O&G Labour Week Part 1.

I'm only 2 days in to my labour week and I'm already struggling. I'm supposed to be in for midwives handover at 7am every day. Day 1 - alarm clock for 5:45am...next thing I knew I woke up again and it was 6:30am. Didn't get to the hospital til 7:10am...by the time I got changed into scrubs for labour ward...it was like 7:20am. Day 2 - alarm clock for 5:45am...actually got up this time. Arrived at the hospital at 6:55am and traffic wasn't bad. I actually tried really hard to make it to handover...ran to get changed. By the time I got out...I had apparently missed handover already and the midwives said I should aim to arrive for 6:50am tomorrow. In my head I was like "6:50am?! Yeaaahhh right." Dreading it already. Also I have been sooo tired. I would sometimes catch myself dozing off in the ward because I start so early in the morning...but still get off at 5ish pm. Brutal. And when I get home...I hardly have the energy to eat and all I want to do is sleep. So unproductive.

Pretty exciting first day though. Saw 2 normal vaginal deliveries. Also assisted as a first assistant on 2 caesarean sections (aka I got to scrub in and actually do proper surgical stuff...not just hang around and watch - just the consultant surgeon, me, and a scrub nurse - what a dream). Also witnessed an emergency caesarean section as the baby was stuck. When the emergency button was pressed it was like a TV show. It was crazy. Loads of people ran in within 5 seconds of the buzzer going off and everyone knew what they were doing. Anaesthetist was already making his way to theatre and some of the theatre staff darted to theatre to prep. About 8 of us were racing the bed down to theatre. It was really surreal. Obviously there was a sense or urgency. The mother had to be put under general anaesthetic (most caesareans is under spinal so the mother stays awake and just can't feel anything down below). Staff was frantically prepping the theatre with the equipment...it was just organized chaos. I was so scared to get in the way so I just crammed myself into a tiny corner of the room. I obviously couldn't scrub in as it was an emergency and the registrar had turned up.  Eventually we managed to get the baby out and I finally got to see the link between the paediatricians and obstetricians. The paeds team was already waiting for us ready for the baby and for any resuscitation as it was a complicated birth. Baby came out floppy and wasn't crying/breathing. It was a very tense moment as we handed the baby over to the paeds team. Unfortunately I'm with the obstetrics team so I couldn't go watch the paeds team work their magic. Finally after a few tense minutes we heard the baby cry and you could see the relief on some of the staffs' faces. I'm sure it was pretty scary for the mother herself as one minute she was just about to give birth but the baby got stuck..the next minute she's asleep. Also the father is left waiting outside of theatre after seeing a bunch of people wheel off his wife. Pretty scary situation for the family in general I would think.  I couldn't say I had as much fun  in the afternoon though. Immensely boring after a frantic morning. But the morning certainly made my day though.

Day 2 - quiet morning. Waited til 9am for elective caesarean sections. Again was really lucky and got asked to scrub in and help out...but not to the certain extent of a first assistant. Still makes a huge difference when you're scrubbed in. I even got to transfer the newborn to the crib after we pulled him out. It was really cool. After the sections...again went quiet again. Saw 1 normal delivery and that was it. Next thing to knock off my list: Instrumental Delivery (eg. using Forceps or Ventouse Suction). Really need to get that signed off tomorrow.

Labour week to be continued.......(if I'm still alive by the end of it)

Lack of Sleep.

5 weeks in! 2 more weeks to go. This has got to me the toughest week in terms of waking up. Every morning I am waking up at 6:30am to get ready, but it doesn't help that there isn't much to motivate me to get up.  I think the only thing that is making me wake up on time is the fact that I have to drive other people to the hospital so they kinda rely on me. I also think that being 5 weeks in, there isn't much else to see. Most of the patients we see have acute illnesses as most of the special illnesses get referred to a bigger hospital. 

