A DAY IN THE LIFE: OBGYN NIGHTS

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Today was my last day of shadowing in Obstetrics and Gynaecology (OBGYN). I can't believe 6 weeks have already passed! Anyway, I finished my placement with a week of night shifts. The saying that everything happens at night in OBGYN is true - my night shifts where certainly busier than my day shifts. Anyway, here is a run down of one the night shifts I had. As you all know, things in Medicine aren't routine - there is no such thing as a typical night. Hope you enjoy! 
6.00pm 
Alarm goes off , Wake up. Jump in the shower. Eat some dinner

7.15pm 
Leave the house – just a 10 minute drive to the hospital (I drive for night shifts because the 30 minute walk after a night shift seems like several years). When I arrive, I go straight to the delivery suite and get changed into my scrubs, thermal socks and crocs. 

8.00pm 
Get hand over for the gynae wards first then the obstetric wards from the junior on call for the day

8.30pm 
Ward rounds with the medical team - we see all the acute patients and those who are waiting to deliver on the delivery suite. The team is comprised of one junior doctor who I'm shadowing), one junior registrar and one senior registrar plus a LOT of midwives!

8.45pm 
Ward round interrupted by bleep...junior doctor is asked to of the gynae ward to see an emergency patient. She lets me clerk her in and start management. 
Note: clerking means take a history, do an examination and formulate a plan which includes ordering some investigations and writing up some medication to be administered by the nurse/midwife 

 9.30pm 
Back to the team, catch up on what we missed on the ward round. Jobs to be done by the junior doctor/ me immediately after the ward round are:
  • Cannulate three patients 
  • Review a lady who had a Caesarean section a few hours ago with query post part haemorrhage
  • Write some discharge letters for patients on the gynae ward 
  • Take some blood samples from one patient 
  • Review three emergency patients waiting to be seen 

11.00pm
Unscheduled theatre.  A lady originally scheduled to have a normal delivery now needs a Caesarean section for failure to progress through labour. The senior registrar lets me be first assistant!
The first assistant role basically is helping with the delivery - usual tasks include holding the retractor, suction, following sutures, 'pushing; the baby out, taking cord bloods if needed. 
I always stay to help the nursing staff get the woman cleaned up and moved to recovery (remnant of my healthcare assistant days!)

12.30am 
Finish the case (took longer than normal because the woman had undiagnosed placenta praaevia (placenta covering the cervical opening) and there was a lot of bleeding to control) 
Grab a quick bite to eat with the junior doctor 

1.00am 
Bleeped to go to A&E to see a patient with a query gynaecological course of abdominal pain. I clerk her in and start management (with the supervision of my junior doctor of course!) 

2.00am 
Senior registrar is bleeped to an obstetric emergency - a lady in labour at 24 weeks with a breech baby. 
I ask to stay to observe. 
Pretty emotional but awesome to see - baby was born okay (weighing 550g!) but needed resuscitation (which was incredible to see - such skilled neonatologists! I hope to be that proficient with babies if ever I have to deal with emergencies like this) 

4.30am 
Junior doctor asked to see a post delivery lady with query sepsis. 
There is an obstetric sepsis protocol that needs to be followed if an obstetric patient is found to have sepsis. 
Between the junior doctor and I we start the protocol which includes blood cultures, septic screen, arterial blood gases, fluid resuscitation, antibiotics 

5.30am 
We have some down time so I ask the registrar if I could have my Case Based Discussion with her. For this, I present a patient I saw and the registrar grills me on the subject! Nerve wrecking (especially at this time in the morning) but good practice!

6.30am 
Time to get scrubbed in again. This time its a lady being sent to theatre for a delivery trial with forceps. Pretty straight forward delivery once things got started. 

8.00am 
Day team arrive. 
Hand over to them about the night shift and tell them of any imminent jobs that need to be done. 

8.30am 
Time to go home! 
I get changed and head straight to my car. 
These cold nights/ mornings mean I need to scrap some ice off my windows. 

8.50am 
Home! 
Traffic in the morning delays my time to bed! 
As soon as get in, I have a quick shower and make a to do list for when I wake up. If I feel particularly awake, I make some breakfast but this happens 50% of the time! 
I have another night shift tonight so before I sleep I do some work/ send some emails, etc. I also talk to my familia if I can because night shifts mean I'm awake when they are asleep! 

11.00am 
Bedtime! 



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