Three weeks into third year

It's now three weeks into 3rd year and I've just about survived all my clinics without killing, hurting or mentally scarring my patients (I think I have anyway).

I'll start with the lectures, they've been challenging, interesting and scary at the same time. From the sheer amount of detail in abnormal ocular conditions to the real life knowledge of occupational optometry via the life changing low vision and special assessment. First year is all about bringing everyone up to the same level and getting people used to the university way of teaching whilst instilling basic principles and some background knowledge. Second year builds on this and you start to learn practical applications such as binocular vision and contact lenses. Third year is where it all comes together, it's all about applying principles in practice and smoothing out the rough edges in knowledge and patient interaction. It is knowledge gained in third year is what I will be using on a daily basis in my future career, assuming it actually goes into my brain.

Onto clinics, which are the main part of the third year, I've had 2 primary care patients, 1 contact lens patient, sat in on 3 special assessment clinics, done 2 dispenses and 1 collection. What have I learnt from all that? That at the moment I am nowhere near ready to see patients unsupervised or finish my degree. Have they really been that bad, probably not but they have certainly shown how much more I have to learn. The main problem has been me getting myself into a flap and not following a logical order with tests or allowing small little things to throw me and knocking my confidence for the rest of the test. Both my first contact lens and primary care were a bit of a fluster and whilst I recovered in primary care, I was still a mess at the end of my contact lens clinic. Thankfully I had a really nice patient who knew what they were doing for the teach but it still really annoyed me that I was such a mess. The plan, is to create a little crib sheet so that I have something to refer to if I lose the plot again. I don't intend to constantly refer to it, that would ruin the flow of the test but at least it gives me a fallback and hopefully writing it out will settle things in my mind better. The other main learning I have taken away from primary care is the need to refine my funduscopy technique with Volk style lenses, I should have plenty of time for that during my dissertation (more on that in a bit).

Special assessment has been the most challenging clinic but the most rewarding at the same time. I've seen three very different patients, a young child with Down's, a 44 year old with severe learning difficulties and a 14 year old who really didn't need to be in the special assessment clinic. The tests have shown just how much a simple eye test can vary based on the patient, from using glowing gloves as a fixation target for ophthalmoscopy to having music on to calm a patient down so you can test them.

Finally my dissertation: "Can an everyday mobile phone camera be used to image the retina instead of an expensive commercial retinal camera?". This was my first choice based on my previous history with mobile phones and I'm really looking forward to the challenge and gaining the experience with Volk style lenses. I've got lots of ideas where to take this, possibly too many for the time and word count I have for the project but it's going to be fun.

Third year begins

So after a busy summer of working various placements I do have an offer for a pre-reg position, a new weekend job and a slightly healthier bank balance even if I would have preferred to have a little more time to relax. Now however it is almost time for third year to begin.

Last week was Freshers week, my 7th in total, and I managed to survive (just) despite having a cold develop and being knackered the entire week. Wednesday especially I was walking round like a zombie for no real reason. The week was spent organising OPSOC and signing up members, new merchandise launches on Monday and then getting and trying to decipher my clinic timetable.

Seriously?!

To be fair it's not that bad once you figure out the pattern and know which group you're in but just a bit scary the first time you see it. Overall mine isn't too bad apart from a few Thursdays towards the end of term when I go 9-6 straight with no breaks - it's going to hurt!

I am looking forward to starting back again, seeing real patients and learning more, although the first few weeks maybe a bit sketchy. The main thing I want to know is what I am going to write my dissertation on, get that in a week or two, as I actually want to start writing it mainly as I have a feeling the second semester is going to get hectic. I will probably not be saying this once I have the title and started it but that's life.

It's not easy being green

Today I have been helping out as a victim, sorry volunteer, for a summer research project at Cardiff university. These projects are undertaken by students between second and third year to help gain an insight into research ready for third year projects and to see if a PhD or Masters would be something they would be interested in. The projects also help to keep Cardiff at the leading edge of eye based research that the school of Optometry and Vision Science is so renowned for.

Today I have been helping with a project funded by Coopervision being conducted by one of my friends comparing the effects of over the counter blepharitis treatment compared to baby shampoo. In particular it is looking at the effects of the scrubs on ocular comfort and staining. This has resulted in me having fluoroscein and lissamine green put into my eyes, leading to me having a fetching shade of green eyeshadow for most of the day.

Still it's a small price to pay to help for driving research forward.

From blue to green

So after 6 weeks at Boots in Swansea last week I started a 4 week placement at Specsavers to see how the two companies compare and which one I would prefer to do my pre-reg with if I am lucky enough to get offers.

The first thing that struck me was the similarities in pre-tests and the handover coming out of the room, then the differences in offers - both lens types and the pricing. Learning all the lens types will be tricky and having done some dispensing with Boots I thought I would be good to go with Specsavers. WRONG! Single vision is fairly similar but the differing offers and types of varifocal mean there is still a lot to learn especially with the lab instore. I am actually looking forward to spending more time in the lab looking at how glasses are made and what the differing tolerances are which I feel is going to be a good start to third year.

So far I have been enjoying this placement just as much as my first in a different way. The staff are really friendly and have been nice enough to invite me out on the staff night out on Saturday and I've seen a lot more pathology, which has been good. I even managed to successfully diagnose a patient's sub-conjunctival haemorrhage this afternoon (I didn't tell patient but checked with optom afterwards and I was correct).

That's all folks!

So on Saturday I finished my placement at Boots. It was a mixed day, good as I don't have to get up early in the morning to go to work (7am is too early for me) and sad to leave all the lovely staff and customers I had met in my time working there.

