I’m excited to bring the first of many posts during my clinical years. I just finished two weeks on the pediatric hematology/oncology (Hem/Onc) service. This is a field that I’ve been quite interested in and I’m excited to share my experience with you all!
This is when the night staff resident will give you updates on any overnight events, new admissions, and any to-dos for every patient.
This consisted of me reading about the patients I will be taking care of that day. Electronic medical records are a gift and a curse, however. They have a lot of useful information but unfortunately are hidden very well.
Things I would read about included overnight events, labs, and vitals. I would also use this time to read up on conditions or medications I wasn’t familiar with.
Before I would go see my patients, I would make a list of everything I wanted to ask or examine for each patient.
To give you an idea of patient load, I began my pediatric rotation by taking care of 1 patient and then gradually moved to 4.
This is the time I actually go see my patients.
I often could see my patients within 10 minutes. Thus I would use the remaining time to finish my notes and prepare for rounding.
They didn’t always exist but on many mornings there were scheduled education session. The best part about these conferences was the free food and coffee!
Pediatric Hem/Onc does table rounding which means that we sit in a conference room with computers and talk about our patients with an attending physician. Other services tend to go to the patients’ rooms as a large group.
This is also when I present my patients to my attending. In my presentation not only do I report what happened overnight, but I also provide a plan of what I think should be done for them that day.
This is easily where I’ve grown the most in a short amount of time. I’ve become more comfortable in my oral presentations, the medications, and more confident in my care planning.
This is just another educational session that we often but not always have.
This time is the most variable.
It’s often a great time for me to help the residents and attendings with whatever needs to be done.
Sometimes I’m calling outside hospitals to get patient records. Other times I may be routinely checking in on my patients to observe their progress.
Often I was dismissed by my residents at 4-5. I did stay until 7-8 on my call days which each student had to do once or twice per week.
Often I would be in bed by 9. The long days can wear you out.
Prior to bed, I would use the leftover hours to eat dinner, read for my shelf exam at the end of the rotation, and relax.
If this schedule sounds busy, it’s because it was. I still enjoyed it and had very little complaints about the hours.
This is nothing new. Everyone expects and is told that your clinical years will humble you on how little you know.
Nevertheless, just because you know Mt. Everest is tall doesn’t mean you’re not amazed when you’re at the base looking up. I was as low on the Everest learning curve as one can get.
By no means am that far from the starting point two weeks in, but I have become comfortable faking it till I make it! 😀 Fake confidence can take you a long way.
A common notion of pediatric Hem/Onc is that it’s a sad field. Yes, there are unfavorable outcomes for some of these kids, but many of them have long lives after their treatment.
Regardless of their prognosis, I was amazed by the resiliency of these kids and their families.
One would expect them to be broken after being in and out of the hospital as much as they are. No, instead they continue to persevere.They are true fighters.
These two weeks have highlighted how minuscule my problems are compared to these kids. It’s thus easy to wake up at 4:30 and stay till 7 or 8 in the evening.
I could see myself doing this in the future.
In pediatrics, your patients, and the parents put their trust in you because you’re part of the care team.
Even though my stethoscope has had very little use, my pen light was recently bought, and my smile is hiding my incompetence, they don’t hesitate to trust me with their care.
I’m just amazed when I can walk out of a room knowing things their families and friends may not even know about them.
I’ve always had an eye on pediatrics. It’s been an age group I’ve worked with most of my life.
Still, in a hospital setting, you expect to see kids that look terrible due to their illnesses.
While many of them have seen better days, others are hilarious and adorable even while sick.
Sorry if you’re currently eating but some of my biggest victories have been overcoming constipation in these kids.
Often this was the only thing left keeping them in the hospital. So it’s crucial to put the child on an appropriate bowel regimen. Thus there is a level of pride when you help that kid “go” home. (I thought that was pretty was clever :D)
Also, you don’t know true success until you can get a fax from an outside hospital with records which are believed to not even exist.
It’s the small things you guys. 😀
Now it’s here and happening.
It’s exhilarating, scary, and shocking all at the same time, but I wouldn’t want it any other way.
My next two weeks will be more relaxed than these past two.
I will be transitioning to spending a week in the pediatric emergency department and another week in the newborn nursery. Excited to share those pediatric experiences as they come!
If you haven’t already read about what the rest of my clinical years will look like, read about it here.
If there is something specific you’d like me to address in a future blog post, comment below or email me at [email protected].
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Until next time…
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