APPLICATION: Courses and Careers

1.1       I was inspired to study Diagnostic Radiography when my Aunt who works as a Radiographer told me the wonderful experiences encountered on her shifts at the Hospital. She sometimes brought X-ray images home and taught me the mechanisms of X-rays and anatomy and physiology. I could, however, not study Radiography as it was not one of the courses offered at Universities in Myanmar. I have been working as Care Worker since April 2011 and my responsibilities include working with other care workers and coordinators as a team to provide effective care to our patients. For the best care of the patients and to advance myself to a higher position, I made a decision to study Bachelor of Science in Diagnostic Radiography at the University level, which will prepare me to provide holistic healthcare to individuals, families and communities. I believe I will succeed in this very demanding health care professional role. I am confident and excited with my carrier choice.

1.2       As I have fervent desire to become a professional Radiographer, I have chosen to take Access to HE course in Radiography conducted by Kensington and Chelsea College, in order to pursue BSc Diagnostic Radiography course at University. This Access course is the first step on the path to making my goal a reality. I am especially interested in studying Anatomy, Physics and Mathematics in this Access Course.  The areas of new learning and challenges studying in Access Courses are Anatomy, Psychology and Sociology. Mathematics and Physics I studied in the University help me hugely in studying X-ray, Magnetism, Radio Active Decay, Ionization radiation, radioactivity, electromagnetic.

2.1       According to entry requirements from the University, I take Access to HE course in Radiography conducted by Kensington and Chelsea College. I went to Royal Brompton Hospital for work placement at Imaging Department. I gained opportunities to speak to different levels of Diagnostic Radiographers and discussed about a Radiographer and his/her role in the hospital. Furthermore, I observed how Diagnostic Radiographers performed X-Rays, CT Scans, MRI Scans, and Ultrasound. I have a BSc Mathematics Degree from Yangon University in Myanmar and an NVQ Level 2 in Healthcare. This is to prove that I have the necessary skills to undertake research skills for tertiary training, which would be beneficial for my University training as a Diagnostic Radiographer.

 3.1

Actions Plans by terms
Actions	September 2012 to June 2013
	Term 1 (Sept 2012-Dec 2012)	Term 2(Jan 2013-March 2013)	Term 3 (April 2013-June 2013)
Studying Anatomy, Psychology, Sociology, Mathematics, English, Communication, IT and Physics. Literature review for research assignments. Submitting assignments: Blood and Cardio-vascular System, Psychology and IT. Sitting examinations: Mathematics and cells system. Taking Work Placements at Hospital. Doing research on Universities' entry criteria and preparing for UCAS application and submitting UCAS application.
Studying Anatomy, Psychology, Sociology, Mathematics, English, Communication, IT and Physics. Submitting assignments: English, Physics, Psychology, Sociology, and Communication. Sitting Examinations: Nervous System, Physics, Mathematics, and Skeletal System. Taking work placement at Hospital.
Taking final examination and submitting final papers and assignments accordingly

3.2       I was inspired to study Diagnostic Radiography when my Aunt who works as a Radiographer told me the wonderful experiences encountered on her shifts at the Hospital. She sometimes brought X-ray images home and taught me the mechanisms of X-rays and anatomy and physiology. I could, however, not study Radiography as it was not one of the courses offered at Universities in Myanmar.

As I have fervent desire to become a professional Radiographer, I have chosen to take Access to HE course in Radiography conducted by Kensington and Chelsea College, in order to pursue BSc Diagnostic Radiography course at University. This Access course is the first step on the path to making my goal a reality. I am especially interested in studying Anatomy, Physics and Mathematics in this Access Course.  Mathematics and Physics I studied in the University help me hugely in studying X-ray, Magnetism, Radio Active Decay, Ionization radiation, radioactivity, electromagnetic.

I went to Royal Brompton Hospital for work placement at Imaging Department, I gained opportunities to speak to different levels of Diagnostic Radiographers and discussed about a Radiographer and his/her role in the hospital. They also enthusiastically explained to me about Imaging Department and a Radiographer. Diagnostic radiographers work mainly within the radiology and imaging departments of hospitals, but may also work in surgeries or clinics. I am very impressed with their profession in action, which ascertained my aim to become a Diagnostic Radiographer. When I was in that hospital, I had a chance to observe taking X-ray to see if the knee of an old man who had fallen over, was broken. Depending upon the result showing in the film, doctor will decide the best way of treatment to him. 

