This post was originally written on October 16, 2014.
5:00 am – snooze
5:10 am – snooze
5:20 am — …. Fine. I grab my new change of scrubs and hit the shower. As much as I hate getting up, the warm shower is something I really look forward to in the morning. I go through the motions of washing and think about my day and the things I get to do while I am in the hospital until 8 am tomorrow morning.
6:30 am – I sit at the Maternity unit with the other medical students waiting for residents to tell me to see the new mom’s about their poop, pee, pass gas, pain, walking, bleeding, vomiting, headaches, dizziness etc.
7:30 am – We run downstairs to grab breakfast. Lauren and I have really hit it off with some of the interns, and we joke about random stuff as we eat in a rush before sign-out at 7:45.
7:45 am — Sign out from the night team, triage is full! There are ladies who are in labor and need to be admitted onto the unit from triage.
8:00 am — I talk to a patient, she says she’s here for delivery, regular contractions, no gush of fluid, some spotting, positive fetal movement, some high glucose control issues during this pregnancy but controlled with diet, no insulin, records are in the chart. I run off and present to an intern.
9:00 am — I jump into a C-section. A little intimidated by the attending but the resident with me is sweet so I have a good buffer. C-section goes well. Basically, I am in charge of suction, suture scissors, holding blades, and of course not getting in the way. There’s a delivery after the incision is made, so surgery is put on hold while the attending rushes out. The resident and I chat until the attending returns and then the surgery continues. The baby is breech, and with some maneuvering it comes out – Baby girl! Sutures here, cauterizing there, I put the staples in and help clean her up in the end.
10:00 am — Our ultrasound machine is broken. That is absolutely terrible. Triage is bursting! Alyssa, a 4th year medical student and really good friend of mine, manages to find an extra ultrasound from the ED, and we use it for a bit. I take the ultrasound to whoever needs it. Someone needs a sterile speculum exam in triage 4, I get a bed pan, sterile gloves, speculum, flash light, and a sterile swab for an FFN. After that I walk over to triage 3 to record an AFI on a lady going home (thank goodness).
11:00 am — They call for scrub! Off to another C-section. I scrub in. I was really nice to the scrub nurses last time so now they like me a bit better than last time. This is a repeat C-section and there are a lot of adhesions so it takes a little bit longer to get to the uterus this time. Soon we see the head and soon the baby is out! Another baby girl squirming on the field. I suction the baby’s mouth. They tell me to give the baby to the nurses. This is stupidly a big deal for me. Never have I ever been the first person to hold a baby in a baby’s life. I am so excited and petrified at the same time as I pick up the little, warm, slimy, screaming bundle and place it safely in the hands of the nurse. Pretty much the highlight of my day so far. We proceed to close up, I do my whole staple thing, and we are done.
12:00 pm — Random errands. Get ultrasound here. Put it in that room. Bring it back to triage. Ultrasound that patient and see if it’s vertex. Do and AFI, print it out, ETC.
1:00 pm — LUNCH. I’m all by myself. And it’s kind of amazing. As much of an extrovert as I am, this is one of the rare lunches that I have alone, and it’s so so peaceful and wonderful. I catch up on the news, reply to texts, study a bit, and of course just sit in a daze and look at the view of the city.
1:30 pm — Back upstairs! Aaaaand back to scrub into a C-section. With a different attending this time. I have the same jobs as always. Got to transfer the baby to the nurse again, which yet again made me feel excited and petrified at the same time. Seriously, after the fact, I always imagine all the ways that transfer can go wrong and I get reallllly freaked out. Didn’t have much time for those thoughts in this surgery though because for some reason I got suddenly got quite bad at cutting sutures which I have been doing fine with ALL DAY. Oh well. I will move on. I did discover that the new attending I worked with went to the same medical school as my dad!
2:40 pm — Out of C-section and back to triage work. Lauren is back from morning clinic so we divide all the med student work. More ultrasounds. Make sure a baby is vertex. One of the interns has us med students round on all the ladies in labor, see how they’re doing, check how their pain is controlled, how frequent are the contractions, and look at the fetal heart strip. He writes all the notes on what we report.
4:20 pm — The afternoon is starting to drag. This is really not a good thing because I still have 16 more hours here. Everyone is pretty stressed today, a bit snappy really, and I am doing my very best to both be helpful and also not be a tripping hazard *sigh* I’m getting hungry again.
