Thursday, December 4, 2014

Catching Babies: Babies Having Babies

November. As the holiday season rolls in we start planning for staff parties which always end in carnage of the alcoholic nature. No one knows how to blow off steam quite like the emergency services. Throw a Christmas bauble at any party night in December and you will almost certainly hit a Nurse, Midwife, Doctor, Fireman or Police Officer. We spend most of the year throwing our hearts under the feet of the general public and when given the excuse to throw off our public persona we do it with just as much passion.

Meanwhile in the labour ward the younger generation has also been throwing their passion around and every second person who comes screaming through our doors (usually quite literally) is barely a teenager, let alone an adult. I find pregnant teens to be some of our most challenging clients. Take all the hormones of youth, throw in some pregnancy hormones, immaturity and a healthy dose of fear and you have a situation which brings as much sympathy as it does aggravation. It always makes me sad that these girls and boys are having babies when they are babies themselves in most cases. These girls bodies are often just not ready to push out a 7lb baby when they are fourteen or fifteen and the pain and terror when they go into labour is really hard to watch. They just don’t have the maturity to cope with it, never mind the actual raising of a baby. It can be really hard to calm someone down when all they want to do is scream, cry and shout for their mum. And if you think it’s hard to get a teen to do what you ask in everyday life then try doing it when they are in pain. Even when you tell them it might mean the health or life of their baby their first thought is often only themselves. It’s almost always a battle of wills that leaves you exhausted. I feel even worse for the girls’ mother’s when they come with them to the labour ward because it must be so awful to watch your child in pain like that and know there is nothing you can do to help. Sometimes, in those scenarios we find ourselves looking after their well being as much as that of the patient or arguing with an overwhelmed parent over management when they only see their child in pain or sick.

This week I looked after a 17 year old girl whose waters had broken early and was showing significant signs of infection. The baby was breech and the doctors decided the only option was to deliver her by caesarean. It was a challenge trying to explain to a young teen why it wasn't a good thing that we had to deliver her baby two months early and try to get her to understand that the baby might have significant health issues for the rest of its life as a result of prematurity. Then to manage her as she woke from a general anaesthetic having had caesarean section, confused and in a lot of pain. Knowing she had no idea what was in front of her. She sobbed in pain, groggy from the morphine, clutching her 17 year old boyfriend’s hand while the paediatric consultant explained the condition of the baby in ICU. I met the eyes of both of their mothers over the bed and saw the knowledge in their eyes of the hard road their children had to face and my heart hurt for all of them. I hope that the cautious optimism of the consultant is well placed because both the new parents were going to have a lot of growing up to do, very quickly. 

Bring on that Christmas party because I have a serious need to let my hair down and get involved in some alcoholic carnage.

Catching Babies: Doctors and Nurses and Midwives…oh my!

Ah October. The temperature drops with the leaves on the trees, rain washes in, the wind blows harder and the nights get darker. The delivery rate has dropped and we all take a big sigh of relief. And, this October at least, half the hospital staff decide it’s time to have a baby. Truthfully, I’ve been away for most of this month doing my other job so it seems to me that the delivery numbers have gone from OH MY GOD to OK THEN in a blink. I missed the gradual decline. Now it seems that every second patient is a nurse or doctor, this is unusual. It’s like nine months ago there was a party I wasn’t (thankfully) invited to or that the staff newsletter had a two for one offer on maternity care.

It’s probably wrong but looking after someone with any kind of medical treatment is on my list of Things I Don’t Enjoy Doing. Nowhere near the top mind you cos this job has certainly introduced me to many, many things that I don’t like doing. They are hard work, no matter the speciality they work in, in fact it’s worse if they haven’t done any training in maternity. It makes everything you do that bit more fraught, from putting in drips to taking them to the operating theatre. It makes you anxious in case you screw anything up because they are mostly going to know you screwed it up, this adds to the pressure of making sure everything goes well. Then there is the knowledge factor. They know just enough to think they know enough. Maternity is a speciality, there are differences. Losing 500mls of blood when you’re pregnant is different from losing 500mls of blood at any other time. If you lose that amount of blood during any other time it’s a major haemorrhage. But there are also similarities. It’s really hard to reassure someone that they will be fine in those circumstances when they know the risks involved.

This month though, almost everyone behaved themselves while I was there. No major dramas, no big highs or lows. It’s been nice for a change that there was nothing especially memorable to write on this blog. The most memorable thing that happened was the night I looked after a woman in labour wearing a ‘dip me in chocolate and throw me to the lesbians’ t-shirt and her partner with the badly covered-up white supremacy tattoo and even they were no problem. Let’s hope the rest of the year proves to be as restful…but I’m not holding my breath.