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Hello and good evening. Um, I'm going to start talking because we've got quite a lot of people talking tonight, so I figured that's that's like the early hello and welcome to session to the healthcare Siris. This session is focusing on the mg T or multi disciplinary team. Uh, tonight we have four wonderful humans presenting on their various areas of expertise we're going to start off for for as lead the talk about nutrition dietetics. We then have Melanie presenting about pharmacy, uh, Charlotte presenting about mental health therapy and saudia covering the physical therapies. They're wonderful people, so it should be a good session. Teo, give you again The time table we have also this week is the multiple separate team week next week. Pediatrics and geriatrics. Uh, and you can see what everything else is that's coming up. Any queries? Please do message to email me at Freddie Cooper. A on with that, uh, I need Razaleigh angina. Share your slides so I can Yeah. Give me a second. This is Rosaline for those who owned hurt. Okay, good. Okay. And I will now be quiet in hand up. Oh, can you see that? Okay. Yes, that looks fine. Okay, Perfect. Oh, thank you so much for having me. And thank you so much for inviting me Freddie as well to do a talk. Mining's Raz on D. I am a dietician at the robot in hospital in Chelsea on it's recently merged with guys in Saint Thomas is on stay. Um, going to talk a little bit about what I do in terms of nutrition and dietetics, but just a little bit more and broadly as well. About escape of nutrition and dietetics. I'm just gonna give you, like, a couple of seconds to you holes on to think about. What do you guys think when you think of the word dietician? Um, on the reason I want you guys to think about that is because typically, when I tell people that I'm a dietician, the first thing people say to me is, Oh, can you help me lose weight? What about the five to diet? What about the Keto diet? What about this diet? Have you heard of the fast 700? I think it's the last 800. Actually on there's a kind of the main questions I get, but actually dietetics is farm or complex than that on. Actually, I didn't really do much of that at all. If I'm being completely honest in the rolling minute, the movement so something which a lot of people don't realize about dietetics is that we work with pretty much every single clinical condition. Yes, we work with obesity and weight management, and we can work in bariatrics as well. But it's very more complex than that. We can work with cancer S O. If people need feeding cheese because of like a head and neck cancer, we can work in terms of like liver. So if their liver enzymes aren't working and how the nutrition kind of relates to that, we can obviously work in places like diabetes as well and think about insulin, even things like the pancreas and the enzymes that they release and whether you need external enzymes. We also do a lot of like nutrition support in terms of looking at people's symptoms, unhelped them to symptom control. Um, but that's very much within an acute hospital setting. We learn a lot about nutrition and science, and we bridge all of that information into easy to understand information for our patients on. The most important thing, which I think people don't realize about dietetics, is that there are so much more work outside of the any chest, so you can work in industry, for example, so pretty much every single supermarket needs a dietician. Andi might be thinking, Okay, but what did they do? So one example is a zoo. Guys know there's been an increasing like plant based milk, so things like milk, things like on you almond milk and those kind of things on the supermarket own brand milks. Plant based milks didn't have fortification in them. So I know the as. The Dietician did a whole big project about making sure that the milks were fortified with iodine, just to make sure that people are getting enough in particular because they had noted that pregnant women were not getting enough iodine. There's obviously private practices. Well, there's public health, so making huge changes on a really big scale on, So you probably heard about the sugar tax on, but that's something that a lot of people work on. They also do lots of different roles in terms of like they go out to communities and see what people are eating. So we do have data about roughly how much calories people are eating in the whole population, how much protein people are eating. And that's because of public health work. Research is a huge thing, so I don't know. There's a lot of does this diet worked as a low carbohydrate diet work. All of this is being researched by dieticians on Dove Course sports Nutrition. A lot of people like Teo see how to optimize different athletes on, but they also like to sometimes get other kind of qualifications in sports and much these things together as well. So I just wanted to go through kind of a day in the life of what I do you, and this is very much what we call an acute dietician. So I work in a lung and heart hospital and see lots of different patients with lots of different heart conditions and lung conditions. Um, so, generally, recently, my work has mainly been in critical care. On when I tell people I work in critical care, they say, Oh, like, what do you do in critical care? When patients are stated, then ventilated, they obviously need nutrition to make themselves get better, but obviously they're unable to eat and drink. And so we often cheap feed people, and we think about how their nutritional X to their condition on d think about different regimes in terms of their cheap feeding. Something else I do is a lot of clinics, so we've moved again very much to virtual clinics on but just one on one sessions with patients, and that could be about anything. So maybe if they're trying to build up for a lung transplant or trying to lose weight for a lung transplant that some of the things that I might be doing with them also a big role in terms of like a hospital dietitian is working with kind of chefs in catering on. So this is me with are amazing catering team in my hospital. So, for example, if a patient might be more in the palliative stage or end of life stage on, all they want is six ice creams. I will go down to the kitchen and get them six ice creams or work with the chefs to make sure that I screams a really nourishing and really tasty on. We do a lot of working with the chefs. They actually really help us to make sure that patients are getting enough food and nutrition. I'm pretty much getting them anything they want. Also, a big part is kind of MDT working, which is shown on the right hand side. So I often work a lot with doctors on. That's the top picture. So if symptoms are under control or making stations about feeding, that's something that we might work together with. I also work together with physios, an occupational therapist, which is the bottom right hand corner, also psychologists. So if patients are eating may be due to their mental state, we might go in with a psychologist or, if we may want to make sure we optimize in their nutrition to make sure they could do that busy. Oh, that's a great thing as well again. While several drinks a dietician, they think of diet and food. Like I was saying before, a huge thing is, keep feeding. So if a patient is unable to swallow or they have an unsafe swallow or they're just not getting enough nutrition in, we might consider inserting a short term nasogastric tube, and that's just a thing to you, which goes in your nose and in your tummy on. We'll think about the regime behind that on what works for them on a longer term patient. If they've got a poor swallow for quite some time, we might also think about the ethics of feeding directly into the stomach. So having a procedure called a gastrostomy on again will be thinking about how much nutrition they need on how best to see their lifestyle. With that on what the upkeep of that tube. It's one of the big things I want to mention is the NHS family. I know. When I was kind of your guy's age, I didn't really know what I wanted to do on. I think the one good thing about being a dietician and as is, and all of my other colleagues who are coming after me, is the bigger neck chest family. So you get to meet lots different people from lots different backgrounds and get lots of good social lights on diffuse do cool Project Psycho have done in like the right hand corner. So that's an ice cream project. You get to go to conferences abroad so that was in Dublin with your colleagues on golf so that it's just really great to have people to lean on. And it's really nice to be part of the big Any chest family is what I think. One of the things was that I didn't really know I want to do, and I kind of chose dietetics because the degree was free and I want to be in a caring profession and it was easy for me in terms of my mobility. But there are lots of other jobs which can which you couldn't go into. So, for example, you could potentially go into like leadership if you wanted to. In the NHS, you could go into, like, not too different aspects. Just because you choose any chest career in terms of like a busy or a dietician, that doesn't mean you have to stay like that forever. You can still work your way up within the NHS in different roles on get extended rose a slow. So I've spoken a little bit about what I've been doing the daily basis, But how did I get there? So it's pretty much thinking about GCSE S and a levels on d I had a little bit of an unusual, I guess. Stop. So, um Jesus, he's I always thought at the time it was like the end of the world. I actually only have five g c sec do to extenuating circumstances of my health on I was also put back a year in school because of that is works I'd miss like three years of school. And the reason I'm sharing that is just because if you are here sitting, be like, I don't know if I'll have the right gcse s or a levels Um, there are definitely places which will accept you, and you just need to look into a little bit further. They generally do like chemistry and biology on. That's just because when you do do the degree, it's very chemistry and biology. Heaviest slashing. The first couple of years there are definitely some access courses which have come up. So you know, for example, Burke, Back in London, a lot of people went there, didn't access course and then came to university. I went thio and also they're looking into apprenticeships in the future, but I think we're still a little bit off from that on. Then you could also do and lost his version. If, for example, you do bio chemistry as a, um, undergrad, and then you could always think about losses and nutrition. Dietetics. What is the degree like? And what has that looked like? So generally they're 3 to 4 years on, but they are pretty lecture heavy, especially for the first couple of years. So it's pretty much learning your biochem, like all of your amino acids on, while stuff sometimes consume a little bit boring. Initially, it's actually really important, especially when you're working, for example, with metabolic diseases that you might have heard of things like PKU. And where is that? An amino acid you should do is like not good to have on. So you have to work with the patient to get every single other any no acid to make sure they're getting enough protein. Except that one, Um, it's quite lab heavy years. Well, in the first couple of years, we also have a diabetic kitchen. So yes, cooking is part off being a dietician. So we had a full year of dietetic kitchen labs, so we would think about things like cooking on a budget. Think about world foods. You get a lot of placement. So I had three and a chest placements in a public health placement at Public Health England on. So you got to learn a little bit about what's going on in the NHS, but also what are other roles? When I did the degree, it was still any chest funded, So I think there will be a bigger scope for wider placements. A swell and one of the big things I will say is, um, even if you don't choose Teo, be a dietician. I think finding a degree or university, which suits you is really important. So if you go someone, you get a really good five. I think that's a really good thing. Sometimes it's not always about the name or what that university will offer you in terms of extracurricular. That is about the feeling. You don't have to take that piece of advice, but I know I at the time something I kind of thought about was all I need to get into a university with a good name on. Actually, the one good thing about dietetics, for example, is because it's a vocation on day. No matter which university you go to, you're pretty much get a job. So you find somewhere which suits you and find something which it matters to you because that will be really important cause you'll be there for 3 to 4 years on. Lastly on marked mainly by exams, there's something called osteo, which is where you're practicing with a patient on get marked on that. So your communication skills on also your placements and my final thoughts is just dietetics isn't for everyone. I would love you guys to choose it. But no matter what you choose, even if you choose a different degree, give it a go in the NHS is my big thing. Um, you can always come to me if you have any concerns or questions. My email address is on the slides S o. If you do you have any worries, Please feel free to reach out. But otherwise that's pretty much it for me. I want to keep it quite short in case there were other questions, but yeah, I'm more than happy to take any questions. Thank you. That's really good. So just reading them off the top. This one might be a bit brought that what does acute mean? Oh, that is a really good question. To be honest, I'm we tend to use the word. And Freddie you can come in if I have no explaining it right as well. And anyone else can acute in terms of keep the unwell. So if someone's, if someone has a short term illness where they need to be in hospital and you'll probably hear that a lot in pretty much all of these different professions. So, um, you kind of have yet patients with short term illness who need hospitalization that's acute on then the opposite of that is community. So when you go to your GP, that would