I was very excited for my pediatrics rotation, not only because it was my first rotation, but because inpatient pediatrics was a specialty I saw myself going into. My rotation consisted of 2 weeks in the pediatric emergency room, one week in the NICU/newborn service and one week in the pediatric clinic. 

In the pediatric emergency room I saw a wide variety of cases. I saw many adolescent and pediatric psychiatric cases, many covid-19 rule outs, infants with fever in which we had to rule out meningitis and UTI, acute otitis media, abnormal vaginal bleeding, kidney stones, minor lacerations, dysmenorrhea, palpitations, burns, syncope, sexual assault, allergic reactions and marijauana abuse. This wide variety of cases meant my first few weeks of my clinical rotation were very educational. I got to practice taking problem focused history, and knowing when to expand, I got to practice physical exams, placing IVs, performing nasopharyngeal swabs and strep swabs, I got practice dressing wounds.  The most interesting part for me was educating my adolescent patients on safe sex and pregnancy. I could tell that these were not topics that they were familiar with and that by taking the time to speak to them about birth control, condom use, and the need for regular follow ups with an OB-GYN during pregnancy this would benefit them. One of the aspects I valued in this portion of the rotation was being able to present a case, assessment and plan with a differential to my attending. In the beginning I was not sure what was important to include, but the feedback they gave me was extremely valuable and I could tell that I improved greatly over the course of the two weeks and that was the feedback I got from my attending at the end. 

In the NICU and newborn service, I got to work with a wonderful PA. I attended rounds with her every morning and we performed newborn physicals. I got to listen to many newborn hearts and lungs, I got to practice performing Barlow and Ortolani maneuvers to check for developmental hip dysplasia.  I got to feel the sutures and fontanelles. At the beginning of the week I was not confident with what I was hearing on heart and lung exams, because newborn hearts were much faster than I was used to listening to with the older children the week before, but by the end of the week I was confident with hearing normal heart and lung sounds in newborns. I also got to attend several C-sections and assist with resuscitation of the baby, I even got to cut an umbilical cord. I attended rounds in the NICU each day as well, where we reviewed how each baby was doing, it was really special to follow these babies every day and see them improve as the week went on. 

My final week was in the pediatric clinic, I worked with primary care physicians and specialists. By the end of my primary care days, I was very well versed in milestones, and vaccines, because the clinic was so busy I saw more than 20 patients on each day, I got to practice physical exams and review milestones for many different aged children. 

My favorite specialist on the rotation was with pulmonology. On all of the patients we saw I got to listen to their lungs and review an asthma action plan with the physician. The physician was an expert teacher, and pulmonology is a field I am interested in. I learned how to use several different types of inhalers. For instance for younger children they use a spacer with a mask because it is difficult for them to take one single deep breath in, but with older children they can stop using the mask and just hold their breath using a spacer. 

One thing I need to work on still in the pediatric population is not being afraid to approach a crying child, I was nervous to upset the child further by listening to their lungs or heart, or looking in their ears or nose. It is important for me to remember that doing these physical exams, and even sometimes procedures such as IV placement, is crucial for the health of the child, so even though it may be upsetting for them, I am doing this to help them feel better. For future rotations I would like to practice more procedures. I would also like to improve on my history taking skills, my differential diagnosis, my assessment and plan. 

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