This is a little late, as I finished my Pediatric rotation last Friday, but wow, it was intense. I ended up being gone from my apartment for roughly 13 hours, which is why I have been a little absent from social media! But I can honestly say that I learned so much during my Pediatric Rotation and all of those hours of driving were completely worth it. I had a really tough preceptor and she had extremely high expectations of me, something that took some getting used to the first few weeks. But I ended up excelling under the pressure and I’m so thankful I was able to do my rotation at this site.
Here’s a little look into what a typical day was like:
Wake up and shower. I made the same breakfast every morning of egg whites, hash browns, and 2 pieces of bacon to give me some fuel throughout the long day. After I made breakfast, I would spend the rest of my time before leaving for work doing some simple studying – typically I did practice questions in the morning.
I ended up wearing my hair up every day during this rotation (because toddlers and babies can pull hair), so that saved me a lot of time in the morning and at night while I was getting ready. I typically just washed my face, put on my acne medicine, a light moisturizer, sunscreen, and I was ready to go for the day.
This is the time I left every morning. Most mornings I listened to Physician Assistant Exam Review podcast on my way to work. It was pretty stressful the first week I was driving, because I only moved my car to DC for this rotation and I wasn’t used to driving in the traffic, but by the end of my rotation I was an old pro.
Arrive at clinic. Depending on how I felt, I either studied in my car until clinic started at 8am or I closed my eyes to take a little nap. I have the amazing ability to be able to nap any time, any where, and it really came in handy with this rotation.
Clinic doors opened! My preceptor ran a half an hour late every morning (super annoying), so I used that half an hour to set up our laptops and start looking through the charts of the morning patients to get an idea of what kind of cases I would see.
Patients were scheduled for 15 or 30 minute appointments depending on what they were being seen for. We did a TON of physicals during the first 3 weeks I was on rotation because school was getting ready to start. I was actually very happy with the way this worked out, because I found it really helpful to see a wide variety of healthy children to have a comparison for when I saw sick visits.
With that being said, we also saw multiple sick visits every day and these numbers dramatically increased once schools started and kids started sharing germs. Some of the more common cases we saw were strep throat, viral URI, constipation/diarrhea, rashes, croup, and asthma exacerbations. In office, we could test for strep, influenza, and mono, and we also did urinalysis. For every sick patient that I saw, my preceptor required that I gave a brief oral presentation with history, pertinent review of system findings and past medical history, physical exam findings, and then my top differential diagnoses with their accompanying treatment plans. It was honestly really intense at first, but I think it made me into such a stronger provider.
Our patient population was a pretty wide range from below poverty level to very affluent, which really affected the kinds of conditions that these patients presented with and their family’s understanding of their condition. Learning how to adjust my expectations of what the parents were able to provide in the history was something that was challenging for me at first – I couldn’t understand how someone wouldn’t know how many ounces of formula their baby drinks at a time. And I had to learn how to ask a question in many different ways to get the best possible answer and the biggest picture. Seeing pediatric patients is so much different than seeing adults, and it took some adjustments from my Primary Care rotation.
Typically, we had about an hour and half lunch break. Most days we ran like 15-30 minutes late (which was why lunch was so long – to ensure that we actually had time to eat if we ran far behind). Some days we also went to see new babies in the hospital to do their first exam. The pediatrician I worked with routinely saw babies in 2 hospitals near her clinic. During the drive we would discuss cases that we had seen that morning, or anything interesting and unique that she had seen in the past.
On days we didn’t go to the hospital, and weren’t running horribly behind, I would do some studying during my lunch break. Typically this is when I would read Case Files, because it was something light to carry to and from work every day. Or, I would look up diseases on Up-To-Date.
This was the start of the afternoon visits. Very similar to the visits of the morning, though there did tend to be a good deal more sick visits in the afternoon.
This was the “official” time that we closed the office for the day, but most days we ran 30-40 minutes late. The 2 hours of visits were reserved for just sick visits – so no physicals were scheduled for this time. So depending on how acutely ill the patient was, and if we needed to do nebulizer treatments in office for wheezing (something that was pretty common), would determine how long those visits actually took. I found that most parents really appreciate the fact that sick visits were guaranteed access during the later hours of the day, because if they had to take off work to pick up a sick kid from school, this was typically the earliest they could get to the office.
Once we finished seeing patients for the day, we reviewed all of the charts and signed off on the day’s notes. One of the best things about this office’s setup was that I was given my own laptop to use during the day! It’s seriously helpful to be able to chart as you go. For every patient that I saw, I charted every aspect of the visit. So I would typically write in my top differential diagnosis and treatment plan for the Assessment and Plan portion of the note, and then my preceptor would go in at the end of the day to make it official and make any needed changes.
Typically, this was about the time I left the office. It took me anywhere from an hour to an hour and 15 minutes to get home at night, depending on the traffic. I normally called my mom during my commute home, or listened to music.
I also ate my dinner in the car as I drove – which was almost always a peanut butter & jelly sandwich. I was normally too hungry to be able to make it all the way until I got home to eat, and eating a sandwich in the car was something simple.
I would get home, take a shower, and do an hour or two of studying every night. My preceptor had this amazing habit of giving me “homework” every night, which was something that she thought would be helpful for me to look up based on the cases that we say that day. I would look up her suggested topics, and then I would work my way through the PAEA EOR Topic List.
After I finished study, I tried to give myself around 30 minutes of unwinding “me time” every night. This was anything from watching an episode of HIMYM to reading a chapter or two in a book for pleasure.
I didn’t end up working out during the week these past 6 weeks. It wasn’t something that I felt fit neatly into my schedule, and there were things higher on my priority list. I do regret that decision, because I think doing regular exercise would have helped me feel more energized.
I tried to go to bed no later than 10pm every night just because of how long my days were, and how mentally fatiguing they were.
So that’s a breakdown of a typical day during my Pediatric Rotation. I seriously loved every moment of my rotation and I learned so much from my experience! Next stop is Inpatient Medicine. I’m definitely going to miss the kids and the conversations I had, but I’m looking forward to going back into a hospital setting – I had done all of my patient care experience in a hospital. I love the dynamic there, and I’m looking forward to seeing how Inpatient Medicine goes.
I hope you enjoyed this little look into what my Pediatric Rotation! I’m hoping that with not having as long of a drive for Inpatient Medicine, I’ll have some more time to post updates. I’m also going to be doing the usual posts on what was in my pocket during Pediatrics and how I studied for the EOR exam sometime this week. As always, feel free to follow me on social media (Facebook, Instagram, Twitter), or subscribe to the blog to get a better look as I try to survive life with a stethoscope and some sparkle.