it's a long journey

-for tomorrow's doctors.

-Is that cold?

-It's quite fiddly.

-Do you pull it towards you?

-This year, they've mastered

-all kinds of new skills.

-This is a difficult skill.

-This is a difficult skill.

-

-It's uncomfortable for the patient.

-I'm going to pretend to be a doctor.

-I'm going to pretend to be a doctor.

-

-Yay!

-They've seen patients

-at their most vulnerable.

-They've learnt how to build

-a relationship with them.

-How are you feeling

-about going in today?

-Really nervous.

-That's such a weight off my mind.

-Lovely. Thank you, Mos.

-Thank you very much.

-Some of them have matured.

-It's taken four years but I think

-I've found the right balance.

-They're all a step closer

-to becoming tomorrow's doctors.

-They're very special young people.

-We want more of them.

-Is it an honour to be a doctor?

-Yes, it is.

-It's a wrap.

-S4C Subtitles by Testun Cyf.

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