Life As A Houseman- Pediatric

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Entering pediatric as a last posting was tiring. Why? Because you had to deal with infants and kids. You need to use up lots of energy, more careful and meticulous observation with prompt management.

Ohh...babies are so cute. Ohh... babies are so adorable. This is all bull shit until you experienced the true hectic of pediatric posting.
Without further a due, let me introduce you this cuteness overload + stress overload + tiredness overload+ anger overload posting.

Paediatric positing in HSIJB divided into 2 parts:
1) NICU (neonatal intensive care unit)
2) Paediatric wards

You have to spend 2months in each unit. I was rotated to paediatric ward 1st.
To pass paediatric posting, you need to pass your NRP (neonatal resuscitation) well.

In the paediatric ward, you have to deal with children aged between >1month old or <12years old + their parents. It was difficult task as children tend to cry...not a little bit, is A LOT!

They cried to express everything!!! really speechless
-meet strangers then cry
-blood taking sure cry
-branula insertion confirmed cry
-nebulization also cry
-eating medication might cry
Basically, it was difficult to handle them.
And most of the time, parents became anxious when their child sick. You need to face anxious or difficult parents. You never know how difficult it was, until you experienced it yourself

You had to perform branula insertion or blood taking for these pitiful children. You learnt and practise the proverb "united we stand". Children tend to struggle and the commonest reflex was withdrawal. Hence, you need few more people to restraint the children while these procedures being performed. It was almost impossible to perform blood taking alone in paediatric patients except they were mature enough.

What if, you failed your blood taking or branula insertion? Luckily the nurses in paediatric ward were nice, they have lots of experiences and they are kind enough to help you. But most of the time, you have to try yourself before asking for help. If they failed, MOs need to be called.
But, you will not like to trouble your MOs too much right? as they will think you are not competent enough. Practice makes perfect!

There is a ward called paediatric oncology ward/ nephro ward. It was super stressful area. You are dealing with oncology patients( those leukemia/ carcinoma patients) , who admitted for chemotherapy/ neutropenia sepsis/ flaring of disease/ newly diagnosed etc.
They are fragile, they are long term patients, they had experienced multiples scary procedures such as lumbar puncture, chemoport insertion, frequent blood taking etc.
You will never understand how much they had gone through.
Because of the reasons above....It was really tough to work here. Lots of workload, detailed documentation required, but luckily the specialists were super nice.

Next is NICU rotation
During this rotation, you learnt how to resuscitate a newborn. First, you need to study your NRP well.
You must pass the NRP course throughout this rotation, you will be assigned 1MO/Specialist to guide you for the NPR.
All of you will be divided into small group of 4 or 5. And all of you need to request teaching from the assigned MO. Your achievement depend on your effort

Once you learnt your NRP well, you will find that, it is easier and understandable to resuscitate a newborn.
Once there is a c-section under emergency settling, your MO will ask you to attend the resuscitation depend on neonate's condition. If thick liquar, your MO will accompany you for resuscitation as risk of intubation is higher. If other mild condition, you had to attend the resuscitation alone.

Of course, your MO keen to assign those who have higher competence and knowledge in resuscitation of newborn. It is kind of reassure and they believe you can resuscitate the baby well. Those who had poor knowledge and poor attitude, you wont be given much chances until you improve yourself.

Bad things is ....if you went for resuscitation and you think this baby require ICU admission in view of tachypnoeic (TTN) or whatever reason.
However, when the baby arrive at NICU, baby is not longer tachypnoiec, you will kena scold /sarcasm by nurses. This is part and parcel of life....

Overall, NICU rotation mainly -preterm baby, severe jaundice baby, septic baby and ill baby. Most of the time you need to assist your MO. Nurses in NICU are competent, but fierce at the same time. You need to get along with them well by offering helps.
I do enjoyed this posting except the part of crying baby and difficulty in getting iv assess of toddlers.

I believe you will enjoy too.