RAMBLINGS OF A MIND UNTAMED

Not sure if I did enough of the load today but it felt like smooth sailing in MAC today.

Perhaps, I missed something. And thats why I had extra time on my hands.

I apologised to the poor med student that I was not a shit magnet.

And at dinner to help my toddler not get bored by the adult conversation I turned the story of my women today into a story about a princess who was ... I want to say stupid but the more PC way to describe them might be confused or vague.

Princess no 1.
Woman who had her first baby in Pakistan 4 years ago, had an IOL for "post dates"? and got to 4cm and was said to be failure to progress and sent for emergency c-section now came in spont labour, membranes intact, contracting on and off 1:10 or less. on the CTG, off the CTG. Not wanting pain relief. Saying her pain tolerence was high (I don't deny that may be so). She could have gone home at some points but she just wanted to hang around. Like hanging around would make her cervix open faster (it doesn't, midwives believe that early presentation and longer presentation at hospital decreases the likelihood of VBAC success-- I am absolutely not sure this is supported by evidence but the way this goes is, the more interference, the more things they find wrong with you, the lack of progress etc. they can use these against you and some how you find yourself on the slippery slope of signing a consent form for a c-section you didn't want or are not sure you need.

So she sat in the corner all day, in bed 8, taking up space. Waiting.

Princess no 2.
"Hi. I want to tell you about my underwear. It's been wet, like you know, damp. Since yesterday. But like, I'm not sure how much comes out. and I haven't been wearing a pad because I haven't got any, so I can't see the colour of the liquid, so I don't know if its like. Abnormally coloured.

Oh here I am in birth unit. Did I put a pad on? No I couldn't find it/forgot." But here am I and my .. soggy undies from like, yesterday...


Princess no3.
Hi. I'm 21. This is my second baby, the first one is 2 years old and a total screaming terror. I'm 34 weeks pregnant and also Aboriginal. My other risk factors include being 37 kg at approximately 155cm tall. This makes my fundal height inaccurate, but actually my dumb midwife forgot to measure my fundal height, which is bad. This should be a part of every basic assessment (BP, HR, CTG, FUNDAL HEIGHT, PV LOSS, BABYS movements, ?dysuria -- all this in 5 mins is your traditional midwives assessment supposed to be done in normal conversation).

Now I wonder super hard what was her FH because she looked teeny tiny despite being 34 weeks.

Anyway so. The notes said, CTG for SGA but - what it didn't say was (and now i'll go back into her voice) I had a bleed last week and on ultrasound there was a "mushroom like appearance in my uterus" and the doctors scared me about an abruption but i didn't want to stay in the hospital anymore so i DAMA'd and went home agreeing to daily CTGs. Which I came and did as I pleased over the weekend, but now I'm getting that crampy feeling I had last week again, and I've got this dark brown discharge in my pad that's pretty thick. The midwives think its old blood but I'm scared and sad that I'm about to loose my baby so I've packed my bags and I'm ready to be admitted to hospital.

Princess no. 4
I'm itchy and the clinic doctor sent me upstairs to ...
I'm not sure why but the midwife said she'd figure it out - and then started reading my notes but found other aspects of it more interesting than it should have been. I had gastric banding a few years ago but I still eat whatever I like. The dietician says i have irregular CHO amounts and eat high fat diet. So I've now gone all fish and salad to try and be healthier. I'm 45 this pregnancy so that probably also doens't help.

I'm itchy. I don't know what it means. The midwife was surprised I'm not of Indian or South East Asian (but caucasian) descent.

As I arrived the midwife said : so you haven't had a CTG yet? (no I have) and oh so you need bloods done? (and no I had that too) and I thought oh. You haven't had a review yet? But .. wait. Didn't you just SEE the doctor? who sent you here? Like .
This is where a more senior midwife would have said "look doc, so is the clinic going to do the CTG and bloods? cool so can you like. just gimme the MRN, and I can put her in the MAC book. and we can recheck the bloods when the results come and then call the lady if she needs a script? There's no need for her to come and sit in MAC to wait for results...
Instead of me who is like :yes send her up and I'll figure it out later when she gets here since you said she needs to be here, like even though she doesn't.


Princess on the phone
Hi, when i walk I have pain. But when I rest i don't and it's better. The baby moves well, or it did this morning. Not sure now. I haven't taken paracetamol - because (no reason why) but I'm worried about this pain. I know you said it sounds like round ligament pain but it hurts bad. And my PAPP-A was high which I know is a risk factor for miscarriage /non continuing pregnancy so I'm extra worried. I can't come in until 4pm is that ok?

