Some rules for Labor and Delivery

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Thievery Corp.

Thievery Corp.

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I got this from a friend when I told him I was on L&D.
The Rules of Labor and Delivery



#1 It does not matter how long you have been waiting for a patient to deliver, or how long she has been in labor, stepping off the L&D floor for any period of time (eg. for a cup of coffee) is a sure way to get her to deliver. Without you. Friedman curve be damned. Clinical trials have shown this to be the most effective form of induction/augmentation known to man.

Corollary to Rule #1: The Domino Effect. It does not matter how many patients you have in labor, when one of them delivers, they all deliver simultaneously.



#2 It does not matter where your attending is while your patient is in labor (eg. Arkansas or Helsinki), she will have gotten there before you, delivered the baby, and written her note by the time you get there.

#3 You WILL get soiled. It does not matter if you are wearing a NASA spacesuit or where you are standing (eg. behind a “firewall” of nurses, Helsinki or Arkansas), you will wind up looking like Sissy Spacek did at the end of “Carrie”

#4 The best way to ensure that your nurse pages you for the delivery is to tattoo your pager number to your patient’s perineum.

#5 The best way to avoid “looking pasty” in obstetrics is to reassure your patient that everything is fine, and then calmly give yourself a shot of Stadol.

#6 Waiting in-house all night for your patient to deliver vaginally is a sure sign that she will need a 4am cesarean section after you have gone home.


Anyone have some more thoughts?
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#1. Head down, mouth shut, do what you're told, and try not to make eye contact.

#2. Repeat #1 until rotation over.
 
Thievery Corp. said:
The Rules of Labor and Delivery

#1 It does not matter how long you have been waiting for a patient to deliver, or how long she has been in labor, stepping off the L&D floor for any period of time (eg. for a cup of coffee) is a sure way to get her to deliver. Without you. Friedman curve be damned. Clinical trials have shown this to be the most effective form of induction/augmentation known to man.

Corollary to Rule #1: The Domino Effect. It does not matter how many patients you have in labor, when one of them delivers, they all deliver simultaneously.

#2 It does not matter where your attending is while your patient is in labor (eg. Arkansas or Helsinki), she will have gotten there before you, delivered the baby, and written her note by the time you get there.

#3 You WILL get soiled. It does not matter if you are wearing a NASA spacesuit or where you are standing (eg. behind a “firewall” of nurses, Helsinki or Arkansas), you will wind up looking like Sissy Spacek did at the end of “Carrie”

#4 The best way to ensure that your nurse pages you for the delivery is to tattoo your pager number to your patient’s perineum.

#5 The best way to avoid “looking pasty” in obstetrics is to reassure your patient that everything is fine, and then calmly give yourself a shot of Stadol.

#6 Waiting in-house all night for your patient to deliver vaginally is a sure sign that she will need a 4am cesarean section after you have gone home.
Click to expand...

#7 When a patient presents you with a "birth plan," she's just increased her risk for a c-section by 10%. The more elaborate the birth plan, the higher the probability that she will end up needing a c-section.
 
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#8- Pregnant women do not have veins

#9- If you ignore the above rule and start an IV/line, congrats. You are most likely in an artery.
 
#10: There is always feast or famine. You will a)twiddle your thumbs or b)have babies shooting at you from the hallway. If you have a resident that will let you deliver, it will be A.
 
rowan said:
#1. Head down, mouth shut, do what you're told, and try not to make eye contact.

#2. Repeat #1 until rotation over.
Click to expand...

Absolutely. Excellent advice. The residents will still call you a useless human with the skills of a kindergartener, just not as much as your classmates.
 
- at your first delivery, the woman will crap all over herself; everyone else will think this is normal

- at every delivery, one nurse shall be assigned to repeat "She's beautiful!" over and over in a sing-song voice, as another nurse cleans the blood, mucus, and feces off of the screaming infant

- in L&D, nurses not only outrank residents, they are actually smarter; this is more of a reflection on the residents than the nurses

- for all med student deliveries, the patients shall be chosen in order to maximize the libido-killing of said student
 
Thievery Corp. said:
I got this from a friend when I told him I was on L&D.
The Rules of Labor and Delivery
#4 The best way to ensure that your nurse pages you for the delivery is to tattoo your pager number to your patient's perineum.

...

#6 Waiting in-house all night for your patient to deliver vaginally is a sure sign that she will need a 4am cesarean section after you have gone home.


Anyone have some more thoughts?
Click to expand...

