Take photos of your baby on the scale – now you’ve got the date (in the timestamp information) and the weight. Plus a cute picture of baby!
Take photos of the after visit summary. You’re going to lose the paper anyway. (Unless you put it in your binder!)
Takes photos of the doctor’s business card. Make a contact for them immediately, including their after hours contact information, if it’s different than their daytime contact information. Be sure you know how to make appointments, and how to get in touch if you can’t get a same-day appointment for an urgent problem.
Take photos of rashes, bites, lesions, scrapes, whatever you want to run by the provider. Take videos of weird sounds your kid makes while breathing, the barky cough they had last night, or the funny way your toddler is walking. With videos we can see what you’re seeing, even if your kid won’t perform on cue in the office. Rashes evolve, so it’s helpful to see how it changed over the course of the rash. Just take the pictures.
You’ve got a limited amount of time with the doctor or nurse practitioner. Make lists of your questions in advance. I like to list my questions in the calendar appointment in the notes section. Sometimes I print the calendar entry, so it has the appointment information and my questions all on one page. Then I have somewhere to take notes, and it can go back in the medical information binder.
Don’t assume you’ll remember the answers to your questions, especially if the visit is punctuated with crying, screaming, or destruction of office property. Visits are stressful and harried. Write down the answers, or even record the visit, with the provider’s permission.
Have a medical information binder. This can include after visit summaries, referral information, test results, imaging reports, etc. If you see a specialist, you would be surprised how frequently they will not have received the needed information before your appointment, and you carrying this information by hand can save weeks of inter-office phone tag.
Keep a list of all your child’s providers, including name, specialty, address, phone, fax and email. This can save you a lot of time looking it up at each office when you’re filling out medical information releases. I even include my child’s daycare provider, for medication authorizations.
Clinical Record Keeping
Keep track of your baby’s measurements. You’re not going to remember all the weights, but they’re important. If you’re using an app, make sure you understand whether it’s using decimal pounds or pounds and ounces. I’ve seen some apps take 10# 8 oz and turn it into 10.5 lb and then the parent read it back to me as 10# 5 oz. These discrepancies make a difference.
Keep track of the date, weight, and where the weight was taken. Scales are different, and even an ounce in either direction can make a difference in how we evaluate growth in a young infant.
Don’t let anyone weigh your young infant with a diaper or clothes on. Diapers weigh around 0.5 oz. Depending on how accurate the scale is, that can make a big difference in rounding. Some scales are accurate to 0.5 oz, some to 0.25 oz, some to 0.1 oz.
If you can do everything in grams, even better!
If you’re asked to keep track of how much your baby is drinking from a bottle, keep a running total over the course of 24 hours. Sometimes parents will say that baby drinks 2-4 oz every 2-4 hours. That’s anywhere from 12 oz to 48 oz, which is not useful information. Instead, write down how much she actually drinks at each session, and add it up at the end of the day.
None of this needs to be fancy. Paper and pen work just as well as an app.
Many providers have online access, but if they’re using an Epic or Cerner patient portal, you often need to do the initial piece of setup in the office. Talk to the front desk about what you need to do to get set up for their portal.
Who answers the portal messages? A nurse or the provider? Sometimes it’s helpful to have someone who will track down the answer for you. Sometimes it’s helpful to have direct access. Either way, it’s good to know.
Some providers will email with patients — ask how they prefer to be contacted with questions. Our office has a secure texting service. I will do almost anything to avoid calling a provider’s office, so email or messaging is crucial.
Does your state have family access to the state’s immunization registry? Washington State does. Makes it easy to print pre-populated immunization certificates for daycare or school.
If your kiddo is getting oral medication, get lots of syringes. The pharmacy might only include one in the bag but will happily give you a dozen.
Some pharmacies have a special stopper that will allow you to turn the bottle over and draw the medication out with a syringe much more neatly than sticking the syringe in the bottle. You can also buy them online.
Before using each syringe, put scotch tape over the numbers. This will make the numbers last longer – you’d be surprised how quickly they wash off otherwise.
For long term oral medication, get the Miracle O-Ring syringe. This O-ring will move smoothly for a very long time, unlike the regular black rubber plunger syringes, whose plungers get sticky within days.
Luer tips have a screw-end to attach needles. Slip and catheter tips don’t. Usually we prefer to give medication with a slip tip syringe. (En-fit is a variation on the screw-end used for feeding tubes.)