Sure. Whenever you'd like since you really want an assessment - so whats your medical record number and name. Cause I can't find you in the system. You know what. So We've had the discussion, and we've talked about causes and normal things to experience in pregnancy. You said you want an assessment - and that's your right - to come in, as we are open 24/7 how about, you go on your merry way, and come in when you can and i'll go talk personally to the reciptionist to figure out what your file is so I can write a note and hand you over to the PM staff because I'm outta here by 15:30.

The Dari lady

This is my ignorance, on handover, the buzzer goes to call for a 2nd midwife to attend a birth and the in-charge sends me (oh man my heart is in my boots I'm so nervous) so I go anyways because face your fears - and I'm introduced to a p0 non english speaking lady who speaks Dari.

and I look at her and think, you don't look Indian.

but that's beside the point.

The main point is suspected macrosomic LGA baby on scan, for IOL in a few days but she started spont labouring earlier so here we are.

Pushing for 30 mins, head coming down slowlyish.

Macrosomia, macrosomia, macrosomia, my head says.

There was a 3a tear last week. The previous midwife says "theres an epis scissors and I've loaded the syringe for infiltration." I look at it on the birth trolley.

I didn't see her draw it. up but there's no time to get another set of everything. I'm just glad its all prepared.

she leaves to like, talk to the drs and finish up the notes so it's me and the Dari lady (who I think is from india, but she doesn't look Indian. but thats not important) and I think we're gonna need an epis.

Then a student pops up.

This day could not get any better. but actually this was a very independent student so that was nice. But I was the one who needed to cut the epis.

I decide to infiltrate in the chance we might be cutting an epis.

I've seen this done like, less than 10 times and the last time would have been more than a year ago, so I dig deep into my brain and I think I did it right.

How am I still a midwife, I wonder. I feel like the wild west.

It looks correct when i've done it. I had to do it a few times because it didn't seem like i put very much. I probably did about 15 mls all up.

And them after 4 pushes of not getting very far, I think I'll cut one.

And So I did. Right during the contraction, and no she did not have an epidural.

The baby did not bust out, and still had a ways to go -- such getting me worried that I called for a 2nd senior (ha like I'm a senior... 8th year wages and title and all) and I say I think I've cut it too short. And she's like too short or too early? and that got me thinking. Was it a bit too early to cut it?

She did a very controled set of pushes too then eventually the kiddo appears and all is well and good despite the large gush of thick mec after the kid.

I changed the chart from SAGO to postnatal -- the observations would have been wrongly classified otherwise. The student forgot to do that and I didn't spend the time to correct her.

Or was it the RM before forgot to do it. I don't know.

She wasn't Indian, she was Afghanistan. which makes sense although if I looked at her and was to guess I'd say she was from south America, or Chille or something.

But Afghanistan is way more common around SSH area. Anyway.

Because I also had :

Lady no2.

Termination of pregnancy, medical. for --- and kill me now i didn't find the time to write it down:

Anencephaly

and something else.

This was her 3rd Top.
She was a G4P1. No one could figure out from the notes what the other TOPs were for, and it wasn't really a time to ask.

she was only 24 and her one live birth was a 2 year old.

I made a massive mistake today -- so I was delivering the placenta and the cord snapped. Great. We ended up waiting an hour (first I did a VE and I had no idea wtf I was feeling for) so I call the educator who does a VE and explains: She's 5 cm dialted and the cervix is holding the placenta in. And she can't get past it.

She thought there was a low chance that she would birth the placenta naturally. We tried her squatting on a pan and giving it a good go -- but that seemed to not get anywhere. So I sat on the doctor to come and do a VE and the doctor had a go - but then was like nup.

theaters it is.

I forgot to somehow weedle into the conversation with the admission pre op nurse that it was for a TOP. Not like, the baby was born and then the placenta cord snapped (Cause that happens too and yes that means theater too).

And after i left the staff started asking the lady about her baby.

oops.

I forgot to deliver the placenta container with the lady so I went back down later and bumped into the pre op nurse who said "can you tell us somehow next time" and I was like. Oh. Yeah. Damn.

Then I spent the rest of my time doing clinical photos and trying to do momento photos, and the educator said "let me do them" lol and she re-did mine because in her very kind words "those (that I had taken) are a little confronting.

