Day in the life of a pre-reg with Katie Geraghty

Posted in Emerging Talent on April 20, 2017
Author: Sam Reed

Hi, tell us a little bit about yourself and your decision to study Optometry?
Hello, my name is Katie and I'm currently a pre-reg optometrist in the Specsavers store in Kirkby, Liverpool. I am from a small village in the west of Ireland and moved to Coleraine, Northern Ireland to study Optometry at Ulster University. My decision to study optometry roots from a young age,
I always wanted to work in a medical field, then it was through trial and error and lots of work experience in school that I decided optometry was for me. I graduated from UUC in 2016 and moved to Liverpool to begin my pre-reg, and here I am! 

How have you found doing your pre reg with Specsavers?
I don't think you can ever be prepared for the transition from student to pre-reg, it is a big change,
but it is so great! You have spent 3 years or more studying all these different aspects of optometry
and you now get to put it all together step by step and understand the eye and the eye examination so much more. It's quite rewarding when you start to realise you actually know what you are doing, why you are doing it and the advice you are giving is correct.

Every store runs things a little differently, so I started testing pretty much straight away. The day-to-day testing becomes so routine very quickly. I think that is what is great about Specsavers, the sheer volume of patients, its easy to get stuck in and start practising. While I was testing from the very beginning, I was never on my own. I always had the support of my supervisors, the DOs, the CLO and of course the floor staff. 

One thing that deserves the highest praise is the Specsavers courses for pre-regs. An introduction course, a course which breaks down every competency in Stage 1, a pathology course, contact lens course and one final course to breakdown Stage 2 and a chance to try some mock OSCEs. It is ran by college assessors so the information is extremely relevant and it's also good fun, you see a lot of your university friends. You are never on your own within Specsavers, there is a pre-reg team there if things aren't going as well as you'd hope. They are a great team, super friendly and easy to get in touch with.

When I compare my pre-reg experience to my friends who work in a hospital setting, for example, it is very different. While these pre-regs see a huge variety of pathology and can ret keratoconic patients perfectly, they often tell me they fear working in high street practice after pre-reg, because they feel they do not know how to do a straight forward routine eye test. They also do not have the courses and the support network that is within Specsavers.  

What does your typical day/week in store look like?
At the moment, I work 4 week days and every second weekend, which is ideal. Of my 5 days a week, I currently spend 4 days testing and one day dispensing - great for getting my dispense numbers. I am on a 40 minute clinic which is still plenty of time. If a patient doesn't show up, I have 40 minutes to fill in my logbook, write referral letters or any small jobs that I have to do.

I meet with my supervisor for an hour every Wednesday, where we talk about how things are going, anywhere I feel I am struggling and if he thinks there is anything I could do better. We also review patient records to make sure everything is tight for use during assessments.

After each assessment I look ahead to the next one, see what patient records I need, particularly in dispensing, ocular disease and binocular vision. I make a list of these patients and make the floor staff aware of what I require in terms of the patient, whether it's a diabetic or a young child. I think this is so important so you are not starting to panic a week or two before the next assessment about not having the appropriate records.

I have just passed stage 1, so I had to spend a lot of time studying recently. I do try dedicate two evenings a week to study, and I think that works quite well. Just writing and organising notes, so that in the week or two leading up to an assessment I have everything I need to just start learning and revising. 

What makes you most proud of your time at Specsavers so far?
I have had a couple of occasions where I have been proud. There was a registered sight impaired patient recently who confided in me that she was experiencing visual hallucinations, that she was worried about what was happening to her, she honestly thought she was going crazy. The look of relief when I told her it was what a condition called Charles Bonnet Syndrome and that it was completely normal will stay with me forever. She was so grateful for my help and advice and that she felt comfortable enough telling me this. That made me proud as a clinician that she felt that way. There was also a lady, who was 99 years old at the time, and is now a magnificent 100, who cried when I told her I could refer her for low vision help. She was completely independent and well abled, but feared she would have to move out of home as she was struggling with daily tasks such as reading and cooking, due to her AMD. That was a lovely moment.

