Night Shift: JWs and C/S

One of the first things Anita and I had to do when we started our shift was do an H&P on a pregnant fifteen-year-old girl. That went along well until Dr. B (one of the FP residents) came in and started listing all the things that could go wrong in childbirth (hemorrhage, C sections, etc.) She looked really scared (wouldn't any kid?), but when Dr. B mentioned blood transfusions, she said, "I can't get blood transfusions." That sounded like something out of Ethics; sure enough, her aunt confirmed that they were Jehovah's Witnesses and don't believe in getting blood transfusions (for fear it'll damn them to hell). Everyone else's thoughts: so this girl is allowed to get knocked up, but not allowed to receive someone else's blood? Still, since she's a minor, if she does need a transfusion, a judge is a phone call away and they can get one for her. Toward the end of my shift, she was having trouble with labor and had to have a C-section (more on that later)

I was allowed to scrub in on my first C-section today...of twins. (Jedd was all, "Quit stealing my twins!" when I told him later at lecture; he wants to deliver twins) One baby was breeched (hence the reason for the C-section, or C/S), that that one was pulled out first, followed by its sister. But...the uterus kept bleeding. In a lapse of judgment, Dr. D (2nd year resident) let me feel the uterus to feel how boggy it was when I asked, and Dr. C (4th year resident) quickly told me not to do that since the uterus was in lousy shape. Oops. Turns out it was a bad case of uterine atony; they had to give lots of oxytocin and other drugs, and ended up having to do a B-lynch tie (which make the uterus resemble "rump roast") to stop the bleeding. Needless to say it was not your everyday C-section. I got to retract for a while. Later I was called to help in another C/S, but I ended up not going b/c I was so exhausted. If I had gone it, I probably would have passed out and that wouldn't have done the others any good. Dr. C shared a story about how one med student fainted in the OR once and no one could get to her for a few minutes b/c they were all sterile.

The triage room was really busy and the nurses were a lot crankier than usual. Kids kept wandering into the triage area from the waiting room looking for their moms and they'd be sent back to the waiting room. One girl used the patients' bathroom and one of the older nurses, thinking she just wandered in out of nowhere, told her she can't use that bathroom. "But she said I could!" said the girl, pointing to a younger nurse. Turns out the girl's mom was a patient. And the second time I was supposed to do the C section, I poked my head into the ER and asked the charge nurse if she could get me some gloves. The nurse glared at me and threw up her gloved hands (she was sterile), but another nurse said she'd get me a pair. Turns out I didn't go anyway, so I hope those gloves weren't a total waste =( Dr. B had to go around writing tons of H&Ps b/c of all the new admissions, "scutwork" he called it. I started about 2-3 H&Ps today but each time he told me not to bother finishing them. Then how can I practice doing them? Anita and I ended up following him to do charts, but nothing came from it. We did see Justin in the hall (around 5:00 a.m.) and waved.

Oh yeah, I got to deliver my first baby today! I was in triage doing the mom's H&P when her contractions started getting worse and it was clear she was going to give birth real soon. "Keep your eyes on the prize," was what Dr. B told me, and this baby just slipped out on its own without any pushing from Mom. I was able to pull him out, and boy, was he slippery! (No, I didn't drop him). I had some trouble maneuvering him to cut the cord, but I think I did ok for my first delivery. Hopefully I can deliver another one in the next shift =)

Jedd and Aaron had case presentations today, and Dr. C was there to pimp away. That means whatever I do my presentation on...I'd better know my stuff forwards and backwards.