Shoe Money Tonight

Occasional ramblings by an anesthesiologist/mother (and sometimes her husband).

Friday, December 22, 2006

Night OB call round-up

So I've been on nights all this week and I still have one day to go. Here's the highlights of the last 4 shifts.

Total Patients: 14
Average age: 23
Age range: 17-40

Low Points:

Monday night - I was paged every hour, on the hour, usually just as I was drifting off to sleep in the call room
- I finally got to sleep at about 4:30am (and got up for sign-out at 6:30)

Tuesday night - even worse than Monday
- I was in the OB wing from 7pm until 4am
- not a single epidural that was placed before I arrived was working well
- my first case was a c-section on a 171kg 40 year old
- 1:30 am stat section just as they were about to do a 3rd degree repair
- the OB team deciding to start the 3rd degree repair while we're still in back with the section and then deciding they needed anesthesia for the repair (leaving the poor woman in stirrups at least 15 minutes waiting for me to finish with my other case)

Wednesday night - all of my patients were 19 years old and some were on their second baby
- another 7pm urgent section
- I was told the room was "all set" and then found I practically needed to re-stock it
- during the day 1 c-section had been done - and no other work by the OB person (no post-ops, no new drug tray, no restock of the cart) so I had tons of catch-up to do

Thursday night - we have friday am conference at 6:15 (and I was presenting), so I told the entire OB staff that I
would be unavailable for epidurals and such; so of course at 6:10 they asked me to do an epidural
- yet another 7pm urgent section
- I got to do a blood draw/iv start on a 15 year old with major attitude

High Points:

Monday night - I got to do a combined spinal epidural
- no c-sections

Tuesday night - the attending bought me food (of course I was too busy to eat it)
- I got the spinal on the first stick, no re-positioning of the introducer, all I needed was a longer needle
- all of my patients delivered before I left, so I had nothing to sign out
- the OB attending on that night said she liked working with me

Wednesday night - I managed to get an epidural on a pt stuck at 9cm for 2 hrs (she delivered 2 hrs later)
- I put in one epidural in 15 min start to finish (a new record and I wasn't trying to rush)

Thursday night - I put in an epidural at 9pm, she went for a section at 11
- no pages after the section until the 6:10 am epidural request (aka SLEEP)

Last night I heard one of the funniest things ever said by an attending. There was a discussion about the 15 year old. She had told the nurse she was too dehydrated to pee for a urine sample and told the resident she was peeing all the time. The OB attending commented that the patient had a diagnosis of LLPOF. And what is LLPOF?

Liar liar pants on fire.

I know I'm going to use that one someday.


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