After O&G - came Paeds...
According to the Nursery schedule- I am first Resus again today- which means I will be holding the damn Pager. Which means I will be resuscitating babies in the OT and labour ward. Which means I will be doing all the baby checks in the maternity 2 and 3 wards and attending to all the open card issues there. Which also means that I would be working until at least 11 pm today.
Which basically means I have to be prepared for another damn tiring day of running around.
At 6 am sharp, just as I am about to enter the Nursery – my whatsapp application rings. ‘Ailing where r u? I need to handover the pager to you.’ My colleague who is post night posted in the Nursery whatsapp group.
When I appear in front of him, he grins and hands the grey pager over to me oh so happily. He seems to make it no secret that he is so happy to be getting his hands off that thing. I can’t blame him.
He informs me that there are 2 pending cases, one MMSL which is currently 5cm, And another emergency Caesar for poor progress of labour.
Damn, I think to myself, I just took over the pager and already they are two cases waiting for me.
I head up to the maternity 2 ward- where I am welcomed by the oh so familiar sound of running ctgs and waiting babies. I bypass the patients- some with babies beside them and some strapped to ctgs, and the O&G housemen rushing through their morning reviews and reach the baby room.
The baby nurse greats me happily and I ask her how many new mothers and babies are for discharge today which baby checks were not done. She hands me the record book and I count 6. Well, not too bad. I’ll try to squeeze in as many as possible before the pager beeps.
I reach the first baby and get permission from the mother to check the baby. I quickly auscultate the heart and lungs and feel for the femoral pulse before the baby starts wailing. And then just on cue- the baby starts wailing loudly. After checking the baby from head to toe, I find myself cooing to the baby ‘open up your eyes baby, open up your eyes’.. rocking him back and forth with the opthalmoscope in standby.
Just then, the pager beeps. 4012. Of course it is the labour ward. And of course it is the O&G houseman. ‘Hi- it is regarding the case I referred to you guys just now. The 40 weeks gestation with MMSL in room 5. Os is full now.’ Oh great. How I love the word meconium.
I rush down to the labour ward and into a room where the O&G MO, a couple of HOs and a few nurses were surrounding a labouring mother. Checking quickly that all the equipment I need were there, I wait. Progress seems to be slow- and the MO decides to perform a vacuum delivery. ‘Room 5 vacuum!’ The 0&G HOs begin scrambling to get the vacuum cup and the vacuum machine. At least they do not need to scramble to page me. As the MO performs the vacuum and the head finally appears, I find myself praying hard. The baby is finally out. ‘Please, please baby cry’.. I think to myself. I hate having to perform direct suction on a newborn. After a couple of agonizing seconds which seem like minutes- the baby lets out a loud wail. I sigh in relief. No need for direct suction. After the baby has been wiped and dried and suctioned, and doesn’t seem to be in respiratory distress, I call the nursery to inform the nursery MO and nurses that I am admitting a post vacuum delivery baby for observation.
I have barely finished documenting in the baby card, when the O&G houseman finds me and says that they are pushing the poor progress in labour into main OT now. I thank her and finish up my documentation and head down to OT.
When I reach OT, the baby nurses had already prepared the suction and the self inflating bag and have warmed up the radiant warmer. I peep inside and see the Caesar already in progress. The Doyan is already in the placed in the uterus. The O&G MO performing the Caesar is very fast and efficient so I better get ready now.
Again, I wear my gloves, check the equipment and wait, and pray. I hear the sound of suction- and I know it is almost time. I peep in and see the HO giving fundal aid and the MO trying to deliver the baby. Soon the baby is out. Cry, baby cry.
The nurse carries a wailing baby over to the warmer to me and the other nurse. I swear I can hear the baby wailing ‘mama’. And I am just glad that she is crying loudly.
As I reach back the maternity ward to continue the baby checks- the baby nurse informs me that the HPC for one macrosomic baby is only 1.9, another baby is vomiting and several SB results have come back and are due for interpretation.
By the evening- I have attended 6 caesars, 2 vacuums, done newborn checks for 15 babies, interpreted 10 SBs, admitted 4 babies into nursery and 2 babies into the general ward.
It is now 6:30 pm, and I am taking SB for a baby in nursery. Squeeze and release, squeeze and release. The bottle fills up slowly with precious blood. Just as I am done, the pager beeps. This time, the O&G HO sounds frantic. ‘Baby flat! 39 weeks gestation, antenatally uncomplicated, no meconium- room 7!’ I can feel my hair rising. I can imagine the scream of ‘Baby flat!’ in the labour room and the ensuing scramble to page me. Yelling to my colleague to inform our MO on call nursery/NICU- I rush over to the labour room. I wonder, is there anyone attending to the baby? PPV X 1 given by O&G MO looks nice written on the nursery clerking sheet. I find a couple of nurses giving free flow oxygen to the babv and the baby is now crying. Apparently he started crying after tactile stimulation. Thank God. My MO soon arrives and asks me to just continue observing the baby and admit for observation if there is any signs of respiratory distress.
Just then, the O&G HO comes in to inform me that they are posting another emergency Caesar for macrosomic baby in labour.
And I still have 4 more hours to go before the end of my day, a day in the life of a Paeds Houseman holding the pager.
