So, today we were giving out some sort of deal on c-sections; everyone seemed to want one. Actually, everyone seemed to want babies in general, any way they could get them, but since I was the only med student working on the floor on L&D, I was doing the sections (each c-section, whether it be a private patient or clinic patient, has to be manned by a med student).
We had three, which doesn't really seem like a lot when you think about it. Each lasts about an hour, a little bit longer if we're tying tubes while we're in there (which we did for the last two). But when you consider that you have to keep an eye out for when they take the patient back to the OR to get the spinal anesthesia in and get started, that's actually quite a lot of time dedicated to c-sections. So much so that I missed all of the vaginal deliveries because I was either getting ready to go to the OR, in the OR, or wrapping up after a case. With all of that time dedicated to the surgeries, I didn't get the chance to follow around the second year resident manning the floor as she did cervical checks on the patients, so I didn't get the opportunity to introduce myself to anyone, and by the time I was done with the last one, nobody laboring was close enough to delivering to make introducing myself worth it. Oh, well.
Appearantly, I was being too hard on my OB residents in my previous posts and I hurt my intern's feelings (sorry, Suchi). So let me clarify: there are good residents, and there are not-so-good residents, and this applies to every specialty, not just OB. My team on labor and delivery/post-partum is a good one, and Suchi is a good intern (and no, I'm not just saying that in case she decides to read my blog again). She knows what she's doing and she makes me laugh, which is an important quality in residents--I don't think you can stay sane if you don't have a sense of humor. Besides, she's probably the first doctor I've worked with who actually knows that Preventive Medicine is a field with its own residency programs, and she doesn't think I'm insane for wanting to do it (at least, she hasn't said she thinks so if she does).
Tomorrow is my last day of labor and delivery, and I'll be working triage, which is comparable to urgent care for pregnant women--most of what we do at triage is rule someone in or out for labor. It's hit or miss at triage as far as having an easy day or getting slammed. I'm hoping tomorrow is an easy day (knock on wood), because I have more oral exam tomorrow afternoon, and I still need to study. We'll see how that goes...
2 comments:
So, if you get a person in triage at 9cm, do you get to follow them to their room, or do you have to pass them off to someone (a L&D nurse, for example)... What is your cut-off for admittance in triage there? Just curious.
There's not necessarily a cut-off as far as how dilated that earns admission or not; rather, it's if they're capable of changing. If they come into triage at 5 cm, and are still 5 cm two hours later after walking around, they usually get sent home, but if they come in at 3 with contractions and change to 4 an hour later, they usually get admitted.
Everyone gets passed off to an L&D nurse (most of the time, the nurse:patient ratio is 1:1 on L&D), but when they come in at 9, there are usually doctors coming in pretty quickly to check up on them.
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