How working as a pediatrician has changed since Covid-19/Life lately

Hi friends. Hope you are all doing ok!

I’ve been back at work full swing for a few weeks now (before I was mostly doing remote work with a few shifts on occasion.) I didn’t fully grasp how much things had changed until my second or third time back. The adjustment has been interesting to say the least…while I wasn’t around for the full swing of the pandemic (while adult medicine was exploding, pediatrics ER visit and admissions went wayyyyy down as families avoided hospitals), adjusting to the changes has been harder than I thought. Here’s a couple of ways work life is different from the pre-Covid era.

Cloth mask (with surgical mask worn underneath) to make things a little more kid-friendly :)

Dressing for work. Back at my residency, I had a colleague who never wore scrubs outside of work. He swore by either dressing professionally or changing on arrival and again before returning home. We all kind of side-eyed him and gently teased him for this. While I wouldn’t wear my scrubs out to a bar/on a regular basis, I’d wear them on my couch at home or for a quick grocery run after a shift and not think twice about it. His argument? Scrubs were historically meant to be worn inside hospitals ONLY, and doctors and nurses would change before going home to keep all hospital germs in the hospital.

These days, once I’ve handed off my pager after my shift is over, I change into gym clothes or a second pair of (clean) scrubs, switch shoes, drive home, take everything off and shower before touching anything/anyone else at home. Plus, as much of my work gear as possible stays in the car (I wipe down my phone and wallet and bring those in, and avoid bringing my laptop to work as much as I can.) I do still go into work wearing scrubs, but they are ALWAYS clean/laundered.

Food and drink bans at work stations is no longer just an inspection week rule. There are strict rules on infection control that get semi- ignored most of the year unless the hospital is getting inspected by an official body. OK so this sounds bad to an outsider, but when the choice is between not eating or drinking for 10-12 hours straight and occasionally sneaking a few almonds or sips of water from your flask, you just keep the damn food and snacks in your backpack or somewhere close by. A lot of people who work in ERs won’t have time the entire shift to go to the break room every time you need to eat or take a drink.

Pre-Covid - mask-free drinking sparkling grape juice for New Year's in the ICU

Post-Covid, we take these rules a lot more seriously, mostly because no one wants to take their mask off in the middle of a busy ER. I make sure to hydrate well and eat right before my shift starts, and head to the break room to eat at least once during my shift (although I do occasionally sip water in the work area to avoid getting dehydrated.) Personally, I just want to minimize removing my mask in the work area as much as possible.

Infection control is a big deal. Honestly, infection control has always been a big deal, but it’s certainly more visually obvious now. Bleach wipes and hand sanitizer sit on every surface. I wear a gown, mask and gloves when seeing every patient, not just patients who may have an infection. For procedures I add a face shield that looks like it came out of star trek (wish I had a picture!) Before entering each room, I re-screen any family members for Covid-19 exposure or symptoms. I take the extra step of washing my hands after each patient (normally I would just use hand sanitizer.) The plus side of all these changes: not a single case of work-transmitted Covid-19 has been documented at our hospital (woohoo!)

Sick days are back (woohoo!) Residency programs are notorious for their sick day policies, or at least mine was. The official rules may say you shouldn’t come into work while sick, but the culture? If you can stand and string together a sentence, you show up to work. I remember one of my chief residents proudly recalling the night she fainted in the ER after suffering from a bad GI bug, got bolused with IV fluids from the nurses and then went back to work. At one point, I came in every day of work my last year of residency with a high fever and cough (don’t worry, I wore a mask, and every time I only showed up because I thought the fever had broken. I’d go home as soon as it came back), only to find out on my last shift of the week I was flu positive!!  No one wants another person to be called in to ‘cover’ for them, especially when the job is so tough.

To be honest, these trends are pretty toxic and unhealthy. Not only do they make for exhausted and unnecessarily disenfranchised health workers, they’re also terrible for infection prevention and control. So it’s been nice to see that in the post-Covid world, not only are you not expected to work when sick, you’re actually not allowed to. My job (and many others) require an attestation be completed before every shift- you literally have to confirm you haven’t had a single Covid-19 symptom before coming in to work, every day, no exceptions.

Those are probably the biggest changes. Obviously patients have changed too- whereas emergency pediatric care included a lot of visits that weren’t true emergencies, these days very few cases like that are coming in as people avoid hospitals as much as possible (some times too much.) We’re still doing a fair amount of injury treatment (sutures and splinting FTW!) but overall things are wayyyy slower than they’ve previously been.

Besides that, life has changed pretty drastically too! We moved! This time into a beautiful big house with a yard.

We added a couple of roommates too- my sister and her dog moved up from down South to start residency up here in Boston.

And in a few months’ time, my husband and I are also sharing a new addition…

Yep! We’re pregnant!

And we’re over the moon excited. While I’m not sure how much I plan to get into pregnancy and motherhood on this blog, I sure have been thinking about it a lot, so my guess is I’ll feel like writing about it from time to time. And knowing how little I personally have heard about mothers working in global health, I’d love to share with you all how we as a family plan to make this career work (although I’d love to hear your experiences too!)

This is getting super long, so let me end it now and wish you all a great week!