Tips for Locuming in a New Specialty – Paediatrics
You may have chosen to do an F3 year for lifestyle reasons, to try out different specialties you didn’t get during your foundation rotations, or to gain more experience in a specialty you’re particularly interested in. Of course, if you’re a current F2 or F3, you might've missed out on rotating on to different specialties because of the coronavirus pandemic.
Whatever the reason, at some point you may find yourself working in Paediatrics for the first time having no previous experience in it!
This can seem like a daunting prospect, but this article will explain what the job will be like, highlight the common clinical scenarios you’ll likely come across, and share some tips to help you prepare for starting the job!
Where Will I Cover?
Most hospitals have a similar spread of clinical areas you may work in as a Paediatrics SHO.
In different units you might be asked to cover both Neonatal and Paediatrics, although in some larger units there would be two SHOs for this.
Delivery Suite/Labour Ward – Different units will call these different names. They'll be run by a Labour Ward Coordinator, who will be very knowledgeable and a good point of call for any questions.
Obstetric Theatres – Most units have one or two dedicated theatres which are usually very close to the Delivery Suite. These will be for elective and emergency procedures, which you could be asked to attend for deliveries.
Postnatal Ward – Postnatal women who stay in hospital tend to stay because their baby needs extra observations or treatments, because the mother needs support with feeding, or because the mother needs treatment.
Paediatrics Ward – These will also usually have a Children’s Assessment Unit (CAU) or something similar attached to it, or run from it. The ward may also have patients that have been admitted for treatment or observation.
Accident and Emergency – You may be asked to assess children in A&E. Most of these will have a separate area for children to be reviewed in.
Clinics – You may or may not spend time in Paediatrics clinics as an SHO. If you do, it will be very well supported by senior colleagues, so the rest of this article will focus on your on call role.
What’s the Day-to-Day Like?
When covering Paediatrics on call, your daily responsibilities will include:
Participating in ward rounds with the consultant or registrar on the children’s ward or Neonatal unit.
Reviewing children on the ward and providing discharge letters or prescriptions.
Assessing children in A&E or CAU. Most of the time, at the beginning, you'll be able to ask the registrar for advice with these, as Paediatrics is a very well supported specialty.
Being present in theatre for elective C-sections where there is a foetal alert on the system, for example if the baby has a known medical problem from anatomy scans.
Being present in theatre for any emergency C-sections, in order to review the baby if they were delivered in poor condition.
Reviewing babies postnatally and screening for problems. For example, doing a septic screen if the mother had a temperature in labour, or the routine new-born and infant physical examination (NIPE) screening examination that all babies have after delivery.
Attending Paediatric emergencies. You'll tend to hold the Paediatrics crash bleep and will be called if there's any concern that a child or baby is extremely unwell or peri-arrest. On Delivery Suite this may include being present at emergency instrumental deliveries, crash C-sections, or if a baby is born in poor condition. Usually your role in these situations will be to assist with life support measures, sometimes to cannulate, take bloods or do capillary blood gases, or to help in general. This general support could involve scribing, gathering equipment, or checking observations. You'll also need to be trained in Neonatal Life Support to assist in emergencies.
Our Top Tips
1. Try to get some initial taster experience beforehand if possible.
2. Practice getting observations and taking bloods from children or neonates if you can.
3. Read up on Paediatric emergencies so you know what to expect, and make sure you're up-to-date on Neonatal Life Support training.
4. Use the trust guidelines to help you, including antibiotic guidelines.
5. Ask for help if you need it! People will be happy to offer support.
Paediatrics is very different from other specialties, and you're likely to need a lot of guidance and advice at the beginning, but this is completely normal and to be expected. The seniors tend to be very approachable and helpful, and most decisions are led by the senior doctors.
If you follow our tips and advice, it should make the process of starting work in Paediatrics for the first time much less daunting, and you should be able to hit the ground running when you start!
We've also written guides for each of the main specialties, giving you tips on how to settle into those departments. These are especially useful if you haven’t rotated through that specialty in your Foundation Training rotations.
Tips for Locuming in a New Specialty – Emergency Medicine (Coming soon)
Tips for Locuming in a New Specialty – Trauma & Orthopaedics (Coming soon)
This article is part of a wider series, supporting doctors like yourself with a comprehensive set of guides to ensure your F3 year is a success. These guides cover everything from initial planning, options for moving abroad, help with finding work, and tips for making the most of the experience. Click here to visit our F3 Resource Hub to explore the full list of guides and articles.
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