Thursday, April 7, 2016

day in the life: 24 hour OB call

as always, details have been changed slightly
5:30am: time to wake up! Luckily I've been getting up at this time for months now, so it's slightly less shocking than it was nine months ago. I take a quick shower, and put my makeup on. I've recently starting using the Estee Lauder light doublewear foundation (review coming soon!), and this Too Faced blush (that's currently 15% off if you are a VIB!), hoping it'll last me through the day. 

6:00am: CR and I start at the same time this month (he's on an emergency elective), so I make us both breakfast as he gets ready. We're running low on supplies though, so scrambled eggs and turkey sausage it is.

6:20am: I pack my snacks for the next 24 hours (hard boiled eggs, turkey jerky, carrots, and a few left over Easter candies), let the dogs out, and head out the door. Don't I look thrilled? (ps. my sweater is from L.L.Bean and it's the best). 

6:35am: I've been saving my Starbucks reward to get the biggest drink I can today. I pick up an iced tea for my friend Neel, who is on the rotation with me. 

6:55am: I arrive at the hospital, and check the OR schedule. We don't have any surgeries until 10, so I head to the L&D floor.

7:15am: After getting report from the doctor leaving call, we quickly round upstairs on our post-partum patients. I love seeing the new moms and babies! During this time we see how the mothers are doing after their delivery, talk about plans after they leave the hospital, and discuss any specifics for discharge. And ogle babies :)

8:00am: Back on the floor, the attending starts working on her discharges, so Neel and I read for a while. The nice thing about being on a rotation for the second time is knowing when the doctors want you around and when they don't - this is one of those "don't" times. 

8:30am: Since we have surgeries coming up, we head down to grab a mid morning snack before the surgeries start. Hospital eggs aren't actually that bad!

8:45am: Right as we get upstairs, a patient I saw the day before comes in in rip roaring labor. For the next hour, we help the nurses and stay with her while she progresses through the stages of a labor. 

10:00am: I leave to go get ready to scrub in for our first surgery, a laparoscopic hysterectomy. The doctor lets me put in the ports, work the camera, and then close the port sites at the end. I didn't get a lot of hands on time in surgeries when I was on general surgery, so I'm excited to get to do a bit more now. I've been really practicing my hand tying, and while it's quite different in real life than it is when you are practicing at home, I'm glad I don't royally mess it up. 

11:45am: We run downstairs to grab lunch - today it's pulled pork and carrots. We grab lunches for our attendings, and make sure to grab a few extra sodas too - we need our caffeine!

12:00pm: We go back in to check in our laboring patients - she's getting close to delivery! 

12:45pm: I leave to go scrub in our next surgery, a laparoscopic tubal ligation. Again I get to put in the ports, work the camera, and close the port sites. Neel stayed behind with our laboring patient - he ended up getting to deliver the baby!

1:00pm: Our last surgery is a dilation and curettage and a hysteroscopy to help diagnose postmenopausal bleeding. To do this, the surgeon dilates the cervix, scrapes the inside of the uterus for a sample, and then uses a small camera to look inside the uterus. 

2:00pm: A patient comes in for a biophysical profile, which is an ultrasound and non-stress test to see how baby is doing. Since we had not seen one done up to that point, we go down to ultrasound with our patient. I think ultrasounds are one of the hardest tests to read, so I'm happy that the tech tells us what she is looking for. If you think about, it's kind of crazy that we can see the inside of our bodies, and see what a baby is doing while they are still in there!

2:45pm: When we return from ultrasound, all of the ladies on the floor are in the beginning stages of labor, so we read for a while. It's nice to have a bit of down time to get reading done, since my shelf exam was coming up and I really wanted to do well.

4:45pm: One of the women is ready to push, so we go in with our attending. Since Neel got to help deliver the baby this morning, it's my turn. Once the head is delivered, my attending lets me deliver the rest of the baby. Once the baby is out (yay!), we wait for the placenta to be ready to delivered, then clean up mom, help get the room cleaned up, and then leave so the parents have time alone with their new baby. 

6:00pm: A postpartum patients had some questions, so we go back upstairs to see her. 

6:30pm: We admit a patient to the general medicine floor for an abnormal cyst. Neel and I get to do the history, so we busy ourselves with that for a while. Then we type up our note just as we get a text message from our attending that another woman is starting to push.

7:55pm: Neel's second catch of the day! 

8:15pm: And then the next patient is ready to push. While this is not her first child, the pushing stage ends up being almost two hours long - in the end, I got to help deliver the baby!

10:00pm: CR drove over to bring us pizza, which was so nice of him because we live 30 minutes away from my hospital. I felt bad because we thought the previous delivery would go a little quicker than it did, but luckily he wasn't too upset about having to wait. Mushroom pizza helps with that, I suppose ;)

10:30pm: When my attending found out that CR was at the hospital, she insisted that he comes to the floor to meet her, so we all sat in the kitchen, eating more pizza and discussing our new found obsession with Clash of Clans (she's the reason we even started playing the game). After that, Neel heads home for the night, since he's doing a 24 hour call in a few days.

11:00pm: We get a consult from the ER, so we go down to the history and physical, and eventually admit her for abnormal bleeding. I watch as my attending puts in the orders and make sure everything is in order for her D&C in the morning.

1:30am: Time for another delivery - this is her first baby, so the pushing stage again takes almost two hours. I have no idea how these women do it - all you mothers out there are superhuman, I swear.
3:15am: With no other women being close to delivery, I go lay down in the on call room. While I wasn't really tired up to this point, I fall asleep almost instantly.

5:45am: I wake up to my attending knocking on the door, saying we're pushing in room four. The baby is delivered 15 minutes later.

6:45am: Neel shows up with Starbucks for all of us. Friends on rotations are the best kinds of friends.

7:00am: We listen to report (where the attending from the previous call tells the doctor who is going to be on call about all of the patients), run downstairs to grab breakfast (more eggs), and get ready for our surgery. It's my attending's surgery, which is why I chose to stay - if she's here, I'm here. This one is an oophorectomy, and since I scrubbed in yesterday, it's Neel's turn.
9:30am: We have a stat c-section for a breech baby with chorioamniotis - since Neel did the last c-section, this one is mine. I hadn't seen a breech birth up to that point, so I was a bit nervous. Everything went well in the end, but it does make me so thankful for modern medicine. I try really hard not to think about what happens to these women and babies if it weren't for ORs and sterile surgical techniques, but it really is crazy how much the whole birthing process has changed in the last one hundred years.

10:30am: I pack up all my things, and head out the door. I am so ready for bed.

11:00am: I arrive at home, let the dogs out, jump in the shower, and then climb into bed. I'm kind of exhausted at this point, and sleep for the next five hours.

Day in Review
hours slept: 2
hours exercised: 0
meals cooked: 1
hours studied: 3
steps walked: 13,682
patients seen on my own: 1
babies I helped deliver: 5