be more the community side. Or if you see a dietician in your home, that's the community side. So it's just the distinction between hospital and at home. Essentially, I think that that's mawr dietician than the General. But yeah, acute generally means, sort of, really. It comes across the short, short term, like newer presentations or new exasperations older things. You don't have things like chronic, which is a longer term where it gets a dietician. You have community problems versus acute. They come into hospital problems. Um, two people last. Same question. A row here that's just popped up. People will ask that one in a second. Going down the list or excuse me? What qualifications do you need to become a dietician that you covered that quite well, having you just sees a levels or access courses at the moment. But sciences, I'll say a lot, people. I did my undergrad. I didn't undergrad in biology and a lot People at my university do the nutrition degree and then went and started dietetics afterwards. So it seems to be quite think it's popular. Turn it. Yeah, it's slightly longer that thing, but yeah, I think so. You can get that's the other distinction. There's like a nutrition degree and in nutrition and dietetic. So the word nutritionist is not a protective title. So anyone here can call themselves a nutritionist, whereas a dietician is a protected tight or you're under the hep C PCR rules and regulations to follow um, Syria. That's kind of the main difference. With dietetics, you can work within hospital settings where, as as a nutritionist, you can't never very broad one for you here. What is critical care? Critical car. Oh, um oh, I'm gonna get with the phrase big sick. Yeah. So it's where, like, the sickest patients in the hospital are You call those wars critical care on Essentially, they're really sick. So in terms of like, they can't breathe from themselves. So really sadly, because their lungs in my house to the lungs or heart essentially very knackered on they have tubes which breathe for then So they're completely asleep. Essentially on they have a tube which does the breathing on. Do they require one or mawr organ artificially support, I think. I think that's again quite specific, really to where you are. But yeah, critical care. Very sick people. Normal critical care sort of encompasses intensive care and sort of the areas near to that. But the Razadyne works in a very specific the worker Brompton, don't you? Yeah, very specialized. That's very, very much heart and lungs. So heart and lung patients who end up getting that sick, I think a lot of them are gonna need breathing supporting the like because believe they're not your heart. It's quite important for when you start breathing what's involved in your breathing. Do you work in a team of doctors in's, or are you left to yourself? Yeah, so it's different Power Hospital. So there's always a team of dieticians, but you're pretty much in autonomous practitioner, so you will go to the walk by yourself, see patients by yourself, and then you can come back and ask your team members for support. If you need anything on that's quite different. Actually took a lot of the other therapy. So you're one of the other therapies. For example, occupational therapists and his ears will often go together. Or sometimes a busy owner therapy assistant will go together. Where is it? As a dietician, you are a little bit of a lone wolf. That's not to say you don't have support. You have your other dieticians. You were sitting in the department to support you, and you've also got your busy nose in your MD TV's and your doctors and nurses to support you as well. Yeah, um, how long is your typical work day? Do you do nights and do you do shifts? Yeah, I said that The one other good thing about being a dietician, I don't know whether They're small change, but we pretty much do 9 to 5 or 8 30 to 4 30 on day. Few hospitals have started doing weekend working, but still like not the majority. So for the moment, it's a pretty good work. Life balance, no nights know shifts. No weekends. Certainly from what I've seen, it tends to be have one or two dieticians for the whole hospital, the weekend on call. And that's normally at home to answer the phone if you got a problem. Kind of, um so in that sense, it's quite nice. Unless you really want to, like, be nocturnal on what? Only nights, In which case, maybe not dot Yeah, there's Ah, thank you. So yes, thank you. Browse. Uh, then we've got a couple of people asked. It might be the same person post that twice straight after what GCC's did you get. So I only had 5 to 60 so I only have the two sciences maths, English language. They don't even having this literature on D i t. So I only have five. I would have had a six, but the the school I went to you, um well, I actually attended it what's called a people's or Farrell unit. Onda. Um, what should I was a bit of an incident where my artwork vandalized on go. I had to drop a GCSE because of that. But I think like the learning point from this is, you know, I've only got five GCC's. I'm sure lots of you out there have got far more than I do on day so I can get there with five Jeezy. Essie's trust me. You guys are probably much smarter than me. And they're going to do much better than me. See if I can do what you guys could do it. I think that's a really good message to take away way. Haven't really talked so much about some of the people who are doing these talks. We have got quite a variety of different speakers for different backgrounds and different sort of standings. We'll talk more about them another time. Um but yeah, I think that is a very good message. Take away, which is ultimately, don't give up. If you want to do something, keep at it and find a way. Uh, what is a normal day at work like for you? Yeah. So that's what you're really nice question. So I'll get in a 8 30 then we have a computer system which says, how many people live in your body? So we'll go through their federals and look at what's appropriate and what's not on. Then we'll decide how many patients we want to see throughout the day on, but I'll go to the wards and go see the patients. I might go down to the kitchens and work with chefs. I might then have a clinic in the afternoon. So that virtual clinic or on but someone might be. It might be a face to face a Kleenex here in the clinic room and patients that they're they're coming in from their homes or the communities. And yeah, that's that's kind of a day, um, lots of mg t. So myself, the doctors, the physios, the occupational therapists, psychologists will sit down often multiple times a week to go through our patients and to see how we can work best together as a team. So it is really, very depending on what conditions patients have. Um, what kind of support they need. Some people in hospital if they are quite well nourished and not eating might just need some extra snack source of extra supplement drinks where some people might need the tube feeding way. Also do kind of we look at things like they're waiting on the palm tree on. Do we also look at the biochemistry? So that's kind of what science comes in and get We work together with the doctors this world to look at their clinical picture. Um, so, yeah, I think that was one of the ones later on, which is what sort of stuff to discuss in the MG team meetings? Yeah, be barriers to eating. So why patients are eating? What's going on? Is there symptoms in the way of there feeling really sick so they can't eat, So then they might need a tube. Are they? Have they got reflux? Have they got stomach pain? Or they got bloating. They got a dry mouth or they got issues swallowing. So we look at all these different symptoms, so it's quite a holistic, like I think that's the thing about genital. Six is it's It's very holistic. Have they gotta and are they really depressed? And that's why they're not eating so We'll discuss that as a team and think about which medications are best, maybe to use or what the best way is to escalate the nutrition. Or can we work together and do joint or abused? Have a talk to them together? So yeah, yeah, um, there to here. I'm gonna look together, Which are what are some of the key skills that using your roll on What are some of the big challenges that you face? Okay, so I think keys gills is definitely communication. Um, I will say, um, you're not someone who isn't a good communicator. Don't necessarily let that put you off. And that's because there are rules where, for example, in critical care whether patients are very sick, so they don't talk, you can still do the role, and you don't have to talk to patients. But I do think communicating is one of the biggest things. And that's because if you can imagine a patient, for example, who comes in and is looking to lose weight, there's so many resources out there. If it was a simple is losing weight, most people would have done it by now. So it is a lot of kind of nutritional counseling on. We do learn a lot of counseling, skills and psychology behind that, and so building report with your patients and getting to know them. To me, that's the best part of the job and getting to know their life. And sometimes it's not even about the nutrition. You go into a clinic and you're just getting to know who they are is a person, because that will help kind of build that relationship and then help them to you improve the nutrition once you've got that relationship a little bit later down the line. So I think, um, yeah, I think communication is like the biggest thing that doesn't even cover communicating with your doctors and your nurses because they need to know your plans as well. Um, I do think science is somewhat important because we do a lot of calorie counting protein counting. We might do a lot of like We work out how many calories people needs through special equations like the fat counting. So there's a lot of maths and kind of science linked into a different nutrients. Um, so yeah, I think just having being on the ball with kind of, since science and math is really important as well. And what was what was the second question? That was, uh, some of your challenges I think you pretty much covered improve quite big changes. I think also, one of the big challenges in the NHS is when you are working in a multi disciplinary team with lots of different doctors and nurses. You're not always going to see eye to eye on. That's okay. That could be really challenging, though. When you think I don't know what patient needs a cheap because they're not eating, the doctors are saying no, um, that could be a really challenging dynamic. So again, I think that comes back to the communication skills and their ability to build relationships and things like that on that can definitely some of the challenges bring it out again. That someone who's asked about your role in the MG t. I think I think we've sort of answers that in some your earlier questions. If someone wants any more details on that, feel free to ask again. A bit more specifically, I think we've covered quite a lot on that, Uh, what is the best part of your job. Um, honestly, it's made a business going to sound so cringeworthy, but it's like when patients are doing so badly in hospital cause they're really sick. So they're really on well on. All they want is I don't know. They want this like the most obscure thinning ice cream and milk shake, and you actually go down to you the kitchen I'm like, for example, this might be like someone who is an end of life patient, and they said they might be passing away on for, like, their last bit of life. Will they want. It's an ice cream and milk shakes and you go down to the kitchen. You get that sorted on, you know, to give someone that pleasure in that kind of stage of there. Condition on their life, I think, is so important because food means so much to everyone. Like for me, it's like the thing I love about food is when I drive me up with any my friends, I go for food. Fruit is such a big part of my culture. In my culture. When you're giving food, it shows love on down. I think food is so ingrained within our society and I think, to be able to make that difference to you people's food when they can get really down and upset about the fact that they're not eating. Um the other part of that is also because, for example, if someone's not eating, family members could be really worried. So you know the whole thing of when you get a cold and your mom's trying to feed you chicken noodle soup on. But I think to bring that all together to bring the family and the patient will together and get something that they want on, get them to eat a little bit more to hopefully help themselves on. Also, potentially that condition that even if it's not their condition, I think it's just a really rewarding job way. Couple of minutes left in two questions The first one is, Do you ever feel overwhelmed by the number of patients you have? Yes, but I think, um, I think that's probably gonna be something which everyone's does, I think especially in the NHS, I think it can sometimes be a little bit tricky with short staffing at the moment on de specially post pandemic, but to be honest with you were quite good at prioritizing. So we have systems in place. So we have, like, what's a safe caseload? So we won't go over that patients. So yes. Okay, occasion. That might be too many referrals, but you'll get the experience just to make sure you see the most important ones first. And the other ones can maybe wait a little bit longer. And then the final question Have you ever tried tube feeding or 4 to 6, as in yourself? Um, I have not tried cheap feeding know 46? Yes. Eh, So for those of you don't know, 47 is what we call in or or nutritional supplement drink. So it's kind of like a small protein based drink. There was a picture of me, a couple of slides back with a nice slowly. I was just telling Freddie before this I I did a project of freezing 47 to a nice slowly to see whether that would be more beneficial. So it's kind of a milk based drink like a milkshake, but it's quite thick, and it has vitamins, minerals, protein and energy and, um, they they're really very person. Some people love them. Some people that's you hate them. That one wasn't my favorite. There's a different one called Scandi Shake, which is my favorite, which you