According to the Nursery schedule- I am first Resus again today- which means I will be holding the damn Pager. Which means I will be resuscitating babies in the OT and labour ward. Which means I will be doing all the baby checks in the maternity 2 and 3 wards and attending to all the open card issues there. Which also means that I would be working until at least 11 pm today.
Which basically means I have to be prepared for another damn tiring day of running around.
At 6 am sharp, just as I am about to enter the Nursery – my whatsapp application rings. ‘Ailing where r u? I need to handover the pager to you.’ My colleague who is post night posted in the Nursery whatsapp group.
When I appear in front of him, he grins and hands the grey pager over to me oh so happily. He seems to make it no secret that he is so happy to be getting his hands off that thing. I can’t blame him.
He informs me that there are 2 pending cases, one MMSL which is currently 5cm, And another emergency Caesar for poor progress of labour.
Damn, I think to myself, I just took over the pager and already they are two cases waiting for me.
I head up to the maternity 2 ward- where I am welcomed by the oh so familiar sound of running ctgs and waiting babies. I bypass the patients- some with babies beside them and some strapped to ctgs, and the O&G housemen rushing through their morning reviews and reach the baby room.
The baby nurse greats me happily and I ask her how many new mothers and babies are for discharge today which baby checks were not done. She hands me the record book and I count 6. Well, not too bad. I’ll try to squeeze in as many as possible before the pager beeps.
I reach the first baby and get permission from the mother to check the baby. I quickly auscultate the heart and lungs and feel for the femoral pulse before the baby starts wailing. And then just on cue- the baby starts wailing loudly. After checking the baby from head to toe, I find myself cooing to the baby ‘open up your eyes baby, open up your eyes’.. rocking him back and forth with the opthalmoscope in standby.
Just then, the pager beeps. 4012. Of course it is the labour ward. And of course it is the O&G houseman. ‘Hi- it is regarding the case I referred to you guys just now. The 40 weeks gestation with MMSL in room 5. Os is full now.’ Oh great. How I love the word meconium.
I rush down to the labour ward and into a room where the O&G MO, a couple of HOs and a few nurses were surrounding a labouring mother. Checking quickly that all the equipment I need were there, I wait. Progress seems to be slow- and the MO decides to perform a vacuum delivery. ‘Room 5 vacuum!’ The 0&G HOs begin scrambling to get the vacuum cup and the vacuum machine. At least they do not need to scramble to page me. As the MO performs the vacuum and the head finally appears, I find myself praying hard. The baby is finally out. ‘Please, please baby cry’.. I think to myself. I hate having to perform direct suction on a newborn. After a couple of agonizing seconds which seem like minutes- the baby lets out a loud wail. I sigh in relief. No need for direct suction. After the baby has been wiped and dried and suctioned, and doesn’t seem to be in respiratory distress, I call the nursery to inform the nursery MO and nurses that I am admitting a post vacuum delivery baby for observation.
I have barely finished documenting in the baby card, when the O&G houseman finds me and says that they are pushing the poor progress in labour into main OT now. I thank her and finish up my documentation and head down to OT.
When I reach OT, the baby nurses had already prepared the suction and the self inflating bag and have warmed up the radiant warmer. I peep inside and see the Caesar already in progress. The Doyan is already in the placed in the uterus. The O&G MO performing the Caesar is very fast and efficient so I better get ready now.
Again, I wear my gloves, check the equipment and wait, and pray. I hear the sound of suction- and I know it is almost time. I peep in and see the HO giving fundal aid and the MO trying to deliver the baby. Soon the baby is out. Cry, baby cry.
The nurse carries a wailing baby over to the warmer to me and the other nurse. I swear I can hear the baby wailing ‘mama’. And I am just glad that she is crying loudly.
As I reach back the maternity ward to continue the baby checks- the baby nurse informs me that the HPC for one macrosomic baby is only 1.9, another baby is vomiting and several SB results have come back and are due for interpretation.
By the evening- I have attended 6 caesars, 2 vacuums, done newborn checks for 15 babies, interpreted 10 SBs, admitted 4 babies into nursery and 2 babies into the general ward.
It is now 6:30 pm, and I am taking SB for a baby in nursery. Squeeze and release, squeeze and release. The bottle fills up slowly with precious blood. Just as I am done, the pager beeps. This time, the O&G HO sounds frantic. ‘Baby flat! 39 weeks gestation, antenatally uncomplicated, no meconium- room 7!’ I can feel my hair rising. I can imagine the scream of ‘Baby flat!’ in the labour room and the ensuing scramble to page me. Yelling to my colleague to inform our MO on call nursery/NICU- I rush over to the labour room. I wonder, is there anyone attending to the baby? PPV X 1 given by O&G MO looks nice written on the nursery clerking sheet. I find a couple of nurses giving free flow oxygen to the babv and the baby is now crying. Apparently he started crying after tactile stimulation. Thank God. My MO soon arrives and asks me to just continue observing the baby and admit for observation if there is any signs of respiratory distress.
Just then, the O&G HO comes in to inform me that they are posting another emergency Caesar for macrosomic baby in labour.
And I still have 4 more hours to go before the end of my day, a day in the life of a Paeds Houseman holding the pager.
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