All entries for Monday 10 April 2017
April 10, 2017
Starting on the Paediatrics Ward
We’ve just started our third specialist clinical rotation and it’s focused on Child Health. This is actually a really diverse block. The medical school in combination with our base hospital puts a lot of effort into making sure that our timetables show expose us to various different aspects of paediatrics, so I’ve been to allergy clinics, development clinics and a few others so far – and it’s only been two weeks. We’ve got a lot more of this coming up over the following month. I wasn’t quite sure what I was expecting, but the care and the patients’ needs seem much more varied than I realised. I guess that’s what medical education is for.
In addition to clinics, we are also expected to spend time on the paediatrics ward and on the special-care baby ward (known affectionately as SCBU), among other places. I’m really looking forward to SCBU and to seeing some of the neonatal presentations. We will get to learn how to perform baby checks and see lots of the presentations that affect babies who are born unwell. Although it’s not an always-pleasant thing to confront, it’s part of someone’s health journey. I know that they’re in the best hands possible when admitted in the SCBU and each patient’s best shot at a happy and healthy life comes from being looked after by the staff there. I cannot wait to see it in action.
Taking patient histories (a mainstay of clinical contact, and something we learn from the first week of the first year) can introduce a different challenge with paediatrics patients: I’m rarely talking to one patient, I’m talking to a patient plus a parent and sometimes two! Sometimes the child is non-verbal, sometimes a grandparent comes along, sometimes the parents don’t speak English as a first language, and so on. These are all real-life factors that can make clear communication a more vital and significant part of the history. Furthermore, it can be really intimidating for a child to have lots of adults paying looking at them and asking questions about their health. We really have to ensure that we make it as non-threatening an environment as possible for the best interests of the patient, and all of the doctors on this ward are experts in this and teach us well.
Additionally, there are lots of components to a paediatric history that don’t have so much relevance in adult histories. For instance, we gather information where possible from parents about the child’s pregnancy and delivery, immunisations, developmental milestones and other social factors such as family life, schooling and siblings. These all contribute to a complete health picture for the patient and help us understand their background better than we otherwise would. It’s really good that the med school give us this practice; we need to have it down to an art by the time finals roll round!
John