A Day in the Life of a Senior Resident on Labor and Delivery
6:25 a.m. As I walk onto Unit 3F, Labor and Delivery, I stop by the white board to review the patients on the labor deck. It looks like last night was a busy one for the call team. After reviewing the board, I head over to OR 15 to check the difficult airway cart. Though we usually use a neuraxial technique for Cesarean sections, we always have to be prepared for emergency cases. Levitan stylet: check. Fiberoptic scope: check. LMA: check. Full oxygen cylinder: check. Thank goodness we get a lot of experience with these devices during our difficult airway rotation.
7 a.m. Rounds. The call team reviews the history and events of patients on the unit. We are rounding with our chair, Dr. Suresh. This morning, the team is discussing adverse effects of local anesthetics and how we should monitor our patients. One of the junior residents later mentions to me, "I really like working with Dr. Suresh. I feel like I am always learning with her."
7:20 a.m. The patient in labor room 8 would like an epidural. After describing the procedure to the patient, the junior resident and I come up with our anesthetic plan. She places the epidural without difficulty, and we are pleased to see that our anesthetic plan is giving the patient relief.
7:55 a.m. I stop by the white board to ask the senior obstetric resident about some of the patients on the unit. It looks like the patient in room 8 is not progressing very well. She plans on checking her again in a few hours and will then make a decision regarding a surgical delivery.
8:30 a.m. A patient has presented to OB intake in active labor. She has had three previous Cesarean sections, and is posted to go to surgery for repeat Cesarean section. We take her history, perform a physical exam, secure IV access and follow up on her laboratory results. She is then transported to OR 14. Fetal heart tones are in the 140s - we position the patient and place a spinal anesthetic. The surgery goes smoothly and we congratulate the mother on her beautiful eight pound baby boy.
10 a.m. As I walk down the hall, I hear the obstetrician and nurses counting, "1...2....3....". Looks like the patient in room 8 is complete and pushing. As I peek my head in the door, I hear the reassuring cries of a newborn baby girl.
The rest of the day is a blur. Patients start to fill the PACU, recovering from their surgeries. Between managing the postoperative care of these patients and supervising the juniors during their Cesarean sections and epidurals, time flies quickly. At 3:30, it's time for the day team to sign out to the call team. We update our laboratory information and physical exam and present the patients during afternoon rounds.
As we walk out, I thank the juniors for their hard work and head home to rest up for tomorrow.
– Catherine Seipel, M.D., Class of 2011