My time spent in the ICU department in Hasting was both educational and thoroughly enjoyable. The hospital covers the entire Hawke’s bay population of around 200.000 people spread over a vast area.
The ICU team has been very welcoming to elective students, who choose Hawke’s bay hospital as a common destination for their chosen term; as a result the hospital is well equipped to receive such students, and demonstrate a well organised system providing many contact points and many specialties available for attachment.
My time in ICU was spent with 4-5 different registrars and 6-7 different consultants who are all welcoming and, once the student has demonstrated interest, are keen teachers.
The type of learning that I experienced in ICU is less practical and more based on understanding of first principles of medicine and physiology.
This has been at times challenging, but has provided its benefits by aiding my understanding of such first principles and how these form the basis of management for severe conditions and for the deteriorating patient.
ICU can also be challenging for students for different reasons. An important part of the ICU role for the sick patient is to “support” basic systems in order for the body to heal; this can come across as a conservative approach to medicine, but it’s quickly realised that, for the severe end of the spectrum of certain diseases, providing support is all that can be done.
Furthermore, the mortality rate in ICU is relatively high when compared to other wards in the hospital. This can be confronting for a medical student, but in my case I believe it was eye opening to the difficulties that intensivists face every day, not only for the patient, but also for the patients’ families and loved ones.
A small downside of the set up at Hawke’s bay hospital ICU department is that rotating between 6-7 consultant per week with a 24 hour shift, leads to little contact time for students and patients with each intensivists. This doesn’t allow for trust to be built with the student and can result in less opportunities being awarded.
This is an intrinsic problem to the shift system of ICU, therefore out of the student and academic personnel’s hands. Despite this, my elective at Hawke’s bay fallen soldier memorial hospital was an incredible experience which I would recommend to those who want to experience ICU, patient air transport and the beauties of the north island of New Zealand.