5:30 pm — Did an ultrasound on a patient to confirm that she is breech. I love how excited parents get every time they see their baby on the monitor. This patient pulls out her phone and takes a video of her baby. She is so excited about each body part I show her! She almost is crying and talks to her baby in Spanish as I check the amount of amniotic fluid the little girl is swimming in. Given English is my first language, I’ve grown up hearing Spanish from my mom and all her side of the family. Listening to a mom babble to her baby in Spanish is just so endearing to me! I felt super lame, but I did get a bit choked up.
6:45 pm — Sign out time. All my day friends leave, and the night team joins in. I really hope to catch a baby tonight, we’ll see
7:15 pm — Dinner again. I must be REALLY hungry because I eat this salad and chicken pesto pita every night, and it tastes amazing tonight.
7:40 pm — Back to triage. We admit a lady for induction of labor and another is sent home. Our usual ultrasound is still broken so I am stuck with the old scanner. I take forever with am AFI on the first patient figuring everything out. I think my intern thinks I’m a moron. Oh welllll. The second patient goes a lot faster.
8:30 pm — I go to pediatrics with the other residents for a consult on a 14 year old with dysmenorrhea progressing to chronic abdominal pain in the past 4 months. She has been taking Norco for the past 9 months, so the decision is made to wait until she gets a clean out tomorrow to rule out constipation.
9:30 pm — One of the nurses in triage is graciously going to let me put in an IV on one of the patients, one of my requirements for this rotation. Thankfully I have a verrry nice nurse who directs me subtly every step of the way, and it all goes smoothly. There’s a lady in a lot of pain in triage. Hm. Not my patient and the intern is with her, so I continue on.
10:30 pm — another nice nurse and another check off my list, I placed a Foley catheter in a different patient. That lady in triage is louder now. She really seems like she’s in a lot of pain…and now she’s saying she’s ready to push. Hmm. Again not my patient, plus I’ve been keeping my eye on the girl in room 9 who’s 9 cm and 100% effaced, plus they’ve told me to go interview the lady in holding room 3.
11:00 pm — I’m interviewing a new patient in triage. Suddenly, the nurse runs into my room and tells me the senior resident wants me in labor and delivery room 4. I run over there, and discover the patient is the lady in so much pain in triage! No epidural. Ready to PUSH. I quickly scrub in and join my senior resident. As I watch the mom in sooo much pain, I’m reminded of all the stories of my own birth! Apparently my mom didn’t tell my dad, a radiology resident at the time, that she was having contractions because he was asleep. In the shower her water broke and then she was ready to push! 20 minutes after getting to the hospital I was out. My dad even had to deliver me because no OB doc was there yet! ANYWAY – all this was ironically running through my head as the residents push me to the front. I’m catching this little boy. Mom is screaming. Dad is trying to be brave. Baby is coming pretty fast (which I think it’s cause mom wants him OUT)! I put my hand on the babies head with firm pressure…it slides out…face is down and slides to my right…oh no! Opposite of what I practiced! I improvise which ends up with me hugging the baby to my chest and then laying him out on my right arm, suctioning his mouth and nose, clamping and cutting the cord, and collecting cord blood. Baby goes to mom who is absolutely in love once again with her third son. The pain is almost all forgotten. I turn my attention to the placenta. I look for the three main signs that the placenta is about to come out: cord lengthening, gush of blood, and balling of the uterus…aaand the placenta easily slides out within a minute. There is a second degree tear which my resident sews up. I clean mom up with betadine and cool water.
12:00 am — Another delivery in room 2! I scrub in and assist the intern. As soon as the baby slides out the nurse calls for delivery in room 7. I scrub out, leaving on my booties, mask, and hair net and scrub into the next delivery. Poor girl has chorioamnionitis and it’s her first baby. After a lot of her pushing and us counting to 10, baby slides out. He opens his eyes but doesn’t cry. He’s covered in meconium, poor guy, so he is immediately passed off to the NICU nurses who clean him up.
1:15 am — It finally calms down a bit. I’m sent to triage to do a couple ultrasounds and interviews. I go to another room to see if a baby is vertex on a mom who is doing a trial of labor after a C-section. I find the baby is breech! Sorry, mom. Probably another C-section for you.
2:00 am — More triage interviews. More ultrasounds. More sterile speculum exams. More looking at slides from for ferning. More ultrasounds.
2:45 am — I see no residents around. The intern tells me I can go to bed now and get up in time for rounds at 6:15. I climb into bed in the call room feeling every single spring in that mattress. No complaining though. It’s been a solid day. My eyelids…are…so heavy.