Wednesday, 25 June 2008

Making a difference

I had such an amazing day at work today. In my time working at NewTown Hospital, I hadn’t really done any maternity work so, I was pretty excited when I found my name on the maternity rota for today.

I pitch up at the delivery suite and have a chat with the overnight anaesthetic registrar, who filled me in on how the suite worked and what sort of things I would be expected to do. It all seemed pretty straight forward. A few minutes later on, the consultant of the day, Dr Shah, pitches up and we go and investigate what work we were going to have to do.

There were two ladies who needed elective caesarean sections (C-Sections) and the Obstetric consultant told us that there were a few ladies on the unit that would probably need emergency C-Sections as well.

As a rule, women like to be awake when they have their C-Section, so they can see their baby straight away. This means that we give them a spinal anaesthetic (basically an injection into their spine to numb the nerves there so they can’t feel anything from their chest down).

I’ll be the first to admit that I’m not really very slick with my spinals. The technique is “blind” which means that you can’t see where the needle is going. So, what you have to do is imagine the 3-Dimensional anatomy and relate that image in your head to where you think the tip of your needle is and where you think it needs to be. I’m getting better at them though, and was glad of the opportunity to do a couple more today.

The first lady was called Mandy and she was almost exactly the same age as me. Mandy was very relaxed about the whole thing and said she understood what was about to happen – obviously the prenatal counsellors had done a good job. Her partner, James, on the other hand, was obviously a huge bag of nerves.

Dr Shah did the spinal anaesthetic and, in the process, talked me through how she likes them to be done. Once we were happy that the anaesthetic was working, we gave the surgeons the nod, and they cracked on with doing the caesarean section. 15 minutes later, they had the baby out and the room echoed to the sound of a baby crying as Mandy and James’ baby boy took his first breath.

Welcome to the world, little one.

Dr Shah let me take care of the next lady pretty much all by myself. Mrs McAllum was due to give birth to her 4th child. We’d already seen her in her room to let her know what to expect, to give her information about the procedure and allow her the opportunity to ask any questions or raise any concerns that she had.

The nurse went off to fetch Mrs McAllum and I checked all the anaesthetic equipment in theatre, I drew up the inotropic drugs that I would need and checked that my emergency drugs were drawn up and were readily available.

After siting a cannula into her hand and attaching her to a bag of fluids, I went to scrub up. I got all my equipment ready and made sure Mrs McAllum was in a good position and then I started.

First some local anaesthetic into her back and then I tried to find her subarachnoid space with the spinal needle. I couldn’t. I didn’t feel like I was hitting any bone, so I kept advancing the needle until it was all the way to the hilt, but still I wasn’t in the right place. Spinal needles are 12cm (approx 5”) long and Mrs McAllum wasn’t a particularly fat, so I thought I must have missed. I tried again but with the same result. Eventually, Dr Shah got bored of me poking around in this woman’s back and she got scrubbed up and took over. It turns out that, amazingly, the standard needle was too short for Mrs McAllum, and once we changed to an even longer needle, we were able to find the correct place and give her the injection.

The consultant obstetrician struggled for a while with the operation, but got there in the end and soon enough, Mrs McAllum’s fourth child, a boy, was breathing quietly in his Daddy’s arms.

Welcome to the world, little one.

In the afternoon, we helped two more women give birth. Their babies both had “foetal distress” and they needed emergency caesareans to prevent the baby from possibly being brain damaged or even dying. For the first lady, we had enough time to get a spinal in and working, but we had to give a general anaesthetic to the second lady.

All in all, it was a fantastic day. I was able to help these women during childbirth and, in the process, felt I made a real difference. I saw four babies being born and there were four very happy couples. The birth suite seems to be a very happy and enjoyable place to work and I was grinning from ear to ear as I walked out of the hospital at the end of the day.

I love my job.


Dragonfly said...

Awesome! I like those days as well.

Anonymous said...

It must be such an amazing experience to be there when a new life is born into the world

cornsihgiant said...

put this one in your memory bank so that you can think back to it when you are having one of those unbelievably shitty days!

Jo said...

Fantastic! It must be so amazing :-)