Hospital del Nino

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I began my month of pediatric rotations in Hospital Del Nino on a general pediatric medical floor, following a Nephrologist (kidney doctor) Doctora Bocangel. A very typical, bubbly pediatric doctor who was an awesome educator and communicator!
This state-run hospital treats patients from all over the country and is one of the largest and oldest in the area. We were told, because of the altitude, and the higher pressure (not necessarily that lack of oxygen) this is a beneficial hospital to stop many infections and diseases from progressing.
This hospital has an incredible team of doctors! EVERY single day, a team of at least 10 would visit and give report on each patient. The team included: 2-3 attendings (some of the most intelligent people I have ever met) 2 residents (who would present each case, and then get corrected by the attendings😊, 2 nurses, 1 psychologist, 1 social worker and a slue of medical students, including us.
Throughout the week, besides listening in on reports and progresses, we were able to sit in on consults and “gran rounds,” and of course, MY FAVORITE, play with the patients! 😊
Consults: This was a great learning environment! Each consult took place in Doctora’s office. She would examine each patient (who typically had some sort of urology problem) and then simply prescribe medications, follow-ups, surgeries, etc. Throughout each visit, she would bring us right up to the patient, letting us examine and ask questions. She would also pass the charts out and give us a brief summary and explanation of what was happening.
Gran Rounds: This took place in an auditorium in the hospital. 2-3 cases would be presented through PowerPoint from various department residents. We listened to one from plastics-which was about a small girl who was attacked by a stray dog. The other was from neurology, a 4-year-old epileptic. After the case was presented, the doctors and other residents had an open forum to discuss the treatments and complications of the case. SUPER interesting….the parts I understood 😊
For the Nursing Gals:
1. Lupus! (Very, very rare in children in the US) This particular patient had the hand rash as well as a facial rash! There was a genetic link and the treatment was being continued in a 3 month cycle of antibiotics, antifungal, and anti-tuberculosis medication. This was considered their aggressive treatment because she was so immunosuppressed.
2.Anemia (I think almost every single patient had it to some degree)
a.2 year old boy. The first way the Doctora diagnosed him was holding his palm to hers. His was extremely pale and to her, that was a sure-fire diagnosis. Blood cultures came back with: hmg 1 and hct 5-I didn’t even know these values were possible!
i.They checked him for renal insufficiency: creatine was normal
ii.They checked him for malnutrition: iron was normal
iii.They checked him for parasites: which came back negative
iv.The next test (for some form of lymphoma) was scheduled and the family was refusing because of lack of money.
b.Anemia here is very common, and mainly from the lack of nutrition. These kids are only getting bread and milk. No meat. No fruit. No veggies. The fresh produce they DO get, is never properly washed and therefore leads to more problems.
3.Some major MAJOR differences in sanitation/infection control (I wonder what Professor Welhaven would think…)
a.No gloves are EVER USED>I watched a nurse hang a blood transfusion, start the IV (even dropping it on the bed) and no gloves were ever put on, or alcohol wipes used.
b.There is no IV programming. They simply have a drip rate which they watch with their watches.
c.Breakfast was served to the patients in small plastic boxes; which consisted of a tiny cup of milk and a piece of bread.
d.Patients did not wear gowns and were only bathed at the parent’s discretion.
e.There was a cardboard box of toys for the kids to play with. The toys included a plastic solider with one leg, 3 broken legos, and a calculator with no buttons.
This whole week, my eyes were REALLY opened and there were huge emotional lessons. This all doesn’t seem like much to us, but it is what they know and trust-

It was an incredible first week of observation and experience-really steering me towards pediatrics 😊

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Comments

[Steph]

WOW!
Que ninos tan lindos! :) Sounds pretty eye opening indeed.... that is awesome you are getting to do so much at the hospital and are able to take it all in. Love the pictures! Keep taking good care of those little cute little Bolivian kiddos! :)