||Coincidentally I’m writing these when I’m living the quintessential triple boarder life this week. I make the transition from pediatrics back to child psychiatry this week but for now I am rotating at Primary Children’s in the Pediatric ICU. With such a large catchment area, we see some of the highest acuity cases for multiple states. The hours are longer on this side of the TB experience but still very rewarding. I get to the hospital around 6 am, receiving sign out and begin pre-rounding. I titrate vents, wean vasopressor and sedation drips, and make sure I have enough caffeine available for myself. We round with the fellow, attending, and our co-residents, and it is always a team effort with someone placing orders and someone checking to see if lines can be pulled today. The attending and fellow make sure they take time to teach with pearls of wisdom from every patient. I eat lunch with my fellow residents (yes, there is still time for lunch in the PICU), and we work to make sure everyone gets out at a reasonable time with sign out at 5 pm. I head home, go for a run, make dinner and relax.
||My last day of PICU for this block. I did my usual pre-rounding routine. A particularly sick patient arrived overnight and this is my first stop after sign out. I have concerns about their hemodynamic status so I call for the fellow who is readily available and we elect to begin a norepi drip. My fellow residents are quick to ask if there is anything they can help me with to be sure I get my pre-rounding done. Today is one of the busier days in the ICU but I get through it thanks to my peers and the plentiful free food/caffeine available. I’m still home by 6:30 pm with time to relax and make dinner.
||My first day back on child psychiatry after 6 months of pediatrics. Today I am able to sleep in prior to morning rotation, trauma child psychiatry. My attending greets me with a smile and offers to get me a coffee. We review the patients of the day together and he takes time to ask me how residency is going and what we have been doing for fun during the time of COVID. It is great to know our attendings are so invested in our well-being. Our patients have complex medication regimens but my attending takes time to review it with me and allows me to the autonomy to decide how to best simplify it, while offering feedback. Wednesday afternoons on child psychiatry are dedicated to lectures. I get to see my colleagues and chit-chat about our current rotations. Home by 4:30 and able to go for a run and see a friend.
||This Thursday I am at the Autism Spectrum Disorders clinic. I spend the morning learning about how to conduct and score an ADOS, as well as a WISC. The psychologist is a wonderful teacher, as we can watch the testing through a one-way mirror. Thursday afternoon is for group psychotherapy. I lead a interpersonal group for teens with mood disorders. I have the help of an attending and a therapist to learn how to best conduct the group. One of my most rewarding rotations and a great deal of independence. Even with this busy day I am done with my work by 5pm and head home with time for a sunset hike in the foothills of Salt Lake.
||Despite being on child psychiatry for the next 12 months, I get to do my pediatric continuity clinic. My patient panel today consists of a 2 week well-child exam, concerns for an ear infection in a toddler, an ADHD medication follow-up, and an adolescent sports physical. I relish the opportunity to be able to switch quickly between specialties and utilize the skills I learn in psychiatry on the general pediatrics side. My attending in clinic today discusses psychiatric cases she has seen this week and asks for my opinion on them. A core part of being a triple boarder is education, as colleagues often come to us for thoughts about patients. I’m home by 5 pm and decide on plans for the weekend. Paddle boarding at a local reservoir is definitely on the agenda with this weather. After that, most likely a run followed by biking to a park with a friend. I love to stay busy but Sunday will be dedicated to relaxing in the sun and maybe binge watching a show on Netflix.