Yesterday I jumped back in the Bethel saddle and onto the inpatient wards. My first day back at it was the usual shenanigans of remembering how things work up here. I inherited a service of cellulitic patients mainly (skin infections), with a demented psychotic patient, and a patient with a gout flare thrown in the mix. The first day on any service is frustrating, trying to pick up from where the last provider left off, trying to get a sense of the patients and their diagnoses, and (most importantly) goals and timeline for discharge.
I triaged an ob patient yesterday who was not quite in labor, but definitely flirting with it. The patient is a village health aide who I've talked to on the phone many times. That was a quick reminder of what a small community the YK delta region truly is. Case in point: my demented psychotic patient is the mother in law of a nurse in the hospital that I work with often.
At any rate, I sent my ob patient home yesterday knowing full well she'd return that night and have a lovely, fast delivery for the night float doc. I was pleasantly surprised to find her at 8 cm when I arrived this morning. She proceeded to have, as predicted, an uncomplicated and pleasant (Well, pleasant for me, that is. I'm sure she wouldn't have described her labor as pleasant, though she was stoic in true Yupik fashion.) After about 20 minutes of pushing (described as "a long time pushing" by the labor nurses!!! How's that for perspective on stages of labor in Yupik women?) a pink, screaming baby girl came out much to the delight of all in the room (especially mom who after boys x 3 was told this one was a girl and said "it better be!!") It was a nice way to start the morning.
The rest of the day was spent catching up and meeting the many new patients admitted over night. I inherited a dehydrated 7 month old, a 9 month old with bronchiolitis, and a 60 year old man with chest pain. I managed to discharge 3 of my cellulitis patients, a victory in many ways, one being so I can stop confusing them all.
The radio medical traffic was steady but not insane. My partner on the wards and longtime Bethel doc would beg to differ, however. While I plugged steadily through my notes and work today, he got slammed with scary RMT calls (preterm labor in the village, multi drug overdose in the village - medevac x 2), some ob action, and new admits. This can only mean 1 thing: I'm in for it tomorrow.
I better rest up for the onslaught. Oh, but before I sign off. That picture above was taken from my evening jog last night. Despite the 30 degree weather, I must say it was rather pleasant to jog along the boardwalk into the setting sun. Actually taking the photo was a challenge given my frozen phone and fingers, and the fact that my thighs immediately started to burn when I stopped jogging. I was so excited to be out and about, soaking in some tundra sun, and felt so light jogging stroller-less and dog-less, that I suspect I overdid it. I woke up with an aching knee and had to forego the run this evening. But it's definitely in the plan for tomorrow. That is, if my day on the wards doesn't beat me down. Only time will tell...
No comments:
Post a Comment