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On my first visit as an observer in clinic I was very lucky to observe a new patient intake.

I found myself very nervous upon entering the treatment room, extremely aware of the patient feeling observed and perhaps not really knowing what I was observing. I remember feeling self-conscious for them. Perhaps, in hindsight, I could have introduced myself and explained I am a first year student, and that I was observing a real life setting which we only practice via role plays in class. I imagine this could be linked with OPS A1 and A4, in that I imagine this approach could mean I am being considerate and polite with the patient, treating them with dignity and courtesy, as well as receiving valid consent for all aspects of examination, or in this case of the observation.

While my 4th year colleague was asking the SOCRATES questions, I remember being confused as to what letter stood for what, which highlighted how much I relied on my notes during class. I was also confused with the questions asked per se, as in class I would ask them quite mechanically, whereas my colleague was using SOCRATES as a guide and adapting the questions to the patient. This affected my ego, as in class I usually feel quite confident about my skills, but suddenly I felt really incapable and under prepared. So much so that I thought I needed to revise what SOCRATES stands for, and thought about looking at it from a 'guiding' point of view rather than a prompting question list. Next time I go to clinic, I would like to have a more all-encompassing view of what SOCRATES means, so that I can follow the case history questions without worrying about which letter stands for what, as well as feeling confident with the information I am listening to.

During treatment, I noticed my colleague was using a lot of anatomical terminology as opposed to layman terms, as well as using 'I'm gonna' instead of 'I would like to' when asking for consent. I remember feeling quite shocked, as correct consent is one of the biggest emphases we receive in class. I imagine my colleague was really focused on giving treatment, and these details perhaps slipped their mind, so it makes me reflect on how these simple but fundamental aspects are easy to forget when we are focusing on treatment.

Something else I noticed is when my colleague asked the patient what their expectations were for their treatment, the patient said they did not know. They looked quite confused with the question, which made me wonder why they felt that way. Perhaps they are not used to being asked their expectations. In the future, I might think about re-phrasing that question, making sure they understand that it is asked so that I know what they imagine that I can do to help them, and clarify what is possible and what is not. This could link with OPS D1.

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Obsession with cleanliness, therefore less exposure to bacteria

On this course I've learnt how important bacteria is and how many are commensals. I've learnt to be less obsessed with cleanliness and aware that many bacteria actually make immune system stronger. Less exposure makes you ill easier, like covid pandemic, we all sanitised and isolated heavily for a year now everybody is getting sick for minor things.

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E2) My friend with IBS and today's anatomy lecture on the ANS

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E2) My friend with IBS and today's anatomy lecture on the ANS

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2nd year, 24.05.22

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My favourite lecturer and osteopath told us how osteopaths focus on the patient's health rather than their disease or presenting complaint. For example with Charlotte, his teenage patient terminal cancer, he simply helped her live the remaining time she had to the fullest. I remember feeling quite shocked at first, wondering if there is any point in that, but I soon realised that that IS the whole point. I feel we are conditioned to think that the pharmaceutical industry and medicine has the solution to everything in relation to ill health, and as a result we are always trying to 'fix' ourselves. I believe that when something like terminal cancer happens, or any disease that significantly changes your quality and quantity of life, the most important thing is to continue living life to its fullest potential, because there still is life, and that is where the focus should be. Not on disease.

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B2) My colleague's son's story with cranial

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B2) My colleague's son's story with cranial

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How cranial affected her son.
How I only thought of treating sportspeople and now suddenly I am thinking about treating children. Cranial lecturer's work and her stories of cranial with babies inspired me to see myself doing that in the future. Because cranial is often seen as 'woo-woo', it pushes me to learn as much as I can about it so that I can debunk the inaccessibility myths behind it.

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Osteopath's story about his patient with trigeminal neuralgia.
'You'll be amazed how people open up to you, this is part of your job as an osteopath.'
I truly love my lecturer's stories about his practice. I find them extremely inspiring and a very interesting insight into osteopathic clinical life. In this particular instance he was talking about a patient that had come in with trigeminal neuralgia, a condition that causes an excruciating amount of pain. He explained how his treatment with this patient was to be a listening ear to have a cup of tea with. The patient had a variety of psychosocial things happening in her life which lead her to having this condition. She was feeling lonely and scared, and more than anything needed to be listened to, seen and heard. Her neuralgia obviously did not go away, she needed to be referred, but I believe that in order for her to get proper medical help, she needed to be heard.

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i was observing, she asked how to do a spurlings in front of the pt

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One of my peers having a new pt - pt had what i thought a straight forward mechanical back pain + mostly worried about 'doing back in' because a colleague slipped a disc by pulling a rug out - in my opinion pt needed reassurance more than anything. i found that my colleague was overwhelmed w info and probably fed into pt's worries

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time management
giving too much
boundaries

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comparing myself to others when they give feedback or actually ask the patient questions when they're observing

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feels like a lot of these rules depend mostly on laws and being compliant so you don't get sued.
it feels political rather than genuine interest in that.
there is an element of importance but if a pt comes to see an osteopath how on earth can they not expect to be examined and touched? it seems insane

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My ankle sprain and reflection on pain - RICE - belief youre going to get better

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My ankle sprain and reflection on pain - RICE - belief youre going to get better

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psychology pr1-20230508_115159-Meeting Recording.mp4

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KIRK - BP, exercise, interrelationship of these, 90% him, 10% me

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KIRK - BP, exercise, interrelationship of these, 90% him, 10% me

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if pts complain because they just want us to treat them in a certain way, why are we "satisfying" them if our knowledge advises against it?

ex of CCP and Erin's mum.

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kirk & referral to A&E for malignant hypertension

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patricia and GP letter for secondary hypertension. sx not improving with 3 different medications.

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CH revealed problematic sx.

onward referral - difficult convo - unhelpful, cold, arrogant tutor.

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consent, leading questions, exploration of only functional, refer to "power in osteo" and "what is wrong with osteo"