I was on-call on Wednesday and the best bit is that the doctors on the ward can tell when I am on-call as I'm never on the ward when I am on-call. I try to go to clinics to try and make the time go by faster. As usual...Wednesday - I escaped the ward. I went to the Children's Orthopaedic Clinic for the entire morning. It was a lot more interesting than I expected it to be. I saw a lot of different cases. I was even able to sympathize with some of the patients. Met a girl who is hypermobile, which was affecting her participation in sports.  The consultant was doing a physical examination on the range of movement of her joints and on doing internal rotation of the hip, the consultant asked me if it was normal. I knew my leg could turn that far so I said: "normal". I have never seen such a confused face. "That is NOT normal. LOOK how far it goes!" Feeling a bit dumb/embarrassed I covered my back side by saying: "Oh sorry didn't notice how far it went *blushes*"

Once the patient left, the consultant questioned why I thought the range of movement was normal as it was apparently fairly abnormal. Then I proceeded to tell him that I am hypermobile as well. Then I found out he isn't very good with hypermobility.  The consultant looked quite uncomfortable and didn't want to see me showing my "flexibility". I was quite surprised about his reaction, but thinking about it....it is fairly gross. Fingers shouldn't bend so far back and such.  Haha. Hypermobility is a great party trick by the way. Just thought I would throw that out there.

Anyways clinic took quite long, but we had a lot of patients. What I enjoyed the most about the clinic is that we did not see two of the same case. Every single patient had a different problem and it really kept me awake and interested. For the first time at a clinic, I did not find myself bored. I was constantly engaged and I found each case interesting.  Probably could be one of the best clinics that I have ever been to. Long, but interesting.

At some point the clinic had to end and I had to return to the ward. On the way back, I stopped for a lunch break.  When I returned to the ward I was told there was another clinic happening in 30 minutes. Obviously I pounced on that opportunity and I disappeared from the ward for another 4 hours. By the time I got back to the ward, I only had 4 more hours left of my on-call to do. Luckily when I got back, the ward started to get busy and I got to clerk in a few patients. Most of them were diarrhoea and vomiting problems, so it wasn't too exciting. It was better than sitting around doing nothing.  But because the ward started to get busy, I didn't get to leave til 9:30pm. I had quite a bit of work to do when I got home and didn't get to sleep early. Worst part, I had to get up at 6:30am the next morning again. Thursday was brutal. For the entire day I was falling asleep whenever I sat down.  We also had lunchtime teaching from the registrar and I accidentally fell asleep. I felt really bad as I didn't mean to fall asleep as it wasn't boring. I was just so tired I couldn't keep my eyes open. Now I think the registrar hates me. She wouldn't talk to me afterwards and it was kinda awkward on the ward. Hopefully she'll forget about it after the weekend. And hopefully I can catch up on my sleep.

Paediatrics - Week 1

Wow this week was LONG. First started the week with a whole day of introductory lectures from 9-5. Then on Tuesday it was the start of our placement and the start of long drives early in the morning. Got to the peripheral hospital and the minute I stepped into the Children's Unit, I knew something wasn't right. In first year I had a placement in Paediatrics and you could hear children screaming/crying from outside in the hallway. This time...it was dead quiet. There were no doctors to be seen. We met in the doctor's room and soon all the doctors arrived and did a handover. The reason for the quietness of the ward? We only had 3 patients on the ward and another patient was coming in later in the day. I mean the doctors are all really nice though. All of them are also really keen in teaching as well. They did mention that the lack of patients is common so we do have to be proactive.

We are expected to do 7 on-calls in our entire attachment (7 weeks). So it would make out to be 1 on-call per week. I did my on-call on Friday which meant I was in from 9am-10pm. What a long day. However, I managed to clerk in several patients and I was definitely learning. Also in the middle of the week I got to do baby checks. This is where the doctor would check over a newborn baby making sure he/she is healthy and ready to go home. Some of the babies were so cute; however, after all the baby checks, I feared crying babies. Every time I hear a baby cry, I flinch a bit. Also the funny bit is that almost every baby we checked, the baby decided to leave a present for us in his/her nappy. Lovely. Guess that's what you get in paediatrics. Cute babies and stinky diapers.

Paediatrics is definitely interesting, but the lack of patients in our hospital is really taking a toll on me as I do find myself standing around doing nothing. I also find myself getting bored quite often. Unfortunately there isn't much to talk about for this week. It has been overall quite dull. Not a lot of banter either on the ward. Guess not every placement will be fun. Hopefully next up will pick up. I mean at least I'm starting to get to know the doctors quite well and they are very welcoming. 6 more weeks. Yay....