Often times, pediatrics can be referred to as a different world in medicine. During the first few days of this rotation, I found myself completely shocked at least once a day. My first shock came when I realized working in pediatrics is not always going to be hanging out lollipops or prescribing cough suppressants. New surprises came in quick succession.

During my rotation, I was fortunate enough to have experienced different aspects of peds such as pediatric emergency, NICU, primary care, neurology, and endocrinology. In each sub specialty, I always learned something knew and faced different challenges. Pediatric emergency is where I was constantly practicing my history and physical skills. I found difficulty with keeping the interview concise and problem-focused because it is a faced paced environment and I don’t have all the time in the world to do a deep dive. With the help of my different preceptors, I was able to improve this skill by focusing on specific questions that included pertinent positives and negatives. For example, if a child came in with complaints of diarrhea it was vital to ask about how many episodes today, what the diarrhea looks like, if the child has been tolerating liquids well, and if anyone in the house is sick.

To my surprise, I discovered the value of technology during this rotation. Many times, parents came in concerned about an episode of vomit or diarrhea looking out of the ordinary. Thankfully, these worrisome parents took a lot pictures and it would help the providers build better differentials. I remember a mother came in freaking out about her child sticking a toy up his nose. She showed us a picture of what it was and it turned out to be candy! This allowed for a less urgent situation because we put him under observation to wait for it to dissolve, rather than attempting to fish it out with forceps.

I learned very quickly that pediatrics you deal with 2 patients – the child and the parent. My preceptors reminded me that it was important to differentiate what the parent says versus what the child says when I presented. After a few days, I grew more comfortable with solely interviewing instead of asking the parent all the questions. I found that parents tend to exaggerate their child’s current illness.

According to typhon, I have seen 124 pediatric patients and it was enough to teach me a lot about myself and as a PA student. I learned how to adjust my presentation of a patient to different preceptors who had styles. I learned how to place a central line in a newborn via the umbilical vessels. I learned that asking about liquid tolerance is more important than food tolerance in children. I learned that the APGAR score will never be a 10, the highest is always a 9. I learned how to perform a physical exam on a child who is mortified of providers. I learned how to understand a parent’s concerns and worked with that to tailor the reassurance they needed to hear. I have a lot of improvements to make when it comes to throwing myself into doing more procedures. Going forward, I will learn to develop differentials early on and facilitate discussions with my preceptors because thats when I learned the most. I will carry everything I learned in this rotation to the next. This was my first rotation and it was truly memorable!