I have definitely ran into some challenges. I think what I found difficult in the beginning was trying to explain to patients that I was concerned about their eye health and I wanted to refer them to the hospital, but trying not to panic patients. AMD is always tricky too, when you try explain to patients that due to these changes at the back of their eye their vision is getting worse, and glasses cannot make it better. I think you also have to learn to almost protect yourself a little from these patients lives. As a clinician you have to be sympathetic and empathetic with people, but sometimes you can get a little upset. I know one gentleman I dealt with who was incredibly kind told me he was terminally ill, and I did cry when he left. So you need to look after yourself too, because sometimes what you learn about patients can be quite difficult and upsetting

How have you developed?
I am a completely different optometrist now to who I was back in August. When I started I was unsure of the reasoning behind the tests I was doing, carrying them out only because that's what I was told to do in university. I didn't trust my management plan and advice, I had to get that checked all the time by my supervisor. 

The big question students want the answer to is "how do you reduce your testing time?". Well, once you understand what tests you need to do and why, the test times come down quickly. If someone is emmetropic, asymptomatic and there is no movement on a cover test is it really necessary to do fixation disparity? And if you are are going to do fixation disparity do you need to do maddox rod? That obviously is not the case for every patient, but you learn to tailor your test to each patient individually.

Your case history will change a lot too. For example, I know I used to ask patients "do you suffer from headaches?" and "do you experience any pain around the eyes", people will normally volunteer that information when you ask about headaches. Also, you will get people who often present with the same symptoms, and you think "Ah, I've seen something similar to this before" and then you can almost guess what's coming next. Once you learn to gather all the relevant information you need to make a preliminary diagnosis, then you know what tests you need to do and then everything speeds up.

What do you love about your job? What is a challenge?
My absolute favourite thing about my job is my team in Kirkby. We are one big family, and from the beginning I felt I fitted in and was so welcomed. Everyone is supportive and so encouraging. Before every exam I think each member of staff tells me how far I've come and how much they believe in my capabilities. They are also the personal support I need, as I moved here alone, and I do miss home so much, they help fill the void. 

Every patient presents with a new challenge, sometimes I can honestly say I do not know what to do, the test results don't make sense, or I don't know what the pathology is at the back of their eye. But it's all learning, that is why there are supervisors. Accept defeat when you don't know, and get help from another member of staff. 

I think now because I'm facing Stage 2, I feel like the end of pre-reg is so close, keeping morale is hard. I do just want it to be over, but now I have the hardest exam to face. I think that's my personal challenge, encouraging myself, remaining positive. But as I said, I'm lucky with the team I have

What are your thoughts and plans for your career once you have qualified?
I have a few ideas going around in my head at the moment. I want to keep improving my clinical knowledge, completing WOPEC courses, doing some more EOS work, be it in glaucoma or minor eye conditions. I think that's important. Maybe in two or three years I'll look at an IP course too.

I've been to two Specsavers events for students as a facilitator, which I really enjoyed. I liked speaking to students and answering their questions, giving advice as best I could. I liked meeting staff from other Specsavers stores as well, getting to know how they manage their stores. I definitely want to do some more work in that area. 

My boss told me a few weeks ago that he believes I could be the youngest optom director in Specsavers. He thinks I should get on a managers course and pathway as soon as possible, that I'd be really good in that area. So, another idea to toy with.

Then there is Vision Aid Overseas with whom I really want to work with.

So who knows! I think let's just get through pre-reg for now. But the options are endless with Specsavers. I know no matter what I choose next I am going to have an exciting career.

Describe the Specsavers culture in three words
Diverse, changing, advanced

What advice would you give someone looking to start a career in optometry?
Research it! When I started optometry I honestly didn't know very much about the course. Right now, I wouldn't change my job for the world, I love it, but while I was at university I definitely didn't think I'd make it to the end. The degree is not easy, you need to be prepared to work hard. But you also need to enjoy it. Learn to balance the hard work with the fun. Balance is so important. You want to look back at uni and say you thoroughly enjoyed it. I graduated at 20 years old, then it was into the big bad working world. You grow up very quickly, so enjoy every minute of it!

The only thing I would change so far, is I wish I got more involved in university. I was "too shy" to go and join sports teams and societies, even to join the optometry social outings. In my final year I moved in with a girl who became my best friend who really brought me out of my shell and I had an incredible final year. So my advice is put yourself out there, meet people, make memories, work hard. You only have a few years to enjoy it! Optometry is an exciting career that is ever changing and Specsavers are the first to get behind every new idea. Specsavers is always offering new courses, new experiences and personal development. Go for it!