make with fresh milk. Um, and that's the good thing about being a dietician is that you can try. That's different foods. So, for example, I was just trying through the catering like their new menu. So yeah, it's an ms with the 47 not try to keep feeding on get I can see a quick question from Saudia, Um, which just says, Why? Why did you choose dietetics? Um, so very quickly, to be honest with you. As I mentioned, I don't have this brilliant story. I'm really sorry. So I try to start headaches because I want to go into a camp profession and I will stop between a youth worker, a teacher on dietetics. Honestly, the degree was free, so that was kind of why I chose it on. Do you know think the good thing about diabetics is if I wanted them be a teacher afterwards, I could go into teacher trainings. I needed a degree on the same with the youth work, so it kind of opened up a whole load of things that I could have done. So for me, it made sense because there's lots of different avenues you could go. Did you decide at school? Yes, but pretty much when I was 17. I just had to make a rush decision on that was kind of that. How did you discover it? So yes. And no one came in to school or anything to teach me that all this is what a role of a dietician does. Unfortunately, But my sister is a psychiatrist, so she works in the NHS, is a doctor on. So she kind of knew a little bit about the role. And I just found it through kind of Googling as well, if I'm being honest on. But when I was on well, I had a love for baking on, and I just kind of put the two things together, sides and baking, and that kind of leads dietetic. So here I am, but I'll be quiet now. It's quite cute way. Thank you so much. Thank you. So you also have a question to walk to put in the chat or email them on. But I think next is Melanie do that. Okay. Just try and get my presentation getting I don't understand. Especially a black screen. Uh huh. Screen if you And if I stop sharing, have you schedule screen? Go yet? Just get it. How you doing? Hang on. Really? Whoops. You see my screen? Yes, it is. Pharmacists. Yes. Get excellent crackle. Right. Sorry about that one. So I am a pharmacist. I work in asked Oh, small ones about a niece. London barking having refridge Queens Hospital on. So I'm just going to talk a little bit to start with about the types of France's my freedom conceiving. Um, So there's three main types of pharmacists, so there's kind of the biggest one is community pharmacy, which is the one. You're probably all familiar with it. So these are your pharmacist that you see on the high street in, like, boots, Lloyd's etcetera. The's people Will These pharmacists rather they help with managing patients medicines when they're at home. So this will include, like, their regular medicines on anything when they get like, What is that word again acute. If they get an infection or anything like that, they can that their role is off developing quite a bit on. They now do a lot of pharmacists. We do actually things like clinics, so they'll be plenty clinics to wanted to people's blood if they're on a certain type of drug or for giving them like vaccines for like they're going traveling or flu vaccines, that sort of thing. They can also help with managing small, minor conditions, like if they get like an eye infection or head lice, scabies or something like that. They can sell them something from behind the counter and then save some time to go into a GP and then the industry. So I haven't had any experience of industry and say, I can't really say too much about what they do. But these are like the big pharmaceutical companies, so improbable, heard of fives or a natural Seneca at the moment. So they all have farms. It's working, they're they're involved in drug discovery and also medicine formulation. So there is a difference between drugs and medicines, So drug is the active ingredient and which has the effect on the medicine is the vehicle We used to get that drug into the patient and to get it to have an effect. So, for example, if you think of insulin, it's not just a tablet we have to give. It is an injection on We did. It was a lot of research done, and I think that still ongoing research to try and get it in the easier way to administer. So for a while there was an insulin inhaler, for example, so pharmacist would be involved in that on then this hospital pharmacy. So that's what I'm going to kind of speak about most because that's what I do. So I'm not gonna touch on that too much here. And then there's lots of other areas that pharmacy's come work in, so GP surgery's actually becoming a really big thing. Now I'm really pushing to get pharmacist and GP surgeries again. It's not something that works or not too sure what they do. But they're basically will be seeing patients helping manage patients medicines. I think a lot of them are prescribers, so you could get pharmacist prescribers, get a lot of different describes nest optician prescribed, um, not just doctors. Then there's other areas which is a smaller so academia that be like similar to industry, that working in research, but it's at university. On the probably a teaching element there is. Well, then prison Army cosmetics on a say cosmetics or spoke was medical groups, those that would be like. But what I mean by that is Botox. Say you get pharmacist that can get Botox injections if they have extra train, which I I'm told her nose a lot of money. So essentially that something I should look into. Uh, it's not going on to the next. More technical troubles. Okay, so this is just to make brief mention on pharmacy technicians. So I mentioned pharmacists. Pharmacists, contrary to popular belief, do know really do much in the way of sticking labels on boxes? Well, really, any I can't remember that all. Sounds like a label on the box. So pharmacy technicians, they work below pharmacist, But they are still credited under the governing body, which is the GI PHC. So there's kind of like three levels in a working in the pharmacies, a good pharmacist, pharmacy technicians, and then you go to pharmacy assistance. So pharmacy technicians is growing a growing profession. They've been going for the benefit, recognized officially for 10 years. 10 years. I think last week or so. That's how I can remember. And they they're allowed to do a little bit more than take the an assistance so they can check things and they have. There's a few other little things they can do, depending on the type of training. They have additional training and then assistance. They're more the people who are kind of doing the basic sort of work with dispensing medicines on day, working on the counter. So they'll probably the person you meet when you if you go into boots, they'll be taking in a prescription for you. So then we're going into my role. So this I'm going to talk my role about working on the ward's say, I do have quite a few different roles in hospital pharmacy, because even with the hospital pharmacy, there are quite a few different areas that you can work in. And I'm rotational because I'm still quite junior. So I work in a lot of different places, but wherever I'm working, I have water responsibilities and I think getting towards kind of the most interesting to talk about so we're gonna talk about so the biggest thing I do is make sure prescriptions are safe and effective. That's kind of ongoing. Took most of the rest of the presentation on, so I'm not going to talk about that here that will be coming up in a few minutes. Honest is riding information and advice to patients on D. H C P stands for healthcare professionals. So by that I mean the pressures mainly mean nurses and doctors. Sometimes I'll link in with the therapy teams. Vizier therapists, conventional therapist on a speech language therapists after I don't really have much to do with dieticians very often. Generally, when dieticians come up to me in a panic a little bit because I don't know anything about their feeds but with the rest of them are given bit more of ice on that advice could involve going award round. Or it could just be when they come up to me with questions or if I noticed something that needs to be we just working to calibrate it is part of the multi disciplinarian on. Then I should also be providing advice to patients. So we change patients medicines a lot when they're in hospital. Um, on sometimes they don't really know what they're taking what we've done, the very confused. So hopefully the farms. This has got time to get around and explain what we've done on why we've done it and anything they might need to be aware of with the new medicines. Then I put supply of medicines on there. But when I'm in a ward, or even generally, I'm not actually that involved in the supply. I just know what I need to order. So I just write on a piece of paper and it goes down to dispensary and they'll send it up to the walk for me, kind of. It's an important part of my role, but it's I spend more time with the first thing lives. Next, let's find out. I say, I said, we're gonna talk about How do I check a prescription is safe and effective, so I'm gonna talk about case study a little bit later. But I think you need to know this or terminology noticed. You understand the case, then we're gonna go through, So these are kind of questions. I'm asking myself when I'm looking. A prescription say is indicated for this patient now indicated, means is it is this drug use for the condition that we're trying to treat Onda. Is it the most appropriate choice for this condition that we're trying to treat for this particular patient? Next question is, is it contra indicated there. Contraindicated of the opposite of indicated so contraindicated means we absolutely should not be using it for this patient, um, and then cautioned, is it's a little bit less than contraindicated. You can still use it, but maybe we need to do extra monitoring. Maybe there might be an alternative that might be better. May be just that. You need to be aware off something. Maybe we could get the patient a choice. We don't that that often. We should do that a lot more that something's off moving more towards as a drink drug working with the patient. And that's questions kind of quite self explanatory. So the dose and frequency So, for example, like 10 mg three times a day duration, duration. A lot of drugs, a long term but not necessarily on some drugs shouldn't be used long term, say need to consider that next question is, does it interact with any of the other medicines so some medicines can increase or decrease the effect of patients. Other medicines on really not only patient tend to be on more than one medicine at a time. So we actually be aware of that. The some medicines that are more prone to interacting and some interactions that I just remember because you just come across them a lot. But we'll go through an example of that little bit later, and then I need to consider the side effects. So, for example, if I was looking at like a morphine prescription, morphine is cost, causes constipation. So if I see somebody was on a lot of morphine, I'm thinking, Where's the laxative? To get to help with constipation? Um, but also, it might be that I'm thinking tied in with cautions a little bit. Is this patient is it is this side effect that I mean that we can't really use this drug for this patient? Okay, so hopefully that makes sense. Um, so what does this mean for the patient? So but this's basically need to talk about my patient case study. So this is a real patient. I have stripped it back a little bit just to make it a little bit easier to follow, but this was a real patient at a real intervention I made. So this is kind of so you can see how my role perfect stations on how that fits him with. I say MDT. To be honest, this is only really the pharmacist in the doctor, but just cause it is difficult to find one where everybody's involved. So this patient came in the hospital with an upper gastrointestinal bleed. So that means a bleed in the stomach, which is very bad. This patient up a g I bleed, we call them itself is a short term, but I mean bleeding the stomach. If you hear me say that, did you ever lied? That is, for this chap. It was caused by an ulcer on that also was actually caused by a bacterial infection. The bacteria is called helicobacter pylori. So up a job leads can actually be fatal. Symptoms could be like blood in the stores or vomiting blood, that sort of thing. That's right. So the treatment that dream I'm gonna talk about is the proton pump inhibitor. Now, don't worry, you're not going. That means that's what we talked about. And that's This is the main part of intervention, so we're going to talk about in a bit more detail. We also gave him antibiotics, of course, to treat the infection. So this patient's proton pump inhibitor was actually given by an intravenous infusion. Um, and the new intervention that I made. So the patient is given intravenous infusion. We use paper charts and my transfer, but old fashioned. So it's prescribed on the back page of the drug chart. It's not prescribed with the rest of his medicines. He was on quite a few months since, so when the doctor had gone to do his discharge letter, she had written all the regular tablets. But she missed off the proton pump inhibitor because it was on the back page. So I was screaming off the drug, the discharge, and I thought, Yeah, yet all it's fine. And then I'm reading just double checking why he was here and everything. And I said, Oh, he's had a bleed wise, you know, on a proton pump inhibitor. Then I realized that he's had the infusion, and that needs to then carry on so normally, if they had a confirmed ulcer, they'll give high dose for six weeks on and then they'll know. I think they get rescope. They review. After that, I don't want the buttons on looking good. So what is a proton pump inhibitor? So this probably looks like a bit of a scary diagram, but we don't really to worry about most. Basically, this is one of the cells in your stomach, so it's a parietal cells to see the label bomb, and these cells produce acid so the you see the H pusses those of protons on the proton pump inside. So they those hate pluses of the acid basically, and the so acid in your stomach your stomach cause, like a lining that protects it, protects the actual cells is like