The world of medicine is like a bubble. A lot of people THINK they know what goes on there, but unless you're down in the trenches it's unlikely you do. So here is my semi-anonymous blog, here to tell you what really goes on in the life of a medical resident.

Sunday, September 03, 2006

My First Day of Pediatrics.

I learn a lot at my job. Here are the gems that came out of my first day of peds.

1. Don't ever, ever assume that just because you are a doctor, you are allowed to touch your patients. First, make sure to ask permission from the nurse, the peds staff, the senior resident, the child's parents, the baby herself, the cafeteria lady and the housekeeping staff.

2. If your patient is a newborn, you are not allowed to touch it while it is sleeping or after it has eaten. So if you need to do a physical exam, that leaves about 8 minutes in the early morning and another 4 minutes sometime in the afternoon. Nurses will enforce this rule with the ferocity of a rabid pit bull.

3. If there is a parent in the room, it is best to assume that they believe that you are there to do their child irreperable harm. Regardless of whether or not you actually intend to touch the child. In fact, the fastest way to befriend your patient's parents is to agree that everyone working at the children's hospital is horribly incompetent. Yourself included.

4. Many people in pediatrics have devoted their lives to children because they aren't that great at relating to adults.*

5. Every crib on the pediatrics floor will work slightly differently. Which means that you will look like an idiot trying to release the side of the damned thing for 10 minutes while the parents of your patient stand by, amused. It's hard to garner any respect after that.

6. Children are very different from adults. Don't ever think that anything you've learned in your previous 14 months of residency will prepare you for dealing with children.

7. Pediatricians and pediatric residents spend an inordinate amount of time discussing how no other physician in the medical universe knows the first thing about treating children.

8. Parents will describe every episode of vomiting as 'projectile' if it is coming out of their child. Even if it just dribbles down the front of their sleeper.

9. At some point in parenting school, parents learn that if they smoke outside their cigarette smoke cannot possibly have any effect on their child's asthma. This is a belief that they will defend and argue to the death.

10. Trying to get back into a regular schedule after two months of shift work requires copious quantities of caffiene.

* Vitamin K is, of course, the glaring exception to this rule. Cause she's just wonderful to everyone. Even when she's sleep deprived.

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Anonymous Anonymous said...

bad day, huh? i send hugs.


12:59 AM

Anonymous Kim said...

Hey, it's been awhile since I've been able to visit and I like the new template - works well with your style and oozes energy! : D

And this post made me LOL right here in the ER!

5:34 AM

Anonymous Sandra said...

Just remember that parents who come to the hospital are lost and feel helpless but they do know how their children are when they feel good.

You are a team and you must keep all team members (the parents) aware of all procedures. This will ease their fears enough so that you have them helping you.

I know because I've lived through it and have met at least 10 different types of doctors.

Plus it's the childs well-being that is the most important.

6:08 PM

Blogger Liana said...

Had a baby a few weeks ago who was 8 weeks old, with progressively worsening vomiting of all oral intake. Asked the parents if the vomiting was projectile, which they adamantly denied. A few moments later, the kid, who was lying flat on his back 10 feet away from me, vomited with such force that he drenched me with an arcing stream of regurgitated pedialyte.

Yes, he did have pyloric stenosis.

7:33 PM

Anonymous Anonymous said...

As a pediatric resident, your post is completely hilarious...and completely true. Love it!

12:25 AM

Blogger Charity Doc said...

This is so MONEY!!!!

You should submit it to the Pediatric Grand Rounds.

Hey, you left out the part about catching whatever snot and runny nose viruses these kids have, leaving you feeling horribly miserable with flu symptoms every time you rotate through a peds month.

5:47 PM

Anonymous jen said...

hahaha, sometimes I wonder if i'm the "bad mom", because as a travel nurse we change peds docs ALOT.
I'm the mom that tells my 6 year old to "Hold your ass still, and let her look in your ears/throat". Instead of being all "protective" and mom-ish.
I'm a very protective mom, but just WANT to get out of the office ASAP because of kid germs.....
Excellent post!

11:32 PM

Blogger scalpel said...

Pediatric patients aren't exactly like little adults; I think of them as more like little Democrats.

5:46 PM

Anonymous Alice said...

The part about the cribs is so true. Hey, it's not limited to pediatric hospital, the ER gurneys in the big hospital work the same way - but kids' cribs were especially bad.

4:08 PM

Anonymous Anonymous said...

In all my wisdom as a PCP, I can tell you that it worsens down the generations! To see better conditions travel back in time ;-)

5:02 AM

Blogger Jenn said...

Rule #4 is SO FREAKING TRUE. There are some pediatricians (or peds nurses, etc) who work well with four-year-olds because that's where their intellectual and social development ended...

4:23 PM

Blogger Nay Denature said...

Hemorrhoids are associated with constipation and straining at bowel movements Pregnancy is also associated with hemorrhoids These conditions lead to increased pressure within the hemorrhoidal veins that causes them to swell Other conditions for example chronic liver disease may also cause increased venous pressure and may be associated with hemorrhoids Hemorrhoids are very common and are estimated to occur in up to one-half of the population by age 50

6:42 PM


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