Rotation 8 Peds Reflection
Types of patients you found challenging in this rotation and what you learned about dealing with them
Pediatric patients had always been a challenging population for me. They could be the worst historians that we would have to rely on the parents for history-taking. They could also be the least cooperative patients with the loudest crying and screaming. I had learned a lot about dealing with pediatric patients as well as calming them down during this rotation. At the beginning of the rotation, I found it very difficult to perform physical examination when the child was uncooperative, fussy, and irritated. Some younger patients would even start moving around and crying which would make it almost impossible to perform ear exam. I learned that patients could be held by their parents in a certain position so that they were not able to move. Then we would just be had to quickly perform the physical exam the best we could. In patients that refused physical exam, we could build rapport with the patients by listening to parent’s heart, then I would also let the patient listen to mine. It is important to spend time with the children and build trust so that we could perform physical exam smoothly.
How your perspective may have changed as a result of this rotation (e.g. elderly patients, kids, IV drug users, etc).
Pediatric population could be a lot more challenging compared to the adult populations because they were not able to provide a full history and they could be very uncooperative. They could also be easily distracted when they were being exam. I have realized when interviewing the pediatric population, skills such as communicating on the child’s level is important. For examples, learning the child’s name in advance, physically getting down to the child’s level, or giving the child a helping role. I would also explain when I interact and touch them. Getting more involved with the patient will help gain their trust and make physical examination easier to complete.
What did you learn about yourself during this 5-week rotation?
During this 5-week rotation, I was stepping out of my comfort zone when I was interacting and communicating with pediatric patients as well as their parents. I always had difficulties getting involved and communicating with children. At first, I felt like I did not speak their language. During this rotation, I was getting exposed to pediatric patients in the ER, in the clinic, as well as in the NICU and mother baby unit. The age range can be very broad from a 1-day-old to an 18-year-old. Communication with patient of different age can be completely different. The more I was getting exposed to, the more comfortable I felt. It was a great experience learning how to care for pediatric patients and spending time educating parents and other caregivers how to care for their children.
What do you want to improve on for the following rotations? What is your action plan to accomplish that?
For my next (also last) rotation at internal medication, I would like to observe procedures such as lumbar puncture. I did not get to see a lot of those in my previous rotations. Lumbar puncture is important to perform because it can help diagnosis serious infection such as meningitis and other disorders of the central nervous system. Besides lumbar puncture, I would also like to see and learn about paracentesis and thoracentesis. I would make sure that I tell the provider that I am working with on that day that I would like to see/perform more procedures. I would also study and read up on the patients that might require these procedures.
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