Snow drifts on the ground.
My breath hangs uncertainly in the frigid air.
Winter still. Stubborn.
But as I drove to work in the warm cocoon of my car, I was transformed by a vision of bright rows of lights, shining festively through the transparent walls of a greenhouse at one of the nurseries I pass by.
I imagine the vibrant lights perched above tiny seedlings, coaxing them to grow despite the lingering reality of winter outside their sheltered walls.
And as the birdsongs further testify this morning, spring is coming.
They know it.
And I am hopeful again.
I enjoy working at a teaching hospital. Really.
It can be extremely, astoundingly, incomprehensibly frustrating when the team of residents on call are a bunch of indecisive know-it-alls. Sounds contradictory, right? Maybe that's why the plan of care for my clinic patient (whose care is overseen by the residents) changed every 5 minutes or so last night. They all know it ALL and are ALL making the decision.
Draw labs at 0500.
(talk to senior resident)
Cancel that, let's recheck them stat.
Straight cath her.
(discuss with attending)
Actually, now that you just cath'd her, I think we're gonna need a foley.
Let's hold off on the Mag.
(enter senior resident)
Pressure's up but we'll just keep a close eye on it. And better draw those labs again.
(update chief again)
Now we are starting Mag. And antibiotics.
And some rectal Tylenol.
And I think she's gonna need a section.
(review with attending)
Yeah, let's just do the C-section now.
Hold that thought, the other clinic patient needs a section, too. This one can wait an hour.
*** hour goes by while I furiously try to catch up with meds and charting and explain to family why, despite the fact that the decision has been made, we can't do the C-section right now***
(re-enter senior resident)
Let's go, we're ready NOW!
Intersperse numerous cervical exams by whichever resident is around at the time, and you may have a potential cause for the chorio.
Baby did great, and the patient came through it all okay.
The nurse, on the other hand, feels defeated and sad. For the patient, for herself, and for a system that could clearly be better.