I left thinking "does she need dostinex ?" at 14+5 I think its a grey zone. It's definatly needed for 2nd trimester but 14+5... is just the beginning.

Lets hope she doesn't lactate at home.

Por por is finding her feet still
I come to my mums house to pick up the kids and I find Wendy's eyes glued to the TV.

My mum claims she can't control her and Wendy keeps hitting May2 in the head, so she turned the tV on for "a long time" (I asked how long and she couldn't say) I turn it off and there are immediate tears. So I did my usual trick - lets go outside for a walk! (more wails) Lets see if we can find a bunny! and instantly Wendy was so excited for this bunny.

We went for a short walk to peruse the street because I was considering a site for OC trailer parking (long story). We figured it wasn't suitable but wouldn't have known until we went down for a look. On the way we met a nice lady in a house with a bunch of kids who offered to show Wendy their baby cat but wendy was scared so we didn't get to see the kitty.

I was walking with my work uniform on so I wonder if that made members of the public more friendly or aware of me.

Cause I clearly am either a nurse or a midwife.

Anyhow. Por por wanted to take them for a walk also but I hadn't prepared the pram with toddler board and my mum was worried that since Wendy woke up complaining of ?knee pain (she's two) and she had a tonne of scratches on her face and bruises everywhere (lol she was a bit wild yesterday at my mum's during my annual UNSW friends Christmas party) that if they went to the park and wendy declared she couldn't walk home that there's no way my 75 yr old mum could carry heavy Wendy and May2 back home on her own.

I might not have minded so much if wendy was watching something good on the TV but it was some weird mime thing. Like what the heck.

LOLs.


Elizabeth didn't sleep well at my mums, She did ok but then would wake up for a drink but then get distracted by the new environment and start getting playful....

at 3am.

Yeah not fun,

And then at 5am. I think I was also dehydrated and so maybe my milk supply was downish. So she probably wasn't as satisfied as usual.

It's late and there's a giant day planned for tomorrow.

Oh and the cleaners came and the house actually, for once since Wendy was born and Pete and my mum had the capacity to help me, smelled clean.

I went back to SSH on Friday for my first shift since having Elizabeth.

It's a bit earlier than when I had Wendy but I think I need the mental stimulation. Midwifery is much more cerebral for me than ICU I think, somehow. But in both jobs, since going part time I really do need to think a lot more, need to consider everything a lot more. Things take me forever. and I'm always learning something.

Like Mifeprostone is $130 and misoprostal is $1.50.

People call Mifeprostone "Miffie".

It's a MTOP drug.

Medical termination of pregnancy.

LADY NO. 1

Friday was the first time I ever gave that to someone, let alone, the first time seeing a fetal heart beat on a monitor and giving that drug, knowing what it'll do to that tiny 21 weeker.

You don't allocate those types of patients to the religious or the pregnant for the most part.

Like, even though its totally our job, and like I fully agree with and understand why we're doing it and it's just going to go downhill anyway- it's still a sad as day for everyone.

Firstly it was a 21 weeker. So the kid was probably half a kg (that's pretty big). Both big and small, somehow. Too small to survive, too big that once in labour, would still feel like something pretty big was coming through.

Its birth just the same as with a 37+ weeker really I think. The youngest gestation I saw delivered was about 26+5 with borderline viability in play the woman had a say and chose for it not to live. The baby was 600g post birth when we weighed it, and, the midwife at the time turned to me and said "damminit, it could have lived".

Facts of the trade that suck.

Almost no one seemed to know how to give the drug.
No one had read the policy -- so I scoured the whole thing looking for useful information. Thats where I read that Miffy was $130 bucks and Misoprostal was $1.50 (so not useful) but that Miffy worked better at further gestations comparatively.



Your not supposed to eat for 2 hours before and after.
The doctor we consulted said it didn't matter but the policy said there was a 30-40% chance of vomiting so I figured on one of the worst days of your life, having anti nausea premedications charted and given at a significant time, and at least waiting an hour or so post lunch was really reasonable.

The thermometer I was using showed she was spiking a temp.

I was then told all the thermometers in the unit were unreliable and broken (even though I changed the battery) its like. We're a major public hospital with funding, why are midwives having to bring their own $20 thermometers to work (which we're supposed to use to check the baby's temperature because its hard using the adult ones) -- when the exxy Welsh allen thermometers are apparently "not working".

