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Casualty: Reflections of a fourth-year medical student

08 September 2023

 

Kgothatso Legong, fourth year student at Sefako Makgatho Health Sciences University, offers advice to fellow students following his first experiences of working in casualty.

 

 

During one weekend, my classmates and I were invited to attend casualty at a local clinic. There, we were expected to observe how casualty functions, how to suture, how to insert and remove catheters on male and female patients, and how to stabilise patients amongst other requirements.

When we walked into that room the first thing we saw was a young woman whose femur was out. The patient was not complaining of pain, I figured out that maybe she was sedated. After taking history from her it became clear to us that emergency services tend to have peak on weekends and public holidays as well.

The room was very busy, even the doctors and nurses at one point felt like we were getting in the way. Here is what to do in an emergency room:

 

 

1. Orientate yourself

It is important to know your surroundings. When me and my group got to casualty, we were fortunate enough to be shown around by one of the nurses. He did not only show us the immediate environment, he went on to show us where are the restrooms were, where we can go to get wheels chairs in case a patient comes in requiring one, and who to go to if it happens we need anything else. The nurse also took his time showing us where all important equipment were placed. At the end of the day I knew the whole casualty like I had been there for months.

 

2. Be effective in following instructions

As a student, you will be sent around to run errands inside the room. If you know exactly what the doctors and nurses are asking of you and where to get the thing they are asking it becomes way more easier. Therefore, as much as you need to familiarise yourself with the surroundings, also familiarise yourself with common medical instruments such as bag valve mask, cervical collar, oxygen tanks, stretchers, defibrillators, and so on.

 

3. Be curious to learn

Sometimes doctors and nurses will be so much consumed in their work that it can be very easy to neglect you as a student. Knowing in which moments to call out their attention and which moments to not is crucial. Usually when healthcare professionals are resuscitating a crushing patient is not an ideal moment to distract them and tell them to teach you. However, doctors and nurses are more than willing to teach you when the situation is brought under control. At that moment, you can say to them, “Doctor, I saw you administered 10mg of …, then you did this, can you please tell me why?”

 

4. Injuries could happen

Medicine is a profession that carries with itself some risks. One of those risks is a needle stick injury. Medical students need to know the protocol of what to do if you injure yourself with a needle while on duty. Protocol might differ from hospital to clinic, but what is important is that you need to report the incidence urgent as possible so relevant treatment can be swiftly commenced if need be.

 

At the end of my casualty visit I was excited to go back once more. Casualty can be very unpredictable. We went from having elderly men in the building to assisting a child.