Adventures in Nursing, Part 6

For some reason, lately my brain has been blocking out memories of my past hospital experiences. However, today I remembered a story from my Parkland days that I thought I would share...

WELCOME TO RESIDENCY

I have previously noted that life at Parkland is chaotic and crazy. It really is, thinking back, I don't know how I did it. You would go 12 hours without sitting or eating or drinking. The thing to remember is that what the nurses go through is nothing compared to what happens to the 1st year residents ("first years") at Parkland.

These folks really deserve a pat on the back and a lot more money than they get, at least in residency. They do 24 hour shifts on the same no sleep, no food, no sitting. They don't spend the entire 24 hours on the floor, that would be insane. However, they do have 12 hour shifts on the L&D floor and then the other 12 hours are spent on rounding the postpartum floors, doing paperwork, just what you want after 12 hours of running around like a chicken with its head cut off. Plus, you are fresh out of med school, which is awesome on getting your prepared in theory, but there is hardly any actual, true patient care. As a 1st year resident at Parkland, you are expected to perform EVERY VAGINAL DELIVERY on the West side, which is the high risk patient area. Luckily, you don't have to do c-sections, but you still better be prepared to work. With more than 50 babies being delivered at Parkland every day, you can imagine how hard it is for a lone resident to keep up with the constant flow.

Now that you have been prepped on what it is like to be a resident in Parkland L&D, I will begin my story. One night, I was in a delivery with this sweet first year and we were having a pretty smooth delivery. The baby came out quickly and I was busy cleaning up the baby while the first year waited for the placenta to come out. Then I hear, "Uh-oh". This is not something that an OB nurse ever wants to hear while at work, because it is never a little uh-oh. I looked at the first year and she is holding the umbilical cord in her hand, but there is no placenta attached to it. Then I look at the patient and she is pouring out blood. I say, "What happened?". The first year says, "I guess I pulled too hard". "Ya think! Would you put down that cord and clamp off her placenta so she doesn't bleed out right here!" I said. The resident does as I say and I run over to the intercom to call for a higher level resident to evaluate.

Did I mention this was the same resident who I had the shoulder dystocia with? See Adventures in Nursing, Part 3 for that gem of a tale. I manage to use the intercom correctly and call for the 4th year resident to evaluate bleeding. The 4th year was not prepared for what he happened upon, but what was I supposed to say, "Fourth year to Delivery Room 1 to evaluate First year's uh-oh". Unfortunately, I think it was the first time that the Fourth Year had seen an detached umbilical cord as well, so after several attempts to remove the placenta manually, it was decided that the patient needed to be taken to the OR and have the placenta surgically removed. Luckily, I was still unable to do any OR procedures as I was still in my nursing residency so I was able to move on to a different patient. The poor First Year, ended having to clamp the placenta off with her hand until the patient was back in the OR. I think the patient also ended up with a small blood transfusion. The resident told me the next day that her hand was very sore and felt more like a claw. Poor gal, I am sure that she has made an excellent doctor and I hope that she has stopped saying "Uh-oh" in an crisis.

This story is dedicated to my sister-in-law who hopes to go to medical school, remember the joys of residency!