NRHSN 2013 dinner speech

Delivered on the 16th August to the 2013 NRHSN NextGen conference. Only went over time by 3 mins….

[soundcloud url="http://api.soundcloud.com/tracks/106300612" params="" width=" 100%" height="166" iframe="true" /]

Talking to future country doctors, nurses and allied health providers about rural GP work, communication skills, teaching and family at the National Rural Health Student Network conference.

RDWA Keynote Speech

Delivered on the 24th May to the 2013 RDWA Conference. First time I had to speak for 30 mins!

[soundcloud url="http://api.soundcloud.com/tracks/93919033" iframe="true" /]

“Gerry grew up for 22 years in the outer suburbs of a small Victorian town called Melbourne. So how was it that this ‘city boy’ ended up undertaking GP training and wanting to work in rural South Australia? Was it family heritage in the bush, inspiring placements, the lure of aviation or all three? Surely they will find out he barracks for Collingwood sooner or later….”

Impetigo: Rocky style

Having difficulty remembering what the lesions look like, what antibiotics to use or what else to education patients? No fear, in 3 minutes your problems will be solved. Apologies for poor singing/pitch and subliminal pro general practice messages…

 

 

 

Country GP taught me to fix my jumper

IMG_1785

Poor old jumper

I have a favourite black jumper. In fact, its helping me write this post at this moment. Everyone has an item of clothing just like it. Unfortunately, the price paid is increased wear and tear. My black jumper started to develop a large hole under the armpit area at the start of last year. The nurses in Wudinna would give me grief when I started wearing it in the winter (sometimes for the cold, other times to disguise a non-ironed shirt…)

Tools of the trade

Tools of the trade

Eventually, enough nurses, family members and people on the street convinced me to get it repaired. Some said take it to a shop and other offered to stitch it up themselves. After politely declining on a few occasions, I found the opportunity to repair my old friend on a recent trip to Melbourne. Mum provided the obligatory box of needles, thread and scissors. But I had never fixed up any sort of material damage before, the only relevant word I knew was ‘darning’ from Elenor Rigby by The Beatles.

But the truth was I had done something like this, in fact I would do it once or twice a week. Often patients would present to the clinic with large cuts and lacerations and need stitching. Surely I could use these skills here? During a medical student and intern placement in country South Australia, I learnt a number of tips and tricks for suturing. In Jamestown, a pulley type horizontal mattress and running subcuticular stitches were taught to me by the great GPs there. To finish off each run of suture, I managed to remember how to do a hand tie. Amazing what can come back to you after three years!

Concentration at the kitchen table

Concentration at the kitchen table

So away the stitches went attempting to close the large axillary dehisence in my jumper. One aspect that was different was having to thread the cotton through the needle tip. That took steady hands and a large amount of accomodation (see cross-eyed picture above). Luckily I avoided any needle stick injuries as the material edges started to oppose. It probably took me 3 times longer than stitching up skin, but I eventually finished. And I can report that there has been no further wound separation since!

Has anyone else used medical/surgical techinques for everyday tasks? Im sure there’s more out there…(looking at you Leeuwenburg)

I had to cut my own threads!

I had to cut my own threads!

 

Suprapubic Rainbow

I remember my first removal/re-insertion of a suprapubic catheter (SPC) very well. In fact, it will be something that will remain in my memory for a long time to come. During medical school there had been plenty of standard urinary indwelling catheter (IDC) insertion and removal rehearsals with those hard rubber models. I’m sure we all know the ones with the unrealistic non-malleable appendages and ‘bits.’ Then I had even managed to practise many real life IDCs on the hospital wards as a senior medical student (and actually longed for those practice manikins that actually held their shape!) But I had never been able to attempt or even witness a removal of a catheter that went straight into the lower abdomen. We had learnt all about suprapubic techniques in paediatric rotations, but my first foray into this area was during a country general practice intern placement (PGPPP).

My patient for the day was a 50-year-old lady who had been using suprapubics for the past year. However, she had found the whole process so painful and unbearable that each change was conducted at the hospital under analgesic cover. Unfortunately her level of pain tolerance, or lack thereof meant that these episodes were usually quite a scene. Three changes before my shot, the patient had throttled the closest nurse out of sheer desperation. Luckily the GP in this town was open to alternative techniques and enrolled the help of a hypnotist from the next major town. On previous changes the patient had been instructed to imagine everyone naked and giggled her way through the whole procedure. Then it came my turn. Fortunately the naked trick was not being used this day. As I entered the room I could hear singing. My patient had been hypnotised and was already in a trance like state singing the tune “Somewhere over the Rainbow”.

So it came to be that my first suprapubic catheter removal was performed with the patient calm and singing sweetly in my ear. Unfortunately, the Wizard of Oz has since lost some of its magic for me and consequently will never think of the Yellow Brick Road in quite the same way again! I guess Im just happy it wasn’t a double rainbow “all the way across the sky…”

Page 1 of 3123
Copyright © Dr Gerry Considine. All Rights Reserved 2013