Happy Holidays 2015

It’s that time again – time to spend long hours at work eating way too much food, trying to be festive. You see, holidays (all holidays) are weird on the labor and delivery floor.

Take Thanksgiving, for example. This year, I saw three patients during my 14-hour night shift.

One was a patient from our antepartum unit and was being induced at 34 weeks for preeclampsia with severe features. In other words, she didn’t get to pick when to come in.

The next patient came up from the emergency department screaming. Our team heard the noise from the resident workroom and came running, and I got gloves on just in time to deliver the baby in the triage bed. She said “I’ve been having contractions all day, but I didn’t want to come in until I was sure this was labor.” Yep, definitely labor! She barely got her panties off before the baby was born.

Later that night, the obstetric emergency pager went off. This triggers a whole team to rush to the scene: OB nurses bring mobile fetal monitors and equipment for a precipitous delivery, and all available OB providers drop what they are doing and head down. We arrived in the ED to find the baby on the warmer and mom sitting up in bed with the clamped umbilical cord resting between her legs. She said later that she kept telling her mom she thought she was in labor, but her mother refused to let the patient “ruin Thanksgiving dinner” by insisting on going to the hospital. She delivered less than 2 minutes after arriving in the emergency department.

No one came in thinking “Maybe my water broke but I’m not really sure.” No one rolled into triage with musculoskeletal low back pain, or round ligament pain, or irregular contractions. Everyone who came to triage actually needed to be there. It was amazing. 

 

Even the days before the holiday are different. In the days leading up to the holiday, you see lots of people who aren’t really in labor but hope they are, because they want to hurry up and have the baby in time to be home with their other kids on Christmas/Thanksgiving/Festivus/whatever. Most of them get sent home, extra cranky because they still have a ton of shopping and cleaning to do and now they have wasted 2 hours in triage. Bonus points if in-laws are about to arrive and they were planning to use being in labor as an excuse for a messy house, or to get out of visiting Aunt Millie.  

The remainder get admitted and are upset when they realize that the baby is not going to be born in the next hour and that they are going to be stuck in the hospital for the holiday. 

Still, I actually love working on holidays. You get fewer nonsense calls and fewer nonsense triage visits. Everyone tries to be festive and make the best of the situation, and most of the patients make an effort to be nice. This week, one of our PPROM patients (preterm premature rupture of membranes – her water broke at 22 weeks and she has been in the hospital for 2 months) left a gift basket “for the doctors” in our work room. Almost no one cursed at me this week, and lots of people brought cookies. 

It’s always lame to miss out on celebrating the holidays with your family, but if I have to be without my family on a holiday, I would rather be on the labor and delivery floor than anywhere else!

So with that, I would like to wish all of you a very happy holiday!

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