So what did I learn from my time there:
1. I talk too much - not something I ever thought I would get told, but seems I try to convey too much information at times which results in wasted time and the point not being made properly.
2. Customers love me :-) always good to hear that from customers and staff. It seems 10 years of retail experience has paid off, as communication is a key part of optometry. Although point 1 means I still have areas to improve.
3. Optics is definitely where I want to work, it was so interesting to work in a proper store and see the difference glasses made to how people felt about their lives, and the difference referrals for cataracts or emergencies can make.
4. There are lots of good links between different parts of health care (both within Boots and others) but more could be done to help customers get the most benefit from one provider.
5. As I mentioned in first week round-up, optical consultants do a lot more work than I previously gave credit for them.

I received some very useful feedback from my time with Boots and was really glad I did the placement, now to wait and see if it leads anywhere. Many thanks to all at Swansea, Carmarthen Road - Sharron, Sam, Adele, Michelle, Chantelle, Jordanna, Abigail, Renee, Erin, Philip, Rhys, Mark, Sian, Sabera, Paul, Danielle, James and Karen for putting up with me and my random questions for 6 weeks.

Halfway through

I am now halfway through my summer school placement with Boots, and learning more and more every day. Over the last couple of weeks I have had some challenging but constructive criticism, met last years summer school student and been to cover in a different store.

The great thing about the placement and the job is you never know who or what is going to walk through the door of your practice every day. The store I am at has a wide ranging customer base, lots of over 60's NHS patients (often with cataracts, glaucoma or another age related condition), to middle aged people who like the range of styles available, to people on benefits and children coming in for first few eye tests with a few emergency cases thrown in for good measure. Because of the wide range of customers it is important to be able to adapt your questioning style when doing check-ins and how you talk to customers when they collect glasses, I'm glad I've got 10 years retail experience as otherwise it can be very daunting.

I have started dispensing, just single vision at the moment, but everything has to start somewhere. Dispensing is that final stage in the customer's first visit to the store (second visit is collection) and the point when all the lifestyle questions and the recommendation from the optometrist all come together. This is when a good demonstration of all the upgrades is key, and whilst I haven't sold any yet I have done well with glasses cover. Whilst some people may see these upgrades as pushing unnecessary products to make money I have yet to see anyone promote anything that wouldn't be of use to a customer. I am really glad I can say that as pushy sales staff who slam customers with unnecessary products to hit targets or lie their own pockets really annoy me and I've seen a few.

Going to cover another branch was a good experience as it showed the consistency of approach throughout the company, even if the other branch did have an even more temperamental NCT than my usual one. Those things really are the bane of my existence at the moment. Port Talbot was small and quiet with just 2 of us and a locum in which was vastly different to Swansea with 2 optoms and about 6 of us on the shop floor. I made the most of it by having a look at other parts of the systems that I hadn't used before, like Glasses Studio, which I look forward to using soon.

Next week I have a visit to another Boots store planned, this time to see the links between a pharmacy and the opticians, and hopefully I will get a chance to speak to an audiologist as well so really see how the one health idea all comes together. I also look forward to dispensing multifocals, which at the moment seem a little daunting but then so did single vision before I did that.

Week 1 thoughts

Last Monday I started a 6 week programme with Boots on their Future Optometrist Programme. The scheme is designed to give students a flavour of retail optics and how Boots works in particular. It also acts as a 6 week interview from point of view of company and allows the student to get idea of whether Boots is right for them and how they get on with the staff where they may well be working on the pre -registration year (pre-reg for short).

My placement is in Swansea so involves a nice little train journey in the morning, although this gives me a chance to catch up on TV or books I've missed out on and catch a nap if needed.

The first impressions were good, the store is reasonably well equipped and more importantly the staff are really friendly and seem to put up with all the random questions I've been throwing at them all week. It's very strange for me to not know anything about the system or how anything works, after doing the same job for over 10 years I've worked out exactly how the systems in my current job work.

Although I had received and read the student guide to the programme I was a little surprised about doing so much work as an optical consultant and it wasn't until I went to the introductory conference in Birmingham on Thursday which put the programme into context. I'd been thinking too literally that it was all about optometry but it isn't; the optometrist is not alone - they are working as part of a team and to understand the team you need to understand the other roles. To this end I have been welcoming patients into the practice, answering the phone, adjusting glasses, running though collections, making appointments and helping with pre-screening. The amazing thing is that this isn't all optical consultants have to do; there is extra paperwork for NHS and PEARS forms, asking lifestyle questions as part of pre-screening to aid the 3 moments of truth, helping with referrals, managing emergency patients, checking in glasses and of course dispensing, with the aid of a dispensing optician for tricky dispenses. I apologise to all optical consultants and assistants I may have unwittingly looked down on, they have a vital role to play and put in a lot of hard work to ensure the branch runs smoothly.

The highlight of the week was the welcome conference in Birmingham on Thursday. This highlighted Boot's purpose "We commit to enrich the life of every person. We are a health led optician, yet care about a whole lot more." It also highlighted the 3 moments of truth which are used within the customer journey to ensure the customer gets the best possible service. I look forward to seeing the results from the customer metrics and working out ways to improve them, over the next few weeks.

I had my first review on Saturday which was a bit nerve wracking, I was confident I had done okay but am always worried that there is something I've done wrong or missed. However it passed without a hitch, I got some good feedback and a plan for the next few weeks is developing so I am looking forward to the rest of the placement, if not the early starts.