So we made clinical decisions based on her "rising temp" (speeding up the induction being the main decision) and putting her on a proper sepsis pathway rather than a probable sepsis pathway. This reminds me, i did fill in the paperwork for a yellow zone clinical review but I didn't start the sepsis pathway paperwork.

There's too much paperowrk.

The poor lady was afraid of pain. It was her second child, her first was a c-section at 6cm. I think she is a 3 year old who might have thought a brother or sister was coming.

It's like how do you explain that to your child.

Maybe they hadn't told her yet. The lady looked fattish so could probably have gotten away with it.

I keep seeing that heartbeat in my minds eye. Poor baby. May it's soul rest in peace. It was likely living in an infection ridden world which was getting smaller and smaller by the hour as the amniotic fluid had broken and there was hardly any left. Sorta like a fish in a tank but say only 10% of the volume remained.

She will likely remain in my memory bank of memorable patients for quite some time.

At one point in the day, she seemed quite surprised when I mentioned I hadn't given this drug (the miffey) to anyone before so I was reading up and double checking all the things I had to do in regards to it.

Breastfeeding Hx. She fed her first child for approx 3-4 days she said and then sorta it didn't work out so she gave up.

At that time I didn't bring up more information which in hindsight I should have, which was that we should give her a medication to surpress lactation as that would complicate an already stressful time.

Lady no 2.
Heavy smoker.
40+
with a very young looking husband considering.
4th baby,
many previous miscarriages (10?)
muslim.
Nice lady
36+0
kept having irratable uterus/tightenings/contractions on and off since 3am.
Cervix remained long and closed.
When the endone settled her pain, then you could see what her uterus was doing on the CTG more clearly and it made her contractions seem worse But actually it was because she would stop withering around so it could monitor them more effectively and clearly -
rather than them actually being "Worse" (I think, anyway).

I barely had time for a palp (where does time go...).

I had to transfer her to u/s for a scan because her previous scan was really bad (polyhydramnios and macrosomia) but then subsequent scan said normal liquor volume and normal sized head (lols) so they just wanted to check that because they'd already convinced her to a c-section based on issues 1 and 2. So was the bad scan right or the good scan right.

The inhouse scan was there to decide.

Apparently the good scan was right.

As I left the contractions/etc, hadn't fully settled and she was still there on the worlds longest CTG that I have to admit I was doing a piss poor job of monitoring.
Also they were planning not to intervene in stopping the birth should it continue as 36+ weeks is good enough, really, in the scheme of things.

Memorable moments of the day
So I'm in ultrasound with lady no2. and we're talking about why would we have more children (like you know, conversational) and the sonographer guy comes to me and shows me a name on a paper and says "is she coming for a scan" and I say no, I have her too and they've cancelled her scan. And he says "so what do I record"? And I say I don't know, she doesn't need it anymore because they've decided ...
...
..
and then I think hum. Maybe I shouldn't say too much. In anycase, the scan is no longer needed.

Lady no.2 about to have baby no 4. doesn't need to know that Lady no1. is having a bad day next door.


Does she now.

Count your blessings cause it ain't easy for everyone.

The social worker coming in and doing a whole speil and show with Lady no1. She looked quite young. But it made me also think about the types of people she has to see in the hospital and what she has to do all day. Talk to people basically having the worst time of their lives. When is the happy patient?

Last week I had my first shift at SSH for 2023.

I had women with all the problems.

Lady #1 from oversease - but like odd overseas. Like born in x country and then migrated to a country which has a reciprocal agrement with Australia, but it only works in reverse. Aka. that Australians can go there and get healthcare but they can't come here and have healthcare? I don't want to say which countries she's from because then that would probably be as good as identifying who she is.
She thought she could wing it without healthcare in pregnancy because the country she is from is one of those with a cultural belief that pregnancy is a normal state of being that doesn't require healthcare (sorta, if your low risk, but she wasn't) but turns out she had hypertension in pregnancy and had no idea. So she came to Australia on a holiday visa to visit her husband who is working here, supposedly went to the GP a few times, and another local hospital a few times for various reasons - but then gave birth at home to a much smaller baby than the gestation she thought it was.
Due to her hypertension postpartum, they think she had it in pregnancy, which would have contributed to the poor growth and demise of the fetus (most certainly probably would have caused its death). She gave birth to it at home and was brought in by ambulance.

She's refusing a post mortum due to the cost. While it may show why the baby died, it may also show nothing. But it was really small for it's gestation.

