A Day in the Life of a Pediatric Surgeon

Pediatric surgeons are busy with balancing the demands of home and a very important job.
Andrew Schulman1

Have you ever wondered what your surgeon is doing all day? Why he or she is sometimes hard to get ahold of? Why doesn’t “on-call” mean “available to talk”? For insight into the answers to these questions, here is a typical “on-call” day in the life of a pediatric surgeon at Pediatric Surgical Associates.

 

6:00am- My alarm goes off. My wife is already up and dressed, making breakfast for the kids and getting them ready for school. I move my daughter’s hamster back to her bedroom, as it was keeping her up last night. I take a quick shower and shave, then head out to make my operating room (OR) time.

6:45am, deadline for pre-operative paperwork- All patients, prior to surgery, need to be re-examined in the pre-operative area to confirm that there are no changes to their health that would preclude surgery. I also review the surgery with the family to ensure there are no additional questions. The hospital is quite strict about getting paperwork complete 45 minutes prior to the surgery start time so that the OR runs efficiently. Those who fail to meet the deadline can lose privileges to schedule early cases.

6:48am- I look for my patient in the pre-operative area but I cannot find him. The nurses tell me that the family hasn’t shown up and cannot be reached. While the nurses make phone calls and reorganize, I have time for a bowl of cereal and a cup of coffee.

11:00am- I finish with my elective (non-emergency) cases for the day. While operating, I received several phone calls regarding new consults, so I see them on my rounds, in addition to my current patients. One patient is being transferred in from an outside emergency department with possible appendicitis. Because pediatric surgery is highly specialized, surgeons have to be supported by specially-trained nurses, technicians and anesthesiologists. Few hospitals have these resources, so often I see children who have been transferred because they cannot get the care they need locally.

1:00pm- My rounds are done. I have seen and examined all of our patients in the hospital, spoken to families, written orders, evaluated laboratory studies, reviewed x-rays and discussed care with the pediatricians, pediatric critical care specialists and neonatal critical care specialists. The transferred patient needs an operation so I schedule it with the OR. While the OR takes time to prepare, I make my way to the surgeon’s lounge where food is provided by the hospital. I am very grateful for this since there is no time to get lunch. Studies show ORs that provide food run more efficiently, since surgeons stay close, avoiding lunchtime traffic delays or long cafeteria lines. This gives me time to write notes on each of my patients for that day, documenting my assessment and care plan.

2:00pm- The OR team is about ready for my case, but they are waiting on a medication from the pharmacy before we can start. I get a call from a colleague at the teaching hospital saying that he needs help with an operation. I tell him I’ll be over as soon as I’m done here.

3:15pm- My case is finished. I immediately write the operative note describing the procedure and the post-operative care orders, and discuss the surgery and post-operative care plan with the parents. I change out of scrubs and drive to the teaching hospital.

3:45pm- I get to the teaching hospital, but my colleague is performing another operation and not ready for me. I take this time to touch base with my residents who help care for our patients. In training to be general surgeons, residents rotate through several sub-specialties, like pediatric surgery, to get experience. We review the patients together and in so doing, I teach them about the field.

4:20pm- My wife texts me to see if I’ll be home in time to help make dinner. It’s taco night, and I usually cook the meat. I text that hopefully I’ll make it in time to eat, but not necessarily in time to cook. She understands, sending a kiss emoji. Good timing, my colleague is finished and ready for my help.

5:30pm- The case went well and I actually got home in time to cook!

7:30pm- My colleague calls back for my help. He has another case and this one is an emergency, so I give my kids a hug goodnight and head out. My wife is left with the dinner dishes and a quick goodbye kiss.

10:00pm- I get back home. The case went very smoothly, and the child is doing well. My wife and I chat a little to catch up and then we get ready for bed. I get two calls from the residents updating me on our patients. I also answer one call from a parent who has questions following her child’s surgery.

3:00am- I wake up to the sound of ringing. Is it my alarm? No, it’s the resident calling. I try to find a quiet place to talk and not disturb my wife (although she usually wakes up). Another child has a life-threatening condition and needs an emergency operation. I give the orders over the phone for the necessary preparations, then make my way in.

3:30am- I see the patient and confirm the resident’s examination. I meet with the parents and describe the surgery. It’s my duty to explain to them the gravity of the situation and the odds of survival. It is a very sad moment but I focus on what I can do to help. I go through the operation in my mind, thinking through different scenarios so that I am prepared. The OR team is ready to go.

5:00am- It was a difficult operation, but it went well and the child survived. The parents are anxious but relieved. I tell them to call me if they need anything. I walk out of the hospital and drive home. When the cacophony subsides and I pause to catch my own breath, I am so grateful for the health of my own family.

 5:30am- I crawl back in bed. I try to be quiet to not disturb my wife, but as usual, my shuffling has awakened her. We both fall back asleep, done with another day of call.

For more information on keeping your child safe and well, visit www.pedsurgical.com.

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