When you actually have to stay in house for call, the only reason the nurses will page you, if you even have a chance to sleep, is not for the delivery you followed since you took over the board at 7am, it's for an H&P for a woman, who will be seen and discharged. While you've returned to L&D, you discover the other woman delivered an hour earlier, leaving you, the med student on OB/gyn, with no baby catches for the entire 6 weeks.
 
Miami_med said:
#10: There is always feast or famine. You will a)twiddle your thumbs or b)have babies shooting at you from the hallway. If you have a resident that will let you deliver, it will be A.
Click to expand...

#11 It truly is worth the effort to cajole and coax your patient into getting the epidural. That way, there won't be that awkward moment when she clutches your arm and says "The pain is getting so bad, give me some meds," and you'll have to say to her "I'm sorry but...it's too late." Particularly as she now has your arm in her pincer-like grasp.
 
smq123 said:
#11 It truly is worth the effort to cajole and coax your patient into getting the epidural. That way, there won't be that awkward moment when she clutches your arm and says "The pain is getting so bad, give me some meds," and you'll have to say to her "I'm sorry but...it's too late." Particularly as she now has your arm in her pincer-like grasp.
Click to expand...
#12 When the patient specifically tells you she doesn't mind medical students watching her delivery, the attending will kick you out of the delivery, telling you "This patient doesn't like medical students, she's a little funny like that."
 
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#12: you may once to consider wearing a face mask with a shield so viral or infected (HIV,syphillis...) fluids don't gush into you mouth or eyes. Heard of it happening, and you wouldn't want it to be you
 
rowan said:
#1. Head down, mouth shut, do what you're told, and try not to make eye contact.

#2. Repeat #1 until rotation over.
Click to expand...

Corollary to Rule #1: Do not give anyone an excuse to yell at you, and you will not be yelled at. This includes attendings, residents, nurses, and the whole 9 yards.

#13. Bring your own alarm clock. Just because a resident tells you theyll wake you up during your night shift when youre needed doesn't mean they actually will.
 
#14. If it's finally your one chance to catch a baby and you're actually sitting between the legs for the first time... the mother will require an episiotomy and the attending will shove you out of the way like a bouncer shoving out a 19 year old with a bad fake ID.
 
stay away from Labor and delivery nurses they are the bitchiest of the bitches in the hospital..

i agree with the keep your mouth shut. dont speak until spoken to and minimal eye contact may keep you out of trouble. not a guarantee.. and whatever you do please.. Do not .. i repeat.. do not congregate at the nurses station on an l and d floor with the pigs.. that is guaranteed to get you in the gossip. Because all the nurses do there is gossip, eat donuts and cookies and demean men and doctors because they can do a better job.
 
Haha, #1 is probably the truest thing in the world on OB. Nice work.
 
johankriek said:
stay away from Labor and delivery nurses they are the bitchiest of the bitches in the hospital..

i agree with the keep your mouth shut. dont speak until spoken to and minimal eye contact may keep you out of trouble. not a guarantee.. and whatever you do please.. Do not .. i repeat.. do not congregate at the nurses station on an l and d floor with the pigs.. that is guaranteed to get you in the gossip. Because all the nurses do there is gossip, eat donuts and cookies and demean men and doctors because they can do a better job.
Click to expand...

:thumbup::thumbup:

Also, DO NOT argue, and DO NOT attempt to justify yourself. If an attending tell s you to do/change something, you do it.
 
smq123 said:
I think this is pretty much true for all rotations. The fun part of being on the absolute bottom of the totem pole, I guess.
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Depends. After spending some time on the floor, you know which attendings not to mess with. Some are ALOT nicer, more understanding, and more willing to teach than others. In my experience, OB has a shortage of these...
 
#15 avoid eye contact with all residents and all med students who have made public their love for OB.. These people, once they catch glimpse of your eyes, they will know you are not one of them... if they catch glimpse of that frightened winse in your eye when the nurses shout "STAT delivery!!", you might expose how you secretly think all of this as just downright insanity, which you will avoid steadfastly until the day you die... once that gets out, they will all attack you like a pack of wolves. Notable that their rage is directly proportional to board scores and inversely proportional to the number of offers they received in "better lifestyle professions."
 
prazmatic said:
Corollary to Rule #1: Do not give anyone an excuse to yell at you, and you will not be yelled at. This includes attendings, residents, nurses, and the whole 9 yards.
Click to expand...

Wish this were true. Some reason to yell at you will emerge, regardless of what you do.
 
# never wait on a primip. she will take a century to push down...

# please avoid food...we don't want to manage mendelson's syndrome, if we eventually decide to section

# An IV line should be set up during labour....you will be the better for it if she decides to have an atonic uterus.
 
Akuffo said:
# An IV line should be set up during labour....you will be the better for it if she decides to have an atonic uterus.
Click to expand...

