Thursday, 28 June 2012

Desperately seeking DOPS...

Anyone in a London medical school can probably tell you about the horror that is the DOP system. 

Essentially these are "directly observed clinical procedures". Note the words 'directly observed' - oh yes, this means you not only have to find the procedure that needs doing (often trickier than it sounds) but also find some lovely member of staff and persuade them to:

a) let you do it,

b) watch you do it, and 

c) fill in a form.

Sometimes this is easy because seniors are helpful and encouraging. Equally it can be an absolute nightmare when everyone is busy and you suddenly spot an elusive DOP that you have been waiting to do all year. Obviously its very important that we should all be competent at basic procedures but sometimes the chance to do things just doesn't arise in your particular ward or clinic setting. The scary part is that you can fail for not getting these done. Its a high risk strategy to leave them till the end of the year. Its the only reason I can think of that students are insanely keen to do rectal examinations when the opportunity arises. The chorus of "Oooh, please, please can you let me do that" is unthinkable otherwise...

THE BASIC DOP

This one is really embarassing. For those of you who have never seen a pulse oximeter - its basically a plastic gadget that clips on someone's finger and tells you what their oxygen saturations are via a handy monitor reading. Simples. Its pretty much impossible to feck up. Which means trying to find a nurse who will fill in the form is a tad tricky. When I waved my form apologetically, the sister called all the nurses together, made me repeat what it was for and then they all laughed. A lot. I like to think they were sniggering at the form, not me, but you never can tell... Somebody asked why on earth we had to get a form signed for it given that we were supposed to be bright enough to be at university. Which was a fair point although of course just because you can do organic chemistry doesn't mean you can do up your shirt buttons. Technically speaking, you can go into a big discussion of the importance of O2 sats but in reality none of the nursing staff want to listen to a medical student witter on about this when they are busy.

Even worse than that one is the bit where you have to get someone to sign a form when you observe them giving an infusion. People look at you in confusion. 'But it says "Directly Observed Procedure"' they say. And we say 'Yes, you observe us observing you'. Hmmm. And then they have to fill in the boxes saying what we could do better and what we did well or the DOP gets rejected. I'm still not sure how you can watch someone badly. Unless perhaps you shut your eyes or fall asleep.

THE IMPOSSIBLE DOP

At the other end of the scale is the rare DOP. These ones are like gold dust. I've spent months asking people if anyone needs an intramuscular injection or a nasogastric tube. Inevitably you just missed an opportunity or you get told to get someone to write a letter to some secretary to see if another admin person might possibly get you into a clinic where such things are done. Given the glacial speed of admin I decided that was an unviable option. Fortunately for me two came along in one day right in the nick of time. Like buses. But that was after days spent desperately wandering the wards, theatre and A&E in search of a signature on my precious DOP forms. You know things are desperate when you ask if its allowed to IM yourself in the thigh for a DOP...

So my top tip is extremely dull: BE SUPER ORGANISED AND GET THIS STUFF DONE EARLY!


Time for a celebratory Kimberley!


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