Barnaby Growling's Guide to NHS Audiology Placements

By Barnaby Growling

AUDIOLOGY STUDENTS LEND ME YOUR EARS!
This guidebook aims to tell you about what is to come, in a way which perhaps the textbooks on your recommended reading lists do not. A select number of iconic authors (you know the ones) have dominated the contents of Audiology BSc, and MSc, recommended reading lists for generations; because they provide the masterful descriptions which denote our current understanding of how the human auditory system works, and how we examine its various parts.

They took you behind the amplification curtain; to explain everything that you could ever wish to know about: how hearing aids work and how these instruments are prescribed. They have all rightfully endured the test of time, and it is undeniable that we owe many of our clinical methods to each of these author's meticulous contributions.  

What our Audiology forefathers didn't mention however; are the unexpected things that can occur when you apply their pure research-based recommendations, to unfiltered members of the general public, inside the bustling clinical workhouse that is the NHS. For those of you who desire an unabridged idea of what being a modern-day Audiologist in the NHS is actually like, through the medium of true anecdotes, then they are all waiting for you inside this guidebook.  

• Language: English
• Publisher: Barnaby Growling
• Release date: Oct 4, 2020
• ISBN: 9781527274839

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Copyright © 2020 Barnaby Growling. All rights reserved.

For permission to use material from this text, contact Barnaby Growling by: E-mail: [e-mail]

No liability is assumed for damages resulting from the use of information contained herein.

Contents

I The Mockridge House Rules 4

II There’s Nowt so Queer as Folk 14

III The Privilege of Being a Butterfly 35

IV Prisoners, Professionalism &

Cognitive Dissonance 50

V Audiologist, Know Thyself 56

VI Suspend your Disbelief 73

VII Sod’s Law 82

VIII Profit by Others Experience 86

IX Thrown in at the Deep End 98

X Deaf (with a capital D) 109

XI Miscellaneous 116

XII Superhuman Brains &

Speech Bananas 119

Afterword 137

Acknowledgements 140

About Barnaby Growling 141

Preface

My fellow Chameleons,

According to the modern-day visionary Simon Sinek: People don’t buy what you do, they buy why you do it . I will honour Mr.

Sinek’s sentiment, by confessing something to you. I wrote this book to serve as emotional compensation for the absent Audiology guidebook, carefully basted in reality’s juices, which wasn’t there for me when I was a newbie Audiology student about to start his first clinical placement. After training in the NHS for a few months, it became apparent that many of the routine clinical occurrences; which are woven into the fabric of working life as an NHS Audiologist, had been left out of the textbooks on my university recommended reading lists.

I remember that it served as quite a shock to the system when the pure principles that had been sold to me, during my 1st and 2nd year undergraduate indoctrination, first revealed themselves to be almost the antithesis of what is practicable in a time-pressed NHS Audiology service. Breaking students of their unyielding academic philosophies can be a jading experience that I have since observed many student supervisors grapple with over the years; in their attempts to produce: efficient, empathetic, and flexible qualified Audiologists that the NHS needs.

In the eternal battle between academic purism, and real-world practicality, there exists a tacit truth. To be a well-received Audiology student, you must learn the ways of the dutiful chameleon.

Your first duty is to routinely pray to the gods of your university.

This duty necessitates: completing written assignments, presenting case studies, returning to campus for lectures and group projects, signing off your clinical logbook, and meeting the expectations of your practical examiners. Furthermore, your university will be expecting you to practically adhere to a combination of British Society of Audiology (BSA) recommended procedures, peppered with a few of their home-grown procedural preferences, 1

which will also be considered sacred. Fast forward to the start of your placement. There you are ready to move to a brand new city, equipped with all of your: well versed BSA inspired scripts, chronologically organised logbook, key skills sheets, and a thinly optimistic veil that barely covers the terror that you are wrestling with inside. You also take comfort that every elected NHS Audiology department, affiliated with your degree, has been specially accredited by your university to train their students. Marvellous, this all seems to be in order, until…

