Thursday, November 4, 2010

Blood, Needles, and Vajayjays

I acted like a complete ass (or as the British would call it, “arse”) during my first time to assist a delivery.

There I was, looking so important in my grass-green scrubs, gazing intermittently at the glass partition between the delivery room and NICU, making sure my hair was in place. The clinical preceptor was giving an orientation and final instructions, and I just nodded my head and joined murmurs of “Yes, Ma’am!” We were finally out of the classroom and laboratory, away from plastic mannequins and simulated environment. We were finally let loose into the clinical area.

“Gravida 2, 5 cm, her bag of water ruptured already!!” An orderly was wheeling in a pregnant woman in labor, her face contorted in pain.

“Vital signs and FHT now!” Barked our preceptor.

I felt like I was in the middle of Grey’s Anatomy episode (or Scrubs, more like it) as we scrambled to assist the woman to her bed in the labor room. One student took her blood pressure while we get a blanket to cover her lower extremities so we could expose her swollen belly to do Leopold’s maneuver. I could finally hear the baby’s heartbeat through the stethoscope; I counted, then marked the spot for future monitoring.

“BP 130/80 mmHg, the FHT is 130 bpm, contractions regular.” I said, wiping my brow.

“Another patient for C Section! I need two of you to scrub now!” Another patient came in a stretcher, and two students from our group scrambled for their OR gowns and start preparing.

Just as we thought it couldn’t get any worse, our preceptor screamed again. “Multipara, 10 cm already, I need you (pointing at me) and you (pointing at a friend) with me at the delivery room NOW!” The rest, stay with the other patient and monitor the progress of her labor!

“B..bb...but, Ma’am she’s not my patient, my patient is the one at the labor room.” I stammered nervously.

She just glared at me and walked hurriedly to the delivery room. I followed.

“Where’s the whiteboard marker for recording the time of delivery at the whiteboard?” She asked loudly while the patient was being assisted into the Lithotomy position.

My classmate and I looked at each other. “You didn’t tell me about any marker!” I hissed.

“Where is the Methergine ampule? Where are the sutures for the Episioraphy? Where’s your BP ap?”

“Uhmm.. ah.” I looked around in panic.

“Prepare those things NOW!”

And off we went. “Where were you during orientation?” My classmate demanded. “Oh shut up let’s just find those things.”

“Crowning!” The midwife and our clinical preceptor were instructing the mother how to push. Then the midwife did something that would take weeks to disappear from my mind: she took a sharp Mayo scissor and cut the woman’s perineum to widen the birth canal. The woman screamed in pain. Blood oozed.

I felt faint, I thought I’d collapse into the big bucket where they dumped the placentas. I wanted to slide the woman to the side so I could lie down for a while. Kidding.

The baby came out faster than I expected. No observable “internal rotation”, “extension” and all that cardinal movements we memorized in the classroom. The birth itself took no more than a few seconds. Just like that a person was born into this world.

“BP?”

“130/80mmHg.”

“Inject Methergine 1amp.”

I prepared the medication and administered it via intramuscular route. The woman was almost delirious; she did not even notice I stuck a big needle on her arm. The neonate was brought to the NICU for cord care.

We assisted the woman into her clothes and did the after care. As we watched her being wheeled away in a stretcher, my clinical preceptor asked me:

“Ok, so did you learn anything new in this exposure?”

“Yes Ma’am,” I said as I fanned myself.

“…Listen to instructions.”

---------------------------

I never thought I'd say this, but I miss duty days :->

2 comments:

DENASE said...

I also miss sometimes those duty days where shits from everywhere in the corner of DR and NICU get scrambled because of time-pressured works. Can't even hit the right action to do and the right words to say because of nervous-I'm still a student now, so I guess I still manifest these things here.

Another thing, Someday I will crown myself as the 'Vital Signs taking master' Fuck that activity!

Thad said...

@DENASE: hehe that's what we all go through. Yeah vital signs taking is the most boring routine task but I guess even medical interns would still be forced to do that by their own instructors.. oh well proper assessment benefits our patients so guess its worth the effort :->

Thanks for the visit

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