Thursday, November 20, 2008

36 hours is a long time

I did my first 36 hours of call earlier this week. It's kinda intimidating to think about that many hours in which anything or nothing can happen, stretching out ahead of you. This only preps me for when I do my first entire weekend next month - from Friday night to Monday morning. It wasn't too bad, but I was definitely wore out by the end. Here's a recap...

8:00pm - I get a call from a patient who has a history of fast labor with her first baby. She thinks she's in labor and plans to head to the hospital in about 30 minutes. Calls me back 20 minutes later to let me know her water has broke and she is contracting one on top of each other. So I strip off my pajamas and throw on scrubs and start the mad dash to the hospital to meet her. She lives much closer so I call ahead to the hospital to let them know she's coming and that she will likely be pretty active. Now, because of those stupid photo zones, I can't fly too much but there's no traffic so I still make pretty good time. I'm 10 miles down the road when the hospital calls and says "she's complete and +2, when will you be here?" Twenty minutes. Never gonna make it. I tell them to have a resident stand by. The resident doesn't make it. I miss it by 6 minutes. The nurse and FOB caught the baby :) I was very disappointed especially since she birth standing up (which freaked the poor newbie nurse out) and I haven't caught a baby like that. I would have loved to have done that!!!! Anyway, everything ended well.

So I go back home as there's nothing else going on.

2am - a young primip comes in because she's worried about some spotting/bleeding after intercourse. No pain, just wanted to make sure everything was ok. She's 5cm with a bulging bag of water. But contracting irregularly, and not feeling them. I give orders to let her walk a couple hours and I go back to sleep (I had been asleep maybe an hour up to this point).

4am - she's still 5cm but now feeling crampy with contractions....ok, keep her and I will come in a little later to break her water. I go back to sleep.

6:45am - crap, I need to get out of bed and get in gear. Hit rush hour traffic, arrive at the hospital about 8:15am. The lady is still just mildly crampy, 5-6cms, narrow pubic arch makes me nervous. I break her water and send her walking. She gets going and progresses to complete after walking, showering, and dancing with her boyfriend.

11am - she's pushing

1pm - The caput is +2, head is still at 0. I call the doctor for a c/s for failure to descend :( My first c/s in 4 months :(

I first assist for the first time and it went well! I was nervous and clumsy but the patient was happy that I would be staying with her and helping the doctor. The doc was very nice and helpful as was the scrub tech.

While this is happening, another patient comes in. She is also a young primip. She also walks for awhile and then changes her cervix. I keep her for labor.

I break her water around 6pm - she's 5-6cm now and requesting an epidural.

Shortly before 10pm - we have a really nice delivery, no lacs, after 30 minutes of pushing. She did a fab job.

I go home.

11:45pm - I fall asleep.

12:15am - The hospital calls to inform me that the young lady has a large hematoma. After discussing with the doc, he will go in to drain it. I feel obligated to go back as it is my patient.

1am - they are already in the OR and taking care of it. Patient is out cold. I hang around and watch him finish up. I wonder how often the nurse was looking at the patients' bottom, for a grapefruit size hematoma to have formed. The bleeder was small.

2am - Back home - I go straight to bed to rest my bloodshot eyes. Not a peep from my pager the remainder of the night!!!

And I get to do this again this weekend :p

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