Furthermore, I observed how Diagnostic Radiographers performed X-Rays, CT Scans, MRI Scans, and Ultrasound. Radiographers meet new people constantly and are highly regarded by the patients for their professionalism and the support they provide. They need to operate sophisticated machines and to be computer literate is an experience I already possess when I worked as a Data Analyst for Metronet.

I have a BSc Mathematics Degree from Yangon University in Myanmar and an NVQ Level 2 in Healthcare. This is to prove that I have the necessary skills to undertake research skills for tertiary training, which would be beneficial for my University training as a Diagnostic Radiographer.

I have been working as Care Worker since April 2011 and my responsibilities include working with other care workers and coordinators as a team to provide effective care to our patients. The ability to work as part of a team is also a required skill for Radiographers in the NHS.

Moreover I obtained Care Worker of the Month Award from the Company in June 2012. I believe my strong communication skills, patience, empathy and ability to problem solve, which are all important to a Radiographer, have been developed through both my College student and work experience that I have completed. Working as a Care Worker has given me contact with a range of people and I have learnt how to work independently as well as part of a team.

For the best care of the patients and to advance myself to a higher position, I made a decision to study Bachelor of Science in Diagnostic Radiography at the University level, which will prepare me to provide holistic healthcare to individuals, families and communities. I believe I will succeed in this very demanding health care professional role. I am confident and excited with my carrier choice.

I already have appointment for work placement in other two more hospitals in order to get hand-on experiences in Imaging Department.

4.1 & 4.2        The questions which are most likely to be asked at interview are as follows, including my own answers to questions.

Question: What is the value of assertive communication?

Answer: Assertive communication is the ability to express positive and negative idea and feelings in an open, honest and direct way.

Question: What role do you play in group work?

Answer: I studied and discussed together with my classmates regarding the subjects we taught.

Question: What is the biggest challenge you have had to overcome?

Answer: My biggest challenge is to pass HE Access to Radiography course with merit and distinctions.

Question: What are the proudest of in your life so far?

Answer: The proudest of in my life so far is being a mother.

Question: What is your honest opinion of your own skills of using formal, written English?

Answer: Honestly, I am able to write to get the readers understood clearly.

Health Care Professional Role

The primary health care team normally consists of the physician, nurse, social worker, medical technologist, physiotherapy, nutrition, dentistry, health education, and communication. These professionals play an important part in health care. The active professional intervention is vital to positive outcome of the patient’s treatment.

Radiographers use the x-rays to create images of body parts and organs for diagnostic functions. Their roles vary depending on the type of x-ray that a patient needs. They detect disease and broken bones. The different types of images include: fluoroscopy, MRI, x-ray and ultrasound. A computed tomography (CT) is used by radiographers to create 3D images showing the internal part of the body. The computer then splits the images into slices to show much more tiny details about the body. The scans from CT aid the doctors in diagnosing cancer and other serious diseases.

The X-rays that pass through are captured by a detector which gives a 2D illustration of all the structures. Treatment involving the use of radiation is called radiotherapy.

Radiographers use the magnetic resonance imaging machine (MRI) to develop a 3D map of body tissues. The machines usually build a 2D or 3D map of the different types of the tissues in the body which radiographers use to determine if a tissue is either normal or abnormal. The use of ultrasound machine is to check circulation in the human body. It is used to examine organs such as the heart. It involves the use of high frequency sound waves in order to produce pictures of the internal part of the body. The ultrasound machine is very important to radiographers because they can use it to observe the health of an unborn child.

Mammography is the X-ray examination of soft tissues like breasts. It has been used by women to screen for breast cancer, and in viewing male's breasts. The radiation in mammography is softer than that used for harder tissues. Dental radiation involves the use of a small radiation with a high penetration because teeth are relatively dense. As such, a dentist can use X-ray equipments to examine teeth and gum.

