Monday
Today’s task is to train a GP to insert contraceptive coils. I observe, encourage and offer advice. Our healthcare assistant chats to the patients, relaxing and distracting them, making our job a breeze.
In the afternoon I attend my monthly psychosexual seminar. A group of us bring anonymous cases of people with sexual problems such as pain during sex, low libido and erectile dysfunction. We focus on our interactions with the patients and delve for clues that may reveal the cause of these complaints.
Tuesday
When I arrive at the sexual health clinic, the waiting room is bursting at the seams. The team and I work our way through the assortment of genital warts, vaginal discharge and morning-after pill requests. Every time I prepare to call a patient, a sea of hopeful faces looks up at me. As the afternoon drifts into the evening, I insert a contraceptive implant in a 16-year-old girl who comes in with her 10-day-old baby. I feel like I’m attempting to give her a lifetime of parenting, sex education and self-worth in the 30 minutes I get to spend with her before the newborn’s needs become more pressing.
Wednesday
Wednesday is community gynaecology – a mixed bag of women’s health problems and minor procedures. My first patient of the day is, at 55 years old, attending for her smear test as her practice nurse and GP have struggled. I explain it might be more difficult now she is postmenopausal. We are both up for the challenge and 15 minutes, various contortions and fiddly manoeuvres later, she is heading to the cafe for the medically recommended cup of tea and iced bun.
The rest of the day follows a theme: managing period problems – too few, too many, too heavy, too painful.
Thursday
I start the day with an early pregnancy clinic. This can be both the saddest and the most joyful of clinics. The first woman I see had a previous miscarriage and is terrified about a spot of bleeding this time around. The ultrasound probe picks up the reassuring flicker of a heartbeat and she dissolves into tears of relief. The morning proceeds with its usual highs and lows, causing delight and devastation in equal measure, depending upon the news I am obliged to impart.
The afternoon is teaching medical students. My session is the last of the day and by the time I arrive, the room is stuffy and the carpet strewn with a sea of discarded coffee cups. For the following hour I try to engage them in discussion around contraception. I have the advantage of props – they express the usual disgust at the female condom, horror at the coils and puzzlement at the vaginal ring.
Friday
The week draws to a close with a local anaesthetic surgical abortion list. I am being supervised by my trainer and assisted by two nurses, so it is quite a squeeze in the tiny treatment room. For the women I see this is no ordinary Friday. They have arrived here following an often complex and difficult decision-making process that may be lonely and daunting. For me, it is the end of another week and I will be back to do it all again on Monday. That said, no two weeks are ever quite the same.
Most difficult decision: The most difficult decisions in my job are usually made by my patients. My role is to facilitate them.
Most satisfying result: Ensuring the 16-year-old mother doesn’t have to worry about pregnancy for the next three years.
Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.
