As I write this, it is the Christmas break and I, along with most if not all of the other grads, am taking some annual leave over the festive period, having recently started my final (!!) placement of the scheme. That means it was about this time last year that I completed my orientation, which for me finished shortly before Christmas, so I have been thinking back to the experiences I had; something which I thought would be a good topic for my latest blog post.
If you’ve been reading about the grad scheme, you may have come across the term ‘orientation’ or perhaps already know a little bit about it. For those who don’t, the first month or so of the NHS grad scheme is known as orientation and is spent largely away from your placement base, out and about visiting a wide variety of different departments and services. Although this takes place during your first placement, it is designed to be wider than just the services provided by that trust. Orientation will largely be within the NHS, but might also include visits to related organisations, such as social care, charities and public or private sector organisations, if they provide services that it may be beneficial for you to understand. The aim of orientation is to get an induction to all things healthcare, by spending time observing, and being involved in, the giving of care; this will be mostly front line care but might also include some support functions. It doesn’t matter that you may not be working in, or even with, many of these departments during your time on the scheme or afterwards, because it is invaluable to learn about different areas of the NHS and begin to understand how the many sides fit together. It’s also an opportunity to hear about and see first-hand some of the efficiencies, and challenges, of different teams across the health and care system; a great starting point for your roles on the scheme and beyond.
While orientation has obvious benefits for those who have no previous experience working in the NHS (like I hadn’t), it is also useful for those who have experience in one or two areas from previous jobs, but might have had limited insight into others, as it provides balance to some of their experience and offers new perspectives. I was fortunate enough to see a wide array of services during my orientation, from viewing a tiny premature baby in an incubator in a neonatal unit, to smashing my daily step count walking the hospital corridors as a porter, to observing teeth removal in a dental surgery – even meeting a few graduate scheme alumni along the way. I thoroughly enjoyed each of my orientation experiences and wouldn’t possibly have the space to write about all of them here – or do any of them justice. I have therefore picked out a few standout moments for me, and the main themes I took away that orientation caused me to reflect on.
The first is the expertise that our NHS staff bring. I noticed this many times on orientation, for example observing a surgeon carefully and precisely navigating the instruments during a delicate laparoscopic operation, or sitting in on a weekly ward round at a child and adolescent psychiatric inpatient unit, where I listened to a team of experts in various areas sit down with each patient in turn, discuss the week’s progress in each area and agree a course of action for the week ahead. We are so lucky to have such expertise and knowledge accessible to us whenever we need it, especially as it is free at the point of delivery, and we need to retain that precious expertise and keep it coming in to the system for the future.
As well as expertise, something else I took away from orientation was the outstanding emotional resilience of NHS staff, and their ability to keep a cool head in urgent, difficult or distressing situations. The main example of this I witnessed was in the Resus area of A&E when a gentleman entered cardiac arrest. Suddenly there were 12 members of staff around the bed, who began working as a team to resuscitate the patient. Despite the urgency of the situation, I appeared to be the only one panicking, as I watched everyone else quickly but calmly do exactly what needed to be done. I was amazed to see staff working so effectively together even in the most stressful of times. Very sadly, the gentleman could not be saved, and after several attempts, the decision was made to stop resuscitation, and he passed away. It was a privilege to be a part of his final moments and the experience will stay with me for the rest of my life. It struck me just how difficult working in healthcare can be at times, and how brilliantly emotionally resilient – and relentlessly caring – the staff are; despite the obviously emotional nature of what they had all just experienced, nurses and doctors were asking me if I was okay! I spoke to a couple of the nurses after the event, and they said that they wouldn’t be human if it didn’t affect them, but they take comfort in the knowledge that they did their best for the patient. I applaud anyone in a role where such situations are a regular occurrence, as the strength and resilience it takes to do their job is something I had never given due consideration to before.
Another thing I learned about the NHS is the equality and consistency of care provided to all. Throughout my orientation I witnessed care being given to people from all walks of life, and noted that each and every patient was treated with the same kindness. This was most apparent when speaking to a psychological therapist in a maximum security prison, who explained how he uses his therapy sessions with inmates to help them understand the contributing factors to their behaviour, and works with them to reframe their past as part of their rehabilitation. NHS staff see their patients as patients first and foremost, which is vital when providing care to a diverse range of people.
Finally, the biggest thing I took away from orientation was the amazing compassion with which patient care is provided. I heard nurses on a night shift in A&E gently telling a patient’s husband to go and get some food and rest, as he had been sitting by his wife’s bed for many hours while she was very poorly with suspected sepsis. They reassured him that they would look after her while he was gone, and reminded him that he also needed to look after himself at this time. And while on an ambulance shift, I was intrigued when an ambulance technician I was chatting to told me that he speaks aloud to unconscious and deceased patients the same way he does to conscious patients: for example, saying ‘Excuse me’ as he reaches over them for something in the ambulance, or ‘I’m just going to put this here’ as he attaches some equipment to their body. When I asked him more about this, he explained that his patient is his patient, and he treats each one with the same friendly compassion, regardless of whether or not they can see or hear him. To me this is a truly admirable quality, and these are just two examples of the compassion provided every day by our caring and hardworking staff.
Hopefully that has given some insight into what your orientation might be like if you are thinking of joining the grad scheme. It was a jam-packed period which went by quickly, provided lots of insight, and was pretty exhausting, but so worthwhile! The scheme website describes it as “a unique opportunity” and I could not agree more. I am very grateful to everyone who let me work with them, probe and quiz them with my many curious questions, and to the patients who I spoke to and whose care I observed. While out and about, I received many comments from both staff and patients about how pleased they were that someone from another department had taken time out to listen, watch and learn about their area. So I would encourage anyone already working in the NHS or healthcare, whether you’re thinking of joining the scheme or not, to visit other services if and where you can. This will not only build your own understanding of a new area, but is especially important in breaking down barriers and building relationships to help prevent the NHS becoming too fragmented and siloed.
As I have just joined a new Trust for my final placement, I hope to visit one or two of the services they provide in the new year, which will add to my ever-growing understanding of the health and care system. However, nothing will be quite as eye-opening as my initial orientation experience. While each trainee’s experience is unique, and no two days in the NHS are the same, you will no doubt learn a lot from this fantastic opportunity and I guarantee that even the least reflective of people will take something away from it. Utilise the chance to see many different areas of healthcare, gain hands-on experience and have first-hand conversations with patients and staff – what could be a better way to learn more about how the NHS operates and set the scene for your future career in healthcare?
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