Radiologic technology is the science, involving the use of x-rays for therapeutic or diagnostic purposes. The radiographer performs the examination which creates the images needed for diagnosis. Radiography needs scientific knowledge and the technical skills to provide quality patient care and to get important diagnostic information. Radiographers must understanding human anatomy, pathology and physiology, and the medical terms. Radiographers link patients and radiologists. They should remain sensitive to both physical and emotional needs of the patient. They should also involve ethical judgment and critical thinking while at work. The provision of customer service and quality improvement allows radiographers to become an accountable part of the health care team by assessing professional performance.

Radiography is a profession that changes due to technological advances and demand for change driven by shortages in personnel within the healthcare system. Some radiographers have utilized their skill and expertise so as to increase the expertise available to patients, thus improving the health care of patients. The role of radiographers expands, and so does the potential for risks. As such, they must care for patients appropriately and comply with code of professional conduct. Each health professional is still accountable and responsible for their actions legally. Threats that could arise through radiographers' role expanding include medico-legal.

The importance of professionalism in health care

Professionalism can be divided into three different sections. These are professional parameters, professional behaviours and values, and professional responsibilities.

Professional parameters is relating to the principles of ethical and lawful matters. Professional behaviours and values are relating to the area of knowledge and abilities, and also bonds with patients and team members. Professional responsibilities include personal, employers, patients and social responsibilities.

Behaviours mean attitudes. Values mean beliefs of one’s self. Professional behaviours and values could be broken down into altruism, acceptance and non-judgemental attitude, confidentiality, accountability, communication between professional and patient, as well as self-improvement.

Altruism is defined as an unselfish act in response to a goal in offering service to others. This applies when a patient comes to a health care professional for treatment. In this situation, the patient’s needs are crucial to attend to rather than the individual professional’s own needs but this does not mean that the professional must put aside or sacrifice their health or other factors in their life for the sake of the patient. In terms of giving care, compassion and treatment to the patient, a professional must prioritize the patient first rather than himself.

Say for example, a physician finishes his shift for the day and is about to leave his workplace when an emergency accident case of a child comes in. There is a lack of workforce at that period of time as it is the holiday season. Instead of leaving the hospital to attend to an appointment made after work, the physician should attend to the case before leaving.

Altruism can also be associated with genuineness, empathy and compassion while performing a task. When a person is evoked with empathy towards another individual, altruistic motive is created. In other words, empathy gives rise to help being provided to the individual in need. Indirectly, altruism not only enriches the experience of a professional but also matures the professional with in numerous cases handled every day. Professionals with altruism will have good social relationships with patients and colleagues. On the whole, altruism is being passionate about one’s profession.

Another key ingredient in professionalism is acceptance and non-judgemental attitude. Accepting a patient include listening and responding to patient’s feelings with sensitivity, showing sincere concern towards the problem, recognizing others’ opinions and generating respect. Besides that, acceptance is also inclusive of construction of patient’s strengths and recognizing the ability of each patient for transformation to overcome problems.

On the contrary, there are many causes which hinder a professional from practicing these values. Among them are deficiency in psychology knowledge and self-awareness, unfairness, and biasness.

On the other hand, non-judgemental attitude is allied with acceptance. In a smaller picture, non-judgmentalism is defined as free from favouritism and prejudice. A professional is ought to treat a patient with rights rather than taking the patient as an entity. As a matter of fact, patients should be treated and cared for with equality and without judging social class, race, colour or creed.

Another vital cornerstone in professionalism is confidentiality. Confidentiality is the responsibility of not disclosing a patient’s information to colleagues or members of the society. This information is sensitive as they comprise of the patient’s feelings, discussions and feedbacks from the professionals plus medical records. The chief elements are trust, truthfulness and fidelity which must be rooted in both professional and patient. In a patient-professional relationship, patients disclose embarrassing, shameful and agonizing information to the professional with great trust and expectations that the professional will safeguard this information.

Confidentiality is not absolute whereby under a specific situation, revelation of information is required. For example, when a problem is suspected, such as child abuse. In this case, it is the responsibility of the professional to take appropriate actions based on the ethical laws.

