Listed below are 3 days (in a row) that I have had the pleasure of undergoing recently. You can't make this stuff up. The only thing that makes it better is wine. So for those of you wanting to "know what it is like to be an OB ," here you go.
2:00 am - Page #1 - Induction for preeclampsia, asking for pain meds for contractions. Nurse didn't bother to check the orders I had called in the evening prior, for pain meds, for contractions. Oops.
3:00 am - Page #2 - Triage - 32 weeker, pain with urination, no contractions, cervix closed. UA, Rx antibiotics, see in office.
5:00 am - Page #3 - Induction requesting epidural, IV bolus running. Please come in?
5:01 - 5:15 am - Lie in bed and curse the universe.
5:15 am - Shower, dress, warm Bean's am bottle, label bottles for daycare, prep CindyLou's breakfast, take upstairs to Mr. Whoo, drive in to hospital
5:40 am - Arrive, find a place to pump while epidural gets placed.
6:00 am - Check now comfortable patient, 6 cm, BBOW, no contractions picking up on the monitor, AROM, IUPC
6:15 am - Start rounds
7:15 am - Triage patient, term, in labor, 4 cm. Write admission orders.
9:00 am - Induction patient now 9 cm/0 station, variable decels, FSE. Call office, cancel AM patients.
9:30 am - Breakfast, pump, rest in empty labor room.
10:30 - 11:30am - Dictate delinquent charts, field office pages for various "emergent questions."
11:30 am - Labor patient gets epidural, induction patient complete, but too numb to push...laboring down.
12:00 pm - Check labor patient, 5 cm, SROM after epidural (she had thought she had peed) comfy.
12:30 pm - Pump, induction patient pushing.
1:30 pm - Labor patient feeling pressure, complete, starts pushing.
1:45 pm - Deliver labor patient's baby, placenta, get called away before laceration repair to catch induction patient's baby.
1:49 pm - Deliver induction patient's baby, sew 3rd degree laceration (14.5 in head).
2:10 pm - Return to labor patient's room, repair 2nd degree laceration. Write orders on both patients.
2:30 pm - Sign off NSTs, head to office, stop for fast food lunch on the way.
2:45 pm - 6pm - Office patients.
6:30 pm - Arrive home. Make dinner.
6:32 pm - Page # ???? - Triage patient, 38 weeks, oligohydramnios. Admit for induction.
7:30 pm - Baths, stories, and bedtime.
8:30 pm - 12 am - Dishes, bottles, tv, and sleep.
7:00 am - Page #1 - Triage patient, 39 weeks, labor, 4 cm. Admission orders.
7:30 am - Rounds, oligo induction 3 cm/60% effaced, start pit, encourage ambulation.
8:45 am - Arrive at office, pump while signing off labs.
9:00 am - 5:30 pm - Office patients (32, not too shabby!), charts, 20 min for lunch and pumping.
5:35 pm - Page #2- Labor patient 9 cm with BBOW, call Mr. Whoo to pick up kidlets, drive to hospital.
5:50 pm - Check oligo patient (who's been walking the halls all day long on pit). No cervical change. Decide to rest overnight and restart in the AM.
5:54 pm - AROM Labor patient, complete, fetal decels, resolution with O2 and reposition. FSE placed.
6 pm - 8 pm - Intermittently push with patient. Get hemorrhoids. Pump with "fred" the hospital pump. Fun times.
8:15 pm - Maternal exhaustion, deep variable decels, successful vacuum delivery, repair 2nd degree episiotomy.
8:30 pm - Write orders. Check on induction for post dates for the AM. Finally leave fragging hospital. Curse universe once again. Get page from UTI triage patient...still with painful urination. Encourage to continue antibiotic.
9:00 pm - Arrive home.
9:15pm - 11 pm - Dinner, Ti.Vo, and bed.
6:30 am - Get up, pump, see kids for 2.5 seconds, drive to hospital. Eat breakfast bar. Yawn. A lot.
7:00 am - Rounds. AROM oligo patient, place FSE/IUPC.
7:30 am - 1st surgery of the day. L/S, endometriosis, ovarian cystectomy, lysis of adhesions. Dictate. Talk to family.
9:30 am - Check on postdates patient, getting epidural. Pump. Round some more.
10:45 am - 2nd surgery of the day. L/S, endometriosis, adhesions, H/S, endometrial ablation. Smooth. Dictate. Can't find family.
12:00 pm - Check back with postdates patient. 4 cm, AROM, IUPC. Contractions not nearly as impressive on the IUPC.
12:15 pm - Oligo patient's epidural not working. Re - do epidural. Pump. Consider eating, but get called for...
12:30 pm - 3rd Surgery of day - LEEP, easy. Dictate. Reassure overanxious family.
1 pm - Grab bag of vanilla creme cookies from Doctor's Lounge for "lunch." Get paged to speak with 2nd surgery's family. All is well.
1:10 pm - Check Oligo patient. Cervical change! Yesss! 5-6 cm, comfy.
1:30 pm - Finally finish rounding on 10 patients. Write orders and scripts and discharges.
2:30pm - 4th Surgery of the day - D & C, endometrial hyperplasia. Lots and lots of curettings. Pray for no cancer. Dictate. Talk to family.
2:55 pm - Check post-dates patient. 6 cm, sleeping. Check oligo patient, sleeping, no cervical exam.
3:00 pm - Circumcision on 39 weeker's baby.
3:30 pm - Leave hospital, get fast food snack (mmm, french fries), go to pick up kids a little early from daycare. Feel like a good mom.
4:30 pm - In the midst of gathering kids from daycare, get urgent page. Oligo patient complete and ready to push (!!!) !@#@*#&(*!&
4:31 pm - Drive like a crazy person to the hospital, with kids hanging out in the backseat. Leave frantic messages on Mr. Whoo's cell to pick up the kids at the hospital.
4:45 pm - Arrive at hospital. Hand off kids to kindly nurses. Feel like a terrible mom. Go catch a baby.
5:15 pm - Repairing laceration and working on post partum hemorrhage. Guess birth weight exactly. Get word that Mr. Whoo has arrived to pick up the kids. Also, post-dates patient is 8 cm.
5:30 pm - Finish paperwork, check post-dates patient - 9 cm. Call Mr. Whoo, check on kids. Kids are sad and miss the mama. Feel like a criminal. Cry a little.
5:30 pm - 8:00 pm - Hang at the nurses station. Pump. Feel sorry for myself. Whine a little bit. Check post-dates patient. Patient begins pushing once night shift nurse is ready.
8:00 pm - 10:00 pm - Pushing. More hemorrhoids. Anguish. Bitching at the nurses station. Occasional fetal decels, and, finally, fetal tachycardia.
10:10 pm - Have "come to Jesus" talk with post-dates patient. Decide to place vacuum. Successful vacuum with one push. Berate myself for not doing this 2 hours ago. Repair 2nd degree episiotomy. Get the birth weight right within one ounce.
10:30 pm - Finish paperwork. Hear about term fetal demise getting admitted (not my patient, but still devastating.) Leave the god forsaken hospital. Curse the universe, once again.
11:00 pm - Arrive home. Shower, dinner, and bed.
Glamorous, is it not? More wine, please?