You land on another planet called NHS Audiology. It’s gritty, rushed, and constantly pressed for space. The system dances on the head of a pin; as the left leg choreographs ever-increasing patient demands, it is repeatedly tripped up by the right leg; as it seeks to cut costs by sacrificing funding for sufficient numbers of permanent staff, and cutting edge equipment. Inside the mad-house, real people are waiting for you: elderly people, vulnerable people, inappropriate people, unwashed people, and incarcerated people. Most of whom are hard-working taxpayers who have waited weeks for the benefits of your finite competence.

In stark contrast to the controlled training scenarios of your university lab sessions, these real people called patients, make a mockery of the script. They say weird things, and they do weird things. Most are hard of hearing; some are hard of understanding in equal measure. Some will test your patience, others will break your heart. Your second overriding duty is to them and their well-being, irrespective of how scary and alien they may seem to you. Finally, there is your third duty. Your duty to those who will sit shoulder to shoulder beside you during your training; Audiologists, of all shapes and sizes. Each with their own unique ways of orchestrating things, each one contractually obliged to accommodate your ineptitudes in their busy clinics; primarily for your benefit, but also for the benefit of the patients who will be counting on you to help them.

You will become their righteous accomplice to corners cut, and shortcuts taken. The old idiom ‘Do as I say, not what I do’ will ring in your ears like hypocritical tinnitus. Some Audiologists will relish your presence; having deemed the teaching of you to be the finest way to nourish their continuing professional development Nonetheless, not all of them will delight in the prospect of their workdays being made more intensive than usual by your requirements; which by the way is essentially guaranteed to all who take on the responsibility of supervising students; which Dr. Stephen Bergman captured in his knowing proclamation: Show me a med student that only triples my work, and I’ll kiss his feet .

Some of your supervisors will fit you like a glove, others will feel like a pebble in your shoe. Your mission is to drink deeply from their knowledgeable example, without becoming corrupted by their enticing bad habits. All the while endeavouring not to stray from the unyielding evidence-based beliefs that your university preaches, which unfortunately tend to become more and more out of touch with your working reality, the further into your placement you get. In short, you must become the dutiful chameleon.

To assist you in this difficult quest, I present this guidebook.

Even if you wholeheartedly disagree with many of the philosophies that I put forward in this text, I hope that the true anecdotes may stand alone as a heads up; for all of the dirty little clinical events that probably won’t have been included in your university curriculum, which you are no doubt bound to encounter out there, in the NHS wilderness, regardless. After reading this, you might see them coming.

I wish you all the best, as you adapt your camouflage, over the coming months. I only ask that you pay any knowledge gained forward to your students in the future; just in case they might also find a use for it.

You will make it through, one step at a time.

Yours Sincerely,

Barnaby Growling

I The Mockridge House Rules

When my grandparents were alive, they were very much creatures of habit throughout their retirement. Married for 60 years, my Grandmother always slept on the left side of the bed, and my Grandfather slept on the right side of the bed. They would both rise at 8 am and descend the stairs to have half a grapefruit each, for breakfast, along with a cup of tea. Gran would prepare a light lunch at 1 pm, enabling them both to catch the lunchtime BBC news round-up, before switching over for Neighbours on Channel 5. The afternoon would be spent attending to their large victory garden, and then Gran would prepare a more substantial tea, normally comprising meat and vegetables, at 5:30pm.

They would both watch the HTV West Country News between 6–6.30 pm, the ITN national news between 6.30–7 pm, before settling in for an hour of soap operas: 7 pm Emmerdale, 7:30 pm Coronation Street.

What they watched after 8 pm was fair game, and varied from evening to evening. But they always honoured their pre-agreed sensible bedtime of 11 pm, at which point they would ascend the staircase to bed, but not before setting the table in preparation for tomorrow’s breakfast. They both deviated from the schedule on Thursdays, which was the weekly shopping day, and Sundays, which involved cooking a substantial Sunday lunch, without fail.

