eLetters

2 e-Letters

published between 2016 and 2019

  • King's College Students' Perspective on Risks and Hazards in Clinical Placements

    As fourth-year King's College London medical students, we have read this article with great enthusiasm and felt we could identify with the concerns raised. We want to offer an additional perspective.

    In terms of direct hazards, we have noticed that some of our colleagues have felt unsafe on specific placements. This is undoubtedly the case in psychiatry where patients may, unfortunately, become verbally abusive and at times physically intimidating.

    Additional concerns may arise when students are placed peripherally in areas where there is a substantial crime. This can involve anything from petty theft to more serious crimes like muggings.

    A clinical risk that we have been well trained to anticipate and handle are needlestick injuries. This is an example of adequate preparation making us feel more comfortable, i.e. working with sharps despite risks involved.

    There are times when senior staff expectations are exceedingly high, and due to indirect risks such as stress and burnout, us students may fail to reach these standards. In some instances, lack of support and understanding perpetuate the cycle of stress. We have, however, noticed that this is less likely to occur when students have a longitudinal supervisor.

    Overall we understand that certain risks are unavoidable, and we appreciate the vast number of measures in place aimed at safeguarding against risks and hazards during clinical placements. From our experience as medical stu...

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  • Abdominal massage and gastric residual volume on development of ventilator-associated pneumonia

    Dear Editor,

    We read with interest Malissa Warren's comment entitled, “Abdominal massage may decrease gastric residual volumes and abdominal circumference in critically ill patients” for our study, “The impact of abdominal massage administered to intubated and enterally fed patients on the development of ventilator-associated pneumonia: a randomized controlled study,” which was online published in the Evidence-Based Nursing Journal in April.
    It is possible to criticize the fact that we did not include the protocol that we applied for enteral feeding and GRV measurement in the study methodology in detail. However, we want to say that there was no difference between the experimental and control groups in terms of both feeding rate and amount and GRV measurement. Both groups were homogeneous in these respects because this is a randomized controlled study. In the same article, there is evidence that there was no difference between the groups, for which GRV measurement is not suggested in terms of VAP development.1 However, this evidence is still disputed, and the necessity of GRV measurement is supported by some researchers.2 The writer also indicated that abdominal circumference measurement is not reliable in the case of oedema, acid, anasarca and obesity. We want to respecify that both groups body weights are similar (experimental group=69.9 16.7 and control group=69.7 16.3) and no patients with oedema, acid, anasarca were included in this study....

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