The last two weeks have been insane. Who knew that nursery could be so intense?
The second week we got a bit of a break, because our census wasn’t as full as it was the first week. And because my cointern and I had such a hard time keeping up, by the time the second week started we had a system down to be as efficient as possible. That doesn’t mean it wasn’t…exciting. I got called to a meconium birth, which is a normal part of our nursery duties. Essentially it’s when the amniotic fluid has already ruptured and the baby has a bowel movement before birth. High risk for aspiration and respiratory issues at birth. Usually everyone as a whole isn’t super worried about them, except this baby appeared to the world not breathing. In a regular room, the OB can turn around and place the baby on the isolette but somehow the OB got stuck between one stirrupped leg and the equipment table and could not place this baby. So guess, without hesitation but also without really thinking about it, grabbed the baby and got to the isolette as the NICU team got to work. It seemed like forever that nothing was changing, which prompted the mom, who had an epidural, the attempt to get up. The nurses managed to get her back down and after a call to the NICU attending, we got baby crying and moving which was great. But so very terrifying. Human life is terrifying start to finish.
The rest of that week wasn’t too crazy and I finally got a golden weekend after 3 straight weeks. I was so exhausted and just mentally all over the place. I don’t know how we can change a system in the way medicine has it but in the moment, I was just happen to sleep in a little bit.
This last week was pretty interesting though. I managed myself in so many freaking c-sections, even one for a 32 weeker. I think I got the hang of just regular newborn things and a little more comfortable managing respiratory issues but being in the OR still makes my brain crazy.
I also managed to get into it with a nurse. We had a mom who has some issues, mostly that she connected her baby losing just a little too much weight and some problems with breastfeeding together to equal that she was in trouble and being a bad mom. Which was not the case. But when I spoke to her we decided to add some formula supplementation until she was comfortable and her milk had come in fully. A solution to a problem.And for anyone who is a breast feeing maniac, it doesn’t matter in the event baby isn’t eating. Babies need to eat. Holding off food for ideals will never make sense in this context. Well, she apparently got more upset as the day went on because of the general stress and one of the nurses decided that I must have done something wrong, blamed me to the patient and then tried to tell my preceptor I was using “scare tactics” on a mom. My attending shut it down but I was massively pissed off. In a not intern move, I confronted the nurses myself. The issue in totality ended up being completely resolved, especially after the nurse needed my help with a verbally combative grandparent. Long story short, always communication your concerns to someone’s face.
A finally finishing off with a 24 hour shift on Friday. Honestly, thank the entire world for great seniors. The second year with me really helped me out, since the floor is still a world away for me. It’s just a huge jump and you still need to manage the nursery. We had a kid who ended up with a pneumo and she caught it. I just want to be that good in a year.
Themes of the week so far:
Week 2: GBS+
Week 3: Paretns who don’t listen and weird babies.
Last week of nursery!