Besides that, another requirement of a professional is to be accountable. Accountability means being liable to one’s judgments and being able to give explanations when required. Related to this, professionals must be knowledgeable and experienced in their skills and performance in accordance to their practice. This includes fulfilling the duty to obey by the ethical laws and avoid appalling practices and responsibility towards patients.

Accountability has connection with patient-professional relationship. A helping relationship is formed based on this fundamental relationship. Basically, a helping relationship is whereby a professional addresses solutions and advice to the patient as part of the recovery process. This relationship should be mutual in which the professional acknowledges the views of the patient. Essentially, a professional should be familiar with the faiths and values of the patient as well as to decide what is best for the patient. Not only that, a professional should be able to empower and motivate a patient for an ongoing process of treatment which requires psychological skills. On the other hand, the patient should be informed specifically regarding the medical care received.

Patients approach the professional due to mental and physical ailments. So, the professional should give the best care to the patient. With efficient communication skills and positive nature of the patient’s participation, this relationship will continue to grow with time as long as there is readiness to listen and congruency from both parties.

Another component in professionalism is collegiality. Collegiality is the relationship between colleagues who seek the requirement of respect, mutual trust, acknowledgement of each other’s knowledge and cooperation between team mates. As this relationship can have an adverse effect on a patient’s wellbeing, it is the duty of the professional to maintain healthy relationships with their team mates. This involves critical teamwork skills especially when it comes to referrals, consultations, discussions and diagnoses. When a conflict occurs, team mates should discuss the matter without being affected by personal prejudice and come up with a suitable solution. With this, the patient is guaranteed to receive a standard and holistic care.

From a professional point of view, self-improvement is another key substance in the practice of health care. A professional should evaluate themselves rationally from time to time based on their attitudes, efficiency and interest in their field of practice without presuming that everything is known well to them. With respect to this, a professional is expected to continue education to update their knowledge and skills. Not only that, they should get involved in discussions with other health care professionals, professional training and consultations. The experience obtained will ensure delivery of appropriate treatment with efficiency.

A professional should also seek help from other professionals when required. The willingness to accept critics should also be implanted as this will lead to a better understanding of the level of competency of a professional. It is solely the duty of the professional to ensure that the standards and values practiced are in par with the level of competency required.

In conclusion, the professional behaviours mentioned, if practiced to the utmost interest, will generate a positive impact among health care professionals in order to offer quality service and treatment to the patients. Together with the practice of professional parameters and responsibilities, there will be an indirectly pose on the health care system to be effective in serving the public.

http://www.ukessays.com/essays/nursing/the-importance-of-professionalism-in-health-care-nursing-essay.php#ixzz2Jeh7tBuz

Blood Condition Medical Notes(report)

MEDICAL NOTES FOR:    MRS ANN

Condition:                            Anaemia

Summary:     This report explains about the anaemia and the structure, function and composition of blood cells and examines the effects of Mrs Ann’s medical condition on her physical health and on her lifestyle. It elaborates how Blood disorders can affect the main components of blood and plasma.

The functions of blood could be divided into three parts: transportation, maintaining body temperature and controlling of pH. Blood carries nutrients and gases namely oxygen and carbon dioxide between the heart, the lungs and rest the body. It transports nutrients such as glucose, amino acids, micro-nutrients, vitamins and minerals, fatty acids and glycerol, from the digestive tract and storage sites to the every part of body. The waste products carried by blood is detoxified and removed by the liver and kidneys. The kidneys filter all of the blood in the body. Excess salt is removed from the body in urine. Furthermore, it produces heat to the skin in order to regulate body temperature. There are plasma proteins in the blood which is associated with defence such blood-clotting and anti-bodies. The blood consists of white blood cells known as “Leucocytes” and red blood cells known as “Erythrocytes”.

In order to maintain the optimised body temperature, the pH of blood must remain in the range of 6.8 to 7.4, otherwise it begins to damage cells.

Composition of blood

Blood is classified as a connective tissue and consists of two main components; plasma and formed elements. These include 55% of Plasma and 45% of formed elements, which is called Blood cells.  In the blood cells, 99% are erythrocytes or red blood cells and 1% is leucocytes or white blood cells and thrombocytes or blood platelets. The formed elements are enclosed in a plasma membrane and have a definite structure and shape. All formed elements are cells except for the platelets. Formed elements are Erythrocyte, also known as red blood cells, Leukocytes, also known as white blood cells and Platelets.

