Originally posted by augmel
to HIFI and others,
so far, third year has taught me that i like taking care of kids and i like procedures. what kinds of procedures do neonatologists do most often? is that field the most procedure intensive of pediatric subspecialties?
thanks for any replies.
Can't argue with NSG98.
We do a lot of procedures. My personal favorite is periphaal arterial lines since I think it is by far, the most difficult and technically challenging one of all.
The amount of procedures you do is
HIGHLY dependant on teh type of practice you are in.
IF you are an attending in an academic center, chances are the only procedures you will get to do are the ones that the fellow can't do. If you have a good fellow, you might not do a procedure the entire month ( because I worked with many attendings who never did a procedure in our month on service)
Sometimes, an attending does call at night without the fellow, or does a transport, or covers the unit if the fellow is on a transport. Still, the fellow let's the resident have thr first crack so even if there is no fellow, the most senior person ( attending) might not get to do anything, if the resident is successful
Some months as a fellow, when I did just a few intubations ( and I trained in the largest NICU in America ) because I had a great resident that could always get it.
I worked with a brand new faculty that did her fellowship at a fairly small program, with a small NICU. It was funny because I figured I had probably done 5-10 times the procedures as she had, and I Was only a second year fellow at the time
In private practice, it can be a lot different.
My current unit is a 25-40 bed Level III unit, and there are no residents or fellows. I work with a NNP, and we split up the procedures. I wtill do my own PICC lines, chest tubes, thoracentesis, and art lines because I'm pretty particular about how I like it done.
Neonatology and anesthesiology are a couple of fields where you get really really good at procedures.
I always had a great admiration for IV access skills. I'm pretty good about sticking IV's into tiny babies. My mentor at Baylor could put an IV into a dehydrated mosquito and I tried to model my skills after him.
RT's NNP's Nurses are learning more and more skills.
This is BAD for pediatric residents. Not only are meconium stained infants, not routinely intubated any more ( a time honored maneuver where peds residents learned to intubate) but they are doing less and less time in the NICU, and allied health care people are competing for the procedures.
As a result, residents are graduating having NEVER done a neonatal intubation. Believe it, I have seen it!!!!