a soft. But it was described was a lining that, um, because you need to be protected from the acid. So when that lining is broken down, that's when you don't get ulcers, because when you're so it also comes in contact with the acid. That's very bad. So I don't think I've explained that right well, but hopefully getting it here. So with a patient who's had an officer a way we can treat it is we can reduce the amount of acid that their stomach is producing. All these parietal cells are producing, so the proton pump inhibitors, if you haven't guessed it, they act on the proton pumps and they stop. That process of the cape last is potassium, So they stopped the K plus from going into the cells on the proton protein, the get acid from coming out of it. So which means that you get less acid in the stomach, which is good because you don't get then the damage to the cells, which means you don't get an answer hoping that make sense. So then after EKG and that was ill. So that's what this chapter is on. It's a drug called Omeprazole. You want a third of it? Can't remember. It's brand name now talking about. I should have written that because you can actually buy. And that was all from the chemist, but only a very low dose. Thank you. How so? Then this. You may recognize these questions from earlier on with How do I screen a prescription? So these are the questions I was asking when I was screening the imeprazole. So indication. So what's it for. So these are the two things and that is useful listed on the side there reflux, which you might have heard it was called heartburn. People say, Let me get the heartburn when it's basically means when the acid goes from your stomach into your esophagus, your esophagus is basically the truth that goes in your mouth to your stomach. And when the acid goes into the esophagus because you haven't got that protective lining that goes in concert with your this upset lining your esophagus, Um, and it's very painful on that. It's also used for treatment doses, which were what this guy's having it for. So contraindications and cautions so. And that result doesn't actually have any specific contraindications, which is good but every an allergy status. Because somebody might be allergic to a map result. I've never found one, but with a true allergy anyway, and then cautions, So, um, that result increases your risk of fractures on. It also increases your risk of infections. So if you think about it, the acid in your stomach is there for a reason. It's there. Teo kill any bugs that get into your stomach so that they don't get into the rest of your body so that soon as they get to the stomach, it kind of they're defeated at the first hurdle. But if we're reducing the amount of acid in your stomach, then we're gonna have less of a defense against infections. So you more likely to get especially infections that affect this off go the gastrointestinal tract. Basically, digestive systems are eso dose and frequency. So the dose of the episode actually again it could I don't really see it less than 20 mg, but you can actually go to down to 10 mg. Um, once or twice a day goes up to 40 mg. So for this trap, we gave him 40 mg twice a day for six weeks to be reviewed as an outpatient. So it's quite a long time on Hopefully. Well, actually, I followed up on this patient since cause I was doing him for a thing. For course I have to do, um, and he's not come back into hospital with any more bleeds. So hopefully that that results worked on my intervention has prevented him from having any further comes, at least for the time being, so they don't think about interactions with the big present treat interacts with quite a lot of things because of the way it works when it's metabolized. The one over in there is a drug called DVT graph or clopidogrel because of the patients like to call it on. Clopidogrel is a blood thinner. So by taking omeprazole, you reduce the effect of the computer girl. I think you reduce it actually reduces, um, which means that patients are gonna be more. Is it having a blood clot, which is very bad for those patients who were meant to be busy. The patient will be in Connecticut is a patient who is more risk of having a blood clot anyway. So if you further increase that risk then by preventing yeah, no good a side effects. Omeprazole is generally pretty well tolerated. The any kind of side effects you might get our these symptoms that affect the digestive system. So constipation, diarrhea, don't know pain, nausea and vomiting. But like say it's generally pretty well tolerated, you don't really get people having too many problems with it. So I think that was my last one. Just try. I don't know, sir. I put a little bit. So this isn't actually relevant for this patient because he didn't have reflux. He had an ulcer. But with reflux, there are some things that you could do so non drug things you can do So these are kind of things that I should be telling patients to do to try and reduce the amount of medicines be giving them. Because love farms, sister, my drugs, medicines, we actually would rather people weren't on to any medicines. So I said that it's the acid moving from the stomach up into the esophagus that causes the pain from reflux. So when you're like when you're upright, the acid is kept down your stomach by gravity. But when you go and lie down for veg, that's when it tends to be an issue. So a lot of people find after dinner they have next year because they're lying down so the acid could go from the stomach and go into their esophagus. So things you can do it sitting upright to eat to make sure that the food fully going down you're not ending up with some of it coming back up again, grazing the head of the bed so some people, but like a pillow underneath the mattress, just push it a little bit or extra pillows underneath the head. Um, I think that eating 3 to 4 hours before you go to bed because when your stomach's really full, that's gonna be more risk of the acid. But I want to come back up into the esophagus, so giving a bit of time before he then lie down for beds can help when again eating smaller meals, um, on a weight loss. If they're obese, spot will be stronger. Well, not done very well with the spelling of this, like all these this larger in general. So if when you're overweight and also when you're pregnant, though, when you're pregnant, you can really do anything about it. Apart from weight nine months. But it puts pressure on to the stomach, which then that pressure on stomach squeezes the acid up into the esophagus, so reducing weight can help with that only throw away. Obviously, you get trigger foods as well, like spicy foods or acidic foods, so we devised patients to avoid those on as always, smoking on exercycle consumption are very fat on. They cause everything including reflux. So I would advise patients to cut down on that if they can, if that's the people for them. So that's basically my role. Um, I want to talk a little bit more about the pharmacy things. If you have any questions about how to become a pharmacist or anything, least you put them in the shop. But that's everything from me. Freddie, have you got any questions? You do? Hang on two seconds. Let me share a nocturnal of slide. Just because I don't like it being black of the back. That good? Beautiful. So, uh, where where you quest started? Melanie. Questions. I'm gonna put to you the last question we had for for Roswell. Have you ever had 4 to 6 or tube feeding? No. But surely would be more relevant to ask me if I had any of the drugs. I mean, that's a very different question and gets very much in trouble. Feel so that one. How do pharmacies slash pharmacists keep track of TC medications and handled logistics? Not quite sure. I understand that, But what you mean by keep track of thumb? You know what? I just read it as it's working, keep track of them and handle logistics. Um, I mean, it's OTC medicines that basically like stock in a normal shop. So you would just You don't have to There's no like, I don't If you're talking about, like, with controlled drugs that we have to monitor, you have to count how much we've got everything that would only be controlled drugs, which are certain things like morphine, fentanyl, heroin. We call it diamorphine, but terrible coke a day. And that's cocaine. A nasal spray, that kind of thing. Those things would have to actually count. Um, we make sure there's no lost any. But with over the counter medicines, you wouldn't need to keep track of it. Really. You would just manage it like a normal shop. Say, you would just make sure you're bringing in a much as you're selling. Basically, I think I don't know if that's what you meant. I don't like about that. Question comes as well as I can understand. Um, so can PPI scores hypokalemia? Yes, they can. I think they can definitely affect your electrolytes. They cause hypo magnesium. Yeah, which is probably low magnesium. I think they do also cause blow potassium. You have to definitely do have to be careful with, um, electrolytes on proton pump inhibitors. That's a good question. I'm impressed. Done them on. They asked it twice. Just just to make sure is proton pump like a sodium channel in a cell? Yes, it's a lot like a sodium channel, but it ran sports protons and potassium instead of, uh, sodium fluoride on me. So your sodium sodium channels to get cool, yes, but with different ingredients. Yes, yes. Um, yeah, I remember having that as an example. Westchester first year medicine having to like describe that it not describe it. If it's pick that, like draw the difference. And it was just awful what qualifications are needed to become a pharmacist. So you need a levels. They always ask for chemistry. And one of the science there was after chemistry. I'm not really sure why, because you don't really need that much chemistry. But I've forgotten all my chemistry. No, And then once you do need that least two sides a little and you need three a levels. But two of them got the science with one being chemistry and then you do a pharmacy degree, which is changing. Actually, when I did, it was a four year course. You come out with Integrated Master's degree at the end on, then you do one year of pre registration training. So you work in either hospital beauty industry wherever you managed to get place. You do examine the end of that and then you're feeling qualified five years total. But I think they're integrating that training in now with the degree on my room. That's very complicated. Yes, they're going to come out. It's fully fledged, you know? Terrifying. Um, it's the cause. Very chemistry. Heavy. I think you saw. Answer that, didn't you? About how you forgot. Know your chemistry? Now the first year is very careful. What first year is that? Like there's a fair amount of chemistry. First year is quite balanced, actually, In that you set what? My year? My unit. I went to UC. Oh, we were. We had a quarter of it was chemistry. A quarter of it was pharmaceuticals, which was what I was saying about learning how to make the medicine rather than make the drug. A quarter of it was pharmacy practice. So learning about basically have to be a pharmacist on the other quarter was, pharmacology says, or biology followed you. Basically, there's one here, which is why I decided to pharmacy. Melanie just really loves drugs, Carol. It's it's doing. Can't say it's her passion. Yeah, why did you decide to do pharmacy? I I really like science, particularly while particularly biology and chemistry. Um, but I didn't want to go on working allowed because although I like mileage in chemistry, I don't like lab work. Really hate being in the lab. But I also didn't I thought quite a few health care courses, dizziness. I wasn't really aware of as many there are out there. I didn't realize how many the were out there, but I had thought a few. So I've gone. I thought about physio. I thought about osteo osteo pathy. You say that medicine nursing. But none of it was quite for May. I didn't really want to do any of it. So I guess pharmacy quite nicely tied in chemistry and biology with the sort of patient facing healthcare side of things which are quite like to see. And you don't have to go. The thing that really put me off medicine was surgery. And so key stuff like that you don't really have to do any of that was not very much like touching of patients, which is quite nice. You you just have to talk to them from a safe distance. There's one here about what subjects a level I think you said isn't chemistry and one other science, chemistry, biology, mass are the best ones to do. I think that's what I did. But there's other options. There you go. I think you have Mass is probably a good one to have. That's quite a lot of math. Sink in pharmacy. The chemistries called voluntary, To be honest, No, no. A huge amount of like art. Um, yeah. Uh, what do you like dislike most about your job? Um so I my favorite thing is going on the ward around with the least the doctors dependent different water and have different numbers. That was always doctors think, because I like being able Teo, you're then able to talk to the patient with the doctor. You can see the patient in a much more rounded way. You could have a conversation with doctors, and it's more of a joint decision between at least you and the doctors. Hopefully you, the doctor in the patient is to how you're gonna treat the patient going forwards. You can discuss things a little bit more just in depth. Where's quite often, Will I have to do is just go around, see the drug chart and then at the end of school and tell the doctor and you've prescribed this wrong. Please, can you change their six, which is not quite as satisfying. My least favorite thing is, um, just I think, working in the NHS you're just very pressured for time on. I think I think just like this, all the pressures of the NHS can be a little bit. I think Rosalie and kind of touched on it a little bit of well with where you're stressed trying to see all your patients because I have to try and see what my patients is a limited about time. And sometimes the patients take longer to see the other days because they're more complicated. Do you think that that's going to be the case with any job in any chest? That I think they're a few more questions, but for the interest of trying to keep the