some advice for doing SubI in Peds

[mochamuffins]

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Hello,
I need some advice for doing really well in my subI in pediatrics in September. I am very nervous about it because it is in my top choice place and the PD will be the covering attending the last two weeks. I was also expected to have more inpatient experience but they accepted me anyway to do the SubI. They have already sent me my call schedule and the names of the members on my team. I am just finishing up a family practice rotation and then have some required short course at my medical school and then doing a primary care rotation in August. So in the mean time, besides the Harriet-Lane book are there any other books I should be reading in preparation? Also, it sounds like that we are responsible for putting in all IVs, blood draws, lines etc. I have never done this on an adult, never mind a peds patient. Any ideas on how to prepare for that without tortuting the poor kid?
Some days I just take the attitude that I will just crash and burn and may forgoe my chances of matching in the program. On other days, I try to look at it as an excellent learning experience and figure that it would be better to make certain mistakes still as a medical student than as a fresh green intern. The days in between my stomach does flip flops.........so any advice is appreciated ( or maybe I need to take a valium).

 

[TexasRose]

Hello,
I need some advice for doing really well in my subI in pediatrics in September. I am very nervous about it because it is in my top choice place and the PD will be the covering attending the last two weeks. I was also expected to have more inpatient experience but they accepted me anyway to do the SubI. They have already sent me my call schedule and the names of the members on my team. I am just finishing up a family practice rotation and then have some required short course at my medical school and then doing a primary care rotation in August. So in the mean time, besides the Harriet-Lane book are there any other books I should be reading in preparation? Also, it sounds like that we are responsible for putting in all IVs, blood draws, lines etc. I have never done this on an adult, never mind a peds patient. Any ideas on how to prepare for that without tortuting the poor kid?
Some days I just take the attitude that I will just crash and burn and may forgoe my chances of matching in the program. On other days, I try to look at it as an excellent learning experience and figure that it would be better to make certain mistakes still as a medical student than as a fresh green intern. The days in between my stomach does flip flops.........so any advice is appreciated ( or maybe I need to take a valium).

If you're really expected to start the IV's, etc, is there any way to get a couple of weeks experience in anesthesia before you go? I've made it all the way to 4th year without starting a line, either. Any time there was a need (rare because the nurses do it at our hospital) for a line or LP, the intern would jump on it. I'm taking an Anesthesia elective to get practice before intern year.

If you don't have the opportunity to practice before hand, then just tell your upper level that you haven't done it before and ask for a "see one, do one" approach with your patients. I'm sure they'd rather have you admit to inexperience and ask for guidance and not hold it against you.

 

[ChildNeuro]

Hello,
I need some advice for doing really well in my subI in pediatrics in September. I am very nervous about it because it is in my top choice place and the PD will be the covering attending the last two weeks. I was also expected to have more inpatient experience but they accepted me anyway to do the SubI. They have already sent me my call schedule and the names of the members on my team. I am just finishing up a family practice rotation and then have some required short course at my medical school and then doing a primary care rotation in August. So in the mean time, besides the Harriet-Lane book are there any other books I should be reading in preparation? Also, it sounds like that we are responsible for putting in all IVs, blood draws, lines etc. I have never done this on an adult, never mind a peds patient. Any ideas on how to prepare for that without tortuting the poor kid?
Some days I just take the attitude that I will just crash and burn and may forgoe my chances of matching in the program. On other days, I try to look at it as an excellent learning experience and figure that it would be better to make certain mistakes still as a medical student than as a fresh green intern. The days in between my stomach does flip flops.........so any advice is appreciated ( or maybe I need to take a valium).

Starting an IV and doing blood draws is very easy to learn, and I'm surprised that some third years don't know how, I probably did one a day on surgery. But don't fret! It is so easy to learn how, and you don't want to show up without this skill. I would put on scrubs and a white coat, go to ED of the hospital you are rotating at ASAP, or preop, or even medicine floors at night, and find a nurse and say that you really MUST learn how to draw blood TODAY, they will probably help you, or assign you to a phlebotomy tech, and they will let you do it. It is so satisfying when a resident on a rotation asks if the CBC, coags, etc. . .are back for a patient and you say that you did it yourself and hand-walked it to the lab. Practice using a "butterfly" ask for it by name, as these are used so often in pediatrics because of the tiny little veins that kids have. It doesn't take weeks to do this, if you do it 2-3 times you know what your doing generally, the only hard part is finding all of the stuff you need. Also, ask to see ABGs done, it is good to know how to do them too. I would review coursebooks for pediatrics clerkship like pediatrics first aid, blueprints and case files as many as possible, the more you know helps . . . have a good attitude, and go in the weekend before the subI starts if allowable, just to familiarize yourself with where the stuff is on the floor, ask a resident/intern to show you around, but also reciprocate by helping them out. Know before day 1, where the lab, where radiology is, where the charts are, where the vitals are, where the tubes for cbc are, where the tubes for coags etc are, how to send labs, how to logon to computer network to get labs, how to get radiology results, then walk around the hospital a bit to familiarize yourself. I always pre-tour the days before a rotation, always. Learn the vampire techniques at your home institution before you do your audition subI, nothing says "I am not motivated" more than a fourth year who doesn't know how to get blood as there are numerous opportunities during third year on all rotations except psych. (Not to be judgmental, sometimes you don't know how to ask, or as you said interns take it away, but this IS the perception).