An emergency room physician completes her overnight shift in a busy, inner city emergency department. She stays an extra hour and a half to complete paperwork then goes home. Although exhausted, she’s “too wired” to sleep.
Eventually she dozes off but the phone calls from family and friends begin. She’s only able to get six hours of interrupted sleep before leaving home for the next shift. The ER physician is fatigued, irritable and frustrated.
“This sleep pattern takes a terrible toll in the short and long term,” says Judith Owens, MD, MPH, director of the Center for Pediatric Sleep Disorders at Boston Children’s Hospital. “Shift work is associated with “deficient” sleep, meaning that both the amount and timing of sleep are altered. Our natural circadian rhythms result in humans being hardwired to sleep at night and be awake during the day, and the combination of this “misalignment” with insufficient sleep can be very problematic.” …Read More
A Vietnamese-speaking family arrives for a well visit and their clinician is English-speaking. Since the family understands some English, the family and provider move forward with the appointment.
During the visit, some aspects of the conversation were misunderstood or completely missed. The family completes the visit and schedules a three-month follow up appointment. Because of the language gap, the family did not schedule necessary, pre-follow up testing because they thought all testing was to be done during the next visit.
According to Teresa Amado, senior interpreter with Boston Children’s Interpreter Services, this is a common scenario — and one that shines a critical light on the need for a medical interpreter during appointments. …Read More
Although the guidelines remain intact, the AUA expanded its scope to include guidelines for the screening of siblings of children with VUR and of infants diagnosed prenatally with hydronephrosis.
Boston Children’s Urologist and Director of Quality and Safety, Caleb Nelson, MD, MPH, provides guidance on the detection and treatment of reflux in children, and offers clinical insight on the screening of siblings and those diagnosed prenatally with hydronephrosis. …Read More
Pediatricians and clinical staff manage patients with urinary incontinence on a regular basis. In fact, an estimated 20 percent of boys and 17 percent of girls, ages 6 to 7 years old experience some form of daytime or nighttime wetting.
Because of the highly personal and private nature of the condition, many children and families are reluctant to talk about wetting with their pediatricians.