Paediatric Clinical Visit- Day 1

Portfolio is the bane of my life. What is portfolio, you ask? It is a compulsory 32 page reflective report on our progress throughout the year, and it is worth 15% of our overall grade in the medicine module. It has been very time consuming and looonnnnnnnggggg because we’ve had to provide evidence for everything, which has been very tedious. The whole thing is due at the end of the week so after Friday I’ll be FREEEEEEEEE.

Part of our portfolio is a clinical visit, which involved us choosing a department at the hospital and shadowing a doctor there as a sort of taster for next year, when we’ll be on placement on a weekly basis. I choose paediatrics and even though we were only supposed to be there to observe a ward round during a morning or afternoon session, Dr T, the Consultant Paediatrician I was shadowing, said I could stay with him for the week, which was really really kind of him.

I arrived at the hospital around 9 this morning (the earliest I’ve been up in weeks LOL), and before we went on a tour of the ward I was able to ask Dr T some questions. I found out he has been at the hospital for 18 years, and decided that paediatrics was for him after his first rotation there when he was still in medical school. Interestingly he doesn’t think that parents get in the way during patient consultations, which was something I was curious to know about, as I’ve always been under the impression that parents and/or guardians infer during consultations, due to their worry for their ill child. Dr T actually said he prefers having them there because younger children are unable to say what’s wrong with them, so their parents speak on their behalf.

After the ward tour Dr T sent me to paediatric surgery, where I was able to observe some circumcisions. This was one of the highlights of the day because I wore scrubs for the first time! I learnt that different colours of hats are worn to represent different roles, so I was given a green hat for students and visitors. Had to take a ‘scrubs selfie,’ ofcourse:

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The importance of teamwork and communication between the team was highlighted throughout the theatre session because everyone had their specific role i.e. anaesthetists, surgeons, ODPs, and they all had to work efficiently to keep to time. I was in awe of the precision and skill of the surgeons, because they have to be even more careful because of how small the children they’re operating on are, so concentration is very important. I was surprised that they listen to music while operating; definitely had a chuckle to myself when Avicci’s ‘Wake Me Up’ came on. I guess this shows that surgeons are more down to earth than I thought!

Patience was necessary because I spent the majority of the theatre session waiting in between procedures while the team prepared equipment for the following ones. I spoke to one of the assistant surgeons, who has been at the hospital for 10 years, and the advice she had for me on getting through medical school was to never ask patients narrow questions straight away, and to always be kind.

In the afternoon I was sent to the Children’s Assessment Unit to shadow doctors there. I talked to one of the Consultant Paediatricians, whose advice for me was to revise and work hard because everything taught in medical school will be needed as a doctor, but also to make sure that I have fun as well. He gave me some insight into life as a Paediatrician; parents can be both helpful and annoying, there are long hours, and it is “better than treating adults because most children don’t lie about symptoms or hide them.” I was sad to hear about the negative aspect to it all such as children dying because nothing more can be done for them, and some being brought in who suffer from abuse at home. This was made even more real when he took me to see a patient whose hypoglycaemia was suspected to be caused by starvation at home. So sad 😦

On a positive note, I got the chance to interact with a 2 year old patient while her blood was being taken for an arterial blood gas test. It was my job to distract her so I used my experience with looking after young children to assist me with this. I used picture books to keep her entertained and this was successful in distracting her because the doctor was eventually able to get a sample. She was so so adorable! 

The day concluded with a metabolic clinic and I was keen to see if Dr T used any of the guidelines suggested by the Calgary Cambridge Guide, and I was pleased to recognise things like open questions, asking “something else?” instead of “anything else?” to get the patients to say more, and the use of body language such as nodding as a sign of paying attention. The patient I observed had low blood sugar, had lost weight recently, was irritable and has recently gone through a phase of drinking a lot of water. He had no family history of diabetes, and this was ruled out because his blood sugar wasn’t low enough to suggest this, so Dr T’s diagnosis was ketotic hypoglycaemia. I found this all interesting because I recognised all the terms used from what we learnt in the diabetes week in PBL, so atleast I’ve learnt something.

Overall it was a great day and I’m thankful for the opportunity I had. It was my first 9 till 5 day and I got back to campus feeling absolutely knackered. I guess this is what my life will be like next year haha… but buzzing to go back tomorrow!

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One thought on “Paediatric Clinical Visit- Day 1

  1. Pingback: Module 1 Placement: Week One | Life As A Medical Student

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