A deepened respect and admiration for residents and fellows: A SickKids staff member gets a unique perspective as a patient mom
In honour of Resident and Fellow Awareness Week, Melanie Hamilton, Education Program Manager, Critical Care Medicine at SickKids, shares her experience as a parent as her child received care from SickKids residents and fellows.
I’ve worked with SickKids residents and fellows nearly every day for the past five years, ensuring that their education and training requirements are being met. While my work is mainly behind-the-scenes and mostly in front of a computer, I thought I had a pretty good understanding of the roles that this group plays at SickKids. I knew they work long hours while on service and have plenty of training responsibilities, including academic and research activities, that fill the rest of their days and nights.
But now that I've had the opportunity to work closely with SickKids residents and fellows in another capacity — as the mother of a newborn patient in the Neonatal Intensive Care Unit (NICU) and General Surgery — I have a deepened respect and admiration for their work. My family's experiences over the last six months have demonstrated to me, first-hand, the value and significance of SickKids' mission.
Walter’s birth at another Toronto-area hospital was relatively uneventful. However, in the hours following his birth, it became clear that something was not quite right. Walter was listless, disinterested in feeding and couldn't maintain an appropriate temperature. After being transferred to that hospital's NICU, his condition remained poor. We were soon discussing a potential transfer to SickKids with the staff neonatologist.
Before being transferred to SickKids, we met a paediatric senior resident from SickKids on rotation in that hospital’s NICU. The resident spoke to us with confidence and great care, explaining a tentative course of action that gave me and my husband the sense that things were under control despite how terrified and tired we felt. We were stunned to learn that the resident had only been at the hospital for four days, as their rotation had just started. Upon reflection, it’s really quite amazing how residents and fellows seamlessly transition from one rotation to the next, and sometimes one site to the next, with such ease. They are required to familiarize themselves and become part of the fabric of a new team and service immediately. The medical education administrator in me knew this, but I had never internalized how challenging it must be to acclimatize so swiftly.
As Walter’s condition worsened, we waited for an inter-hospital transfer to SickKids. We were told by the staff physician that a transfer could take a day or longer, particularly given that it was (very) early in the morning on a weekend. But the staff physician assured us that the senior resident was on the case and doing everything possible to expedite the transfer. Unbelievably, within only a few hours, SickKids' Acute Care Transport Service (ACTS) team, which supports safe transfers for sick and critically injured children to the hospital, had arrived. Walter was whisked by ambulance across the city to the SickKids NICU. It was hard to believe the speed and efficiency with which this all happened.
Walking the halls of SickKids wearing a parent/guardian badge felt very different than what I was used to as a staff member. While immersed in the clinical environment surrounding my son, I relied on the NICU and General Surgery fellows to answer all my questions (and re-answer my questions over and over again, at all hours). As my husband and I were overcome with fear and dread, the fellows patiently and caringly answered our questions and explained the planned procedures in clear, direct and accessible language. In some cases, I stood in the room and watched these procedures being performed on my son at the bedside. There is so much going on in these moments beyond the procedure: a newborn's discomfort and confusion; the parents' fearful and expectant eyes; the noise of the clinical environment, and the trainee’s own assessment of their performance.
Walter was ultimately diagnosed with a condition that is generally correctable with surgery. He spent about a week on the General Surgery unit as my husband and I learned how to care for him at home while he waited for his procedure. Here, too, the surgical residents and fellows played a central role in Walter's care and our education.
In the fall, after a couple of anxious and occasionally complicated months at home, we returned to SickKids for the big day. Under the leadership of one of the most caring and wonderful staff surgeons one could imagine, Walter underwent a six-hour surgery, again crucially aided by the SickKids trainees. By all accounts, the procedure was a tremendous success. Three months later, we now have a bouncing, giggling, content six-month-old baby who has only a couple of tiny dot-sized scars on his belly as evidence of his journey so far.
I have often said that it’s the people at SickKids that make it such a fantastic place to work. While at the hospital with my son, I met so many phenomenal people to whom I will be forever thankful for the unparalleled care our family received. But I now have an even more fondness and appreciation for the residents and fellows at SickKids.
Their adaptability, professionalism and kindness stand out to me as qualities that ought to be celebrated during Resident and Fellow Awareness Week and beyond.
It has been a very humbling experience for our family to witness the many people who rallied around my son. As he gets older, I look forward to telling him about the people at SickKids who helped him so early on in his life. I’ll be sure to highlight the many residents and fellows who took such good care of him. And I will speak with pride about the small role I get to play for some of them along their medical education journey.