Question for the ladies: pumping during an ER shift

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DeadInside

doc in a shop
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Going back to work after having my first child during residency. Any of the ladies ever pump during an ER shift, especially while a resident? Did you find it at all, in any way, doable to pump for even 5-10 min in a bathroom somewhere? Other residents have assured me that its hard, but totally doable, but they were in IM, ob, even surgery, in other words no shift work (i.e. even in surgery most cases do not take longer than 5hrs).

Will my attendings even be understanding?

Any advice would be appreciated if you have had experience with this.

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Try mommd.com , the posters often have good tips. Congrats on your baby!
 
I'm not a resident/attending but I was a tech in the ED. I'm also mother. I'm sure you can find the time if you HAVE to. But think of the days where it's so busy that you don't even have time to pee. I didn't breastfeed when I was working but I can't imagine, on those busy days, being able to find the time. As for them being understanding, I wouldn't say that they would come out and say no. But I could see the frustration when all the rooms are full and there's 15+ waiting and you have to take 15 minutes to pump. Because it'll take at least 5 minutes to get the pump out and get ready, then 5-10 minutes to pump. Also, when you're rushing and stressed out because you are busy, it may take even longer.
 
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I know multiple EM residents and attendings (in residencies and private practice) who have pumped at work...some until their babies were a year old. Honestly, unless you've got critical patients you can take a few minutes out of the department as long as you're not in a single coverage situation (which you won't be as a resident). You may be eating a sandwich or some other multitasking while pumping and you'll have to be willing to wait until there's a reasonable time patient flow-wise, but it can be done.

You will need a decent place to go. You don't really want to be pumping on the toilet. Do you have a resident lounge or something similar where you can shut yourself in with a reasonable assurance of privacy?

I would bring this up with your PD so that they know in advance. Hopefully they'll be supportive.
 
It depends. My son was 2 months old when I started residency and I was breast-feeding. Most of my attendings were understanding and supportive. As mentioned above, make sure you have a place close by the ED to use. At one hospital, the available facilities weren't very close, and it makes it very hard if you have to spend an additional 10-15 minutes getting to someplace to pump. Also, if your shifts are sometimes covered by one resident and sometimes covered by two, ask whoever's doing your scheduling if you can be put on double-resident covered shifts. It's far easier to take a few minutes when you know there's someone else there. Another suggestion is to get there early enough that you pump immediately before your shift starts - that way it's not quite as painful if you can't break away to pump. Just make sure you mention it to your attending at the beginning of a shift - that way they are planning ahead and will often say "Hey - if you want to go, now's a good time."

Good luck - it's can be hard. It was definitely far easier pumping on off service rotations than in the ED, but it can be done.
 
i started intern year with a 3 month old and was able to pump once a shift usually, the attendings didnt care. another resident who was midway through second year didn't have such good luck and had multiple episodes of mastitis. i think the problem is the more patients you are carrying the harder it is to break away for 20 minutes and pump, so you end up not doing it. as a beginning intern i wasn't carrying as many patients so it didn't matter as much for me to pop away. i don't think i would be able to pump if i was an upper level. the only good part was my shifts are only 8 hours, so i would pump right before i went to work and immediately left and pumped while charting as soon as i got home after the shift, so if i didn't get to pump at work it was just 8 hrs without (yes this was painful at times). i think if your breastfeeding is not well established you are screwed (just being honest).
 
Thank you to all who responded. Continuing to provide my 3 month old baby with the best nutrition out there is really important to me, and I am happy to see that, while it will take lots of dedication & planning, it IS possible to pump at work. I know that there will most definitely be days that I will not be able to pump during a shift (mine are also 8 hours). Thanks for all the encouragement DrMom, Emergency & Lynda. In particular, thanks for the smack in the head: I absolutely will not pump in the bathroom (I was just so desperate to pump that I had managed to convince myself this is okay :oops:). Also I will definitely take the advice to pump before each shift starts (for me, pumping on the way to work seems to be the best option).

If anyone else who has been there or has seen this done has tips or words of wisdom, keep them coming as I will be following this thread.

Also, just curious, how many months were you able to keep up with pumping while pumping in the ED?
 
we have had many residents and attendings who did/do this. We have a small attending office. sleep room works also.

I had my child in medical school (3rd/4th year) and pumped for 13 months. (when my kid wanted it poured into a sippy cup was when I cut her off.)
 
I decided not to do so. I'm sure there are ways to make it work, but since I already find it hard to keep up with my peers in the amount of patients I see, and I already have a difficult time staying on top of lab values, rechecks, documentation, I figured I would not be able to pump in the ED.
I do have an attending that pumps on a regular basis without a problem, but she has us to back her up.
 
A few things I learned from pumping during my 3rd and 4th years as a med student with two babies:
1) Directly nurse the baby as late as possible before your shift starts, because a live baby will drain your breasts more effectively than any pump. I learned to "dreamfeed" my baby, getting her to latch on and nurse in her sleep when I was up at dawn to leave for an early shift. Also, don't let them feed a bottle in the final hour before you see the baby again, so that the baby will nurse hungrily and stimulate your supply. Nurse at daycare before getting in the car to go home.
2) Handsfree pumping setup is critical. This can be rigged with a few hairbands around the pump flange hanging from a nursing bra strap, or there are many fine pumping bustiers available for purchase. This allows you to write notes, look up labs, catch up on reading results while you pump.
3) Practice with the pump. After a few weeks dedicated practice, I was like a commando and could set up in like, 90 seconds, and my body was trained to let down for the machine so I could get a good production in 10 minutes. Expect your letdown to improve with practice.
4) No need to wash parts after every use. If you stash them in the pump bag next to the insulated bag holding the bottles of milk, they are at fridge temp. Freshly expressed breastmilk is broadly antimicrobial. Between those two factors, nothing bad will grow in that one day. Wash them at home with soap and hot water or in the dishwasher, once in each 24 hour period.
5) Use compressions and massage near the end of the session to fully empty the breast or target problematic ducts.
6) Watch out for a cold room - impairs letdown. Drape a blanket over your shoulders.
7) If you can manage to push through for a month or two of really dedicated pumping, when the baby is older you will have a lot more wiggle room. So hold that thought close to your heart when you're frustrated. I found that with my second child, the "storage capacity" of my breasts was dramatically larger. With my first child, at 8 and 9 months I still needed to pump once every 5 or 6 hours, but with my second child at 10 weeks I was able to go 10 or 11 hours and just pump when I got home after the shift, and not impair my supply. It gets better.
8) Some women talk about using something familiar to help letdown - a picture, a sound file, a garment that smells like baby. I found the pump to be completely alien and artificial, and did better with complete distraction.

Once I got good at it, most of the people I was working with had no idea. If you're preparing notes or looking up labs, the 10 minutes is not wasted. Find the right space is probably the hardest part. On some rotations I wasted a lot more time getting to the approved space than actually pumping. Lame. Also, if you're engorged, hand-expressing a little into a bathroom sink relieves the pressure and hopefully reduces risk of plugged duct and mastitis.
 
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