Showing posts with label paediatrics. Show all posts
Showing posts with label paediatrics. Show all posts

Monday, 4 July 2011

Children are not mini adults...

...A survival guide for paediatrics.

1) If you look "different" in any way, children will ask questions about it, and parents will (for the most part) get embarrassed. You've probably come up against it at the supermarket already, but if you haven't, have a think about what to say to "why is that lady using a stick / chair? etc". Something simple such as "my legs don't work the same way as yours" works for younger children, and simply "I am disabled" for older.

Decide to what extent you will answer follow-up questions as well. To non-medics I tend to say that "I have a problem with my joints", and this seems to work fine with children. (Medics, I tend to tell what I have, purely because it's not well-known and I want more people to have at least heard of it!)

2) I try to be welcoming to questions and curiosity from kids, because I think that's it's a really good opportunity to de-mystify disability. If kids are staring, or parents get embarrassed, I tend to ask the wee ones what colour my stick is. It seems to open up some good conversations.

3) I did talk to a couple of parents who said it was really good for their disabled child to see a disabled medical student. I didn't know what to say to that, but it made me a bit happy. This isn't really a tip so much as something to bear in mind.

4) Depending on your life experiences, some of the issues that are raised in paediatrics may raise some difficult feelings. Recognising non-accidental injury, for example, will almost certainly be raised.The pictures shows a young girl of about 3, dressed in red, kneeling over
a baby, dressed in white, who is lying on the floor. The girl is playing
with a syringe (no needle though, don't worry!), and mum is watching
over them, her left wrist loosely bandaged by the wee doctor.
Picture by uncoolbob on flickr.

5) The MDT is highly valued within paediatrics, and specialist community nurses are the back bone of chronic disease management in kids. Depending on access issues, home visits may not be possible for you, but nurses often also run clinics from a hospital base, or are part of consultant-led clinics (e.g. diabetes clinic).

6) I found it really frustrating how much better coordinated childrens services are than adult. There's no easy answer to this, but it's not just you. Don't be afraid to voice these frustrations, because most paediatricians share it, because they see the anxiety that surrounds the transition between.

7) If you've not spent much time with babies before, and you're nervous around them, get the nurses to teach you how to change nappies / give bottle feeds. If you muck in, you'll get plenty of experience, and the nurses / auxillaries will love you. (If you like cuddles, barter one nappy change for one bottle feed like me!)

8) Spend time in the play room or with play therapists to hang out with some toddlers. Being able to make a child smile will make clinical exams so much easier - a relaxed child is way easier to examine, and a relaxed parent gives a better history. The easiest way to get a child on side is to say "who is that on your Tshirt? / what is your teddy's name? / what colour are your shoes? is that your favourite colour?". Always ask the child their name and age before (if they can't answer) asking the parent (unless they're very obviously 8 weeks old!).

9) But, if you choose to take this kind of hands on approach, remember : have a change of top around in case you get peed or puked on. (Or know where the scrubs live!)

10) Also, know your limits in terms of lifting babies / children. Don't hurt yourself (by lifting a particularly weighty, but tiny-looking 2y/o like me...) and really try not to drop them!

Thursday, 16 June 2011

Elective (nearly)

It's going to be an interesting few weeks I think. I'm heading to the country of my woman and her kin to spend a month in paediatrics in July. Hooray!

The pros :
1) Kids are awesome
2) Change of scene after 6 months straight placement here
3) If I help feed the babies, I get to cuddle the babies
4) I mentioned that I was disabled when trying to negotiate hours, and the administrator replied offering to sort me out a permit for disabled parking as the staff car park is up steps, without being asked! Miraculous!
5) I get to meet more of my lovely partner's lovely friends
6) Extra paeds practice before finals, and the chance to fit in some ob/gyn maybe, which I haven't covered yet
7) Daft cat gets to come too
8) I get to blow bubbles on placement without getting funny looks (purely for the kids' entertainment you understand)

The cons :
1) [redacted by my future self]
2) We will be travelling heavy, as daft cat can't just be tucked in a bag or something ;)
3) We end here on Friday afternoon, and start there (~8 hours journey away) on Monday morning
4) Little patients puke up on you more than growed up patients
5) The mrs gets her extroverted nature from her folks, and they always seem to worry that little introverted me is sad, when I'm just being

The pros have it I guess! I'm curious to see how a different (but still NHS) trust / hospital handles disabled staff. I imagine it'll be pretty much the same - good/bad/buttugly.