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whitewriterI was in MAC today and it was actually a very relaxing day.
We only had 3 appointments in the morning and only 1 or 2 phone calls.
1 foleys, which I did the VE on - IOL for SGA.
SGA is a funny one. Biggish lady, reminded me of myself so much that when she took her pants off for her vaginal exam (by yours truely) I remember thinking to myself that geeze thats probably what I look like laying down with my fanny out.
Not really something you want to see for yourself to be honest. She was a nice lady.
There was a moment when she said she felt overwhelmed by the experience and i inquired as to what she did for work.
Accounting, she said. And I said yeah, that's worlds away from ... this (the hospital setting and midwifery).
Her VE was a tough one. I haven't been there since pre christmas because I got some super wild shitty weird cold (fever and cough. Then survived Christmas. Then the fever came back? Then I got better) - I missed my last shift to wear christmas scrubs at. That still bites. I also want better Christmas scrubs for next year.
It was tough because her cervix was anterior to the right. It wasn't where I was intending it to be, posterior or even mid. The last VE I had was also anterior but like. in the middle. Not to the side. So I didn't try too hard to like, get into the internal os because I was doubting that what I was feeling was even the cervix (and you'd think I'd know after how many VEs). The cervix when closed feels like the tip of your nose.
Imagine putting your hand inside someones vagina to find this nose, and expecting it to be like, at the bottom back and instead it was like, near your 2nd knucle.
It's a bit like .... is that a deformity perhaps? But no. That was it. So the doc had a hell of a time getting the foleys catheter into it because of its non-standard location.
Anyhow, luckily she actually was an easily to relax lady. Unlike some others I had met.
She ended up being the least interesting patient of the day.
We had a 16 year old 38 +4 weeker come in for an iron infusion. I thought she looked rather young but I was thinking maybe she was 20 or something. The older man whom she was with was cracking jokes and saying how he has an insulin pump and he had to have a big toe amputated and that this iron infusion was nothing and she was going to be fine etc. -- Like he looked like her Dad, but equally, I thought he could be the boyfriend so I just shut up and played it safe.
I was impressed I did amazingly with the IVC, I got it in first go, and it was bloodless. My only complaint is that FML -- the hub thing --- I need to remember to take off the cap before starting the procedure cause I fiddled with that damn thing for so long, with my right hand while my left hand was putting a bit of pressure on the vein to stop it from spurting: I was surprised that worked as a trick, Like I'd seen it as a suggestion before but I didn't think it would work without doing something bad like clotting off the canula - but no, it worked great, the canula waited while my right hand independently unscrewed the cap off the hub - and it already had the syringe with 10mls saline conveniently attached, so I screwed that on and it flushed so beautifully. It was so quiet my colleagues had already prepared the iron infsion in the bag for me so all I had to do was like, start it running into the beautiful canula I had just placed in the pristine arm and vein of a 16 year old whom at the time I thought was 22-24.
Lolz.
She was probably the 2nd most interesting lady of the day
The most interesting lady was a 24 weeker with abdominal pain, who came in unannounced - anyways as they were tending to her I started reading the file and I read this was not her first pregnancy but actually, her 2nd. The first one, she had about 1 year earlier, she got to 22 weeks and had the morph scan and they found what was a deformity of the childs left leg, similar to a club foot (they called it something else but on research thats what it was basically). They said the femur and tibia were both significantly shorter on the left than the right and that the leg may need to be amputated at a later date depending on certain circumstances and that also, there was no treatment to fix the leg (like I was reading with some types of club foot you can like, use a series of casts and so forth to like remould or stretch it the right way).
But this type apparently didn't have that as an option.
They offered some testing of the amniotic fluid - I guess to rule out any other deformitys that may show up on genetic testing -- the NIPT or harmony test did not show it (had come out as low risk) which just points out the weakness of NIPT. Like it tests for heaps of stuff but honestly, you can't test for everything.
And lets talk about this club foot thing. Sure the kid won't be like, a A league basketballer. Or like. a marathon runner - I was also reading they might have some lifelong pain (but also might not) or theres strategies to deal with these - but no test, not an NIPT or amniotic fluid testing is similarly going to tell you if your child will be a gambler or a murderer, or something ? unsavory.
Like if club foot is the worst thing in your life...
I guess if you can't get past club foot, what else can't you get past.
If you can't accept club foot I suppose you better abort the child.
I was telling my mum about this case and she said "Couldn't she just put it up for adoption" and I said- it doesn't always work like that.
