The children we carry at Christmas 

As Christmas approaches, Jess Morgan, one of the Thrive Paediatrics Fellows, reflects on the importance of checking in with each other and building a sense of belonging amongst the team.
Icon - hands holding a heart with a medical cross inside, and snowflakes

The ward is festooned with Christmas decorations. There’s a singing Santa figurine perched on the nurses’ station, fairy lights twinkling along the corridor, tinsel hanging from almost everywhere, staff in antlers and festive jumpers… There’s a real warm and merry feel to Christmas on the paeds ward.

And then there’s a little boy. He’s 12. A boy with the broadest smile and the cheekiest laugh. He’s been admitted with aspiration pneumonia. A background of cerebral palsy and learning difficulties with several challenging admissions to PICU. I could list all the things he can’t do, or instead I could describe the wonderful way he communicates with hand gestures and facial expressions. Or the love he has for songs about numbers. But he’s sick. Very sick.

And it’s Christmas day. The ward has been emptied: the children well enough to go home discharged with appropriate safety netting. But this boy lies in HDU, deteriorating every hour. A family’s Christmas forever tarnished with conversations about the appropriateness of escalation to PICU… with the death of their beloved boy.

Every year I remember this family as though it were yesterday, because there are children we carry, families we will never forget.

So now is the time to look out for each other...

As Christmas approaches and we enjoy the fun and magic with the children and young people we look after, let’s remember that some of us will bear witness to devastating stories. Others will be juggling personal loss or struggle. Many will be navigating personal sacrifice in the name of rotas, pressure from families to be discharged... So now is the time to look out for each other, to maximise that sense of team and belonging that are so tangible at Christmas and really check in with our colleagues.

As part of Thrive Paediatrics, we are hearing stories of paediatricians connecting with one another. A short pause and a cuppa after the ward round. A lunchtime teaching cake club. A Friday afternoon MDT get together. Every one of these small initiatives builds belonging and with belonging comes a greater opportunity to be our true selves.

But how do we achieve this in an overwhelmed system, where the workload is relentless and there’s no capacity to stop? Perhaps this is where Maslow’s hierarchy of needs comes in and a simple reminder that our core physical needs are a prerequisite of doing a good job. So, even when the ward is heaving or clinic is overbooked, when there are no beds left for all the admissions, take a moment to pause and regroup. Tend to your own needs, the needs of your team, and build belonging.

And finally, look out for each other, check in, and dare to talk about the tough stuff. Because let’s be honest, being a paediatrician can be hard. But it can also be amazing!