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PAHopeful: Rotation at Pediatric clinic
作者:USMedEdu
发表时间:2008-10-12
更新时间:2008-10-12
浏览:1182次
评论:1篇
地址:10.
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发信人: PAHopeful (PA-C), 信区: MedicalCareer
标 题: Re: 谈谈儿科住院医生活
发信站: BBS 未名空间站 (Sun Oct 12 00:32:14 2008)

This month I am doing the acute pediatric clinics after last month's
inpatient service. Even Though, I am not in a PED program, I really liked
the CLINIC schedule. The hours are great. It was the first time that I
picked up my kids from the daycare on the first day of rotation, ever since
I started my residency.

The acute pediatric clinic team consists of 2-3 staff, 1 R3, 1 R2, 3 R1, 1
M4 in the morning. Then additional 2-3 M3 join in in the afternoon. The day
starts around 8:15am, we just sign up our names from the scheduled
appointment list when the patient is ready to be seen. I scan the face sheet
first regarding the vitals and CC. Then I log in to the computer check the
recent notes to get the background information such as PMH, SH, ALL, FH, etc.

Then I go into the room. After introduce myself. I joke with/ play with
the kid and their parents for 1-2 minutes. Then I take the history and do a
physical based on my assessment. As I go along, I tell the parents what I
find and what I think. Then I give the parent the whole picture after finish
the physical. I recap the history and major positive and negative findings.
I tell them my differentials and my thought process. I propose my plan.

Then I tell them that I would talk to my staff for the assessment and
management. If there is any difference, my staff's prevail. I ask the parent
and kid if they have any question before I leave the room. Then I find
whoever is scheduled to staff in that am or pm. I present the whole picture
from HPI->PMH->ALL-MED->FH->ROS->Vital->PE->Labs, then my assessment and
plan. Since I had experience before, 95 percent of the time, the staff
agrees with my plan. Then we go back to talk the the patient and the parents.

The staff does his own PE. Fill out the billing sheet and return
instruction. Then send the patient out. After that I type a clinic notes,
similar to H/P, but more short and sweet, on the computer (we are not
allowed to dictate the notes as R1). There is a 40 min morning conference
everyday but I skip the majority of them since the topics were not
attractive to me. Also since I am a rotating resident, I am not bind to
attend the morning conference. Then I have a hour around noon for noon
conference.

The clinic restarts around 1.00pm in the afternoon. I usually see about 8
patient per day and can go home around 4.30pm. The staff has been very
supportive and helpful. They love to demonstrate their own tricks of
dealing with all kinds of situations. The like to show us any interesting
findings, any clinic pearls they can think of. The residents were nice and
easily to get along. I really liked the rotation and joked to switch to PED.
The staff got serous and asked me about it.

I will have a NICU rotation and another pediatric inpatient service rotation
later. What I heard is that they are more demanding.

I did a Friday call for my home department last night. I was the only intern
on call for the service without senior resident. I admitted 5 patients,
carried two pagers for both the impatient service and the call center, answered
46 pages, ran from one tower to another in this huge hospital, slept 1
hour and survived. My previous Physician Assistant Education and ER
experience really get me going.

Even though it is a tough job, I love it.





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※ 修改:·PAHopeful 於 Oct 12 01:02:01 2008 修改本文·[FROM: 12.210.]

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共有1条评论
1   [dokknife 于 2008-10-15 16:54:02 提到] [FROM: 10.]
发信人: luckyal (pediatrics), 信区: MedicalCareer
标 题: Re: 谈谈儿科住院医生活
发信站: BBS 未名空间站 (Wed Oct 15 15:47:30 2008)

I'm the second year resident in Peds now. I love my job in Peds too.

But we are very busy working in the inpatient unit, since most of patients
only stay 1 to 3 days. It seems we have lots of paper work everyday in my
hospital. Our patients usually are not as sick as pt in internal medicine,
but we have lots of admission and diacharge every single day.

I think as a second year, we are signed more patients in our clinic, up tp
12 patient half day clinic. Of course it depends on whether all your
patients show up or not. Sometimes it would be very light with chatting most
of time, sometimes we will be home at 7pm after the clinic.


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