Tuesday, September 4, 2012

Adventures in Babysitting -errr, Pediatrics!

Posted by mariarx at Tuesday, September 04, 2012

Oh man, I can't believe it's already rotation 4! The quiet summers of empty Ann Arbor are gone... soon we'll be entrenched in computer turf wars with the P3s on their direct care IPPEs. Before we get too far into rotation 4, I wanted to look back at my adventures in peds.

Our PY team. I like to think I'm the girl with the gold viking helmet hanging on for dear life.

The generalist rotation, new and required this year, gives you the option of working on the adult (UH) side or the pediatric (Mott) side. I decided to take the plunge and go with peds. Who doesn't love kids? Me. But I did like working with their meds. My mom would be so proud. 

My day on the generalist rotation started with rounds prep. On any given day we had between 2-6 patients admitted to the PY (pediatric gold) team. That isn't a lot of patients... until you realize the work that goes into peds dosing, indications, etc. For each patient I tried to get a good idea of their problems and what all their diagnoses meant (helloooo Google), their dosing regimens, weight based dosing, daily maxes for the medications, indications, and any alternatives that I may be asked about. Safe to say my monitoring form looked like a rainbow in trying to keep all the info divided. My preceptor, Jenny Hlubocky, was really good at giving pointers for keeping everything straight and reminding me to focus on the drugs and not get lost in the world of googling mowat-wilson disease.

One aspect of peds drugs and dosing that I didn't really think about before this rotation was the taste of oral meds. Unfortunately, tiny mouths and esophagi are not made for swallowing tablets - which is where solutions come into play. Doing the taste test with Dr. Streetman and the medical students was really fun, even if I did get a headache from all the random drugs we tasted. Note to the public: linezolid, clindamycin, MVIs, and iron taste GROSS; and chocolate syrup is Dr. Streetman's gift to little kids everywhere. 

After rounds my partner-in-crime Vince and I would go over our patients with Jenny, maybe work on orders for our services, and then have the afternoon to do individual work. Besides our general PY patients, we also worked up the rehab patients in Mott. These patients are usually in the hospital for a really long time (and have a really long MAR), so we would make sure that doses were appropriate and make recommendations for cleaning up the med list - such as getting rid of PRN meds that hadn't been used in a while. 

Our final patient interaction component was med reconciliation. I feel like I spent the majority of my afternoon work hours trying to find parents to speak with about their kids medications... the laws of not speaking to minors alone make medrecing quite the difficult task. 

Besides patient interactions and monitoring, we also had some mini-projects and 2 bigger presentations. Mini-projects consisted of topic discussions about things that may have come up in our talks about patients or just interesting topics in the world of peds. In the effort to bring my own interests into the pediatric world, I ended up presenting my journal club and larger topic discussion about pharmacy administration and its role in the inpatient stay and discharge. Dr. Brummond and Dr. Kelley would be proud (I think). 

Overall, I'm really glad I picked the pediatric side of the generalist rotation. I don't have any other peds rotations on the horizon so this was a good adventure to have. My 4th rotation is ambulatory care in oncology... you'll hear about that soon enough if I make it out alive. Till next time, keep saving lives fellow P4s! 

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