“Don’t lose track of how far you’ve come”

My day-to-day schedule is always busy.

We start with a morning ‘huddle’ where we agree the day’s priorities. When I am testing, I see patients for a variety of eye care, from routine eye tests and patients with new symptoms, to contact lens fitting or aftercare. I like having different patient types in my clinic as it keeps the day interesting and varied. If needed, I also dispense and complete collections which can be equally as rewarding by chatting to patients and helping them find a style which suits them.

My role has changed since I started my pre-reg placement as I have started to see far more complex patients.

At the start of my pre-reg I mainly saw the more routine, straightforward patients. Now as I progress, I am seeing more patients over 60 years old and many more young children. This has allowed me to see more pathologies which has been beneficial, especially with helping me recognise the signs and symptoms of disease. It has also helped me to develop and adapt my communication skills when chatting with people of all ages. 

I am progressing through the Scheme for Registration and am currently working on Stage one Visit three.

I am slowly but surely making my way through the 75 elements of competence that are required to complete Stage one. There is still a long way to go with my pre-reg placement, but I am glad to be making progress.

There is still a long way to go with my pre-reg placement, but I am glad to be making progress

My biggest learning so far is in relation to my communication skills.

When I first started my pre-reg placement I felt that it was much harder to describe conditions to patients. I now feel I have improved in this area and that explanations of conditions come much easier now, as does the breaking of bad news. The rarer conditions can obviously still be more challenging to describe as they are seen less often.

A challenge I have overcome is managing my time in the clinic.

As I continue through pre-reg, my appointment times have naturally become shorter as I become more proficient. The clinic is always busy, and I need to stay on top of the appointment types in my diary so that if I run behind I know when and where I can catch up.

A highlight from the past two months was fitting a three-year-old with her first pair of glasses.

She had her eyes tested at the hospital and came to the practice for the dispense. Seeing her face light up at being able to see her parents clearly for the first time was amazing to witness. She was very happy with her glasses, giving me a big thumbs up when she tried them on for the first time and she kept smiling all the way out of the practice.

Seeing her face light up at being able to see her parents clearly for the first time was amazing to witness

My first urgent referral was a patient whose pre-test fundus photos and optical coherence tomography scan revealed raised discs in both eyes.

The patient had also been having severe headaches and experiencing nausea and vomiting.

I discussed this with the patient by letting them know, at the end of their eye test, what I was seeing at their optic discs and that I suspected this could be linked to the symptoms they had been experiencing. I explained that I would like to refer them immediately for further investigation, which would require specialist equipment only available at the hospital.

It was important to stay calm and factual and not alarm the patient. This was a challenging conversation to have and was quite nerve-wracking.

My advice for my pre-reg peers is don’t lose track of how far you’ve come.

It is easy to think about how much work there is still to do or how much there is still to learn, but it is helpful to look back on how much progress has been made in the short time since leaving university.

I have balanced work with study by making sure I write down all my deadlines and always being aware of which competencies I still need.

This helps me keep up with the workload and lets me plan for future visits. By staying on top of the competencies I require, I can have a quick scan across all the diaries in the morning to see if there are any patients coming in with a potential issue who it might be beneficial for me to test. The other optometrists are always very happy to swap patients if it means it will lead to a good learning experience for me.