Blood disorders can affect any of the three main components of blood and can also affect the liquid portion of blood called plasma. Treatments for blood diseases are vary, depending on the blood condition and its severity.

Blood disorders affecting Red Blood Cells

Blood disorders that affect red blood cells are:

Anemia

People with anemia have a low number of red blood cells. Mild anemia often causes no symptoms. More severe anemia can cause fatigue, pale skin and shortness of breath with exertion.

Iron-deficiency anemia

Iron is necessary for the body to make red blood cells. Low iron intake and loss of blood due to menstruation are the most common causes of iron-deficiency anemia. Treatment includes iron pills, or rarely blood transfusion.

Anemia of chronic disease

People with chronic kidney disease or other chronic diseases tend to develop anemia. Anemia of chronic disease does not usually require treatment. Injections of a synthetic hormone; Epogen or Procrit to stimulate the production of blood cells or blood transfusions may be necessary in some people with this form of anemia.

Pernicious anemia (B12 deficiency)

An autoimmune condition prevents the body from absorbing enough B12 in the diet. Besides anemia, nerve damage (neuropathy) can eventually result. High doses of B12 prevent long-term problems.

Aplastic anemia

In people with aplastic anemia, the bone marrow does not produce enough blood cells, including red blood cells. Blood transfusions, and even a bone marrow transplant, may be required to treat aplastic anemia.

Autoimmune hemolytic anemia

In people with this condition, an overactive immune system destroys the body's own red blood cells, causing anemia. Medicines that suppress the immune system, such as prednisone may be required to stop the process.

Thalassemia

This is a genetic form of anemia that mostly affects people of Mediterranean heritage. Most people have no symptoms and require no treatment. Others may need regular blood transfusions to relieve anemia symptoms.

Sickle cell anemia

A genetic condition affects mostly African-Americans. Periodically, red blood cells change shape, and block blood flow. Severe pain and organ damage can occur.

Polycythemia vera

The body produces too many blood cells, from an unknown cause. The excess red blood cells usually create no problems but may cause blood clots in some people.

Malaria

A mosquito's bite transmits a parasite into a person's blood, where it infects red blood cells. Periodically, the red blood cells rupture, causing fever, chills, and organ damage. This blood infection is most common in Africa; those traveling to Africa are at risk and should take preventive measures.

Blood Disorders Affecting White Blood Cells

Blood disorders that affect white blood cells are:

Lymphoma

A form of blood cancer develops in the lymph system. In lymphoma, a white blood cell becomes malignant, multiplying and spreading abnormally. Hodgkin's lymphoma and non-Hodgkin's lymphoma are the two major groups of lymphoma. Treatment with chemotherapy or radiation can extend life with lymphoma, and sometimes cure it.

Leukemia

A form of blood cancer in which a white blood cell becomes malignant and multiplies inside bone marrow. Leukemia may be rapid and severe or slowly progressing. Chemotherapy or stem cell transplantation (bone marrow transplant) can treat leukemia, and sometimes result in a cure.

Multiple myeloma

A blood cancer in which a white blood cell called a plasma cell becomes malignant. The plasma cells multiply and release damaging substances that eventually cause organ damage. Multiple myeloma has no cure, but stem cell transplant or chemotherapy can allow people to live for years with the condition.

Myelodysplastic syndrome

This affects the bone marrow. Myelodysplastic syndrome often progresses very slowly, but may suddenly transform into a severe leukemia. Treatments usually include blood transfusions and chemotherapy. Stem cell transplant can sometimes cure younger people with myelodysplastic syndrome.

Blood Disorders Affecting Platelets

Blood disorders that affect the platelets are:

Thrombocytopenia

There is a low number of platelets in the blood. Numerous conditions cause thrombocytopenia; most do not result in abnormal bleeding.

Idiopathic thrombocytopenic purpura

A condition causes a persistently low number of platelets in the blood, due to an unknown cause. Usually there are no symptoms, yet abnormal bruising, small red spots on the skin or abnormal bleeding can result.

