So I start neonatology on Monday. It's an elective, and it's my first inpatient rotation ever. I read the reviews for it way back when I signed up, and I could have sworn people said the hours were 7 or 8ish to 3 or 4ish. That's why I scheduled it this month - DH just left town for 12 days so I'm doing all the pick-ups and drop-offs, and daycare hours are 7-5. Well, I just spoke with a 4th year who took neonatology last year and she said hours were 6:30ish to 4 or 4:30! I went back and looked at reviews again and some of the more recent ones said the same thing, and some said it could go until 5. One person said grading was harsh. So now I'm not sure what to do - there is no way I will be able to do anything other than 7:30 to 4:30 for the first week and a half while DH is out of town. I have no family in town and no friends that would be able to help out, and the daycare is not flexible on this. Any suggestions for me? Should I talk to the clerkship coordinator tomorrow, or wait until I go in Monday morning? Should I email the course director ahead of time? I don't want to make a big deal out of it if it's not necessary, but I really don't want to make a bad impression either. I'm really looking forward to this elective and I want it to be fun and to do well. Advice please - I'm kind of panicking here!!!

Is there a daycare employee who would be willing to watch your daughter for the extra time in the morning? We utilize one of our kids' day care teachers that they love for the days clinic/work overlap for DH and I... that way they could just bring her in at the start of the day? And potentially keep her past the end of the day? Just an idea- since day care teachers are really underpaid, it could be a great extra income for the right person!

Good luck!

Unfortunately that' s a no-go. We've talked to them about that before for evenings. The problem is that they all rotate schedules so it's not the same person every morning or every evening. The classroom is open 7-6 (there's a 10 hr/day limit which is why I have to pick up at 5), and there are 3 main teachers and a number of floaters. There are two people there every am and two every pm (three often during the day though), but they aren't the same people from day-to-day, so I'd have to arrange it with a whole bunch of different people for different days and I just don't think that would work, especially since I've asked before about evenings and was turned down.

Am I doomed?

The hours are so early in the day - beg a second-year you might be friendly with too spread the word through their class that you are willing to pay one of them to take her to daycare and pick up and keep her. It's not that long before or after daycare to where their study schedule should be that impeded. For that matter - ask a first year (although they may be freaked out about studying all the time still). Between the non-clinical years - there has to be someone needing extra money who would take this on for you. It's so early still it is before any classes would start etc.

If you don't know anyone in that class - see if you can get permission to email their listserv asking for help. We have personal stuff come through our listservs (but I guess it depends on the school). Use the connections you have to get to people who can help you.

I understand your panic, and I would be panicked too.

If you end up truly in a pinch - register at a place like care.com that screens (background checks) their sitters/nannys and hire someone in your area for the period your DH is out of town.

Good luck - I'm so sorry this stressful situation is dampering your excitement over such a cool rotation. I spent nearly all my volunteer hours for five semesters in the NICU in undergrad doing volunteering/shadowing. It was awesome. The nurses that worked there were just the sweetest people, and the doctor was amazing. A cool field.

On that note - are you friends with any teachers who might take this on for you? It seems the hours you need extra care for her are before and after school hours?

I KNOW teachers would like some extra money!

LOL this is the first time I hear NICU nurses and sweetest in the same breath! They're patient advocates gone mad! I know they're doing it all for the good of the baby, they're extremely competent and I think it takes a very special person to be a NICU nurse, but sweet? oh no. They'll bite your head off without giving it a second thought.

But back to the problem: I agree with asking a student or friend to take her in the morning. Hopefully they can take care of her from the time you leave until 8am so that you don't have to pick up until 6. If it gets busy, as a student, you can always excuse yourself to pick up your child (not every day, but when works goes on unusually late). Better to leave early than to get there late.

Other thing is: why do students come in at 6:30? What time do rounds start? Are the medical records electronic and if so, do you have access? You could do most of your prerounding from home in that case and come in later than the other people. You don't really have to examine the babies before rounds anyway (the nurses wouldn't let you if it's not feed/hands-on care time anyway, see above).

Best of luck.

Baby E, stuck in a NICU somewhere right now, with only brief excursions out, running to L&D every time the darn pager goes off

Well I just spoke to my 4th year friend who's on Cardiology next month and doesn't think she'll need to get in until 8, and she's offered to help out in the am! There are two caveats. One, she won't know her schedule for sure until Monday, and two, she has mono. She's had it for a while, she's on steroids, she feels a lot better, and I don't think IM is actually terribly contagious, and I know she'd practice good hand hygiene. Would I be crazy to put my daughter with her?

Rounds are at 8 as far as I know. The 4th year who's taken it said she got there at 6:30 every day to pre-round on her patients. As I mentioned, this is my first inpatient rotation, so I have no idea how long it takes to pre-round. I don't even know if you do that with your team or if you do it alone? So I don't know if an hour and a half is really necessary... I'm pretty sure they're using EMR, but I don't think I'll have access from home. There's also no way I'd be able to work on it at home with DD around, though I guess I could get up super early and try to do it before she wakes up.

Yes that's what I meant, do it before she gets up. Of course! What time does she get up? You could do it before and then wake her up at the last minute to take her to daycare.

Prerounding is on your own, so you're ready to present on rounds with the whole team. NICU prerounds are mostly off the chart as I said (because you can't examine the baby any time you want) so if you have home access, you would be golden. Even if you just get labs and vitals before, it will save you lots of time. Otherwise, it takes some time because there's a lot of data to record and look over, but it really depends on how many patients you carry and how sick they are. Anywhere from 5-20 minutes per patient. Also greatly varies with the person pre-rounding (I'm very fast, but only because I'm always late and have to rush!). I suggest you get someone to help with your daughter at first, and then as you get faster you may be able to do it on your own. The first day always takes A LONG TIME since you have to figure out where everything is, what all these abbreviations mean, etc. Good luck!

PS I think it's very strange that they make you do NICU as your first inpatient rotation. It's just so... different!

I spoke to another person who did the elective and she got there at 6 to pre-round! She said it takes a while b/c you have to calculate I/O's and at first I'll have no idea what I'm doing. It will of course depend on how many patients I am assigned. DD gets up b/n 6:30 and 7:30, so I'll have to start waking the poor thing up earlier. I really don't think pre-rounding at home is going to work for me because a) I am sooo not a morning person, b) I don't think I'll have access form home, and c) I'll probably have a million questions, at least for the first few days. But I spoke to DD's pediatrician today and she was not at all concerned about me leaving her with my friend who's had mono. Not too contagious, so as long as she washes her hands and they don't share anything, it should be fine. I am really going to owe my friend BIG TIME when this is through!!!

I'm so glad this looks like it will work out. Go ahead and start thinking of a great meal you can make this friend when this is over!

Oh, and about the NICU I volunteered in:
- not a teaching hospital
- small city/small hospital
- nursing staff had all worked together for years - no turnover
- guess I got lucky.

Sounds like they are all NOT like that.

I am crossing my fingers yours is, though, nbp! Good luck!