schedule. I think if we hand over to Charlotte now, now we can come back to some of these of it later. And you could also have a look before wanting to answer them. There's one here you definitely want to check, Which is the mechanism that makes magnesium dropped when you're on a PPI? Um, um, yeah. Charlotte, You, uh, two seconds. Just sharing my presentation. Give me two minutes. Good. I could move to my new slide of added felt Lyrica. A technical differences slide Didn't last long, right? Good. Charlotte and hear me? No. Yep. Well, good. Oh, you can Technically, eso My session is on psychology and mental health care. So it's in the dress and so a little bit about me on down. I currently work as an assistant psychologist in an adult community mental health team in West London on diet. Just trust I work specifically with adults who have eating disorders. Um, my role is to provide kind of early intervention, and so we're trying to help people before they get really on. Well, on trying to help people kind of sooner so often they have better outcomes, and they kind of have less negative consequences. Um, I'm relatively new in that role. My previous role, I used to work great Ormond Street. Um, some sure looks people have heard of some street. Um, I used to work as a therapeutic care worker on the cameras unit at gosh, so Cam stands for child Adolescent Mental Health Service on. So that was a unit that looked after Children as an inpatient. So they stayed in hospital overnight between the ages of seven and 14 on day had a range of different difficulties. Um, which I might go into later on, that I suppose they lost that much. Struggled with the mood that might struggled with their eating. Or they might have also struggled with some unexplained physical symptoms and little team to be due to psychological causes. Eso During that role, I was part of the netting team on work quite closely with lots of the Children on the unit, but also worked really closely with the parents. Um, I suppose my academic background, um, I haven't undergraduate degree, undergraduate degree in cognitive, on clinical neuroscience from the University of Westminster. So yeah, that's been about May So I'm going to start talking about the bioz like Biopsychosocial model. I don't know if some of you might have seen it. I think it's something that's quite commonly used in the area that I work in. Um, but I know that I see. No everybody looks like stuff like this. So the buys like social model of health. It's an interdisciplinary, and it looks at the connections between biology. Psychology on do social and environmental factors on the model kind of specifically examines how these aspects play a role in topics ranging from health and disease all the way to human development. Eso this needle Was this what metal? This model was developed in 1977 says Yeah, 50 years ago now, So it's quite a on old model. But it's something that's still really used kind of every day and what I do now, um, so the bias, like such model if use health and illness, Um, it's kind of a combination of factors. Onda that health mail. This isn't just you 21 thing. It's due to lots of different doctor Austin factors on ranging from some biological characteristic. So maybe genetic predisposition make some behavioral factors. So lifestyle stress and it'll say some social conditions. So the impact of your culture or your family relationships or the kind of social support that you might have around you, all these things kind of plenty in together, Um, two are the great good wellbeing or poor well being, um, an impact, things like that. Um, so, yeah, I suppose overall, the model reflects the fact that all of these they biological site social on psychological factors kind of or intertwine, um, in first a systemic way to other maintain health or also to cause illness. And so when this model was kind of first proposed, it was proposed so people could kind of better understand health and illness. Um, all this application is still, you know, still used. The model is also relevant to topics such a health medicine on day development. It helps clinicians kind of better understand the whole patient, even though lots of people might not use this model kind of pictured. Loads of different disciplines will kind of use this, I suppose, in the back of their mind, having having an understanding that there are lots of different factors that play into why somebody might be sitting in front of you, Um, in healthcare setting. So yeah, that's kind of what I'm talking about. That I'm talking about That because this is a model, that kind of psychologists on people working in a psychology or mental health field use all the time, whether consciously or unconsciously. And so I'm going to talk a bit about psychology. Eso Psychology is the scientific study off the mind and behavior on eso. Psychologists of people who practice psychology, um, actively involved in studying and also understanding those mental processes are also brain functions on dot so behavior as well. Um, so psychologists play a major role in kind of understanding how the biology, the behavior and also the social factors all kind of play together to influence health and illness and cycle just to trained in. Um, you know, I have lots of skills in a knowledge and kind of understanding how all of these processes the cognitive processes. So, um, your emotion, your motivation, your things and kind of help, you know, all intertwined together and prepare the body to develop other good function, or maybe sometimes dysfunction. So poor function on D now They also trained on kind of understanding how these behavioral cognitive functions are altered and how, when kind of things go wrong with things aren't going quite so well for the person on there struggling with their mental health. How do we diagnose this? How do we understand what's going on? And also kind of most importantly, how do we treat somebody? How do we kind of help them move forwards from this time in their life? Um, cycle just work across a huge difference, you know, loads of different settings. And I'll kind of go on to that bit more later on in the presentation. And I suppose one things that cycle just do is you know, we try to help people modify the behavior and also their lifestyle, so to prevent, you know, to provide good mental well being. So roles a mental health. Um, I ask you for a second to try and try and think of a couple of roles in mental health. Um, because there are many. On on the next night, I'll show you just I suppose, a few that I've thought off. But I mean, if you can think of any other ones that aren't on this list. Please let me know. Um, I'll just go over a couple of them. Um, there was everything from different types of therapist. So I suppose therapists often seen people who, you know, if you had if you were in psychological distress, we're struggling with your mental health. Um, you might expect to talk to somebody about that and receive some kind of talking therapy therapists. There are lots of different kinds and the people who provide that s O that ranges from kind of kind of a psychologist to maybe CVT therapists, too. And, uh, it's like a therapists and all the people that are involved in a mental health profession on. But there might be welding practitioners, eso they might work in slightly different services, but they also might provide some one toe on or group interventions with people to try and help them kind of move forwards. Um, there are people who work in schools. There are support workers and health care assistance who might work in hospitals. Um, there's a high interests. Who are doctors with the focus in mental health, there are necessary, um, kind of specialize in my calcium and told Masses, there's a massive, massive range of, um, different people working in the psychological profession. And but I'm gonna focus a bit more today on clinical psychology. Um, clinical psychology is, I said, is an area of, um, psychology, mental health, that whereas if you if you were kind of struggling, um, with your mental health, um, you needed to, um, you know, kind of speak to somebody. Want to one They might be like a psychologist. Might be somebody he might be, too. They're hugely kind of prevalent across the NHS in lots of different sub and provide lots of different aspects to and psychological care. So what do you kind of just like, Oh, just day. Um, I suppose there are four kind of main bits do what connects psychologist might do. And I suppose this can also apply to other professionals in the mental health field. Also in other disciplines, a swell, um So, firstly, what cycle just need to do they need to assess, um, going to find out what's going on on. So assessment is the process of kind of gathering information about the client. Um, might use things like questionnaires kind of standardized questionnaires of being published have been shown to give a really good kind of concrete measure of how something might be doing. Um, my keys rating scales within that as well. And if yeah, you might kind of write a certain question between one and 10 and another way people might, you might Somebody is buy watching them, observing them. Eso kind of direct behavioral observation is something that psychologists will definitely do. Um, that might more common when you're seeing somebody in the hospital setting. And just because they spend quite a lot, you know, if somebody is in hospital, you can spend a lot more time with them. If you see somebody in a community setting or outside of the hospital, you might only see them for me one hour a week. So it's a bit hard to kind of observe the papers. Um, but really, the main thing that people do is talk to them and ask, you know, ask the client how they're getting on on behind of ask, ask questions to get them to to talk about and what's going on for them on dry to understand, um, weather rats and also what they need on glove thing cycle just ain't is formulation and sudden. Not sure from this. Heard of the word before making before, but I suppose formulation is, um, it's trying to understand some of the difficulties with in a kind of a psychological framework, and it's about understanding things that happened in the past for that person on things that have kind of contributed to their problems, things that might be making things more difficult on. Also, some factors that might be maintaining. Um, the thing that's going on for them said things that happen right now that, um making things difficult for the person. And also we try and understand things that might help a swell, because that's really important. Obviously, if you want to kind of get somebody moving forwards to be better, we want to, you know, find out the things that help. Uh, that thing we do is intervention. So intervention is suppose one common intervention that people will be aware of his therapy. Uh, I could talking therapy, and so you a huge amount of what psychologists do is provide talking therapies. That might be what on a 1 to 1 basis that also might be might be a spot of group. And so it might be a few people in a very, um, kind of a little talking about, um, you know that their experiences, um, I'm going through therapy together, and but an intervention isn't just talking. Therapy isn't just everything's in by a psychologist. Some of the interventions might be Rituxan social support. Um oh, yeah. So they might find some social sport they might really might need to be. You know, we might determine that they need to be seen by, like, an occupational therapist to help them with some planning and give to scheduling and things like that on finally, what cycle just do is evaluation. And also we such, um the evaluation is obviously really important because we want to monitor the progress of intervention to see whether it worked to look at the outcome. So and, yeah, we want we want to see whether what we're doing is working whether it's helping people. Um and, um, you know, I'm trying to feed that back on, but improve things. Um, you know, the next time you did it well, so that is a kind of full. Maybe it's and then what cycle? Just my day. So I'm gonna focus a bit on interventions because I think that's the bit that people most commonly associate with psychology. Um, so I've just pumped for inhibitor away more than this, Um, a few different kinds of interventions that cycle just might help with, and one of the first one is guided to self help. And if somebody is kind of presenting with, um difficulty, some people, actually they don't necessarily want to go to therapy. And it's actually a huge kind of commitment that actually they might not be up to at that time. Eso self helpful guide itself. Help is something that might be offered to somebody, and it's a lot more flexible. Um, and the person can do it, you know, they can go whatever pace they want to go. Um, and I suppose it's less restricted than them. Lots of other kind of intentions on. So it might be, um, you might kind of spend a bit of time 1 to 1 or in a group with their condition on they might give you some things and some resources that you can kind of look at yourself and you know, come back, actually, for kind of check ins to see how you're getting on. But really, it's teaching, um, the client or that the person to become their own therapist. And that can actually be really, really powerful, you know, to be to kind of, Yeah, take on that roll yourself, actually. Become urine therapist with the support kind of guidance, um, depression a lot. So that's one kind of intervention. Um, another intervention is great therapies. So I kind of briefly touched on that previously, Um, so a group therapy is point if well, what it says. Um, it's a group of people all doing a particular kind of therapy together. So there are different kinds of therapies that are all kind of evidence based that might be recommended for different conditions or different difficulties that somebody might be experiencing on. I think that something is really important in psychologists that actually just because one person I have a diagnosis of, you know, depression or something, they might you know, it's not that one particular therapy is the thing that is going to help the ms I suppose you want to do. Yeah, everybody's unique. Everybody expresses things differently. um we want