Labor and Delivery, Nights

I’ve found last week’s overnight call to be kind of overwhelming, so I’m just now finishing up the posts I meant to put up last week. In the interim, I’ll publish a few of the funnier moments from the Labor and Delivery floor.

1. Spanish is the first language of many of our patients, and some of our attendings. One of the chief triage nurses is a severe, thin lady originally from Belarus. She has no tolerance for nonsense, and was furious at one of the attendings. As she storms out of the room, she says, in an impenetrable slavic accent: “I can’t understand a fucking word that woman is saying. What is wrong with her? I can’t do this anymore … she just needs to learn to speak ENGLISH!!!!” I don’t think she appreciated the irony.

2. Your teammates’ attitudes determine your happiness. If you have a resident who has no desire to teach, lays into the interns for not working fast enough, and ignores you except to ask you to move out of the way when you’re writing an H&P and she wants to get to her snack pack … it’s going to be a long week. I don’t think it really dawned on me why students on residency interviews feel that the “vibe” of a program is so important until the last week, when I had my first experience on a hospital service that was mildly toxic. On the flip side, some of the other residents I worked with were fantastic and took time to teach even during the craziest nights.

3. Multips in active labor are unpredictable. Again, I “knew” this from reading our OBGYN textbook, but its another thing to see a lady (grand-multip, in fact) come in 6cm, and start delivering 5 minutes later. Her private OBGYN didn’t even make it to the hospital. That was striking – but at least we got her into the bed!

4. Sections are really bloody. In a good way. Is that wrong?

5. Nights are unpredictable – and that’s fun! Some nights we weren’t in the OR at all, and some nights we never left. One night we got paged down to the ED right after stepping out of the OR for a mom with horribly low blood pressure , and as we leave the floor for the elevator I hear yelling and the rolling of the delivery cart. We return to the floor with our patient (she was stabilized in the ED and rapidly assessed), only to see one patient having delivered and another a longstanding placenta previa patient being wheeled in, having passed golf-ball sized clots, in need of a rapid c-section. So we get two OR’s up and running and deliver three babies in three hours.

6. Labor and childbirth are not something to be trifled with. The folks I worked with are some of the most skilled and motivated, and our outcomes are pretty good. However, the “natural course” of labor, even for a normal spontaneous vaginal delivery is anything but “normal” or “safe”. I completely understand why infant and maternal mortality is such a key indicator of progress in medicine and health care.

7. L&D is a truly interdisciplinary team. I think it’s really enjoyable to work with extremely skilled nurses who take substantial initiative in managing their patients – and they really do run the minute-to-minute operations on the floor. I don’t mind that they frequently tell me what to do – although I know some of my classmates do.

Those are some (vanilla, and boring, I know) preliminary thoughts. I have many more stories and I’m trying to strike the balance between HIPPAA, writing as though this were not anonymous, and halfway decent (interesting?) writing. I’m not sure I succeeded here, but I’m gonna keep trying, so bear with me.


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One Response to Labor and Delivery, Nights

  1. AndromedaMed says:

    Wow, great description about labor and delivery stuff. If only I wanted to do ObGyn. It’s. just. so. many. women. And not that I’m disparaging it at all! I really admire the people who do it.

    My rule for HIPAA stuff is that I have to be able to tell the story back to the person the story is about…without them recognizing themselves. Most of the stuff I put in my blog is made up, or a hodge podge of different patients combined into one.

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