Wednesday, October 24, 2012

Paediatrics Posting

This post was actually written about two weeks ago but I didn't have the time to finish it up so here it comes!

I've finished my 7 week Paediatrics posting and are now in my second day of Obstetrics and Gynaecology posting.
In the past 7 weeks, I felt as if I was thrown into a deep, dark hole and the cliff I had to climb to see the sun was just unbelievably demanding. However, it did get better towards the end, perhaps because I acquired new clinical skills and had tremendously sharpened my survival instinct.

In Paediatrics, I became used to running to the bus stop to catch the shuttle bus to Burnley. Used to pacing up and down the ward corridors because there was no patient waiting to be seen. Became used to talk and chat with the senior house officers (SHOs) when I used to fear them last year.
Used to making a cup of coffee while studying the doctor's room because there was no patient.
But most of all, used to be in Paediatrics and I must say, I actually enjoyed and loved this placement!

And to be honest, being in Blackburn is not that bad after all.
The room is good, though small. And we do not have to pay the utility bills and I can switch the heater on 24 hours. BUT, I do not want to stay here permanently. 14 weeks is enough, thank you.

Being in Paediatrics, I've seen a lot of things. I think this is the first time I am truly acknowledged as a medical student. I am doing things junior doctors do, although I do it either under supervision or I'll have to tell a senior doctor what I did so that they can check if I did it correctly.

Assessment Unit
I enjoyed the time being in the Assessment Unit, where unwell children who came in referred by their GP or after being through A&E are assessed whether they need to be admitted or are okay to go home.
I will first see these children, take history and perform some examination before presenting the case to a Registrar (a very senior doctor) and tell him what I think is happening to the patient.
Best of all, I can write on the assessment sheet, devise my own management plan, print my name and sign it off (although no nurse will actually act on my management plan, because the Registrar will review the child later and write his OWN plan). But still, I feel like I am part of the team. And the nurses and doctors were so nice to us. The only person that's not so nice to us are the parents. Some parents are just so annoying and frustrating!

Neonatal Unit
I had one week in the Neonatal Intensive Care Unit (NICU) in Burnley.
Here, I saw very small tiny babies, some are barely 500g!
And they have wires and tubes and needles attached to them, it's sad. I can't imagine what the parents especially the mother will feel seeing their babies in that condition. It must have been heart-breaking. These babies are mostly preterm. Term babies who are for some reasons can't breathe properly, can't get their blood pressures or temperatures maintained or any other problem will be sent into NICU.
One very sad baby that I saw was a cocaine intoxicated baby. I can't remember how many weeks was he but his mother was on heroine while pregnant and really could not be bothered about him. And she was a known sex worker. She did not attend most of her antenatal appointments and refused to see the social worker. She had two previous babies who she fed methadone to "help" them with their withdrawal symptoms and these babies have been taken away from her. This time around, this baby will also be taken away from her and sent to a foster home. They even put a warning not to let her visit the baby unsupervised.

The baby was so irritable and had severe tremor, he was obviously in withdrawal.
His cot had to covered by an opaque cloth so that he is in dark and his blankets wrapped around him and tucked underneath his mattress so that he is sort of "tied up" in the blanket. These measures are to reduce disturbances to him, and his cry was very different from other babies' cries.

It was so heartbreaking to see that innocent little human who suffered the aftermath of his irresponsible mother's action.
Few potential foster parents came to visit him but there have been some changes in plan so as for now, no one has agreed to take him in their care yet. And he was Hepatitis C positive.

I pity him, to the bottom of my heart. But I can't imagine myself adopting a baby like that. Perhaps it is because I believe nature and nurture come hand in hand. Even if I raise him perfectly, he might have the "not good" genetics and turned out bad. I know that's very cruel of me to think that way but I can't help but believe it. That is why our beloved Prophet's bloodline was so protected and they can trace his ancestors for more than 5 generations (I cant rmember exact number).

Perhaps I should end my rants here.
This post might be too long already.
Thank for reading and take care!

-Because life is a test-

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