I’m not sure what it was today, the weather, a lack of sleep or simply a different day with different demands, but I hit my max of what I can handle. We started the day as we typically do showing up around 8:30, which is earlier than most of the doctors and students, and we couldn’t find any doctors for a good hour. We later found out that they have continuing education on Friday mornings. Oh, good to know.
We ended up shadowing a physical therapist that we met yesterday while hanging out in the surgery area. Today he showed us what he does in terms of checking on patients healing from fractures and helping them get the strength and mobility back. So we spent about 45 minutes rounding with him on patients in the surgical ward and the pediatric ward. Hearing a child’s blood curdling screams as the PT slowly rotated his foot so that his bones will heal right was not exactly the most pleasant way to start the day.
Once we were finished we headed back up to the labor ward and things were just starting to pick up. A couple admissions, a woman had just delivered a baby and more were on the way. It absolutely baffles me that women will be screaming in agony and no one even flinches. Every time I hear someone scream, I think to myself, “Shouldn’t someone check on her?” And yet it never happens. And then, Dr. Ishmael (who is basically still a student himself) comes over to us as we’re finished an admission exam and informs us that one of the women is about to deliver. We walk down and see one woman having a tear repaired after giving birth, but don’t really see anyone else who looks like they’ve been prepped to give birth.
WARNING – explicit details of birth to follow.
Oh, just kidding. There’s a baby’s head about to pop out. As Lindsay starts gloving up, Dr. Ishmael just continues to tell her to hurry. Comforting right? Lindsay runs over as soon as she’s prepped just in time to realize that the umbilical cord is wrapped around the baby’s neck twice. “Uh, we’ve got a cord wrapped around the neck!” Lindsay exclaims while trying not to panic. Dr Ishmael simply replies, “Just unwrap it.” Oh right, of course. Fortunately Lindsay was able to quickly remove the cord and deliver the baby without any more problems. As she continued I ran to get some sterile wipes to clean out the baby’s eyes and mouth. We’d heard a few weak cries, but once Lindsay was able to wipe out the mouth the baby started crying nice and strong. While we were busy doing that, Dr Ishmael instructs Thu to get some pitocin. Oh, right, cuz she knows where that’s at and loads needles all the time.
Well we finally got her the pitocin shot and Thu was able to carry the baby over to the baby area to be warmed, cleaned and weighed. Lindsay delivered the placenta and then had to go wash up as her arm had gotten splashed in the process. With Thu and Lindsay somewhat occupied, I was left to clean up the mother. Wipe up the blood around the outside and around the vaginal canal… ok, check. Now make sure you get all the way up to the cervix and clear out any clots. Ok, I’m trying, but mom is scared and in pain. Dr Ishmael keeps yelling at me that I should be all the way in up to my knuckles and the gauze in there too. Ok, ok, I’m trying! How would you feel if someone was shoving gauze up your genital area?
So I finish up, and she’s still got some active bleeding going on somewhere. Obviously I’m not an expert by any means and if he asks me to stitch her up I’m gonna be through the roof. Fortunately she’s going to be moved to the other side and one of the nurses is going to suture her tear. Once she’s headed over to the other side, Dr Ishmael decides it’s a good time to teach me how to examine a placenta to make sure it’s intact. Hasn’t it already been examined 5 times? So as he’s trying to teach me this through broken English, he has no gloves on and can’t really explain to me what I’m supposed to be checking for. Awesome. I finally figure it out and the placenta is clearly intact.
Maybe this scenario wouldn’t be so bad for someone who actually has some background in OB, but for me, the whole situation was incredibly frustrating. Lindsay, Thu and I have absolutely no idea what we’re doing and yet we’re basically handling the entire thing. No one else is around or gloved up in case something goes wrong, none of the nurses came over to offer help or guidance, and we’re basically being talked through this by someone who’s barely even done it himself. I so wish that I had more training. I wish that I had more experience. Maybe if I’d seen this a hundred times before it would just be going through the motions. Maybe if I knew where to find things, there wouldn’t be such a panic. BUT the fact that the health and well being of this mother and her baby was essentially left up to 3 bumbling medical students was more than I could handle today. The fact that a woman can be in labor with no one supervising and nothing ready to support her or the child is something that I just cannot even begin to fathom.
I think what’s most frustrating is that a woman can be in labor and no one turns a head or quickens their step to assist her. We’ve definitely caught on to the fact that nothing get done quickly here, but one would think that a hospital might be an exception to that. Nope. Apparently not. I don’t think I’ll ever get over that frustration but hopefully by the time we leave, I’ll at least be able to do my part to help.
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