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Talkin' bout a bunch of shift work, a big old pile of shiftwork...

Posted Jan 15 2009 7:51pm
Lately, work has been pretty mundane. Routine labors, preterm patients, c-sections, inductions, and the like. The last few weekends have been pretty slow, but this last weekend was hopping. I had 2 labor patients, both laboring with their first. One was married, in her mid-twenties. The other was not married, and a fifteen year old sophomore in H.S. Both ended up with c-sections because their pelvis was too small. Guess which was the more mature patient? The 15 year old had a better all around attitude, a higher level of maturity and more realistic expectations than the older mom. I was pretty impressed. By Sunday morning, we left the dayshift with 6 active labor patients. By the time I came back in at 7pm, they had done 4 c-sections and 3 vag deliveries, with plenty of labor checks, UTI's and NST's. That's quite a bit for our size unit, and for a weekend. Sunday night wasn't too bad. I admitted an induction at midnight. One of the docs is notorious for doing inductions. He'll say they are medically necessary, but upon assessment, we can't figure out why. Suspected LGA in a multip. Or the pre-eclamptic mom with BP's of 110/50's on admission, no proteinuria, fine labs, nothing that would indicate pre-eclampsia or pregnancy induced hypertension. And when we look at her prenatal record, there isn't any indication of pre-eclampsia there either. One of my favorite reasons for induction? Edema. That was the reason for my induction last night. Too bad I had more edema in my ankles than what she had. (yeah, I need to buy support hose) The patient stated at her last visit, her doc told her he was scheduling her for induction Sunday night. Patient didn't request it, wasn't given a reason, and didn't question it. And on our orders, the reason for induction was edema. Just call it what it is, elective, and be done with it. This doc also seems to decide dilatation with what works for him. One of his inductions came in, I checked her, reached to her tonsils to find her cervix, and found her to be 2cm. On her prenatal record, the doc documented 3cm, 80%. When he came in to rupture membranes, he called her barely a 1cm. Huh? Just a week before he called her a 3, now she's 1cm? And I wonder why work can be stressful!
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