Like. Okay, what if no one wants to adopt the kid due to the deformity, then what?
Anyways.
Gostago. Kid 2 woke up
We only had 3 appointments in the morning and only 1 or 2 phone calls.
1 foleys, which I did the VE on - IOL for SGA.
SGA is a funny one. Biggish lady, reminded me of myself so much that when she took her pants off for her vaginal exam (by yours truely) I remember thinking to myself that geeze thats probably what I look like laying down with my fanny out.
Not really something you want to see for yourself to be honest. She was a nice lady.
There was a moment when she said she felt overwhelmed by the experience and i inquired as to what she did for work.
Accounting, she said. And I said yeah, that's worlds away from ... this (the hospital setting and midwifery).
Her VE was a tough one. I haven't been there since pre christmas because I got some super wild shitty weird cold (fever and cough. Then survived Christmas. Then the fever came back? Then I got better) - I missed my last shift to wear christmas scrubs at. That still bites. I also want better Christmas scrubs for next year.
It was tough because her cervix was anterior to the right. It wasn't where I was intending it to be, posterior or even mid. The last VE I had was also anterior but like. in the middle. Not to the side. So I didn't try too hard to like, get into the internal os because I was doubting that what I was feeling was even the cervix (and you'd think I'd know after how many VEs). The cervix when closed feels like the tip of your nose.
Imagine putting your hand inside someones vagina to find this nose, and expecting it to be like, at the bottom back and instead it was like, near your 2nd knucle.
It's a bit like .... is that a deformity perhaps? But no. That was it. So the doc had a hell of a time getting the foleys catheter into it because of its non-standard location.
Anyhow, luckily she actually was an easily to relax lady. Unlike some others I had met.
She ended up being the least interesting patient of the day.
We had a 16 year old 38 +4 weeker come in for an iron infusion. I thought she looked rather young but I was thinking maybe she was 20 or something. The older man whom she was with was cracking jokes and saying how he has an insulin pump and he had to have a big toe amputated and that this iron infusion was nothing and she was going to be fine etc. -- Like he looked like her Dad, but equally, I thought he could be the boyfriend so I just shut up and played it safe.
I was impressed I did amazingly with the IVC, I got it in first go, and it was bloodless. My only complaint is that FML -- the hub thing --- I need to remember to take off the cap before starting the procedure cause I fiddled with that damn thing for so long, with my right hand while my left hand was putting a bit of pressure on the vein to stop it from spurting: I was surprised that worked as a trick, Like I'd seen it as a suggestion before but I didn't think it would work without doing something bad like clotting off the canula - but no, it worked great, the canula waited while my right hand independently unscrewed the cap off the hub - and it already had the syringe with 10mls saline conveniently attached, so I screwed that on and it flushed so beautifully. It was so quiet my colleagues had already prepared the iron infsion in the bag for me so all I had to do was like, start it running into the beautiful canula I had just placed in the pristine arm and vein of a 16 year old whom at the time I thought was 22-24.
Lolz.
She was probably the 2nd most interesting lady of the day
The most interesting lady was a 24 weeker with abdominal pain, who came in unannounced - anyways as they were tending to her I started reading the file and I read this was not her first pregnancy but actually, her 2nd. The first one, she had about 1 year earlier, she got to 22 weeks and had the morph scan and they found what was a deformity of the childs left leg, similar to a club foot (they called it something else but on research thats what it was basically). They said the femur and tibia were both significantly shorter on the left than the right and that the leg may need to be amputated at a later date depending on certain circumstances and that also, there was no treatment to fix the leg (like I was reading with some types of club foot you can like, use a series of casts and so forth to like remould or stretch it the right way).
But this type apparently didn't have that as an option.
They offered some testing of the amniotic fluid - I guess to rule out any other deformitys that may show up on genetic testing -- the NIPT or harmony test did not show it (had come out as low risk) which just points out the weakness of NIPT. Like it tests for heaps of stuff but honestly, you can't test for everything.
And lets talk about this club foot thing. Sure the kid won't be like, a A league basketballer. Or like. a marathon runner - I was also reading they might have some lifelong pain (but also might not) or theres strategies to deal with these - but no test, not an NIPT or amniotic fluid testing is similarly going to tell you if your child will be a gambler or a murderer, or something ? unsavory.
Like if club foot is the worst thing in your life...
I guess if you can't get past club foot, what else can't you get past.
