Friday, January 20, 2006

Extreme On Call

If I survive Labour and Delivery on call this week I will likely survive med school.

I have 100h on the L&D unit in 7 days. One 25h block down (24h on call followed by an hour lecture), 75h to go. Last night I did not see the inside of my call room, and Thursday 19 Jan was swallowed by the black hole.

I will admit to being very frusterated at my more senior colleagues. I had one patient that came in at 04:00h, who was seriously acutely ill, and happened to be pregnant. Obstetrically she was fine, but she needed to be assessed by a real doctor. I made nine phone calls to three different physicians, and no one would come down to see her. By the time I left at 0800h the consulting physician still had not arrived. As one of my mentors so wisely told me, "if you would go see the patient at 3 in the afternoon, you should go see them at 3 in the morning".

Its amazing how sleep deprivation messes with your brain, and distorts your perception. I was curtly reprimanded for my inadequate case presentation by the attending who was taking over the unit at 0800h this morning. Ordinarily, I would have been a little taken aback, but tried to learn from what he was saying, and perhaps ask some intelligent questions about how I could improve things for next time etc, but after being awake for the past 26h, it was all I could do to nod, mumble a few, oks, bit my lip, and promptly leave so as not to burst into tears. Also astonishing upon reflection that this doctor didnt even bother to find out if I had ever done hand-over rounds before, and to then just teach me how.

Basically no teaching occurs between 0300h and 0800h---everyone is too sleep deprived and on edge to care at that point.

But I delivered four babies, assessed more pregnant women than I can count, ruptured membranes, inserted my first fetal scalp electrode (which I had never done before, and I had no one there coaching me through it, I just had to do it, with my heart in my throat I might add).

Really, this next week is just about survival.

5 comments:

Courtney said...

I think my heart was in my throat as I just read that...

I applaud you for biting your lip in the midst of being reprimanded even though what was done to you was an injustice. I probably would have started my next sentence with, "you know what?". Lauren you are a woman God - with humility. Kudos. Especially after being awake and under high stress for so long. *applause*

Anonymous said...

Incredibly difficult to stay awake for so many hours. I am assuming there wasn't time to sleep in the L & D unit between situations. Personally I find it very difficult to be cognitive when sleep deprived. Congratulations to you for holding back on some comments.

Nevada said...

Hang in there girl!!! You are doing great, I can't believe you've delivered 4 babies already, that's crazy! I'm praying for you.

Jenny said...

Wow Lauren, what you're doing sounds amazing, the sleep deprivation aside. When I went home this Christmas I ended up being very sleep deprived and had an interesting conversation with the Canadian Customs Officer in Ottawa. I'm just grateful he let me through!

LJE said...

will pray for you, can't imagine how draining and overwhelming it will be over the next few months.