FINAL ENTRY - Fremantle Hospital

All over red rover! It has been an extended journey, and have come out the other end with invaluable experiences and a much extended repertoire of knowledge and skills.

At Fremantle Hospital I was designated to work within the intensive care unit and cardiothoracic ward. These fields of cardiorespiratory, having highly dependent patients with added responsibility on therapists to perform to the highest standard, gave me fantastic insight into the skills and requirements of a cardiorespiratory physiotherapist. Being some of the most acute and unstable patients of the hospital, you had to be 100% on your game at all times, and constantly monitoring your patient’s status.

Having done suctioning and basic cardiorespiratory techniques on prior placements, as well as having seen the intensive care unit at Fremantle previously, this mentally prepared me to be quite comfortable in that environment.

On this placement, the initial week was mostly observational and noting considerations and precautions that need to be constantly monitored to avoid the dreaded “code blue.” By week three, Kendall and I were running the cardiothoracic ward, seeing patients of our own within ICU and conducting the pre-operation education for patients about to be admitted for heart surgery. This independence gave me great confidence in my ability to embark on a career as a physiotherapist and be able to manage a clinical caseload of my own.

For majority of our placement the hospital was running on a “code green,” indicating that the hospital needed to discharge patients as efficiently as possible in order to free up the emergency department. This is a policy only recently introduced as a result of the 4-hour rule. As we were treating un-medically stable patients, this rarely impacted our ward, though for the few patients on the ward who were borderline, discharge planning needed to be undertaken and occasionally the assistance of the RRAD team was required.

Prior to commencing this placement I was concerned about the four-hour rule impacting time with patients and discharge planning, which did occur on other wards, though within the area I was delegated too, this was not a major issue.

Another concern was my past experience of Fremantle hospital impacting on my placement. Initially it was daunting, though my supervisor was brilliant and demonstrated outstanding patient care which put my mind at ease and resurrected my faith in the Fremantle hospital staff.

Overall I thoroughly enjoyed my experience at Fremantle hospital and only wished that other students had the same opportunity as I did in working in ICU. The patients are much more dependent with a greater intensity in what we do as cardiorespiratory physiotherapists, rather than just the daily mobility review on a general medical ward.

Otherwise I am grateful for the opportunities I have had over this final year in my degree, have learnt a great deal of interesting techniques and have consolidated a lot of our theoretical knowledge as well as meeting some fantastic people along the way.