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“I wanted to push myself beyond my comfort zone”

Indy Ghuman, final year student at Aston University and chair of the AOP student council, shares his insights from a domiciliary summer placement

Indy and julie
At the end of the final term of my second year of study, Specsavers put on a summer webinar which gave those who attended priority access to domiciliary placement vacancies – for the first time giving students the unique opportunity to get a true flavour of the role of domiciliary care in supporting patients who cannot come into a physical practice.

After a competitive application process and the added complexity of a pandemic and personal protective equipment, the placement could not have gone more smoothly thanks to the graduate support team.

Having worked in community practice as an optical assistant for four years, I was familiar with recommending the service to people with a family member who could no longer visit due to health issues. The public are always pleasantly surprised that optometrists are able to work in this way, and I think as a student it is greatly rewarding to see the tremendous impact you can have on one individual’s quality of life by enhancing or improving their vision.

I wanted to push myself beyond my comfort zone into an area rarely spoken about in the university setting. There is something quite exciting about how varied the role is, from the type of patients you will see, to the equipment you use, and where you see them.

On site with the domiciliary team

The placement involved making my way to Southampton and meeting the team in the office. This set up is completely different to the physical store you would expect to see on the High Street. I was able to see the inner workings of a domiciliary business and how impeccable customer service is integral to function, whether that be communicating with families, suppliers, or team-members.

I travelled to a variety of sites including patient homes, general care homes, and special needs care-homes. I helped support the running of the clinics by setting up portable equipment, taking history and symptoms and medications, taking measurements, dispensing, and actually doing some clinical procedures.

There is no such thing as a routine examination because each patient encounter is tailored to that individual

 

What I most enjoyed was the interactive nature of the placement. As someone who thrives in challenging environments I saw this as an opportunity to learn, and most importantly see, ocular conditions. On the first day, the first patient I saw had a macular flame haemorrhage, which required urgent referral.

Optometrist director, Julie Benson, was truly fantastic in ensuring I had the best experience possible and encouraged me to build a rapport with the patients, conduct rebound tonometry with an iCare tonometer, and neutralise the patient’s spectacles using a portable focimeter.

Being able to observe and get involved at each stage of the eye examination, I could feel myself gaining a deeper understanding of how optometrists manage a patient and why things are done – I found this really beneficial as I could feel context from my learning at university fitting into place.

Interacting with patients

The beauty of domiciliary is that there is more time to build a stronger relationship with the patient. Through this you can understand their habitual setting and it enables you to give the best personalised advice and recommendations to suit their lifestyle and hobbies. There is no such thing as a routine examination because each patient encounter is tailored to that individual.

I always see that behind every face and condition is a person and personality, and that is what drives me to want to be an optometrist – to help people

 

I found seeing the deterioration of some patients sometimes disheartening and seeing patients with a diagnosis of dementia was challenging. However it put into perspective how lucky we are to have our health and wellbeing. There were many poignant cases we saw as a team that will stick with me. I always see that behind every face and condition is a person and personality, and that is what drives me to want to be an optometrist – to help people.

From a clinical view, I found ophthalmoscopy on small pupils with cataracts more difficult, as at university you’re used to seeing clear ocular media, but with practice I felt this improved.

To be quite honest, since I had no previous experience of domiciliary I had no expectations and therefore it was a steep learning curve. The team I was fortunate to be placed with were phenomenal, super welcoming, and made my experience what it was.

This placement gave me the chance to see Southampton, Portsmouth, Winchester and the Isle of Wight on a ferry, and as someone with a travel bug I love to explore new places. As I said to the team – Julie, Rosie and Dan – they will definitely be seeing me back in the future.