Pediatric emergency work is challenging. It’s a weird combination of truly sick kids, kids who are sort of unwell, kids who are 100% fine, and, once in a while, kids who are at risk of actively dying. All in the same shift.
I had some experience in it back in medical school, though in a different hospital in a different city. Which basically means starting from scratch when it comes to the logistical things. But clinically, it’s been a wonderful few weeks of refining differential diagnoses and procedural skills. And much in the style of my last few posts, I thought I’d share some little pearls about both working in and visiting a pediatric ER.
Carry on, dear reader.
Gaining rapport with peds patients (I’m on a Supernatural kick, don’t judge me.)
(Just wanna say – after talking to kids nearly exclusively for 2 months, it’s going to be awfully weird talking to adults again. No more commenting on how much I like their Dora socks or what kind of sticker they want.)
It’s been two whole months with the focus entirely on children – it doesn’t feel like it, having spent only a few weeks in each place. For those who aren’t familiar, our pediatrics rotation is split into a number of parts: Clinical Teaching Unit (CTU, i.e. inpatients), outpatient clinic, subspecialty clinic, CTU call, and pediatric ER, as well as a few half-days in neonatal intensive care (NICU). They’re all very different, so it’s hard to review them all as a cohesive group, but I’ll do my darndest.
Working with kids is a pretty unique part of medicine; in very few other places is the family unit so essential to every meeting and every appointment. Not only that, but your approach can be entirely different for exactly same presentation depending on the patient’s age. It presents an interesting challenge and makes you really think broadly.
Remember way back when I wrote about what the OSCE experience is like? The nerve-wracking, sweat-inducing experience? All that adrenaline pumping through your system while you wait to encounter that one station that will haunt you for the rest of your life?
It’s not that fun. (Trust me, a large number of the class tanked the auto-fail pediatrics station. Not fun.)
But I’ll tell you what is fun. The post OSCE experience.
Let me break it down for you:
I’m done 3 of my 4 overnight call shifts for inpatient pediatrics as of 7:30 this morning, and in my slightly deranged, sleep-deprived mind, I started to categorize the parents I’d seen in hospital so far. Don’t ask me why. Stuff happens to your brain on call.
And it’s true what the ever-omniscent “they” say – on pediatrics, you treat the kid and the family. Especially when they’re young, they just go together. And while the kids often need some reassurance about what you’re going to stick in their ear next, it’s the parents that really need the good talking-to.
So let me introduce the 5 parents you’re sure to meet: