So... as a family practice resident we have a requirement to have at least 10 continuity deliveries. This means I see the patient in the clinic for prenatal care, deliver her baby, and then see her after delivery in the clinic. The rough part is that babies come unexpectedly.
I've delivered over 40 babies, but I've only had two continuity deliveries so far... here are the stories:
Patient #1 arrives at 5am dilated to about 3cm, contracting every 5-10min. I am just finishing a 24 hr call shift, but stay in the hospital to follow this patient. I sleep in the call room and emerge every 3-4 hrs to check on her progress. Being a primagravida she progresses kinda slow, and we break her water and help things along with pitocin. So by 10pm or so she's complete and pushing! I help the nurse coach and wait anxiously to catch the baby... no such luck after two hours of pushing the baby is still at zero station. So I consult my OB colleagues and we decide a C-section is in order. At this point I've been in house for 44 hrs. As much as I did want to be there for the birth and assist with the C-section, I was not crazy enough to actually stay. I went home for a little more sleep before I had to return to the hospital for my regular duties in less than 5 hrs. The OB team did the C-section, which went fine and I took care of her the remainder of her hospital stay. I decided that with my next continuity delivery I would NOT live in the hospital to follow my patient through every step of labor, but would allow the nurses and doctors working in L&D to help and call me when it's time for the delivery part. I tried to implement this with my second continuity delivery, but it did not work quite right, as you can see below.
Patient #2, this story is even better.... She arrives around midnight, dilated to 4, contracting every 5 min. I'm 17 hrs into a 32 hr call shift. So I think, this is perfect, I'm already here, this is her second baby and so she'll surly deliver in the morning before I leave. Well, by 1pm she had not delivered yet... so I go home shower and go to bed! I had just about drifted off into a deep post call sleep when my pager went off at 2:55pm. "your patient is complete, hurry up and come if you want to deliver this baby!!" In my post-call daze I get dressed. I glance at the counter and decide that all I need is a pen, my pager and my stethoscope, I grab these three items and rush out the door! As soon as the door locks behind me I realize that my keys should have been on the list of necessary items... now not only am I lock out of my house but I cannot drive my car. Nor can I make a phone call because my cell phone is charging on the counter inside. I knock on my neighbor's door, and coincidently he's about ready to leave for work and offers to drop me off at the hospital. In route I get another page. Moments later I'm headed toward the labor and delivery floor. I rush in only to find out that it was a false alarm... the second page was to tell me never mind she's not ready. At this point my only option is to head back to the call room and try to sleep, which takes a little while but I fall asleep. The next page is the real thing and I make it just in time to catch the baby at 7pm. For being as sleep deprived as I was I did pretty good, the only think I forgot was to put on my shoe protectors and so I got blood on my sneakers.
Only 8 more to go!
2 comments:
Dang Sarah, those are some awesome stories. This is exciting to see you have a blog about your work. Now I can hear all of your cool stories that before only Loren got to hear. Maybe you can post some pictures of you at work? That would be neat.
Hey Sarah - cool that you are posting now. I like hearing your stories too. Maybe I'll finally post my links to blogs I read instead of keeping them in my "favorites". Then other people can link to you - not that I have many readers. About seven, I think.
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