And I think I agree, horrible is likely to be the correct description...
I had a mini-orientation to being on call tonight. Call will be covering the LW. The Labor Ward. Solely responsible for assessing sick newborns, covering the c-section calls, and any infants who get sick in the outlying wards.
It's like newborn M*A*S*H. The babies just kept coming in... The LW is essentially a triage unit and an observation unit, and holds babies until the level 2 NICU can get beds open to take kids, or until the level 1 NICU has beds.
I think there is space for 8 kids. Well, beds for 8 kids. we had 7 kids, 2 of whom hadn't really been assessed when they brought in a premature baby who needed some minor resuscitation (just needed to be bagged). He went onto the last open bed, which was conveniently, the resuscitation bed. The glorious moment, or surprise, was when they brought in his TWIN SISTER (which they neglected to mention) who likewise needed some bagging. It's really all manageable, except that the person covering LW also does all the bloods and IVs. That to me pushes me a wee bit closer to insanity. I was sorely out of practice today, and am hoping for a small miracle in reviving IV and phlebotomy skills before my first call in Saturday.
And again, I had flashbacks to being an intern, when a very wise colleague mentioned a saying: "they can hurt you, but they can't make the clock stop."
I mulled that saying over as I drove home. How the fuck would I manage if I were on call the rest of the night, tonight. I would count down until 8 am. I would literally see that there was an end point to this shift. That all I would have to do is keep kids alive until I get them sorted and into their respective units for further care. And so I thought a bit about the level of medical care, and came to think that when working in extremis, it is not feasibly possible to be the thorough type of practitioner that I expect of myself. That it is not going to be possible to really examine these kids in the level of detail I want to, nor to really review the maternal history and write the detailed notes that I come to expect as being standard.
If I had to guess, I would say that in the 5 hours I was there for orientation tonight, we probably had 12 kids filter though, plus getting called about problems on outlying wards, and reviewing 2 stillbirths. I'm not really sure how one person is suppose to do all of that work, but I guess I'll figure it out on Friday night.
