Introducing… a pediatrician

Dr. Audrey Lim is a pediatrician in complex care at McMaster Children’s Hospital. She has worked at Hamilton Health Sciences for nine years.

Favourite colour: purple/ music: classical/ book: the Bible/ food: almost everything/ vacation spot: Singapore, where I go to visit my family/ animal: my dog Pooch/ holiday: Easter

What do you love most about your job? I have the great privilege of working with children with medical complexity, along with their parents and caregivers. That means these children have multiple medical issues. Some are dependent on technology for daily survival, such as home mechanical ventilation. I am blessed to work with their amazing parents who rise up to the challenge of caring for them. Their homes are turned into mini Pediatric Intensive Care Units with all the equipment they need.

“Giving them guidance, support and proactive management strategies helps to avoid visits to ER and admissions to the hospital.”

One of the many aspects that I love about my job is the opportunity to manage these children in a comprehensive, holistic manner—medically as well as psychosocially. This approach allows them to remain medically stable at home, in school and in the community. I am also very blessed to be working with a multidisciplinary team of dedicated nurses, respiratory therapists and allied health professionals, working towards the same goals for these children and families.

I also love the ability to provide support for parents and home care nurses by empowering them to safely care for these children at home. Giving them guidance, support and proactive management strategies helps to avoid visits to ER and admissions to the hospital.

Describe one of your most challenging days at work. To me, everyday in complex care is full of challenges, as well as possibilities. In an average day I see in-patients and make a plan for their care, attend meetings with their families, run to the clinic to see patients with urgent concerns, visit any patients who have been brought to the emergency department and answer phone calls from parents and home care nurses.

“Some days are definitely more challenging than others, especially when one of our complex care patients is critically ill, or when I have to share disappointing news with parents.”

Although the day is challenging, there is a sense of fulfillment in that we have made a difference for these children. Some days are definitely more challenging than others, especially when one of our complex care patients is critically ill, or when I have to share disappointing news with parents. When a family is eagerly anticipating discharge after a prolonged stay in the hospital (sometimes several months), and their child is not ready or stable enough to be discharged home, that is difficult news to deliver.

 

What do you wish you could do more of in your role? One of my goals is to bring care closer to home for children with medical complexity and to coordinate clinic visits to minimize trips back to the hospital. Providing more care in the community is in the best interest of these kids. I wish I could do more to advocate for consistent, trained home nurses in the community to care for these children in their homes and at school.

Another important area is to advocate for more funding, especially for children dependent on technology. There are many out-of-pocket expenses for equipment or medications that are not covered under the government’s Assistive Device Program (ADP) or private insurance. I wish I had more time to speak up on their behalf.

What’s something you do in your role that others would be surprised to learn about? Something that I do currently, and hope to do more of is home visits, especially for children who are medically fragile with technology dependency and transportation challenges. It is gratifying to see these children in their home environment, and to meet their needs without having them travel to McMaster Children’s Hospital along with their cumbersome equipment, like ventilators, suction machines, oxygen tanks, or feeding pumps.

We also have a unique partnership with Niagara Children’s Centre, that many people don’t know about. We have implemented a Pediatric Complex Care clinic at Niagara Children’s Centre where we see children with medical complexity technology dependency from the Niagara region with a multidisciplinary team from the Niagara Children’s Centre and CCAC.

What do you like to do in your spare time? When I have spare time, I spend it with my family. My 15-year old daughter and I like to go for walks with our dog, Pooch. We also enjoy going to church as a family. We are Christian and our faith is a big part of our life.