NICU elective, British Columbia Children’s Hospital, Vancouver, Canada

My placement at the British Columbia Children’s Hospital has put me in good stead for my last year of medical school and has also prepared me for my internship.

On my first day I was advised that by the end I would have my own patient load, which seemed very daunting.

By the end of my placement I was looking after 3 patients, which doesn’t seem like much but in a NICU they can be very complicated. I was presenting my patient’s at rounds, handing over in the morning and afternoon, examining my babies each day and writing in their notes.

I believe this has made me more confident working independently, with supervision, which will be essential for the coming year and progressing to my internship.

During my elective I was also able to see some very interesting conditions – from the stock standard NICU presentations, to a baby with a right congenital diaphragmatic hernia and another baby with a Vein of Galen.

This ensured I was confident with the management of common NICU presentations but also allowed me to observe the management of more complex patients.

One of the babies on my team also had hydrocephalus secondary to intraventricular haemorrhage and I was able to do a ventricular tap on this baby under the supervision of one of the paediatricians.

I was also able to witness many clinical skills such as lumbar puncture and the insertion of umbilical artery and vein catheters.

In addition, during my last week of my elective I was involved with the care of a baby with Trisomy 13, diagnosed postnatally.

This was a valuable learning experience, as I was able to observe the medical geneticist examine the baby and counsel the mother on the prognosis of this condition, giving me a better idea of how to break bad news.

During my care of this patient I was responsible for calling several specialists, which enabled me to become more confident and competent in appropriately handing over patients to other practitioners as well as communicating in a professional capacity.

Doing this elective has allowed me to become more knowledgeable in my understanding of respiratory and nutritional support for the neonate.

Although they are different to adults, the knowledge that I have gained will be transferrable to the complicated care of sick adult patients.

My elective at the BC Children’s Hospital will be an unforgettable experience due to the experiences I have had.

Some of these babies I will remember forever, and whenever I see another sick child I will draw from these experiences.

This will ensure that in the future I will be confident in the basic understanding and management of extremely sick patients, no matter how complicated the disease process is.