Heparin -induced thrombocytopenia

A low platelet count caused by a reaction against heparin, a blood thinner given to most people who are hospitalized to prevent blood clots.

Thrombotic thrombocytopenic purpura: A rare blood disorder causing small blood clots to form in blood vessels throughout the body. Platelets are used up in the process, causing a low platelet count.

Essential thrombocytosis (primary thrombocythemia)

The body produces too many platelets, due to an unknown cause. The platelets do not work properly, resulting in excessive clotting, bleeding, or both.

Blood Disorders Affecting Blood Plasma

Blood disorders that affect blood plasma are:

Sepsis

An infection somewhere in the body spreads into the blood. Symptoms include fever, rapid breathing, respiratory failure, and low blood pressure.

Hemophilia

A genetic deficiency of certain proteins helps blood to clot. There are multiple forms of homophilia, ranging in severity from mild to life-threatening.

von Willebrand disease

von Willebrand factor is a protein in blood that helps blood to clot. In von Willebrand disease, the body either produces too little of the protein, or produces a protein that doesn't work well. The condition is inherited, but most people with von Willebrand disease have no symptoms and don't know they have it. Some people with von Willebrand disease will have excessive bleeding after an injury or during surgery.

Hypercoaguable state (hypercoagulable state)

Most affected people have only a mild excess tendency to clot, and may never be diagnosed. Some people develop repeated episodes of blood clotting throughout life, requiring them to take a daily blood thinning medicine.

Deep venous thrombosis

A deep venous thrombosis can dislodge and travel through the heart to the lungs, causing a pulmonary embolism.

Disseminated intravascular coagulation (DIC)

A condition causes tiny blood clots and areas of bleeding throughout the body simultaneously. Severe infections, surgery, or complications of pregnancy are conditions that can lead to DIC.

Causes and Types of Anemia

If there is not enough iron in the blood, Iron deficiency anemia happens. If someone don't get 200-240 mg of iron a day in the ferrous sulfate form, it more likely to develop this type of anemia. A shortage of copper can cause copper deficiency anemia. Most people only get 1.6 mg of copper a day instead of the 2 mg they should get. Pernicious anemia is a deficiency of vitamin B12. Symptoms are different than those of other types of anemia and include a burning tongue, loss of appetite, stomach pain, memory loss, depression, irritability, and tingling or numbness in hands and feet. Anemia is caused by not eating enough of the types of food that give you vitamins and minerals we need. It can also be hereditary. Excess bleeding can lead to anemia, and many bone marrow diseases such as leukemia don't let bone marrow produce enough red blood cells. This is aplastic anemia. Other diseases such as HIV, AIDS and chronic diseases can cause anemia. Chemotherapy, kidney failure and infections can damage bone marrow and decrease the amount of red blood cells being produced. Long term alcoholics and strict vegetarians who don't take vitamin supplements can develop anemia.

Anemia Treatment

Mrs Ann’s blood test revels that she has been diagnosed with iron deficiency anemia. She intermittently cause fatigue, and has pale skin and shortness of breath with exertion. It was lucky for her as she has been diagnosed with anemia in early stage of the diseases. Doctor has discovered the cause of the anemia.

Medication, surgery or procedures may be necessary to correct depending upon the severity of anemia. Doctor initially recommends Mrs Ann to take supplements and to have foods with vitamins and minerals. Eggs, beef, lamb, nuts, yogurt, and whole grains are good to gain iron in the blood. Eating 3 ounces of liver twice a month gives easily absorbed iron along with folate and B12. Eating legumes such as chick peas, lima beans, and kidney beans are also recommended.

If Mrs Ann’s condition is getting worse despite taking diet treatment and irons pills, doctor could give either B12 injections or blood transfusion to her.

References and Bibliography

http://www.ivy-rose.co.uk/HumanBody/Blood/Blood_StructureandFunctions.php

http://www.webmd.com/a-to-z-guides/blood-disorder-types-and-treatment

http://answers.webmd.com/answers/1178914/what-is-anemia

http://www.ehow.com/how-does_4611891_anemia-affect-body.html#ixzz2IdDkS2St