Being a student in A&E

Roberta Torricelli

As you may already know or imagine, A&E is one of the busiest hospital departments; patients are always coming in, at any hour of the day, driven by ambulances or self-referred. This means that unlike on other wards where cases may be slightly more specialised, patients in A&E can present with all sorts of emergencies.

 

A&E stands for “Accident and Emergency” and this is where all serious injuries and life-threatening conditions are directed. From there, patients may be sent home or transferred to a more appropriate hospital ward which will continue to look after their care. Effectively, the service provided by A&E is that of a first assessment where patients are seen by a doctor for the first time, stabilized, and potentially even treated right away.

 

When we put it this way it does sound like a lot of pressure, but for a medical student – and for any healthcare practitioner really – it’s an incredible learning environment. As a student on an A&E placement you are allowed to approach every patient with a fresh mind, trying to dig out as many cues as possible as to what might be going wrong. Patients are our best teachers, we learn the most from talking to them and examining them, and A&E is the best place to practice and refine those skills. This is primarily because of its fast-paced nature; since you might not always get the test or imaging results right away, you have to rely more on your clinical skills and judgement. It is therefore really helpful for keeping your clinical knowledge fresh and sharp in mind.

 

It’s also important to know that both as a student and a doctor in A&E – as well as other hospital wards – you will never be left on your own. Doctors, nurses and other healthcare staff members will be with you every step of the way. A&E strongly relies on good teamwork.

 

As a student in a chaotic hospital environment, you may often feel “in the way” of people or redundant, but that’s really not the case and here’s why. Because of how busy it is, people will appreciate your help, whether that is by helping clerk a patient – the medical term used to say “gather information” – or taking some bloods under supervision. Both of these are two really important skills to polish whilst at medical school and A&E is the perfect environment to practice them!

 

Furthermore, although people might be quite busy during the shift itself, they will probably be more than happy to discuss any questions or interesting cases that you might have encountered during the day once the shift is over or has quieted now. Therefore, from a student to a student, my tip is: make a note of everything that you are unsure about or want to know more of whilst you are on the shift, this will facilitate the discussion with your supervisor later on.

 

A&E is also a good opportunity to push some reflections on your end about medical practice and patient care. There everything needs to be done efficiently and relatively rapidly but without ever disregarding the patient’s emotions or concerns, which under these circumstances will most likely be heightened. It’s also a great opportunity to witness how the different members of the healthcare team work together, share responsibility for care and come up with management plans.

 

Lastly, this is a great environment to experience to some extent “continuity of care” in secondary care. This is an expression we use in the healthcare field to indicate a prolonged relationship between the patient and the healthcare team whereby the patient’s condition is managed but also followed up later on to ensure a good outcome. In practice this means that after an A&E shift – or evening during your shift – you can follow up in to the wards the patients that you have clerked with the team to find out their future plans of care.

 

Not all hospitals will allow early years medical students into their A&E department, primarily for the reasons mentioned earlier. However if they do, or someone offers you to shadow them there, I strongly suggest you take up the opportunity, I promise you won’t be disappointed!