Off Service Intern starting OB tomorrow

[Doc Brown]

Hey guys,
So I'm an EM intern starting on OB Night Float tomorrow. I don't know anything about anything (I'll pause and let the jabs fly) and I especially don't know anything about OB, because at my medical school, we were silent observors. That means I have done TWO pelvic exams my whole medical career, have caught ZERO babies, couldn't read a Fetal Heart Tracing to save my (and I suppose a baby's) life, etc.... In fact, it's been so long since I've been on L&D that I don't even remember what questions to ask in a history.
Needless to say, I'm pretty nervous. I don't want my resident to think I'm any more of a dummy, but to be honest, I really can't do anything useful. Any tips, pocket manual, useful info that'll help me fake till I make it.

Thanks in advance

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[tiredmom]

Hi Doc Brown!
First off, I'm only an MS4, so take all advice with a grain of salt. There is a good small pocket book called Obstetrics Gynecology & Infertility. It's a small, red handbook/survival guide type book that has a ton of good info in it. I would be upfront with your resident on your first meeting about your background and that you've not had exposure to this type of work previously, but you are willing and interested to learn.
Good luck on your night float rotation!

 

[MFMdoc]

Dude, don't sweat it. This is only your second month. The residency is four years for a reason. Just be a good intern: stay on your feet; be eager to evaluate incoming patients; do as many deliveries as possible, don't forget the paperwork. Its your resident's job to teach you and make sure you get it. They should be looking over everything that you do. The little red book mentioned by the previous poster is golden for all OB interns and referred to by all up through the fourth year.
Have fun!

 

[fuzzyerin]

I think the best thing one of our ER docs did during his rotation is fessed up to not knowing anything, but came with a genuine eagerness to learn. If you asked him to do anything, he was always happy to do it, wanted to be a part of it, and became a part of the team. He took feedback extremely well and really was a pleasure to work with.

Remember, the intern you'll be working with is a fresh as you. I remember my frustration at the beginning of last year when the ER resident and the FP resident sat and watched me work. It's not like I had a ton more experience than them at that point - we had all been doctors for 1 month! Ask what things need to be done to admit a patient (consents/orders/H&P) and after delivery (birth certificate/orders again) and do them. Divide and conquer. Your intern will love you for it, the upper levels will be impressed.

Think of how you're going to apply this to your future in the ER. You'll see a lot of bleeders ~ what are the causes of 1st trimester bleeding? Make sure they get a type and sceen to see if they're Rh-. Watch a resident counsel someone who has a missed abortion, cause you'll have to do that in the ER. What causes contractions other than labor? (dehydration, uti, gastrointestinal bugs) Ask the resident on the first day to go over a fetal heart tracing. And ask them to go over the maneuvers for a delivery. That way, if you know it on day 1, you won't look like an idiot when someone lets you do it.

The four questions to ask everyone (over 20-24 weeks) - any bleeding? any gush of fluid? any contractions? is the baby moving?

1st trimester bleeder questions - abnormal paps? intercourse? trauma?

I know most people hate ob and are terrified of vaginas (I still haven't figured out why...I love what I do!) but if you have a positive attitude about it, it's really not that bad!