Life on the children’s ward

Well I survived my first graded OSLER which took place in the last week of my General Practice block. It was hard to take the history in ten minutes and answering lots of questions about differential diagnosis and investigations from the examiners was daunting but I received really positive feedback and I’m very happy with that after my first senior rotation! 3 weeks on and I’m now half way through my child health block at Warwick Hospital. It’s strange been back in hospital having not been in full time since before second year exams. In some ways it feels like a step backwards, from conducting entire consultations and delivering management in GP, I’ve now gone back to loitering behind a consultant on ward rounds and standing sheepishly in the corner waiting to present cases.

At Warwick hospital our placement is organised around time on the children’s ward, the special care baby unit and in outpatient clinics. The children’s ward is a very busy place and very different to other wards. There is a playroom and all the walls are covered in animal paintings and each bay or cubicle is full of family members and a variety of toys. Many children are sent straight to the ward and bypass A&E so there are lots of new patients every day, which means there are lots of people for medical students to clerk! Conducting histories and examinations in children can be tricky to say the least; histories often come from multiple people, parents, grandparents, school staff and the child themselves if they are old enough. Histories are taken while shouting over the top of a screaming child and examinations are opportunistically performed on children trying to wriggle away!

The special care baby unit (SCBU) in contrast is the quietest place in the hospital. This is for premature babies (under 34 weeks or under 2.5kg) and term babies who need additional care. We have lots to learn about common problems that can occur in premature babies and in the immediate postnatal period so there is lots to learn on SCBU. It’s also a great place to get to grips with how to look after newborn babies-something which most of us have little experience of! We can also visit newborns on the postnatal ward and help with the newborn baby checks which is always fun.

In contrast to UHCW, Warwick children’s department is very small but there are still lots of clinics to attend. There are some specialist clinics, for example for children diagnosed with Type 1 diabetes and there are general clinics with a wide variety of conditions. For example in clinic today I saw children presenting with bed wetting, abdominal pain, and headaches as well as children who just weren’t gaining weight. A lot of what paediatricians do is reassure parents and give advice about normal development in children, this may seem a bit dull at first but they have to always consider more sinister causes and ensure these are ruled out. Children can often present with non-specific symptoms and it can be difficult to take a good history, so from what I have seen so far I think you need to be a good detective in order to succeed in paediatrics-something I will need to practice!

Joanne

Luke Pemberton : 07 Mar 2017 10:46 |  Tags: Joanne Mbchb Student Warwick Wms |  Comments (0) |  Report a problem