Placement case studies
Senior House Officer - Overseas placement
"What has really impressed me at the Hospice is the large numbers of staff in relation to patients and the huge amount of input they all give"
Dimitrios Kotsas was a Senior House Officer who joined the Hospice in December 2004 for four months. He completed 6 years of training as a medical student in his native country, Greece, and a further 15-month placement in his hometown Agrinio. Dimitrios said, "After I finished the renal placement my only alternative in Greece was to specialise. I really didn't know what I wanted to do." He decided to gain further experience in England where he could improve his English and medical terminology. He registered with the General Medical Council (GMC) and applied directly for placements. Following an interview at the PCT in Hereford, he gained a place on the Foundation Year 2 (FY2) course. He explained "The FY2 is good as it allows you to see a number of different settings and will give me time to see what suits me best."
St Michael's was Dimitrios second placement of three. He had already spent four months on the Stonebow Unit and left the Hospice to go to Cantilupe Surgery for GP training. Dimitrios took these placements as a ‘package' of primary care options, rather than acute or hospital placements. He said, "If I was to stay in the UK I would like to go for GP training, its more interesting and palliative care is interlinked with this. I'd prefer to spend more time with people and everyday problems."
At the Hospice Dimitrios learned new skills in managing complex situations, especially concerning pain relief and improved his communications skills.
Student nurse ‘elective placement'
Elective placements provide student nurses who are interested in palliative care, an opportunity to develop their skills in this area and to see if this is the area they would like to specialise in
Rachel Evans had been interested in palliative care since her childhood. Bought up in Nairobi by her missionary parents, dying was very much a part of her life. "Death is a significant part of life in Africa - they embrace grief." Rachel said. When she was 10 the family moved back to the UK. Her mother had cancer and the family, including Rachel, looked after her at home until she died.
Rachel became an auxiliary nurse in 1984 and started her staff nurse training in February 2001. Student nurses like Rachel train for three years to become a staff nurse, of which roughly half is spent on theory and half in practice. Rachel undertook 6 placements during her degree, completing her course in February 2004. For the final six weeks of training she undertook an ‘elective placement' at St Michael's. She explained, "The palliative care module at college was very motivating, our tutor Maria Kavanaugh was inspiring. However there was no practice, just theory. I felt I needed experience in palliative care, and wanted to see how it was done properly." She continued, "I gained a lot of experience at St Michael's which has immediately given me the skills and knowledge to address the issue of palliative care in my clinical environment - something that would have otherwise taken me ten years to learn through general practice."
As a staff nurse on the orthopedic ward in Hereford County Hospital, Rachel uses the skills and knowledge she learned at the Hospice. She said, "Holistic pain management is one of the most useful skills I learned. Pain is always an issue, and the holistic approach is essential. I use this approach on my ward every day." She continued "I'm now the Palliative Care person on my ward although the lack of resources is very frustrating, through my experience I can maximize what we have got."
