Hello, and welcome to my blog post for my first week of clinical rotations. After two boot camps that tested and expanded upon our knowledge in needs finding and product development, we have moved onto the second stage of this trip to Costa Rica.
For my clinical rotations, I was paired up with Travis and assigned to Hospital Nacional de Niños, the National Children’s Hospital. This hospital specializes in pediatric care for all departments, including physiological and psychiatric care for children of all ages. This hospital was founded in 1845 and carries a long, storied history of excellent care for the children of San Jose.
For our internship, Travis and I would be given 8 weeks to conduct clinical observations from all sections of the hospital, such as physical and occupational therapy sections, and then complete an innovation prototyping project that would help create a solution for one of the clinical needs that we assessed. For this project, we would be working underneath Dr.Roger Vargas, who is a physiatrist and head of the rehabilitation service for the hospital.
For this internship, our preliminary project ideas would consist of bionic prosthetics, standing orthoses, virtual reality for rehabilitation, or hand rehabilitation. However, in order to understand how to derive and engineer solutions for these problems, Travis and I would need to conduct 4 weeks of clinical observations.
During our first week, since Dr. Vargas was outside of the hospital, we would be shadowing Dr. Camacho and Dr. Saborio, who were Dr. Vargas’ colleagues.
The unique part of Hospital Nacional de Niños (HNN) is that patient visits are segmented throughout the week based on the patient type and whether it is a patient’s first visit to the hospital or not. Newer patients are usually seen on Mondays and Tuesdays, whereas returning patients will come in on other days of the week. This allows physicians to assess the needs of newer patients earlier in the week so that they can schedule future appointments and workups with the patients appropriately.
On Mondays, first-visit burn patients are usually seen in the mornings, and prematurely born infants are seen in the afternoons. The process of clinically observing doctors work with children was fascinating, as it constantly reminded me of the humanity and empathy required for proper and effective healthcare. Nurses and physicians that were working with younger children would get most of their information from the parents, as that source was much more reliable than the children themselves; however, they would ask questions to the patients in an extremely soft and comforting manner to help children feel welcomed and accustomed to such a new and bustling environment.
Patient visits will usually start with the lead physician explaining all aspects of what’s going on with their child and what treatment or care they will be administering that day. Then, parents will be asked a series of questions, sometimes before the checkup and at other times, during the checkup. Our first patient was a boy that burned himself against a motorcycle muffler when he was 1. Now, that he was older, he was making his first visit to HNN after receiving care at other hospitals to diagnose the problem with the skin grafts that he had on his hand around his finger area. This patient still required splints and regular checkups for his grafts since his hand was growing and would often not fully open due to the skin grafts being too small for that area of his hand. After conducting a full examination of his hand and looking into his medical history, the physicians determined that the boy should do specific hand exercises 10 times on each finger twice a day to help stretch his fingers out and promote blood flow to help keep his skin grafts healthy. After discussing this with the mother and setting up a check-in appointment in 2 months, the visit was over.
This example of a patient visit really helped me understand that having a great understanding of the patient beforehand and realizing what the core issue is as soon as possible is one of the most important things in healthcare. A prepared physician or engineer can come into a patient visit with multiple ideas on how to solve a problem, and after looking at the specifics of the patient and understanding their specific ailments, they can select 1 to 2 of these ideas to help concoct a solution.
I hope to translate these skills that I am learning from my patient observations to come prepared for every patient and think of other solutions that Travis and I can create to help rehabilitate patients along with their current medical devices and treatments.
Next week, Travis and I will be conducting more clinical observations, and we will also be heading to the Innovation Center in Hospital Clinica Biblica to get started on preliminary prototyping concepts. Thanks for reading, and I hope to catch you on the next one!