Types of patients you found challenging in this rotation and what you learned about dealing with them:

The most challenging patients I encountered on this rotation were the children who were old enough to be scared of me as a practitioner, but not old enough for me to gain rapport with them. The younger infants were not as phased when I did my assessment on them because they had not developed a sense of stranger anxiety yet, and the older toddlers I was able to find something in common with and establish that sense of trust. I found it difficult for those in-between patients because even though I would be playful and interact with them when it came to the actual physical examination/ administering vaccinations the child would often cry/scream. On the one hand, I can’t blame the patient because I myself was the same way with going to the pediatrician. On the other hand, I found that I was able to overcome this challenge by incorporating the parent into the examination (i.e. showing the child that I am listening to mommy/daddy with the stethoscope too) or using stickers as an incentive to have them cooperate with my assessment. 

 

How your perspective may have changed as a result of this rotation (e.g. elderly patients, kids, IV drug users, etc):

As a result of my pediatric rotation I have a newfound respect for parents. While I am not yet a parent myself, I am able to recognize firsthand the dedication and time it requires to be a caring parent for a child. Many of the families I encountered had multiple children, each with individualized needs whether that be physical or psychological. In addition, often times both parents are working individuals who also have that supplemental responsibility of raising their children. It is often easier to judge a parent and assume negligence when there is an issue with a child that is not addressed, however this rotation taught me to judge each of those parents favorably- as a practitioner you do not always know the full story and what is going on 24/7 at home.

What was a memorable patient or experience that I’ll carry with me?

On my last week of this rotation I had a young patient who presented with abdominal pain. On physical examination, the pain did not seem too extreme and all special tests were negative for appendicitis. However, later that evening the parent called the office and explained that the patient was doubled over in pain and vomiting. Ultimately, he was brought to the nearest emergency room and was scheduled for an appendectomy. For some reason, the next available time for the surgery was the following day, and unfortunately the patient’s appendix ruptured in the meantime. It was difficult for me to grapple with the situation, since nothing on physical examination prompted us to send him to the ER any sooner. Additionally, I was troubled by the negligence on the part of the hospital, since they should have referred him elsewhere at that point for an immediate appendectomy. Had they done so, this would have avoided the rupture in the first place and the negative sequelae that followed. Thankfully the patient was taken into surgery soon after, and when we called to follow up on his condition he had fortunately been stabilized on appropriate antibiotics. 

What did you learn about yourself during this rotation?

Prior to starting my pediatrics rotation, I did not think I would particularly enjoy working with pediatric patients. While I do enjoy working with children, and have been a camp counselor for many summers along with years of babysitting, I figured I would not enjoy the medical aspect of working with pediatrics. As mentioned earlier, it is an often difficult population to work with since they often view you in a negative light. However, it was rewarding to be able to work in an outpatient pediatrics setting because it allowed me to follow up with each of the patients that I saw. I was able to witness firsthand the improvement of certain conditions, or unfortunately the worsening of symptoms and subsequent need to reassess and form a new plan. It was certainly an enriching experience and I plan to take the skills I learned on this rotation and apply them to future ones and ultimately to practice as well.