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Medicine practice

            
            
             When I commenced in post I had a good basic knowledge of the rheumatology clinics.
             I had never worked in an extended nurse post.
             Objectives in the First Year.
             To take over the Gold clinic on a Tuesday morning. This clinic was the first that I took over unaided which was in the first three months.
             Firstly I observed Wendy P. in routine clinic sessions. Then I took over the consultation of patients supervised by Wendy. As soon as we both felt that I was competent I started seeing patient alone. .
             Joint injections were the most daunting task that I undertook. Initially I observed Wendy. I then commenced with knee injections under supervision. Shoulder injections were more of a problem due to a lack of patients being available when I was in clinic. .
             Working Practice at Present.
             Now I am an autonomous practitioner working in a role that overlaps with that of the doctor. Many of the tasks I undertake such as joint injections and clinic sessions are in the scope of extended practice.
             The first clinic that I took over unaided was the Injection Clinic. This involves monitoring patient blood results then giving intramuscular injections. Now in this clinic I am responsible for the care of rheumatology patients. Patients now expect to have any problems dealt with as they attend. This means this clinic is now like my follow up clinic. In this clinic I also administer intramuscular cytotoxic injections. .
             In my routine clinics I see Dr George's patients with Rheumatoid Arthritis. I take a history from a patient. This I expect to become more in depth as I am undertaking a Nurse Practitioner Degree. Routine blood tests are monitored to see if the medication is causing side effects for example a reduction in white blood cells or low haemoglobin, which needs attention. I examine patient's joints taking extra attention in areas where they are having problems such as hips, knees, or shoulders. Any particular problem that a patient has are discussed and help and advice given.


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