At our house here, every single woman admitted to L&D gets an IV. Peroid.


Oh and btw, I'm done with L&D and I could not possibily be any happier that that is over. :smuggrin:
 
Akuffo said:
# please avoid food...we don't want to manage mendelson's syndrome, if we eventually decide to section

# An IV line should be set up during labour....you will be the better for it if she decides to have an atonic uterus.
Click to expand...

I think that it is standard at most US hospitals to insert an IV as soon as a pregnant woman is admitted. (And who "decides" to have an atonic uterus? :confused:)

I believe that it is also standard at most US hospitals to make all pregnant women NPO until they deliver.
 
leechy said:
Wish this were true. Some reason to yell at you will emerge, regardless of what you do.
Click to expand...

True. I suppose I should have added a disclaimer: Corollary 1 is done in the hopes that the amount of yellings will be reduced...
 
:laugh::laugh::laugh::laugh::laugh: its so much fun when dealing with totally immature folks, :laugh::laugh::laugh::laugh: grow up
 
The number of Spanish-only patients you get is inversely proportional to your fluency in Spanish
 
smq123 said:
I think that it is standard at most US hospitals to insert an IV as soon as a pregnant woman is admitted. (And who "decides" to have an atonic uterus? :confused:)

I believe that it is also standard at most US hospitals to make all pregnant women NPO until they deliver.
Click to expand...

The hospital I was at didn't give the woman an IV unless she wanted pain meds. Some were adament that they didn't, but in the middle of pushing, they suddenly wanted meds, and they were upset it was too late for the IV.

(But you can also give IM or intrarectal meds for that decidedly atonic uterus, so you're not stuck if you don't have an IV.)
 
Ashers said:
The hospital I was at didn't give the woman an IV unless she wanted pain meds. Some were adament that they didn't, but in the middle of pushing, they suddenly wanted meds, and they were upset it was too late for the IV.

(But you can also give IM or intrarectal meds for that decidedly atonic uterus, so you're not stuck if you don't have an IV.)
Click to expand...

They didn't make all women NPO? We always did, and gave them IV fluids so they don't dehydrate.

We also put IVs on most women - just because you never know when she'll need a stat c-section. Or if her contractions just don't stay strong enough, and you have to pit her.
 
smq123 said:
They didn't make all women NPO? We always did, and gave them IV fluids so they don't dehydrate.

We also put IVs on most women - just because you never know when she'll need a stat c-section. Or if her contractions just don't stay strong enough, and you have to pit her.
Click to expand...

The women were NPO; I guess I forgot to mention that. I was just focussng on the IVs.

I was in a few emergent c/s that required putting in an IV and spinal or epidural anesthesia because the mom had nothing before going into the OR, including one where the FHTs were down in the 20s-30s. That was a little nerve-wracking.
 
Tired said:
- at your first delivery, the woman will crap all over herself; everyone else will think this is normal
Click to expand...

Yeah, nothing more pleasant than watching a tube of stool slide out of the woman's anus and slowly roll down her buttocks. I don't know how the husbands get over this image, but I'm sure it involves a lot of Internet porn. Note: I don't need a whole bunch of women to start yelling about how it's not the woman's fault and men don't understand because they don't have babies and so on and so forth. I'm not blaming the woman for crapping herself, I'm just noting that it's not exactly the most beautiful sight in the world that you want to think of on your anniversary and I don't think that's a mind-boggling statement to make.

Tired said:
- at every delivery, one nurse shall be assigned to repeat "She's beautiful!" over and over in a sing-song voice, as another nurse cleans the blood, mucus, and feces off of the screaming infant
Click to expand...

I think that's a female thing because there's some rule that all babies are beautiful. Otherwise it makes the whole "you gained a whole lot of weight" thing just no good. Also, it's sort of funny but I don't think anyone ever wipes the crap off the woman. It just sort of sits there or gets squashed as she lowers her leg onto the bed. You can tell I was very fixated on the log of crap.

Tired said:
- for all med student deliveries, the patients shall be chosen in order to maximize the libido-killing of said student
Click to expand...

Yeah, but how many hot pregnant women are there in the world? (Seriously.)
 
doc02 said:
Yeah, nothing more pleasant than watching a tube of stool slide out of the woman's anus and slowly roll down her buttocks. I don't know how the husbands get over this image, but I'm sure it involves a lot of Internet porn. Note: I don't need a whole bunch of women to start yelling about how it's not the woman's fault and men don't understand because they don't have babies and so on and so forth. I'm not blaming the woman for crapping herself, I'm just noting that it's not exactly the most beautiful sight in the world that you want to think of on your anniversary and I don't think that's a mind-boggling statement to make.
Click to expand...

