Day in the Life of a Paediatric Intern

This post originally titled, Waving the White Flag. (It’s Kleenex).

Where to start with Paediatrics? The current headlining scandal? The mind-numbing, soul-crushing duties? The prickly staff? The demanding work days? How about all of it, all at once, the way it is in real life. Nothing about this rotation happens in an orderly fashion. One time our senior registrar scolded us for not completing discharge summaries on time, saying “they are just as much a priority as dealing with procedures for patients on the ward and from clinic and giving medications”. If it’s one thing Paeds has taught me, it’s that everything can be a priority, all at the same time.

But all this non-stop action has succeeded in murdering my already feeble immune system so that I am now sick. With the flu. Probably. Or tuberculosis. Probably (not). If you know anything about me, it should be that I do not handle illness well. I handle it like a boy, really. Which is probably sexist to say but we all know it’s true. Boys are complete babies when they get sick. And so am I. I curl up in the foetal position and demand soup in a voice that sounds like death colded over*. I am utterly useless at anything involving physical, mental or emotional energy and I sometimes fantasise about using telekinesis instead of getting up to retrieve my phone from the counter five feet away.

Going to work today was entirely out of the question, so I used my leftover energy to feel guilty about calling in sick. I know what a Paediatric work day is like. I also know that I have duty tomorrow and I had to make the decision to take today off so that I could have some reserve of energy with which to survive that 36 hour beat.

This is what a Paediatric work day is like for me:

Starts at 8AM (unlike Surgery which would start at 6:30-7 because the earlier you arrive, the earlier you leave. On paeds you leave late no matter what). At 8AM you see patients on the ward until ward rounds start at about 9:30.

Ward rounds end at about 11AM when you start the day’s procedures which include taking blood, collecting urine samples and sending patients for investigations (like xrays etc). This is for patients admitted on the ward, as well as patients here for the day for a review or patients sent up from clinic.

All intravenous medications are administered by the interns, on a strict schedule. Medication also has to be ordered daily from the pharmacy because they don’t send up more than one day’s supply. This means writing up several charts and getting your senior house officers (SHOs) to sign them because your signatures carry no weight.

Then there is other paperwork like writing discharge summaries and prescriptions for the patients leaving. And there is following up of lab results, mostly cultures from microbiology, that require one of you to go into the lab for about an hour to write down results from the 3-4 books that serve as records.

All this takes you until well into the afternoon and suddenly it’s 3PM and you haven’t stopped for lunch. You just gave the 2PM medication but you can’t eat yet because this baby needs an intravenous access (a ‘drip’) and another baby just got admitted from Accident and Emergency (A&E) needing blood and urine cultures.

There are three of you working but it doesn’t seem like enough. The SHOs will ask “Are you the only one doing procedures? Where’s Dr. So-and-So?” and you will calmly explain that Dr. So-and-So is giving medication while Dr. What’s-Her-Face is in A&E seeing referrals and there’s no one left to help you and they will press their lips together and give you a look which you’re pretty sure does NOT mean “That sounds rough, I’ll help you” and instead means “Well. You’re just gonna have to get your shit together” and you move on with your day. Breathe and move forward should be the mantra of Paediatrics.

After you finish procedures, following up the regular lab results for the samples you took off in the day can take you beyond 4PM because some result always comes back abnormal and needs to be acted on. I don’t like to leave that kind of work on the duty intern because duties are rough enough without adding work that’s carried over from in the day. So I never end up leaving before 6PM and usually leave around 8PM.

I’m not going to get into my eating habits because my aunt reads this blog and would probably have a conniption but suffice to say I would not turn down the offer of a live in chef. Or maid. Or professional masseuse. Or all three in one so I’d only have one monthly fee. Am I setting the bar too high?

Fuck it. The bar was high before I even got here. This whole time I’ve been trying to brush it with my fingers, on tiptoe, stretching furiously toward some untouchable standard. Today I got to rest my aching body/mind/soul for a teensy bit. Tomorrow it’s back to the rack.

Flecti non frangi.

_______________________________________________

(*Because death warmed over sounds a little too pleasant. Like Death already got soup and a blankie and now he’s pleased as punch. Although I have been told that my sick voice sounds very sultry so maybe my voice actually is warmed over).

5 thoughts on “Day in the Life of a Paediatric Intern

  1. Davis says:

    Hey Robyn congrats! I need some advice. I am interested in going to UWI med school (doesn’t matter which campus) but I’m from a non contributing country. Do you think there is any hope for paying the tuition? (28000US$-) Does the university offer any scholarship or bursary or anything for students who are from non contributing countries but are Caribbean citizens?

    Also in your former batch, how many students were in my situation (Caribbean citizens but from non contributing countries)?
    Thanks

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    • Robyn says:

      The university offers a host of scholarships and bursaries but I confess I have never paid attention to the limitations of country of origin. Nevertheless most scholarships are specific to campus so you can always visit each campus website to see what fits you best.

      Not sure there were many students in that situation. My class was very diverse so it’s likely but I can’t speak to any specific person’s experience. That being said it is very probable that a student hailing from a noncontributing country was able to afford the fee.

      Good luck with finding a source of finance. My post on financing tertiary education may also offer some more details re scholarships and loans etc.

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  2. kimmykimz says:

    Hi Davis, this is not Robyn but i;m currently in final year at UWI.
    For our year, there aren’t that many non-contributing students…there are a handful though mostly from Trinidad and Tobago as well as Barbados etc. but majority are Jamaicans. I know in the year group below though (2k17), they have a lot more Caribbean students (ie. outside of Jamaica) as well as a handful from the UK.
    if you are from Trini, turks, Bahamas and i believe Barbados, then the goverment usually subsidizes (or pays the entire tuition) even though u are at the Mona campus. Outside of these islands and non-contributing, I am not aware of any scholarships or bursaries provided as those are reserved (for eg at MONA) for citizens of the country by birth. Most (if not all) local scholarships are also reserved for nationals of the country at which you attending university.
    I’d advise that you check with your own country’s guidelines to see if they have any programmes in place that will sponsor you at the UWI campus…otherwise, its the full 28,000 that would be offered.
    Hope this helps!

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  3. kimmykimz says:

    BTW Robin, is it possible for you to kinna give us an idea of how the first week or 2 of internship was for you? I’m deathly scared that my first days will be me walking on the ward and basically being looked at like “MIss! get to work” …and i should know the whole procedure of what internship entails lol
    Like i’ll just walk in bright and early and be expected to just be seeing patients and doing all that you have described on my very first day! no orientation..nothing!
    ANY ADVISE on that FIRST week of internship? Love your blog btw!!

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