This is probably my favorite status: from duty (FD).
After going on 24 hours on-duty (OD),from 8am-8am the next day, one is officially from duty or FD at the strike of 8:01am or when the team on duty (OD) relieves you from your post.
In OB, we try to resolve all our admissions before 12 noon and endorse it to the team on duty if the patients fail to deliver and there is no indication to do a C-section at that moment.
As the only OB intern, most of my FD hours are spent at the OR when we still have patients scheduled for C-section. After the OR cases, my from-duty tasks include going to the OB ward and the Gyne ward to do discharge Internal Examination (IE) on all postpartum and post-op patients. Most of the time there would be 20 or more post-partum mothers lining up outside the IE room at the OB ward.I examine them 3 at at time in one room. I check the introitus, the cervix, the uterus, the adnexae, note for discharges or bleeding and check the episiotomy sites if there is hematoma or wound dehisence.
After the seemingly endless discharge IEs, I change the dressing of patients who are in their 3rd post-operative day, then remove the suture knot of those who are in their 4th post-op day. It’s a challenge moving around from bed to bed.In this hospital patients share bed space, there are 2 -3 patients per bed plus their newborns are being roomed-in with them and that makes them 4-6 in one single bed. It amuses me how they sleep at night in strange juxtapositions, but the sad thing is they put up with it because they have no choice. They cannot afford anything better than this.
I’m expected to be grouchy when I’m FD. Not to mention, tired and sleepy. It’s during this status that always feel the gross reality of a medical career, the endless toiling with little or no pay-back.The hospital cannot afford any allowance for post-graduate interns, just free food at the dietary.A privilege that I have never used or abused.I’ll pass on that.
In this hospital the pay-back that I get is the flux of service patients that I am allowed to manage and the diversity of cases that I see. In a span of a month and a half, I have attended to approximately more than 60 normal spontaneous vaginal deliveries on my own; repaired lacerations and even done difficult episioraphy which on discharge turned out well. I have memorized the steps in C-section owing to the countless times I have been the 1st assistant of the surgeon.
The best pay-backs are those that you do not expect. Small yet sincere.
A week ago, after another sleepless night, I was FD and doing IE on some patients. One patient, Mrs. M., before exiting the IE room reached out and gave me a pat on the back.
A gesture that made me smile.
I was the one who delivered her baby last night. A pat on the back could mean a lot of things. Gratitude, even where it is not due. A couple of them would say “thank you, doc”. I thank them back, wishing they understood that each of them gave me a chance to to sharpen my skills in delivering babies and perfecting episiotomy repair.
The OB intern will be eternally grateful,
but still grouchy when she is from duty 🙂