to try and work with the person to find out what would work best for them and give them the therapy that might work best for them on Give him some skills that they can kind of use moving forwards. And so there are various different kinds of group therapy doing, you know, different evidence based treatments on I'm not going to go into one of those because I'll be here all day. Um, but come to pay for therapy is CBT is one thing that is quite commonly, um, yeah, lots of people have heard off. Um, that kind of I suppose that CBT goes back to that by six social model of trying to change. So sometimes one change your behaviors to change your thoughts on D. You're looking at the thinking between your behaviors and your thoughts that could be done on a 1 to 1 basis that could be done ongoing basis. And finally, there's also care in hospital. Sometimes people might be really on well, and they might need a lot more support, more sport than they can get in the community setting. So they might have, you know, they might need care in hospital. Think the important thing to know about Karen Hospital. See, You know, everybody wants that to be a short it's possible. Um, sometimes, you know, people might get a hospital to, um because, you know, they need help staying safe. But we want that. Everybody wants that to be assured is possible so they can go back to having their treatments kind of back home, where they you know where they're gonna be living afterwards. Uh, is there a few different types of interventions? Um, so where do cycle just provide care? I've talked about a couple of thean tensions, and they're types of care that somebody might receive. Yeah, with a psychologist. But where does that happen? So that can happen in hospitals. It can doesn't necessarily have to have to have to have to happen in a mental health setting. It lots of like, I would just work in general hospitals on both people with physical illnesses. So psychologists come work on place like intensive care, and they might work with people with long term conditions. I've been helping them kind of understand that and come to terms with that, And they might also work on positive. What's with people who are, you know, coming to the end of their life from working with both those people and also their families helping him come to 10 to that. They work with different groups of people. So adults with Children with people who might expect learning disability or you might have a forensic background so might have committed a crime or something. Um, imagine any setting where people are of cycle, just go work. And they settings, um, really, really varied anywhere where there are people, uh, you know, you know, people can unfortunately always experience mental distress. Eso psychologists can work in their settings. Um, cycle just also work with different conditions. Um, again, a wide variety of different additions. Anything from physical or less, too, Um, something with a brain injury to work with older adults or, in my case, like bleeding disorders. Um, my last roll, a great Ormond Street specialized in working with Children who had kind of unexplained medical symptoms where they might be experiencing a medical symptom. And then, you know, all the tests on, but nothing physically is being on the found. Um, and at that point, it was determined it's likely to be due to a psychological course. Yes, I have a logical Cyclops. I collagen. It's come work, know settings, thinking about the link between the brain and body. And but psychologists also work to support teens. Fashion teams on and also kind of wider systems come also provide, you know, I suppose, want to maintain the the well being off the team of the staff working on the team? Well, no. But again, address could be really difficult and stressful place to work. Um, also work within the team to help provide advice. Um, two different members of the MG t on and also to kind of help encourage more psychological view of the patient spoken smoking a lot about, um, the interventions and things that psychologists might do on. I'm going to go on to my size hierarchy of needs, which I think I remember learning in school like that. I'm see me. That's still kind of taught as soon as this hierarchy of needs. Um, so why am I bringing that up? Um, I suppose this is kind of bringing it back to what? I spoke about the beginning, which is the fact that and the biology, psychology and, um, but the environment. Or play together to support somebody's Mel. What, Being a mental well being, I suppose all their psychological needs are this middle part of the triangle. Prestige, self esteem needs feedings of accomplishment. Um, that's where, you know, cycle. Just trying to target their interventions. Um, and often secondary gets lots of lots of referrals. But actually, that's not the only place where we can kind of do interventions on disappoint people, too. That's what people with that mental health and unfortunately, and especially adult mental health services, we might see lots of adults who, um, really struggling. But those really kind of basic needs right at the bottom of that pyramid. They might. They might be homeless, they might have, and no social support around them. Um, they you safety is such an important need. Your wellbeing, they might know, be in a position where they feel safe. And and I think it's really important to remember that it's, I suppose, if somebody in that situation comes in, But you know, like it's like a psychological therapy. Um, it's great, you know, we can try, and we can really try and help with their psychological needs. But until we've thought it, though, is really kind of building blocks, Mike, I suppose if we're building a house that the foundations until those are really solid okay, it's difficult to work on their more psychological needs when when the basics not fulfilled. Um, the reason I'm saying that is because I think it's important to for for him to be aware, Um, that know all interventions will come from psychology. There are other ways of looking after people's mental health needs. The I'm just kind of want one therapies, um, such really, really important parts of NHS of social care and and supporting people with housing. And, um, that was condemned a absolutely amazing things for people's mental health as well. So yeah, I kind of just wanted to talk about that in them. Supposed the masses hierarchy of needs, kind of really pictures. I think quite well, the building blocks somebody needs to have and and you know, we do our confessed, um, you know what's also working alongside their mental health, but it's hard to have really kind of good mental health unless those building blocks really established, Um, so that kind of brings me on to the end of my session. This diagram is probably bit confusing, but I'll try and explain it a bit. Um, my I suppose my message is that although psychologists are really, really important, then do some really kind of amazing work. Unfortunately, any chest is really stretched, and I'm sure everybody has heard about the difficulties with mental health care. At the moment. There's not enough funding and waiting. This saw can be really, really quite long. And so and I suppose that comes down to, uh, you know the bigger issue than I could even touch on in in this talk. Um, but how? It's really important to meet mental health needs at all different levels. Um, with the person at the center, the people around, you know, if every individual has a community, people around thumb and friends, family, neighbors, work colleagues on my communities. Um, but they've also got their physical community around thumb places. You know, they might be part of social organizations or education settings, Um, and then kind of outside of that is the mental health services or community treatments. I suppose where lots people would traditionally expect to see that psychologist, but it's so so important that actually mental professionals working all different levels work within the personal community. And, like the physical community as well as in the mental health, you know, come the second, remember, help teams, um, to kind of promote people's, um, well being and just keep people. Well, um, it's okay. That makes sense. Um, yeah, that that's it. That's it for may. Are there any questions? Um, pretty on, Uh, this year there are questions I will answer a couple very quickly, and then I'll might leave you just type answers to that, uh, extend your job. Affect your mental health? Um, I think it did. Sent an, um, lots of the you know, lots of the clients we work with have gone through some really, really awful things. And actually, sometimes you'll have to be part of things. They're really distressing. Or here something's really distressing. And I think the thing that is really important when you're working mental health is actually looking after yourself on that comes, you know, you could do that a variety of different ways. You know, partly selfcare making sure that you got a good work, work life balance, but also is part of work in psychology services. We have This thing called Supervision is usually an hour a week with somebody who's kind of the next level seniority above you. And it's not pretend you to kind of talk about actually how your work is it impacting you? It's partly to kind of problem self. You might have some difficulties with, um, you know, some work stuff or there might be somebody, um, who is really kind of, you know, getting to you or, you know, something that's kind of really hitting home on gets really important to use your colleagues and spaces like that to talk about what's going on so it doesn't slip into your work, so you cannot see always provide the best care possible. So there are It does definitely affect your mental health. But there are things that are in place to trying to do with that Excellent. And last one. I'm gonna ask you for belly, and then you can type of answers. Your rest is, is there a lot of complicated maths? Sorry, her put math. I'm changing it a mass because we're okay during the course. Is it necessary to have a maths? A level to psychology? So my GI City I remember I got the cities A levels. What? I got a levels. I did three a levels. I took maths as an s. I think I failed it. I think I only got your you on dropped it as soon as I could. So the answer to that is no maps. Um, I got three a levels in geography, chemistry and biology. I think I got a C and D in my level, so we didn't do brilliantly. Um, but the answer is No, you don't need You don't need to do maths. I can't remember the last time I have done maths in the field. Um, you need either a psychology degree. Um, or I think my degree was cognitive neuroscience, which is kind of psychology based on be from then, yes. That doesn't qualify you as a psychologist. That that does allow you to start working in a psychological field, and from then you do further courses. So depending on which kind of therapist you want to be, there are different courses ranging between, I suppose, two years plus, um, that you can do. All right. Thank you. Charlottesville idea. You ready? Just so we can keep the time. Yeah. Oh, good. Just about stopped like I'm Oh, that is showing your actual PowerPoint know the It's like a bigger go profit. Sorry. Me? My new study. Uh, I'm a physiotherapist. I've got two critical cap. It is they're under since John Photo. When we put into giggle, what is your therapist is these are the images. This is no good for your current stuff on a a muscular, skeletal physiotherapist. So you're your stereotypical physio. But everybody thinks about when you see this might do some hands on stuff and we do do a lot of hands on stuff, But we don't do Max our age that some people think again. It's a skill that we can implement, but it's not all that we do. So that's what I'm going to go through. Some of the other expects that we That's why I like it. Because this is what I originally thought physios did. Then I metaphyseal who told me everything else that they do. I decided to become a physio. So there are three main areas and that's what the main areas that you get the most teaching on it unique. So it's your call your respiratory systems on how we can help people. There's a busier with these sorts of illnesses. Um, neurological system. So things like brain in your early stroke. Spinal cord lesions, Parkinson's, um, s votes of different nearer conditions. One my head of his given Barrett's syndrome. Then we go on Teo. Um, sk What we started typically think he's used it, But we can also do things like tremor and orthopedics on post joint replacement things and actually pretty joint replacement as well. A lot of pre have a sweet call it rather than we have what you do most the surgery or post the illness. Uh, then there are so many other areas haven't listed them all. I sort of went off the top of my head rather than feeling everything that we did, Um, so women's health health account. So a lot of people can have continents issues, so that's where you can't hold your urine or your bowels, and we could do things with retraining the muscles down there, Even off the pregnancy. People can have some issues. This year's can get involved in help with that occupational health. Apparently a lot of the occupation Health physio. See a lot of burning figures because we do a three year degree sitting down at uni, and then we get up to do this really physical job. But why do I backed her? We end up seeing our in occupational health sort of us to, uh, fix us, um, PTSD people with, um losses if limbs rehabbing them, training to toe walk again. Things like is a prosthetic suitable for this person? Will they come with a prosthetic? Not like in a in sort of physical sense. Uh, chronic pain. I did a place and on chronic pain. It was really fascinating breathing on topic. It's worth just having a Google about chronic pain and what physiologic do to help. It's also a lot of patient reeducation rather than some of the physical hands on stuff. But teaching patients, this is why we feel paying on. This is why we think you're feeling so much more pay for such a long way around that time. Here's how we can help care of the elderly, Doesn't she quite a main area working care of the elderly wards of people falling over of the people that just medically unwell. But