She had it in a cold cot in its room and other than bring her meals, offer her ice for her breasts and check her observations - the other main thing I did was to check the baby's cold cot remained cold because, decomposition is a thing.

Man. That poor thing was looking rather decomposed by the end of my shift. It was 3 days into her 4 day stay.

Woman number 2.
Extremely anxious G3PO. Meaning, she's had 2 previous pregnancies that didn't make it. The 2nd last one was rather depressing because she had to have an induction at 19 weeks for her dead fetus who had likely died inside her around 14 weeks based on size once it was born.

So that means she carried it dead for 5 weeks.

Now she was in at 24 weeks and 2 days for significant antepartum haemorrhage or APH.

She was intermittently tightening too.

She had an inhouse scan that showed nothing super unusual, the placenta was low lying but not really.
They stopped her asprin - which helps women retain pregnancy if they've had a history of loss- but in the context of an APH wasn't likely to be helpful.

She was so anxious. Everything I said was questioned, They wanted a lot of detail, some of which I didn't have. She wanted me to take care of her on the ward or wondered when I would see her next. Lady, I'm casual.

Turns out she migrated here just before the covid pandemic and then had go through pregnancies 1 and 2 and their subsequent bad outcomes during the whole covid thing too.

Some people have all the worst luck. She wasn't super old. The only thing I thought might have hindered her ability to remain pregnant was her low BMI, which was 17 and I think she was probably a vegetarian. B12 isn't really in vegitables. I'm not her obstetrician so i'm not there to poke and prod.

So I had both. And then I was meant to deliver a 36+2 weeker baby but the other casual just jumped in and did it. I can't very well elbow her aside and be like "but I was allocated this birth and you have a woman, in another room, whose induction your running!"


I'd not have known what to do with her anyways so I just held the toco and watched. Over in approx 10 minutes for the babe and another 5 for the placenta.

I wonder what the induction lady would think if she knew the room around the corner was done so quick. Let alone the G3P0 lady to know that someone would just have a term baby in 10 minutes. While she's been trying since 2019 and has had 0 success.

I had an unremarkable cesarean in the morning. The incharge asked if I felt well enough to go into theater and take on a cesarean by myself, -- as she said, she was concerned if she sent a pregnant midwife to do the case, and they felt dizzy or unwell, or needed to eat or drink; they'd be restricted.

The dizziness was a first trimester issue... which I resolved by working only in ICU where chairs are abundant and u can sneak a snack bag on ur computer. So I took the case.

The elective for previous
The first was an elective cesarian for previous, on a woman who is filipino Catholic but clearly married a muslim man whose name was Mohammed. I asked his name, and when he told me I said I can remember that nice and easy. I wonder what that household does with regards to things like Christmas and Eid. Just have both? Could be fun ... She had no GDM diagnosed in 1st and 2nd pregnancy but in the 3rd there it was. In 1st and 2nd she had LGA babies (well, not strict LGA but for her stature and for Filipino I think it could be classified as LGA: 4.1kg and 4.0 kg -and that being said anything above 4 is considered big (in Australia... but then you hear of women pushing out 5.0 kg babies supposedly just fine and you wonder.. back in the day, they seemed not to be labeled so harshly as LGA.. actually the old cutoff was 4.5kg but still that's 500g bigger than 4kg)and if you didn't have GDM diagnosed then clinicians are sneakily thinking you either had a borderline case or had it but it wasn't picked up.

So this lady had a cesarean for a diagnosed big baby.

And this one, was number 3. So after cesarean number 1, and then number 2, it would be rare for a 35 yr old to then go "I want a vaginal birth" -- plus, this one was thought to be possibly LGA too.

It came out as 3.6kg.

They wanted cord gasses (and I don't know why).

Maybe it was because they thought her diabetes was not well controlled. The HbA1c was a little high I suppose and she did argue with them about taking the metformin - wanting diet controlled instead (but ate custard and other things that were labeled as "dietary excursions"). Her notes sounded really depressing actually.

I thought there was a TOP or a D and C happening in OT prior to this case so I showed up ridiculously late. Usually, I'm supposed to meet the women and her partner prior to the surgery in the wait room, introduce myself, ask about their history face to face, palp their abdomen and do a fetal heart. Write an intro note...

I missed all that -- by the time I got there, they were putting in the spinal and well I can't very well just interrupt an elective cesarean section spinal and say "HOLD IT! MAYBE THE BABY IS DEAD...I NEED TO DO A FETAL HEART JUST TO CHECK" when essentially, in 30 mins, the baby will be out....

