A typical Thursday for a Paediatric Cardiology SHO begins early, with the day starting at 07:30 for a multidisciplinary team meeting involving cardiology and cardiothoracic surgery teams. Although the SHO arrives slightly late, their role primarily involves listening and gaining insight into the patients’ situations, which is crucial for their development and understanding of complex cases. The routine is slightly more demanding this week due to the long day shift, requiring a 07:10 departure from home, which is an improvement compared to previous placements.
During the meeting, registrars present patient cases, detailing the medical histories, current conditions, and treatment plans. Consultants discuss various medical and surgical approaches to ensure comprehensive care for each patient. This collaborative effort minimizes bias and ensures that every patient receives input from multiple experts, fostering a culture of shared responsibility. After the meeting, the team conducts a quick handover, which is efficient since everyone is familiar with the patients from the previous day, allowing for a smooth transition into the day’s activities.
Following handover, the SHOs prepare for the ward round, typically starting around 09:20. They review patient notes, vital signs, and any urgent tasks, such as scan requests or blood tests. This preparation is essential for ensuring that they are fully informed about each patient’s status before the round begins. The ward round officially starts around 09:30, with the consultant and registrar discussing cases while the SHOs assist in gathering information and performing examinations. With three SHOs available, the efficiency of the round improves significantly, allowing for more comprehensive examinations and discussions about patient care.
The team sees all patients in the high-dependency unit (HDU) and splits the ward round to maximize efficiency. The other two SHOs accompany the consultant, while one pairs with the registrar. This division of labor allows for thorough examinations and ensures that everyone learns about the patients’ clinical conditions. The SHOs alternate examining patients with their seniors, ensuring that everyone gains a thorough understanding of the patients’ clinical states across the week. They make notes on necessary tasks and treatment plans, ensuring that all actions are documented in the electronic system for continuity of care.
By 11:30, the team completes the ward round, having requested several tests and coordinated with nursing staff for necessary blood draws. They also discuss any concerns raised by nurses about specific patients, which is crucial for maintaining patient safety and addressing issues promptly. They then transition to the midday handover, discussing updates from subspecialty teams and advanced nurse practitioners. The consultant leaves for a crucial midday bed meeting, highlighting the challenges of bed availability in the hospital, which can impact patient transfers and surgeries.
From noon until 17:00, the SHOs handle various tasks, including discussions with other teams, reviewing patients flagged by nurses, and admitting new patients. They also manage blood draws and cannulations, which can be particularly challenging due to the patients’ complex cardiac conditions. Many patients have difficult venous access, requiring skill and patience. Fortunately, the presence of multiple SHOs allows for a more manageable workload, and they even find time for a sit-down lunch and some teaching from senior doctors, which is often a valuable opportunity for learning.
As the day progresses, the SHO faces a few challenges, including an unplanned cannulation for a baby who lost their access. They attempt the procedure twice but are unsuccessful, prompting a discussion with their registrar about the best approach moving forward. After evaluating the situation, they decide that the patient does not actually need the cannula, demonstrating the importance of rational decision-making in medical practice and the ability to adapt to changing circumstances.
At 17:00, the day team hands over to the evening team, which includes a consultant and a new registrar. The handover is thorough, ensuring the night team is well-informed about the patients. The SHO has a manageable list of tasks, primarily focused on updating patient information, preparing for evening admissions, and ensuring that all documentation is complete.
The night shift begins with the SHO finalizing admission summaries and ensuring that all patient information is accurate and up-to-date. Although they stay a bit later to complete these tasks, the effort prevents any disruption for the night team, allowing for continuity of care. The experience highlights the importance of thorough communication and preparation in medical practice, especially in a high-stakes environment like paediatric cardiology.
By the end of the shift, the SHO reflects on the day’s challenges and successes, appreciating the collaborative environment of the paediatric cardiology team. They feel a sense of accomplishment from the day’s work, knowing they contributed to patient care and learned valuable lessons along the way. With four long days behind them, they look forward to a well-deserved day off, knowing that each day in this role enhances their skills and understanding of paediatric cardiology. The experiences gained during these shifts are invaluable, shaping their future practice and commitment to providing high-quality care for their patients.