we want to keep them as active as possible is that we get in a hospital this quickly as possible so that they're back home in their own environment. To recuperate. Have therapy is what a specialist thing I've got, like, two lectures on it unique, but it's, ah, think it's a It's an area that you can go into community teams. There's a whole wide range of community team, So a lot of things I've rested above. They could be so acute, found community, and you can even have a Q teams within the community. So my previous job to where I'm currently working waas a team called a rapid response team on. We would go to patients to sort of prevent their admission to hospital so we would see other interventions we can do at home to keep them medically fit on day off, safe in that own home to prevent them from being admitted. The hospital, while they recover from what's currently going on pediatrics again, all of this stuff, but in smaller people on any making sure people that discharged home safely on. Sometimes it's a lot more social things, organizing equipment at home, packages of care of the aging and social services. Just making sure that people, when they go back home, they're not just gonna bounce straight back in the hospital did. Going to far There are lots more. This is just a simple the that. So as a physio, I broke them corny things that I took him off the side. But I'll say some of them so sometimes, like I feel like it helped me get back on their feet were helping people to live so of the life that they want on. We always worked quite goal orientated to patients. So if a patient says so, they felon work that on, they say, I want to be able to look up my stairs at home, so we need to look at where the patient is right now, how we can get them there. I'm in set realistic goals in the interim to reach the patient ultimate goal of will cut, the says as a respiratory physio, basically helping people breathe better. There's a lot of different aspects to restore it. Proof is doing, but ultimately it means the patient feel better. Breathed easier, breathes a bit more normal. Breathing is an effort for for us, but when your breathing could be really effortful on, we can look at how we can reduce that for someone. So it's not a scary I also don't have. Advocating for patients is a physio. We get to spend a lot of time of patients. We get to learn a lot more about them, what they want, on, how they see their life on. So we can put together the bigger picture and go to the rest of the team and say, Look, this is what we need to end to do for this patient because that's what's gonna get them better as a whole person. We don't call that like the holistic view. As a video, you are in alternatives, practitioner. So you're responsible for your in clinical reason. Your patients and treatment plans on. You have to stay up to date with current clinical evidence based practice. So a lot of a lot of just continuous learning for the rest of your life. But that really excites me an interest than I enjoy that, and I think a lot of health care freshens because of the way evidence changes so quickly. We all have to be lifelong learners. Um, so yet well told us practitioners we worked about Martin Medic, medical, teen doctors Save the life we help make the most of life. That's something that some people say that busy eight do, um, some example. Off mg t members. So I currently on currently on any neuro strictly irritation on D my current MG t. When I go to the meetings on Wednesday meetings, we have the consultant, the strict consultant on there, junior doctors. We don't have community newer team on, so they're likely to be. The people will pick up our patients to continue that easier therapy, occupational therapy and speech and language therapy into the community. Um, we have the speech, a letter surface, the hospital ones on the teen dietitians, nurses, patient therapists, means physio psychologists and discharge coordinator. That's sort of the minimum. We have all our team on a Wednesday. Sometimes we have a lot more, but it's all we're all saying what we want for the patient, what we think is best for the patient, but we will need to know what each other we're doing so that our ultimate gold helps the patient get to their discharge destination. Go. Um, so what might a good day? So it looks like it varies depending on specialty. So at the moment I said, I'm on strike, I start coming in the morning about eight o'clock, go through the split, the task of someone else that will start from the top of less than what down. They'll work up to screen the patient list to see if there's any new patients that we need to pick up. Um, we have are bored around it. So the 10 30 where it's like a mini m MBT so we'll have the doctors physios ot speech and language if they make it. But the card you need to in the hospital, um, messes on the ward manager on also just quickly catch up to check. That was still on the same time that we had from the NBC meeting, or, if anything, needs to change. So between having screen the notes on the ball around to try and see some patients, um, usually it's It's like it's just over now that I have there, so I'll try and see a new patient because of your assessment. Can take a little bit longer than seeing someone I already know. Um, as I said, we get spend a lot more one on one time of patients. So today my new patient took me an hour and 45 minutes. He was also attracting a lot, which is why it took that long. But we built up a really good report on, like a ball to open up to me a lot more. So I know what's going on in their life so that I can see how the treatment that we're going to give this person affect them in the bigger picture. So if we go back to Charlotte's talk with the Biopsychosocial model, that's what we're trying to do. We're trying to get to know those different assets. Also one's life, to put it all together, to see this pain, this patient not as a patient but as a person. We have to do a lot of motivating of patients. Sometimes patients just wanna stay in bed. They were asleep. They're feeling weak, feeling tired, but actually getting them up and moving. Probably gonna be a lot better for that house getting about hospital quicker so you don't have to bother with patients a little bit in that way. My friend told me to remove the last line, actually kept it in, because sometimes we do end up getting in with the acid juices and personal care. It's no, you know, specifically in our job title, but it is something that we get stuck in with sometimes if needed, especially largest. Get a patient. They've opened their bowels, and it was the same thing that caused that. So how do you become a physio? Eso? What I did was a B S C. Physiotherapy degree, so it's a three year degree. M A C is an option. That's only a two year degree, but it's the exact same. Three is content. In two years on, you still have to meet 1000 hours of clinical practice before you can graduate. I went to Kings College. London at the time was the number one physical therapy. I applied to quite a few others. I wanted to stay around London so I could commute from home. Many others around the country. You just need to check that they will give you the H C P. C registration at the end of the degree because that's what allows you to call yourself a busier. It is a protective title, so you have to have. That's sort of the HEPC registration that we have. I, uh, King's on. Actually, for all of these there were interviews. They varied from an MMI style, which is multiple. Many interviews very similar. To what? You hear that medications have to go through sort of five minutes. Stations. One question the each station. So you got five different interview? Is Islam group interviews on some standard normal one toe one or wanted to interview? So that's two interviewers to meet. Uh, it was just, like gets really don't matter. Some units might specify some subjects, but I didn't notice that when I was applying, I personally did. Biology, chemistry, maths. I get A s history. Um, I find the biology was very useful on some of the chemistry, but really, it's not the end of the world. There were people who had not done any of these levels, and they were okay. It's just there's a little bit of, like body chemistry, and, um like you've got your anatomy and things, but you learn that all a unique and you have the time to go away and cement it. Uh, there are now apprentice rates available. I don't know a lot about them, but I know that their trust specific. So it's like you apply for the job that needs to you being a physio, you don't apply to the guinea. You apply it to the hospital. Trust on the job. Sometimes trust. Specify that you have to be working that trust for a certain period of time before you can apply some just that you apply openly. A rehab support worker is someone that helps in assists, physiotherapists or patient therapist. Sometimes they're specific to, um, one of the profession. Sometimes they'll flip between the two, depending on what it's needed off them, because it's a it's an unqualified role. But you're so you're being delegated the work from a qualified member of stuff. In essence, um, but there are a lot of rehab support. Work is out there that are far more knowledgeable than I am in some areas, because, like the stroke, I've turned up that I'm not being there very long the rehab sport work is being there three years. Obviously, they're going to know a lot more than me, so I'm relying on them for a guidance and get me around. But at the end of the day means the qualify. Remember stuff? It's my registration. That's so what's going on in saying this is what this patient needs? The degree itself was elected in tutorials, practical classes, placements. So placement is where I said, You need 1000 hours of clinical practice. Universities are supposed to organize that for you at the moment. Quite recently, it sounds like a lot of degrees have had shortages of placements, but they have been managing to get people through, sometimes having time into a degree. And I think that's mainly because of Cove it on sometime it was a little bit of over subscription with the new the new Bassett, but it is getting better. I missed some of my hours, my uti on my one of the trust that I've done a previous patient in helped me to organize doing a final placement to catch up my hours. So I managed to graduate. I just graduated a little later than my my colleagues graduate in September. They graduated in July. It is quite exam based, but it varies from Britain and ask ease. And then your placements are marked in some places, they're placement of pass fail. In some places, placements are weighted with the percentage uh so again, you can look at that might factor into which university you pick, Um, and again between written exams and practical exams, That's what most years, by the way, the waiting changes every year, and the knees vary. So if you're someone who doesn't like exams finding anywhere, the waiting is more on maybe the osteo. So you're showing off your clinical skills. Um, or if you love with resound picking, you need That's maybe more academic in the waiting is more on the written exams. So there is something for everyone. My current pain, the future is to complete my band five rotations. So when you qualify, you become about five. If you don't know what the banding means, go Google agenda for change and it just so everyone that works in the NHS except the doctors are on this sort of banding scale for pain and seniority. The most qualified rich professional stopped in and at about five for me on doing rotations. So I rotate a department every six months. So the moment I mean stroke, Um, and this September, I believe in Tomo scan. My ultimate aim is to become a respectful physiotherapist. And then hopefully we won't being something that's called an advanced care practitioner. Um, it's a fairly new role in the last few years. It's becoming much more established there much from or there are many more advanced medical care practitioners at where you have to have something like a minimum of five years post graduation experience. On a minimum off, those a minimum of two of those years have to be in intensive care units. That's what I see us COPDs. What's going on? Something obstructive pulmonary disorder, Freddie, that this is a chronic chronic. Thank you. Oh, I've been working seven days straight, so forgive me. Um, fairly sure is a medical student. If I got that one wrong, you're allowed to, like, put me in the stockade and for tomatoes at me. I'm a physio. I should know beginning that wrong. Um, yes, I've seen these. Some of the things that I want to go into him back in. But there are many others. So I'm not saying the NHS, but there are other settings. You got private health care. You've got sports and elite sports. So that's physios at the Olympics right now. And see if it goes everywhere when it comes to sports, um, social car. You also have fisheries that work in, like social work teams. How assess whether patients have a need for extra support at home and those sorts of things that they're know employed by the NHS. They're employed by a local councils, uh, insurance, work, education, academia. So you could you just need a degree going to do a teaching PDC so you could go do that if you want to be a teacher or if you want to go work in higher education. So teach the physio degree. You can go on and do that. You have to do some like I think I have an embassy to be able to do that. I have seen a little post recently that say that you don't have to, and you could put me to, um a C whilst you start to teach, I'm going to research. So shake the future busier again. Not more than that. That's just a little stopped old, uh, tips being. Get some work experience if you want to do any healthcare degree. Really, it's a bit of foot with codeine at the moment, but keep emailing and asking. I know my current boss is buildings and emails and like he's pestering the trust to open up the work experience again because he knows that there are people that want to come into work experience physio. But just the trusts kept it closed because of comas but fingers crossed. See, um, understand the future job roll that your degrees going to lead to because that needs to come across across that interviews like you can't