Around Bonfire Night, we featured a blog from plastic surgeon Chris Munson. Well – now it’s time to hear from the other half of this medical power couple: Lauren Hill, Paediatric Registrar. This is a longer blog than usual but our chat was full of useful information which we wanted to share with you.
It can be so daunting having to take your child to hospital.
Yes very daunting. Despite knowing the corridors of the hospital like the back of my hand, I felt like a fish out of water myself when my 14 month old baby was admitted to hospital! Hospitals smell funny and can be a mass of noise and chaos; but I want to reassure you that amidst all that there is some kind of order you can expect when you first arrive. I also want you to remember it is our first priority to look after your child.
So what happens when you first arrive with your poorly child?
When you first arrive, we have to identify who your child is and who is responsible for them. They are then ‘triaged’ which means you are allocated a level of need.
Why do you have to wait when others are seen by a doctor straightaway?
In triage, we identify very sick children who need immediate medical review and intervention. This is why it can appear that other families are ‘jumping the queue’. Your child’s level of need is based on a score allocated to heart rate, breathing, temperature and level of alertness – otherwise known as ‘observations’. Observations will be done throughout your stay and indicate whether or not we need to be worried and escalate treatment. Equally, they may reassure us that although your child is unwell; he/she may just need TLC from a clued up parent at home.
So what happens after triage?
You then begin your first story-telling mission to your allocated nurse. Our nurses will oversee your care; from making sure you are reviewed by the medical team at the appropriate time, to getting hold of a breast pump or nappies. They are great emotional support and will be a good listening ear during what can be an emotional journey. You may be seen by a more Junior Doctor or highly skilled advanced nurse practitioner before being reviewed by the Registrar or Consultant. This is when we gather detailed information to help us decide on the right investigations and treatment. Rest assured the senior team always have a handle on what is happening in the A&E department, admission unit and in the ward.
There are so many job titles in hospitals. What do they all mean?
It can be confusing as there are so many doctors at different stages of training. The most recently qualified doctors are FY1s, and after this there are a number of doctors which come under the banner of senior house officers ‘SHOs’. These are all junior doctors who are pre- or early in their specialty training. The senior doctors are ‘Registrars’, who are training to become ‘Consultants’. The senior Doctors oversee the patient flow of the unit. We use our experience to decide whether a child is safe to go home and look after the sicker patients.
Why do we often have to wait so long?
When you first come into hospital with your child, we are trying to answer the following questions:
- What is wrong with your child?
- Do we need to do anything to give us more answers – get a wee sample, do a blood test, order an x-ray for example?
- Is there any immediate treatment we can give your child to make them better?
- Do we need to observe your child for a longer period to see how their condition evolves?
- Does your child require admission to hospital? Is there anything different we can do in hospital that won’t be available to you at home?
Is there any advice you would give to parents bringing their child into hospital?
I would encourage you and your family to ask questions. Don’t be scared to ask for clarification if we use ridiculous words or if you think something hasn’t been clearly explained. It is part of our job to communicate well and sometimes we need reminding to do that in a better way. Good questions to ask are:
- What do you think is going on?
- Are you worried about them?
- What is preventing us from going home?
- When do I need to bring them back to hospital?
Lastly, if there is a clear moment amidst the chaos of turning up to hospital, bring along your child’s red book!
Thanks so much Lauren. I know that your blog will be really useful for parents and carers.