You don't have to defend yourself. I'm a girl and really enjoyed taking care of the patients that I met on my OB rotation. But, if I ever have a baby, I am kicking my husband out of the room. Actually, I'm kicking him out of the L&D suite. He can wait down in the cafeteria, like they used to do in the good old days. There is no way that I'd ever let my husband see me like that. He can come and visit after the baby and I are cleaned up.
 
smq123 said:
You don't have to defend yourself. I'm a girl and really enjoyed taking care of the patients that I met on my OB rotation.
Click to expand...

Wow, I so thought you were a guy.
 
smq123 said:
There is no way that I'd ever let my husband see me like that.
Click to expand...

Yeah, it's a really strange phenomenon. On the one hand, women don't want guys to see them without their makeup on. Then, you get married and all of a sudden they want you to see them straining out tubes of stool onto themselves with half of a head poking out of their vagina and their face all red with the veins sticking out while a room of random people yell "PUSH! PUSH! PUSH!!" at her. And then, when you're done, you have to pretend that's the most beautiful she's ever looked. And that her butt is not big. :D
 
smq123 said:
Really? :confused: What made you guys think that?
Click to expand...

I dunno. Maybe since people don't always go around saying "I'm a girl!", and your avatar, even though it's not you.

In that doctors and bluejeans thread, I had lots of people thinking I was a guy after I said I like to buy nice, non-collared shirts, even with my arctic puffin from Elf avatar.
 
my resident told me there was some study done that if the husband watches the baby actually come out of the vajayjay, he will find his wife less physically/sexually attractive. i think they should have a sheet up at all times, not just for c-sections.
and what is up with some hospitals? where my nephew was born, no one was allowed anywhere near l&d unless you were giving birth or were responsible for knocking up the mommy. where i did my ob rotation, the entire family was in the room to watch the birth, with cameras and videos and everything. i dont really think i'd like a permanent memory of my crotch while giving birth, but hey thats just me.
 
vajayjay
Click to expand...

Where did this word come from anyway? One week it didn't exist, the next it's everywhere.

Did Chappelle do a stand-up special that I missed? ;)
 
No.
Va-j-j was definitely around pre-GA.
Please people, you really thought THOSE writers could come up with something original?
 
I am a 23 yr old male M3, G0P000, 7 days s/p OB-gyn Shelf... still in aftershock, waiting to know if I passed...

Just to give my 2 cents: This rotation is certainly not one of the better ones. There are long hours, lots of time on your feet, but worst of all, there are alot of drama filled and outright crazy residents and attendings. It may not be as bad from place to place, but in general, it is best to just close your eyes and accept what is coming to you. Do whatever you need to do, and take solace in the fact that it will be over before you know it. God speed!
 
More rules:

When you are on call and don't have to show up in the morning for rounds, take as many patients as possible. That way one of them will be sure to deliver, you'll see some sections, but you don't have to get up at 5 am to see them all.

When you do have to get up the next day to round, either
a) If you don't have to log more deliveries (or just want an extra hour of sleep in the morning) follow 1 or 2 primips; chance is they won't deliver.
b) if you need to log more deliveries, follow the multips.


I would also like to add that it is SO true the moment you go home the primips deliver, AND that all the women deliver at once.

I'm on call tomorrow and I will be working like a machine knowing that I don't have to round on everyone the following morning. The residents love it because I help out with the work, and I love it because i learn a lot and get to sleep when it's all over. :thumbup:
 
If your patient goes to c-section, on your way to the OR stop at the kitchenette and chug 4 oz. of orange juice. It will help prevent you from getting light-headed during the surgery. The exception is a true stat c-section, in which case you won't have time to stop and even if you did there is nothing that will prevent you from wanting to vomit as you watch heart tones crash.

I was an OB nurse for three years in two different hospitals. In one hospital every woman had at least a capped IV. In the other, only if she needed it. In both hospitals women had a clear liquid diet except in one hospital it was ice chips only after the epidural was in.
 
Kimmer said:
No.
Va-j-j was definitely around pre-GA.
Please people, you really thought THOSE writers could come up with something original?
Click to expand...

yeah, it's definitely NOT a stretch to get va-jay-jay from vagina.

"Bajingo" from Elliot in scrubs... now THAT's original!:laugh:
 
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