I was on call last night...here's how it went...
I first got a phone call around 11pm from someone who had already had her baby a couple days previously. She tells me her bottom is very swollen and its very painful to pee. Ok, this is a legit reason to be calling...I go over some comfort measures and advise her that she should call the office first thing in the morning to be seen but if her pain is that bad and she is unable to urinate then she would need to go to the ER. Simple and straightforward plan. She proceeds to repeat her concerns again, also bringing up that she has had only one bowel movement since having the baby. Oookay - I suggest what she can do for that while advising her that sometimes it takes a while for bowels to get back to normal. She continues to repeat her concerns. *sigh* Here's the thing - I have told you what your options are - choose one and let me get off the phone so I can go to sleep. It's almost as if she wanted me to tell her she should go to the ER now. Well, that needs to be your decision - its your pain. Jeez...oh wait, how about you meet me in the office for a middle of the night exam...or better yet, I'll drive out to your house and look at your bottom. Ah, no.
I got called about 3am from the hospital. I have a lady there who's 5-6cm and its her fourth baby. Ok, I'm on my way. She was still pregnant when I left at 7am (another midwife came on). But it all worked out well because I caught the baby of a little African woman I had been seeing in the office quite a bit. She came in with an anterior lip (9.5 cms) and pushy. She was amazing - did her thing with not a single noise! Then the nurses ask me to stand by for a patient of another doctor. I say sure but then while the nurse is on the phone with that doctor - she says she is twenty minutes away and could I just do the delivery so she doesn't have to come in. Um, ok. I guess she had just gotten home from one of the other hospitals. I would get paid for it so no reason not to and I love to catch babies of course!
I go in to meet the patient and ask the nurse if there's anything I should know. The patient is 17, second baby, late prenatal care, history of substance abuse. Ok. Her first baby was only 6-9 and had to be vacuumed out. Ok, sounding even better. But this baby looks to be small as well. It wasn't. The baby was 8-3 and she pushed her out with just a small tear. Not bad.
2 comments:
I love when patients call me in the middle of the night and go over and over the same stuff. Sometimes they have run on sentences as they repeat and repeat what they are saying trying to convince me of something. Most of the time I just stop and try to figure out what they are REALLY asking. Most of the time they just want to be told to come in to the hospital because they get some kind of benefit of showing everyone at home how they are "high" risk. I have little patience for that. I have all the patience in the world for most stuff, but that drives me nuts.
My other favorite call is the 11 p.m. "I am out of prenatal vitamins and need a new prescription" call. I have just started telling them to call the office in the morning. That seems to have stopped it.
Exactly! I can certainly be very patient and provide whatever education is appropriate but jeez...once I tell you what your options are you need to make the darn decision.
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