Ah well. I figured, if she didn't feel movements she would have said so by now.

I blame baby brain for stuffing up 2x cord gasses by running them as arterial and venous gasses rather than cord arterial and cord venous(yes they're different) -- before all of a sudden on the 3rd test realising my mistake and having to spend time fixing those. Nothing should come of them as the results weren't abnormal but I hate making a mistake like that. Imagine you run a test, but you run it wrong, and say, one number is high - say the lactate is 10 instead of 6. Then based on that one number either the baby has to have more testing (painful heel prick and crying and blood collection) and the test re run only to find its normal. Parents are stressed for no reason... or could go the other way. Something important isn't picked up..

Small mistakes in healthcare can lead to huge (in my opinion) after effects.

The 22 yr old Prinip
so afterwards I had early lunch and was sent to "cover other peoples breaks" which ended up being me, wandering into MAC and taking a phone call-- which led to me helping out instead with a prinip who was 2nd presentation for ?early labour (? because you just don't know until you assess them).

It's always hard assessing a prinip. You don't want to go in too early and declare them 1 cm after they'd been huffing and puffing away in pain for 12 hours- similarly you don't want to decide they're early labour and send them home to then have the baby in the car park either.

But here we were now on the 2nd presentation: which meant, she had early been assessed as "early" and had gone through 12+ hours at home (without sleep, watching law and order SUV to chillax apparently) so clearly, she was here for a reason. I wasn't really keen to send her home without something and we don't give anything and just send people home (anymore) -- we keep them and monitor (incase something bad happens as a consequence of us either missing the fact that they've progressed faster than we thought or; another problem has happened.

I throw on a CTG because we're probably going to give endone, and if the CTG is bad you don't want to give endone and hide a problem. but if the CTG is A+ then you are reassured the baby is fine, all is well, and it's ok for her to ride along the labour journey at her pace.

She had a classic watermelon- stretch mark stripped abdomen, and the hairiest legs (and down there) I'd seen in a long time for a caucasian(?) 22 yr old.

I also had to do a vaginal exam. The 23:00 one the night before, had been traumatising. The midwife had been a bit rough (ok vaginal exams are extremely hard to do on a 1st timer prinip: and worst if its the first one they ever experienced: so here I was to do a procedure I don't like on someone that would rather not have it done -- but it needs to be done. She's here for a reason. We need to know if she's progressed (or not) and how fast or far and so forth. The previous result was closed and posterior.

I considered to offer her gas for the exam but theres no exam in the MAC area, which means moving to another area... and that was too much effort. So I chose not to offer it to her, but instead promised to be extremely gentle (and I know me, I am really gentle-- which can be bad cause sometimes, it means I don't get the answer and I'm up there being too gentle to a fault- but I've learnt now: take your time is the answer if your going to be gentle).

I took my time so hard, I swear, my hand smelt like liquor (but I wasn't convinced the waters had broken even though she felt "like she peed herself" and had moist underwear. firstly, the pad wasn't stained but it was damp and secondly, I could feel the waterbag - and it felt intact) for about 3 hours after the exam.

I literally felt like my hands smelled like vagina (but worse, cause it's labouring vagina... actually I don't know what a non-laboring vagina smells like 'cause who goes up a non labouring vagina for 5 mins?! (no-one). I washed my hands to my elbows about 3 times.

ApparentlY-- shaving cream -- is the answer. I learnt that tip at the lights of christmas duty that night when I then did some volunteer work in the City from 1930-2300 (and drastically wondered what I was doing there to be honest considering my volunteer uniform doesn't fit anymore so I wore my work uniform with a hi-vis on top) Ab from F/F division told me when he worked in a nursing home, shaving cream is what they used when some god awful smell had to be gotten rid of.

I left my shift at SSH listening to the girls in the tea room talk about the 19 yr old girl who had 3 children that was an absolute nightmare to deal with in labour (swearing, carrying on, being nasty, aggressive, even in front of her own other children) whose children still remain in her care. I walked back to the car park with the girl who warned me about Monday and Friday shifts being "the worst" (and she's right. it's like all the shit gets dumped on Mon and Fri due to the abnormal concept of "weekend") -- Neelab. I'm going to miss their Christmas party thing because I'll be on a 12 hr at my other job.

My next shifts will be on Dec 19 and 23rd respectively.

I wonder if the 22 yr old prinip delivered vaginally like she had wanted.