If you can't accept club foot I suppose you better abort the child.
I was telling my mum about this case and she said "Couldn't she just put it up for adoption" and I said- it doesn't always work like that.
Like. Okay, what if no one wants to adopt the kid due to the deformity, then what?
Anyways.
Gostago. Kid 2 woke up
no subject
Date: 2025-01-20 04:52 pm (UTC)A 16 year old with a older boyfriend? Wouldn't her social situation be on her intake chart?
no subject
Date: 2025-01-21 09:33 am (UTC)I have to say I have been thinking about that "theoretical' (now gone) baby a fair bit over the last few days. I also looked up what it was like to live with club foot, read a little on reddit of people's personal stories, saw some instagram of people who had theirs amputated - for a leg prostesis and they're now athletes or models or whatever despite having missing fingers (along with their missing leg/ex clubfoot). The one example that stuck out was a girl from Ukraine or somewhere similar, and she had been abandoned at the hospital, and they put her in an orphanage and said she "wouldn't live longer than a year" (not sure why, no mention of other issues besides the missing middle fingers bilaterally and the clubfoot) - but she got adopted by Americans who supported her to be normal (surgery/amputation/prostesis). She looked lovely and very pretty and normal.
And I see your point. Imagine being the child who is like, severely rejected by their family... and if the mother says they can't care for them... and you can't guarantee they would be adopted by a loving family (instead of some sort of human trafficking or dying some horrible death in an orphanage etc,) plus the high rates of suicide amongst adoptees etc.
But it stuck with me a little. That this baby could have been something special and different. I suppose thats any baby though. All loss is important. Often if its an IVF pregnancy it will always get flagged but midwives where I work often say "... all babies are special, IVF or otherwise..." (but I guess it points to increased anxiety around the pregnancy itself due to the hardship of obtaining it).
Anyways I'm rambling.
Ah but I re read your comment again -- so what I didn't mention in the post - was this was an Indian couple and this is the 2nd time I've seen an Indian couple abort for physical abnormalities in the child. In a child who would have lived and had a normal brain, normal organs - like they could be stupid but like, so could anyone. The defect wasn't linked to mental retardation or issues with the child's heart or stomach or liver. I feel like this is due to the caste system in India, like they're of a higher caste (clearly, since they've migrated to Australia) and that there is some sort of thing about how higher casts don't have deformities etc. That will reduce the standing of the family etc. (like amongst the Indian community I suppose.
The last time I saw this type of senario (also, Indians) the abnormality was really minor and fixable surgically (no need for amputation and prostetics etc.) It clearly stuck with me because I remember the conversation with the husband who asked if we were going to "take them seriously" this time (the hospital ended up delaying the abortion while they sorted out the ethics of it was born at like 24 weeks). Probably lived for 1 or 2 hours. Could have been vigerous at birth too. Which would have been extra traumatic.
Re: the 16 year old - all I could find mentioned was that she had a boyfriend but they were "on and off again" that she was of aboriginal descent (but she was as white as how Pete is also Aboriginal descent so there's prejudice there) - she looked like what would be typically shown in an American movie as "white trash". Apparently her parents were very supportive. And I later found out that that guy, was her dad. I just wasn't sure at the time I was putting in the canula and running the infusion. I had a quick look at the laws - (you'd think I'd know) 16 is old enough for age of consent in most states in Australia except. SA and TAS is 17. But also, if the partner is the same age as the girl, then it's not considered rape. Eg. if a 13 year old is pregnant from another 13 year old then no one's going to jail.
I have a feeling her parents will end up taking care of this baby a fair bit. I asked her if she got the things ready because she was 38 weeks and 4 days and she said she still hand't put the bassinet together yet. Lolz. Girl, you don't know whats coming ...
no subject
Date: 2025-01-22 08:31 pm (UTC)no subject
Date: 2025-01-23 02:13 am (UTC)In Australia there is zero requirement for any experience as a student with pregnancy or children. Some students are lucky and get it and others don't and still register and then work as an RN, in any area. If you never had work with children before if you gain employment with the children's ward they just start you fresh like a grad (even if your not a grad).
I think this makes our training incomplete. So I guess what I'm trying so say is.... I'm not surprised U didnt have a clue ... But I did think USA trained RNs more broadly than we do here.
no subject
Date: 2025-01-23 02:27 am (UTC)no subject
Date: 2025-01-28 09:51 am (UTC)no subject
Date: 2025-01-28 03:05 pm (UTC)