go to a busier interview and think you're going to be, uh, the doctor or something like that, or you can't yet you don't have to understand a little bit about where your degree is going to leave you on the sorts of things you'll come across you need. So I think it's a quite syndrome heavy. That's because that's about the anything enjoying during this degree. Um, but just find your tribe, find what works for you. I don't really fit in secondary school. Didn't really find many friends. Think I left second your school with two friends. I'm only in contact with one of them now, um, at uni 1000 John. And that's what I found with my friends. I don't really have any friends on my physical degree course, but that varies for everyone. Varies where in the country you go. Who? You? Me? Uh, so just yeah, make make the most of you need go to your precious. But I go around the unions and find out what? So the society they have, uh, if you have but learning difficulties, health conditions, mental health issues just, um I found it very useful to disclose those sorts of things to my unique to get the help. Sometimes they help a little from the you need, but the student union all like from the other for me, um, the specific, unique disability department. But again, it varies If you need to help. Keep asking for, um and again, that might be something to look at before you pick a you need to apply for or to go to. I'm on the same. Actually, on. So for me in the any chest on what trusts you apply to, you know, work in. So I never doctors. It's different where you apply to and where you might so worker. But for me I applied directly to trusts and sometimes two specific hospitals. So have a look on their on their website and find out what sort of people they are. What sort of what sort of the words not societies but networks. They're sort of networks that they have a store, whether you think you're fit in there and work well. And if you don't cut, always apply for another job and move on any questions. So these are so useful resources for all sorts of health care professional rolls the CSP one, the second one down, that specific to physio. That's all. Charter society, physiotherapy, Thea. Others give you information on all sorts of healthcare degrees on the first one I put specifically to the HPI role. There are 14 allied health professions busy. Um, it's just one of them. Patient therapy is one of them dietitians or one of them not entirely sure psychologists or one of them. Someone can correct me on that thie dash elevate website has, um, sort of. It's free to sign up and create an account. You might have to just pretend that you work a hospital, like, just go through the drop down. Whatever. And you can have a look at some of the sort of a learning things available. Um, And again, if you have any more questions, I don't get around altering you. Think of something later. Feel free to email me, uh, in terms of work experience. Uh huh. Email me and I might be able to help you if my if my boss manages to find out the the right person is, Uh, yeah, I was going to say doggie mommy for that, but I can try and no. Okay, Freddy. 17 Parlodel say really amazing bit at the end about universities. I think that is really, really important. Teo. Yeah, I could put you to go entirely about that, but for so many of us here, we got into what we're doing now through things we were doing at the time. So I think that is really very relevant. Points. Thank you for making that started. Um, the questions that want many questions. Actually, for you, I think we've probably exhausted all the poor people. But the question you got currently, how is your work? Life balance. Okay, So my what life balance probably sounds Robert the moment. But that's because, um so as a video return to work 8 to 4, mind five or in my car, in case we do eight or four on D once a week, we'll do 10, 26. So again, it's the same one of ours. Just a different start time. Um and then we were something like one in five weekends. So we'll get those two days off. So I had my two days off last Thursday. Friday, and I'm now being working straights in Saturday, which is one of my brains of it fried. Um, but hopefully that means you got this weekend off. So it does. However, I'm also training to the emergency ambulance crews and John, and that is not free. But that's life decisions bothering life decisions. But what? My balance off physio is actually pretty good because you remain. You get to knock off it for and you actually have an evening to yourself rather than halftime. A part time high. Still do place up and a half hour weeks on. We do on calls. Actually, we do an overnight on course where we have to be a hospital within 20 minutes. If we get called out and we think it's appropriate for physical therapy to attend, that's mainly for respiratory things. Because I respect your stuff, can kill people of weak and kind of fix up. Uh, but what are some important skills for being a physio? Yeah, uh, most think most healthcare rolls. You need good communication as far as it mentioned. Um, I think strong wrists, Yeah, lot beating people up from our visit. And physio. No, I'm single. That's some respiratory physio stuff. It's a technique that will go to sometimes know because you learn. You learn my new hamlin techniques, you learn how to protect yourself. You just need a general physical well being. Um, you don't need to be super fit to be a physio. I'm not super fit. I cycle to work, but I'm not super fit. Um, there's quick question, which, actually you probably might be one of escape place people to answer. Do you know what age hospitals tend to accept work, Experience? Placement. Oh, um, I've got a funny feeling. It's 17. Yes, it is. 17 hour ever. Uh, the hospital I was originally applying for med school, and when I did my medical work experience, I was 16 on there. You forgot? Asked me how old I waas, so they were not pretend you're 17. So I think you're right. It is 17 hours. You can go straight into being on HCA at. I was going to say there are rolls. You can work in a 16 in the hospital. I think it's one of those insurance things some hospitals might know even say under 18. Some of them, it might be. You have to be 18 plus just for security. Um, but I think it's it's dependent on the individual hospital. I think so. If you if you know the hospitals near you, it might be worth contacting them toe. Ask other ideas for work experience. Like I worked in a vet clinic when I was 13 miles to go cannulate ferrets and things. So basically, by the age of about 15, I've finished 90% of my veterinary nursing portfolio, So I was 90% of the way to be a vet, Nous Um, yeah, so you could do some other really wacky things that are applicable. There's a really important thing, I think all anything to do with work experience than that is that anything you do matters, it's purely based on how you for a zit and talk about the skills you've learned doing it. So Okay, it might be wonderful if you get to go and watch open heart surgery. I don't go and watch. Open heart surgery does get quite boring, but wonderful if you get going to really cool. Interesting things sound amazing, but actually, your university isn't going to care. They're just gonna worry about how you've developed a person doing it. So if you go and say, Oh, I didn't actually go on my course Kings. He has had no clinical experience prior to getting onto medicine. Nobody have a job, is a pizza delivery guy and he just talked about how he developed problem solving techniques and communication techniques and all this kind of stuff from being a pizza delivery man on. That was what got him into med school. Uh, how can you work in a hospital a 16 year old. How would you apply? I believe some hospitals will take healthcare assistance, which are sometimes called nursing auxiliaries. Sometimes cool also sort of things, but you'd have to look at the specific hospital, and they requirement for it. Care homes, as someone is just whispered to may care. Homes also tend to take people under 18. They're not quite good for that, actually, on divan. Then, like even if you're not in a clinical roll that you can do things like sitting around talking to the residents, that's not quite good for nursery assistance. I think it could be a nursery assistant. Age 16. Um, there's all sorts of things out there. Like I said, though, it's just purely what you do with it. No, what you do, if that makes sense, PCA hates the a healthcare assistant, and that's they do a lot of sort of in a similar way to water therapy Assistant might be for the Saudis role in Healthcare Assistant is bit of the nursing equivalent, so they do a lot of traditional nursing rolls, things like patient personal care for patients, observations, this kind of stuff on award for in any urine, all sorts of areas. Um, yeah, so that that's basically 88 is looking up. If you want to see, I think it's quite varied roll, depending on where you work, depends what you do. I was healthcare assistant for a year before I went to med school. It's quite good job. I worked in a palace afford had a great time set. Other than that, I think we're out of questions that are sorry. Dear related. Thank you very much. Saadia. Absolutely thank you to all of our wonderful speakers tonight. You all been brilliant, and hopefully everyone's gained lots and lots of interesting insight into different areas They maybe didn't think about before. There's been a couple of questions about things like paramedics and nurses. I deliberately sort of went on the idea. I didn't want those particular roles for tonight. Particles Nursing is It's just so ridiculously buried. There is so much in nursing you can have entire evenings dedicated to different nurses talking about their particular area. Also paramedics because they don't really come into the MDT. You do get them increasingly now in hospitals, but tradition not, not really untraditional. Predominantly most paramedic still work outside a hospital and the MDT tends to be in hospital or sometimes involving community care. So that didn't really play into tonight. Those who are interested in things like paramedics on and nursing fill free to email and I can forward questions and queries and all that stuff that that onto paramedics and nurses. We have got them lying around. Um, they just not booked in to do any sessions. At the moment. I'm thinking about trying to put together a nursing week, maybe where we'd have a session and night about different nursing areas. So if that's the thing of interest, that something of interest on para medicine again, just let me know what you kind of after any sessions anyone wants were here. Well, you want to teach what you want to learn, So please, please, uh, let me know what you're interested in by the email, and we can try and put on sessions accordingly. Um, other than that, the feedback link was in the chat. I will email it around a swells Onda. Uh, yeah. Otherwise I'll see you guys all next week. Also one last question there. So, yes, HCA is paychecks. Don't necessarily require training. It depends where you are with in the UK, different areas seem to have different rules. My one I went into a hospital, got the job and had to do all of my training as part of the job. So the first, like months of my job, was doing the training. And then I started working. I think places I think Kent is a bit funny with it, and I think couple of a counties or a bit funny with it, and they want you to have qualifications to do so beforehand. Doctors and surgery. Let's continue after August. Okay, I will answer those because they are actually relevant. So we are currently in the process of making a follow up Siris. Initially, the plan is to this five Sessions series. See how it goes and then go from there. We've had pretty good attendance and pretty good results in the feedback. So we are going to throw on a second Siris that will start in October. So there will be nothing in September. Nothing. The first couple weeks, October and then we will have another Siris. The next series we're going to go for is anatomy and physiology specifically what that means. We've realized that particular for nursing and paramedics and the amount of amount of anatomy you need to learn to pass the degree we probably can do in several sessions on here. So we're going to probably go for that and try and do. I think it's gonna at the moment it's looking like it will be 10 sessions of about a half a session. On that will be anatomy and physiology, which we use for for any area of healthcare you go for. So that will be after August. That'd be starting in October on sessions regarding surgery. Actually, anatomy and physiology would be exactly what you need at this stage for anything. Surgical. Um, anything you got interest surgical wise. You need to know your anatomy. You need to know it inside out. So those are really good sessions for that kind of thing if you want. If you got queries questions or like that about surgery email. May, you've got my email sent emails to all of you. Email me and we can pass them on to surgical trainees. I can possibly into surgical consultants, depending on what you're after. We can get information back for you in terms of actually sessions on surgery. There's no what we can to fire, you know, via the Internet. Surgery is quite a practical thing, but the anatomy, I think, is the most interesting and useful. But you can learn for surgery over answers that question. Okay, how to use this and you can't. And personal statement, Uh, partly just showing keenness proving that you are interested in things. And if it ended other things Theater? Yes, a personal statement. You know, to further my interest in whatever field you're interested in, I attended this series and furthered my understanding of the NHS and healthcare. Or have you want to phrase it? That's a pretty good thing to put on these at that point the other way. It is then things that interviews If they ask, what other things have you done to develop your interest? You could talk about serious talk about things we've learned. Uh, yeah. There's a lot of ways to make that work. Okay. Other than that, I will end the event now. Any last questions? Excellent. I'll give you about 30 seconds, then I'm gonna shuts down. That'll do it for the night. Thank you. Everybody