All in all, everything ran like clockwork until one memorable evening, which broke the mould. One day, Channel 5 movies premièred the 1997 Nicholas Cage action/thriller ‘Con Air’; to serve as their 10 pm feature film. Con Air is a BBFC 18 rated film, which boasts a running time of 2

hours 3 mins, and an on-screen kill count of 31. On the surface, it is another run of the mill action film; whose target audience is the marketable 18–35 age range, not retired working-class octogenarians. Nevertheless, they became engrossed as they were swept along in the adventure; so engrossed in fact that they valiantly attempted to stay awake past 11 pm to see what became of Cameron Poe. Neither of them managed it and fell asleep ¾ of the way through.

The next morning, when I joined them at the breakfast table, my grandfather immediately leaned over to me and said: have you seen that film that we were watching last night? Yes I have, said I. At my admittance, both of them turned to me and said endearingly Did he get that bunny back to his daughter in the end?

I was happy to be in a position to confirm that Cameron Poe does indeed defeat Cyrus 'The Virus' Grissom, and manages to get back to his baby girl; who he has never met due to incarceration which was earned after defending himself from multiple drunken assailants, while his wife was pregnant, with what was judged to be excessive force. The end of the film sees Poe give his daughter a cuddly toy bunny, which he had subsequently carried with him throughout the entire movie’s perilous events. Country singer, Trisha Yearwood’s, rendition of How Do I Live plays in the background as the two characters embrace, and the credits roll.

After I had finished recounting this sugary conclusion to the film, they both turned to each other, breathed a visible sigh of relief, and said: oh good , before returning to their respective grapefruit halves. If memory serves, I think the only other film that instigated a reaction like this again was Goodnight Mister Tom.

The effect that Con Air had on my grandparents that evening taught me one key thing about the nature of human beings; we all like a relatable story presented in any format. Human beings deal with stories. It is one of the things that sets us apart from other intelligent species. There is no other creature on Earth with the capacity to pass on the cumulated knowledge of past generations, to the next, with verbal recounts. The ability to tell stories, and the ability to absorb their lessons, is key to our evolution.

In 1976, the evolutionary biologist, Richard Dawkins, coined the term meme to describe this phenomenon in his best-selling book The Selfish Gene. Before it was repurposed by the internet, the term meme comes from the Greek word mimema, which means imitated. Dawkins used the term meme to explain the significant time advantages that can be gained by those who adopt

seasoned cultural practices. By listening to stories about the costly trials and tribulations of past generations, knowledge can subsequently be acquired by younger listeners without them having to sacrifice as much of themselves, as their ancestors had to when they were a similar age, to earn advantageous information.

The act of trying to improve on our understanding is an act that only the next generation can benefit from hearing about with maximum profit; because by absorbing stories about how advancements were made, all of the knowledge that was earned by the efforts of their forebears is essentially gifted to them for free. The habit of actively preserving memes and taking the time to invest them in younger generations, through the medium of storytelling, should lead to the systematic progression of that nation. Modern-day human beings are still instinctively tuned in to stories; because our neuroanatomy has not changed much, and stories are still the medium that our elders use to transfer information to us.

Stories speak volumes when they are told well, and they are a legitimate multi-functional tool in the right hands. Much in the same way that a master Cooper can fashion a flawless Guinness barrel out of wood, with nothing more than a: 3lbs hammer, one hand Axe and a draw knife, master storytellers can command the attention of entire audiences with nothing more than their words.

Stories can be used to: teach moral lessons, communicate concepts, and encourage empathetic reasoning. Stories that stand the test of time tend to be those that deal in what booker prize-winning author, Salman Rushdie, calls human truths. Rushdie goes on to explain that the most arresting storytellers ensure that they provide listeners with people they can believe in, who behave in ways that you can recognize; which subsequently tells you something about your behaviour and your nature, and maybe even about the person next to you