Day in the Life: Obstetrics

Happy Monday + welcome to another Medical Mondays and my fourth “Day in the Life” for residency–this time in Obstetrics!

Fun fact–when I was applying for residency programs/making my rank list, I was actually looking for unopposed programs because I thought it’d be cool to be able to do everything, but…I ended up falling in love with the most opposed program on my list (there are about 17 other residency programs here).

Part of what sold it for me was that they had a few residents interested in obstetrics who mentioned they had to compete with OB residents for deliveries, so…they moved our OB rotation to an entirely different + completely unopposed hospital.

If you’ve been here long enough, you probably know I have zero (more like negative) interest in childbirth/OB, but I can definitely appreciate that it’s evidence that they really do want us to be able to pursue/develop our interests!

Day in the Life: Obstetrics

There was apparently one physician who got super bent out of shape if a resident was sleeping in the call room he used once every few weeks, so I just opted for a couch in the lounge.

Clinic

My hours for this rotation were pretty chill! All my senior residents advised that if I had things to take care of, this was the rotation to get it done in. Clinic hours were technically from 8 am – 3:30 pm…

But…as luck would have it, I started here right as they were switching to a completely different EMR (electronic medical record) system. Two providers were ready to quit on day 1 of the change, and everyone kept apologizing to me about the low spirits/high frustration, saying that I was unfortunately there at a really difficult time. Although none of the patients were ever aware of this, there were tears and uncharacteristic swearing in the back rooms every other day and lots of delicious foods brought in for stress-eating purposes.

I absorbed all that I could from the “Go Live” team’s advice/suggestions, and before long, the midwives I worked with were super happy to have me there because I was like a stand-in mini-tech support for them. I unknowingly worked with the head midwife one day and she said super nice things about me to everyone at their debriefing meeting! :]!

My time in the clinic was mainly spent trying to pick up continuity patients for eventual delivery. I tried to pick patients between 34-38 weeks who were relatively uncomplicated, but I did end up getting several with a myriad of problems (health, social, or both).

I got a lot of practice with…

• Measuring the fundal height
• Using Leopold’s maneuvers to determine the position of the fetus
• Getting the fetal heart rate with the ultrasound
• Explaining the signs of pre-term labor
• Counseling for depression :[

Hospital

My senior residents also highly suggested that I bring my computer for the hospital portion of the rotation, as there’d be lotsssss of waiting around (not unlike my OB rotation in med school)–aka ample time to get some studying/charting/whatever else I needed done. Hospital shifts were 7am – 7pm.

The long hours meant I had less time to spend with Muffin and Lord Snow when I was babysitting him, but I guess they kept each other company?

We would look after our patients in L&D (Labor & Delivery) and check up on them periodically + write up labor progress notes, and we were also responsible for OB Triage, for anyone pregnant coming in with concerns about their pregnancy that the clinic didn’t handle and/or if they [thought they] were in labor, and we’d also do postpartum checks.

My first day at the hospital actually happened right after a full day at the clinic because one of my patients was being brought in for induction of labor, so I ended up working for 24 hours. (Shhhhh….) I did manage to do a pit stop for a delicious burrito before heading to the hospital though!

I used to be a repel system for deliveries when I was in med school–very little would happen and it seemed like no one ever wanted to be born while I was on, but  that’s kindasorta changed–we had several super busy nights filled with a ton of patients in OB triage and several patients who were almost-not-quite in active labor. I ended up getting one continuity delivery in, and 2 hours of sleep in a 24-hour interval, so I’m going to call it a win.

The midwife I was working with said she really appreciated all my help and that I was really easy/great to work with. :]! I don’t think anyone suspects how I really feel about childbirth, so I’m going to assume that I’m getting a little better at maintaining a poker face!
I think it made all the providers feel bad to see me “twisted up like a pretzel on the couch” in the providers’ lounge since they didn’t have a call room available for me, so one of the midwives showed me an overflow patient room that had turned into a storage room that I could use to sleep!
So just for funsies, this is the obstacle course I go through to reach “my” bed at the hospital:

I ended up half-living at the hospital for a couple days on end each week because babies are rather unpredictable and I need to deliver 40 to graduate, so it’s a good thing I can sleep anywhere at any time! :P Although OB definitely isn’t my favorite field, I really liked working with the midwives there and I’m really going to miss them!

• How do you make the best of non-ideal situations?
• Do you follow the “fake it til you make it” philosophy? A nurse came over to ask if OB was what I wanted to specialize in and that she was asking because she’d worked with me on several deliveries and thought I’d done an amazing job.
• Behbehs–yay or nay?