Starship Hospital - Fellowship Update


An update from New Zealand.

The Robin Mitchell travel bursary helped me fund a trip to New Zealand to Starship Hospital Paediatric Intensive Care Unit (PICU).  I am now into my second week and have learnt so much it’s difficult to quantify. 

To put this in context my first day involved sitting in handover trying to keep up with the stream of different conditions and syndromes that were the cause of patients to be in the unit, let alone the number of different cardiac procedures that had been done changing normal physiology!!

The unit at Starship is a mixed critical care unit and takes a large variety of both elective and acute patients to both level 2 and 3 care. However, because Auckland only has one PICU the range of pathologies that present is vast and varied.  The beds are supposed to be limited to 16 ICU beds and 6 HDU beds – so 22 in total, but they seem to make space when needed to expand to more than these numbers. Since I have been here here the unit has been almost full and meaning that efficiently managing patients is key to keeping the unit flowing and progressing patients care is a priority.

My days have been spent shadowing the duty registrars, this involves doing both a mixture of ward rounds and attending reviews for unwell children around the hospital.  This has often been down to the Emergency Department where I have seen a number of resuscitations both medical and trauma.  The opportunity to see patients who have been referred has given me a great insight into the thought processes and management from the reviewing team, this is particularly useful as I am usually the one making a referral from the Emergency Department.

I was lucky enough to be invited on a retrieval transport on the first day.  This gave me a great opportunity to see how the transport team was setup and organised.  It also let me see some of New Zealand from the air which is a fantastic opportunity. 

As I enter my final week here it is difficult not to reflect on the amount of learning that I have had to do just to keep up with what is happening – particularly when thinking about cardiac presentations.  I have definitely seen a number of presentations that I may only see once or twice in the course of a career.  The complexity of patients is represented in the everyday work with Consultant’s taking the lead on all cases despite the registrars mostly being post or nearing CCT.

I am hugely grateful to the Robin Mitchell Fellowship team for giving me this opportunity and have certainly learnt so much it’s difficult to put it all down on paper.

Toby Edmunds