5am- Show up at hospital to write some progress notes. Rounds are supposed to start at 6am on Saturdays. The work day had barely started for me and i was immediately thrown into a delivery and assisted Jen, another PA resident. I have never been so glad to be wearing a gown and big boots as this baby came out with a wave of amniotic fluid. I am not kidding you, there was fluid everywhere....including jen’s hair. I immediately ducked behind her as the baby was flying out and saved myself the DISGUSTINGNESS of having amniotic fluid and blood in my hair. I kinda wanted to vomit. This is the first time i have ben grossed out by a vaginal birth [for a second i had decided OB/GYN was not for me...then i changed my mind when i saw the cute baby after]. When we finished up [she had to be sutured up a bit] we joined everyone for rounds.
6am-ish- Rounds were a little different than the ones i had previously been on before because this time we had a patient in the ‘incarcerated’ ward. Basically, an inmate from a local penitentiary had to have a C section and once she had delivered, she is sent to the 4th floor were all jailed patients go. To enter the ward you have to show your ID, go in one door which is locked behind you and then the next door is opened. I was very intimidated.... Each room door is locked and the patients are handcuffed to their beds. To enter a room you need to be accompanied by a guard and you can’t bring anything inside with you [they could stab you with your pen or strangle you with your stethescope...]. I just stood behind the group and kept quiet. I felt pretty safe though considering the guard with us was around 7 feet tall...and i am not exaggerating! As we were walking out of the ward I looked into one of the rooms and nearly peed in my pants when i saw a 20something year old guy just staring at me...he was standing on the other side of the door window tracing circles with his finger and looked like he was crazy...seriously mental. I looked away and walked as fast as i could haha.
After rounds I scrubbed in on a C/S with a resident and attending. The baby was breech [feet first] so she had to have the section instead of a vaginal delivery. It was pretty fun to see the doctors yank out this baby one leg at a time. During the section there is a blue sheet that hangs above the stomach so you cannot see the patients face. By the time we walked into the surgery room the patient had already been covered up. It was a nice suprise to see the mom after the C/S and realize that i recognized her from the womens health clinic that we work at. As we pulled the baby out dr. L yelled happy birthday! we all laughed.
We had another vaginal delivery soon after the C section and then had some time to relax and eat breakfast. As i am eating i hear a big commotion outside in the hall and when i get up and walk out people are running into room 2. I followed to see what was going on and then heard people shouting to get the crash cart. It was all very dramatic. I helped the nurse push the crash cart down the hall and into the room but by the time we got there the patient was fine. Her BP had dropped suddenly when her epidural was being placed [which is very normal] and the nurse couldnt find her pulse again so she thought she was going into cardiac arrest. The patient was fine but I dont think her cousin was....i could hear her down the hall shouting on her phone to family members telling them to ‘get their ass to the hospital’...she was both very loud and pissed off at someone and i tryed to calm her down but then gave up because clearly she was just overreacting.
Later in the day we had a patient come up from the ER that had been in a car accident and was 27 weeks pregnant. We observed her for 6 hours and then sent her home. She also was fine.
Then we had another ER consult, a 19yo pregnant girl got shot in the shoulder. We went down to the ER to see her and evaluate her. One thing, the ER is a great place...lots going on and lots of men around. Seriously, i feel like my standards have greatly fallen because if i just smell cologne i am attracted to someone...its kinda pathetic. Bad thing is, everyone is wearing scrubs so you never know if someone is a doctor or a janitor [no joke, i came into the hospital one day at 5am and the guy cleaning the floor was wearing scrubs] this makes it difficult to find a legit man...
So we get the patients fetal heart rate and see that her and the baby are doing well so we tell them to admit her to L&D when they are ready. Hours go by and we call down to the ER to see where the pt is and it turns out she left. They literally couldnt find her. She gave a fake name and peaced out.
We had 2 fetal demise patient this shift also. Both were full term pregnancies [38-40 weeks] and the parents were devastated. After delivery, it was found that one of the babies had the cord around their neck and the other had a very short umbilical cord that was not being perfused with enough oxygen. I didnt see either of them being born because i really didnt want to have to go through that. After, the nurses take the babies bodies and the hospital has pretty boxes to hold the clothes, lock of hair etc and then another little box of the babies footprints. it was all very respectful and everyone had a similar feeling of despair at the fact that there is no way to prevent these accidents from happening. 2 in 1 shift is a rare event and it made the afternoon a little less happy.
that night i was in another vaginal delivery but i did not get to scrub in since another intern did. i ended up helping the nurse with the newborn and i really loved it. right after the baby is delivered they are passed off to another nurse to go under the baby warmer and get all the goo wiped off of them. I was the first person to listen to his tiny lungs and try to count his really fast heartbeat [babies can have heart rates up to 160!] he was beautiful and although he wouldnt stop screaming, i kept thinking how much i love my job.
in another vaginal delivery that night we had to use the vacuum pump to get the baby out because it was not descending into the pelvis fast enough. imagine a little suction cup put on the babies head and a handle on the other end. it isnt used often but it does help when the baby is not coming fast enough and they start to get into danger. after delivery this kid had the worst cone head i have ever seen [dont worry, newborns have very pliable skulls and the shape will go back to normal]
the rest of the night was me writing progress notes on all the c section patients that were in the post-partum ward of the hospital. i was up checking on patients, looking up their labs, meds, etc and writing in their charts from 1am to 3:30 or 4am. After, i told the resident i was going to sleep in the call room for about an hour. I slept for almost 2 hours and then woke up at 5:15 because rounds on sunday were at 5:30.
i was exhausted.
i rounded on my patients and then the attending said i could go home. i asked if she was sure and the resident look at me and said "if the attending tells you to go home, get out of here." i laughed and left to get my stuff in the call room. i felt ok to drive so i came home, act breakfast and crashed until 4pm sunday. i ended up going to the movies and trying to take advantage of my 12 hour weekend. it was pretty rough knowing i wouldnt have a day off until the upcoming saturday.
it was a long 27 hours but man was it fun.
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