Next was the infamous L&D service. We each worked 4 12-hour day shifts and 3 12-hour night shifts, taking care of laboring patients on the floor, checking medication levels for the residents, and scrubbing in on vaginal deliveries and c-sections (both of which culminated in “catching a baby” if the med student was lucky). On the day shift, students also rounded with the Maternal Fetal Medicine team which is responsible for managing the care of patients whose pregnancies were complicated by preterm labor, gestational diabetes, and other medical problems.
This was a tricky service in the sense that it was sometimes hard to be fully involved, especially during the daytime. Some residents allowed med students to do periodic “mag checks” on patients being managed for high blood pressure, or let them check the patient’s cervix for level of dilation…others didn’t. In addition, it was easy for medical students to miss important events just because there wasn’t a good place to stand that wasn’t in the way of the housestaff and nurses. Even the course directors referred to the workroom in the back as a “black hole” where med students were often forgotten about…at least until the residents started typing their notes there during some of the night shifts.
Despite these setbacks, I had a great time on the service once I got used to the general flow of things. I even liked the 6pm – 6am night shift more than i thought i would; it wasn’t too hard to readjust my sleep schedule, and I always shared the shift with a classmate or two (one girl even introduced me to the cheap but delicious white chocolate caramel cappuccino from the hospital cafeteria one night). I didn’t get to “catch a baby” during a vaginal delivery, but I did deliver a few placentas and encourage a patient or two during labor–of course, I also witnessed the first moments of some beautiful babies. And I got to see the organized chaos that is a stat c-section. I didn’t even have time to scrub in; the baby was out in half an hour tops. And most of the residents and attendings I worked with tried to take time out to teach us students about a topic that was applicable to both the shelf exam and the wards.
The highlight of the rotation by far was when I got to scrub in for the c-section of a patient I’d seen during a direct observation session a few weeks before. When I went into her room to greet her before the operation, her face lit up, and she introduced me to her entire family as “the med student I was telling you all about.” during the operation, the resident let me deliver her baby, guiding my hands through the process. I probably won’t forget that patient or that experience any time soon.