EARLY CAREER EDITORIAL
An Advanced Trainee's Experience at PCICS 2018
Felina Mille, MD
Children’s Hospital of Philadelphia
I was asked to write about my impressions of December’s PCICS meeting in Miami. This was my first time at the conference. Despite that, I was struck by how many of the faces looked familiar. Although PCICS’ membership has surged, pediatric cardiac critical care remains a relatively small and tight-knit community. It was great to reconnect with friends from afar and to meet my contemporaries at the fellow and young attending reception.
A highlight of the meeting was hearing from some of the storied pioneers of the field, like Paul Checchia and Gil Wernovsky. I loved that they sandwiched the program. Dr. Checchia’s lecture was an eloquent call to arms at the beginning of the meeting. Through humor and with great insight, he questioned some of the dogma of our field and offered opportunities for progress. Dr. Wernovsky’s sincere and somewhat personal talk at the end reminded us to protect ourselves as we enter this good fight.
I found the topics of the conference wholly relevant to my practice. In fact, I was a bit overwhelmed by the number of sessions that I wanted to attend. Though I didn’t make it to everything that looked interesting, the sessions I did attend seemed to align around some major themes. Repeatedly, we heard about the need to invest in teams. In particular, to invest in nursing education and to empower bedside nurses to contribute to the plan of care, raise concerns and more effectively rescue patients before they decompensate. This is not a new idea, but is even more relevant in the setting of growing units, high nursing turnover and the ever burgeoning load of bedside data. We were also urged to consider that our responsibility to our patients extends beyond hospital discharge. Our task now is to minimize the harm we do to our patients while they are in our care by recognizing and addressing ICU delirium, practicing restraint in our sedation strategies, treating babies like babies, supporting their parents and initiating early interventions for those at risk of impaired neurodevelopment.Then, there was the cutting edge: designing and implementing systems that cull and integrate data and a brief mention of the potential harm related to medical plastics. I hope to hear more about these topics at next year’s meeting. Overall, this was an energizing and thought-provoking few days. Spending time in the Miami sun didn’t hurt either.