Midwife Mondays 91: OSCE results, a Squidgey Preterm Baby, Sepsis & Triplets!

So this week has been another busy one. So busy in fact that I think my body couldn’t quite keep up. I’m writing this post from the comfort of our sofa, with a cocktail of ibuprofen and paracetamol whooshing it’s way around my body, hoping it makes its way to my left shoulder, which has caused nothing but trouble this week.

Anyway, I’ll go back to the start of the week.

Monday for me was a sleep day after my busy night shift, and ahead of the next one so I spent as much of the day as I could snuggled up in bed with the blackout blinds down. At midday, I received a notification that our results from our Newborn Life Support and Obstetric Emergencies OSCE exams had gone live – eek! So in my half-awake state I logged on to the system and checked – I passed! The Newborn Life Support exam was a pass/fail, so I passed that one, and then our Obstetric Emergencies OSCe was properly marked and I had managed to get myself a first! Did not see that coming at all – really pleased with that! Woop woop – so that’s me done with exams for second year now – just gotta get the rest of my paperwork completed and submitted!

Anyway, M came home from work at about 5 on Monday so I got to see him for an hour or so and then I packed up my bag and headed off to the hospital again.

My mentor and I were assigned to look after a woman whose waters had broken and was contracting irregularly at 36 weeks, threatening pre-term labour. We were keeping a close eye because the monitor was already showing decelerations in the baby’s heart beat. As the evening went on, her labour established much more and she requested an epidural. By 4am she was 8cm dilated and come 5am the baby’s monitoring was showing some more decelerations, the doctors came in and examined her again, by which point she was fully dilated and so it was time to start pushing. As the baby was showing signs of distress, the team wanted to make sure she wasn’t pushing for more than about 30 minutes, so she was giving it everything she had. She was getting closer and closer with every push but the baby’s heart rate was also showing more and more signs of distress so after 40 minutes of pushing, the team stepped in and carried out a ventouse suction cup delivery in the room. Thankfully, the baby came out pink and screaming and apart from a quick trip to NICU for some blood sugar monitoring, was absolutely fine, and a really healthy weight for a 36 week-er at over 3kg (6lb 13oz)!

I slept like a dead thing on Tuesday and then when M came home we went out for dinner and a bit of crazy golf – for some reason, this placement feels like it’s taking a bit more out of me and we haven’t had the chance for a proper date night in a little bit so it was nice to spend some time just us!

Wednesday was a day off, and it was spent doing all the odd jobs that have needed doing, doing a lot of cooking and meal-prepping for the next week or so and a couple of loads of laundry, as well as whipping up some cookies to send to both our dads for father’s day – I make a mean Chocolate Chip Cookie (see my recipe here) and so any special occasion I try to whip some up! Yum!

I was back in the hospital on Thursday, and we were assigned the care of two women, both with incredibly interesting cases.

The first was under investigation for sepsis. She was on half hourly observations, as well as hourly urine output monitoring, a strict fluid balance, broad spectrum antibiotics, a phosphate infusion and all sorts of tests so really we could have been busy looking after just her, but we also had another lady to keep an eye on. This second lady was pregnant with triplets and was querying whether her waters had broken. She had already had a speculum and the results were inconclusive so we got the senior registrar to come and see her and they booked her a full ultrasound scan for later that afternoon so as she wasn’t contracting or showing any signs of labour, we transferred her to the antenatal ward for observation in the meantime – hopefully, all was fine and her waters were diagnosed as intact and she could go home….I’m gonna try to find out when I get back in next week.

On Wednesday evening I’d had a really strong pain in my shoulder which had been building up over the course of the evening, to the point where I actually went to the gym just to sit in the hot tub and try to loosen it off (oh yeah, thats the other thing, we’ve had no hot water this week so we’ve been showering at the gym or the hospital – just to make life easier!) Come Thursday morning it was still really sore and I whacked on a heat patch and headed into work. However, as the day went on, it was just getting worse; it was sending shocks down my arm and giving my the most horrendous headache, making me all muggy, so come 4pm I had to head home – I just couldn’t keep my focus and it was really hurting!

Our hot water was finally back on by Thursday evening so I had a long hot bath and tried to let it all loosen off but it was still the same on Friday so I had to cancel my shift – there was just no way I could focus, or in fact, hold anything in my left arm for more than about 15 seconds…not ideal for labour care really when you end up in all sorts of weird an wonderful positions and often end up holding on monitors or carrying newborns!

Thankfully, I had the rest of the weekend off already (just how my shifts fell) so I have had a few days to recover and let it all loosen off – with the help of ibuprofen, paracetamol, hot baths and regular shoulder massages from M – and I think it’s just about ok for me to head back into work today….I hope! It’s still not back to normal, but the weakness seems to have worn off now and it doesn’t hurt as much….I think it must have just been a tension thing, but it’s something I need to keep an eye on – particularly if it is just tension as that is obviously something that comes with the job. I think I might need to look after myself a bit better, instead of running myself through the ground all the time! Easier said than done, I know, but I’m gonna try!

For last week’s Midwife Mondays post, click here:

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