I’m recently coming off of a 2 week stretch of being in the NICU. This is the my first time being back there since the start of residency over a year ago. I always felt like neonatology was such a different practice of medicine compared to adult medicine and even general pediatrics. While I still think this is true, it’s interesting to see how of year of honing clinical skills and understanding physiology better translates into growing competence and confidence across the board.
We had some pretty tough cases this time around. During my first bout in the NICU was pretty uneventful, at least from what I remember. This time around definitely had more going on. I had the opportunity to place multiple umbilical lines and do a little ultrasound practice. We had a lot of premie births, including a pair of 22 week old twins that were born, weighing less than 500 grams each, a few resuscitations at delivery, and unfortunately a code blue.
It was tough in a different way that adult medicine is tough. With adults and a lot of general pediatrics we have all this evidence to guide clinical practice to the point where so much of it can be algorithmic. With the neonates so much is clinical not only because the lack of robust data compared to adults, but also because so much changes in management based on the gestational/ PMA of the patient.
Overall I learned and grew a lot from this short NICU block and I’m looking forward to getting another 2 weeks later this year (my last ones ever).
nANIMOv 