hospital, OB GYN, physician

Working the Holidays: The Invisible Heroes of Healthcare

No one wants to be sick around the holidays, or go into labor during Christmas Eve Service.  We are constantly reminded that we have no control over these things as emergencies arise 365 days a year and thankfully, there is always a place to seek help and someone who is ready to be of assistance.

The holidays are what remind us of what is important in life.  They are a time for gathering with family and friends when the otherwise hurried pace of life doesn’t usually leave time for a home cooked meal with Mom, chatting with cousins, or playing in the snow with kids.

Unfortunately, some people have to miss these precious moments- their jobs require it.

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If you walk through a hospital during Christmas, you will notice it to be eerily quiet.  Only patients with true emergencies will be there, and health care workers will be ready.

You will see a phlebotomist with a Santa hat on striking up a conversation with a patient while skillfully drawing their blood.  You will see a nurse comforting a woman in labor and a surgeon closing the incision from an appendectomy.  You will see a cafeteria worker flipping burgers and humming a song while he works, providing the sustenance to keep the rest of the team going through their 12-24 hour holiday shifts.

They are all happy to have their jobs, but they are missing their families immensely during this time.  Few professions require the dedication to work during a time when everyone else is tending to the people that make their lives meaningful.

Alternatively, some health care workers may have volunteered to work.  Perhaps the holidays are a particularly difficult time as they are acutely reminded of the loss of a loved one and the memories forged on these holidays in the past.  Working may provide a necessary and welcome distraction.

Regardless of the reason these people are working over the holiday, they are providing a desperately needed service- a service to others at the expense of their own families.  These actions are what remind us all of the need to take care of each other.

Thank you to all of the janitorial staff, medical assistants, nurses, phlebotomists, ultrasound techs, and doctors (to name just a few) who keep America’s hospitals running and care for our patients over the holidays.

Merry Christmas and Happy Holidays!

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birth plan, epidural, episiotomy, hospital birth, Physician Training

10 Things to Know Before You Have a Baby in the Hospital

 

  1. You might get sent home. If you show up pregnant with your first baby and it turns out you aren’t 4 cm dilated yet, you will get sent home because you aren’t in active labor. Please don’t cuss out the charge nurse.   Yes, you are in pain- we aren’t denying that.  However, there are limited numbers of beds on labor suites and we need to keep some open for people who will likely roll in right behind you and will deliver way before you. There are no appointments on L & D (labor and delivery) and you never know what will come in.  Space and open beds are the issue, not laziness of admitting physician.

 

  1. Limit it to 2 guests during delivery. More than that is just a distraction.  If there is an emergency, the last thing we want to be worried about is having enough room to take care of you appropriately without people being in the way. In a true emergency about 10 medical professionals will come barging in your room within seconds and if someone is standing in the way it prevents us from doing our job.

 

  1. Ask for the epidural early. If you plan to wait and see how it goes, likely you won’t have time to get an epidural before baby makes the big entrance.   Murphy’s law will dictate that every pregnant patient on L & D will need one at the same time and there is usually only one anesthesiologist, who will invariably be back in the OR with a C-section tied up for half an hour.  Don’t miss your chance!

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  1. You can have a birth plan, but please have it read as follows: I want to leave the hospital with a healthy baby and Mom.  Anything more than that and we get superstitious.  It’s just like the old wives tale about the full moon and people going into labor- there is no scientific evidence to back it up but we all believe it’s true and witness it happen all the time.  The longer and more detailed your birth plan, the higher the percentage likelihood you are to end up with a C-section. At least it always seems to work out that way.

 

It is true that you can expect to have more interventions and temporary discomforts while having a baby in the hospital as opposed to a home birth.  Expect to not eat when in active labor, have monitors strapped to your stomach and frequent vital sign evaluations.  In my opinion, these are small sacrifices to pay to ensure healthy baby and Mom.

 

 

 

  1. Contrary to popular belief, we love when you bring a Doula to the hospital with you! They help you through your labor, make sure your needs are met, and encourage you through pushing.  They are an OB/GYN’s best friend!

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  1. Prepare to not eat food for a while. We are not doing this to be mean. We are doing this because having a baby is dangerous. At any moment you could become a surgical patient. If you vomit and aspirate, this could be dangerous for your health. Nobody wants to have a newborn baby, aspiration pneumonia and recover from surgery all at the same time.

 

  1. We are going to press on your abdomen/uterus after the placenta delivers. I have seen patients get downright angry about this. The reason behind it is that after the placenta comes out, the uterus can become very floppy and you can quickly lose a liter of blood. Massaging the uterus helps with the tonicity and also helps your doctor assess whether there is a problem or if more medications are needed to avoid a hemorrhage.  Just because the baby AND the placenta are out, there is still a need for assessment. You are almost done!

 

  1. Don’t try to rush the OB who is suturing you after you tear with delivery. Episiotomies aren’t routine anymore and are typically only done when medically necessary.  However, it can be very common to tear on your own with a first baby.  Let your OB take their time and do it right, trust me.  10-20 more minutes of meticulous care will be well worth it in the long run, especially if you were “blessed” with a 10lb baby.

 

 

 

  1. Send your husband to get your ice chips. Let your nurse focus on your vital signs, evaluate the fetal monitoring, and document your progress.  Your husband/support person should be the one getting you the much needed ice.  Besides, it will help your partner feel useful at a time when they are often struggling over lack of control and they want to help you in any way they can.

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  1. You are in competent hands. A normal labor can turn into an emergency at any moment, even in a low risk patient.   In any given day, L & D will have a woman hemorrhage after delivery.  In the next room, the newly delivered baby may not be breathing. 2 doors down a patient just had a seizure and dangerously high blood pressures as her preeclampsia progressed to Eclampsia.  Down the hall a shoulder dystocia occurred.  This happens when the baby’s head emerges but the shoulders are too wide to deliver and asphyxia of the infant makes seconds feel like hours until skillful maneuvers can safely deliver the baby.  I mention these scary but common scenarios because the best thing about having a baby in the hospital is that you are surrounded by scores of people that are trained to handle these exact situations and do so every single day.