After Surgery rotation I had my mind set on a specialty so it was difficult to keep an open mind going into my last rotation. However, it really surprised me. OBGYN is a specialty where we get to build a unique intimate connection with our patients and learn how to speak comfortably about things that most people find uncomfortable.
On days I worked with C.Melendez I got a full autonomy to act as a full on provider writing the HPI in EPIC, placing orders, booking OR, performing a full exam vocalizing my findings, performing and Ultrasound and counseling patients. I am not sure if this was because it was my last rotation or if he extends this level of trust to all of his students but it was really empowering.
This rotation made me very comfortable taking sexual history, talking about contraception options and consequences of sexually transmitted infections on woman’s health and performing pelvic exams and ultrasounds which added to me being a well-rounded provider in future. It also had a pretty big surgical component, which I, of course, loved, and was very happy to be a part of.
Interpersonal challenges I experienced from day one was on OB service. Most midwives acted like they did not want students on the floor and were anything but helpful anytime I asked for guidance. That’s why I decided to begin building my presence with the nurses asking them how I can be of help. Second night of my rotation we were the busiest I’ve ever seen the department, and everyone was really appreciative that I was doing my best to be of service to all patients helping them change the position, getting them ice chips, extra pillows, socks, blankets, etc. These efforts turned out being very fruitful as I got to assist in delivery of five babies that night. Even the patients who initially were reluctant about consenting to me being in the room if they were to have a baby that night ended up asking me to come closer when the time came. This was a very useful experience as now, going into a job which will mean establishing myself as a permanent part of a new team, I know that I can make myself likeable by showing I’m a team player and that I’m there to help, wherever the help is needed.
A memorable patient encounter I will remember was with a 24 y/o patient who came to ER with a c/o abdominal pain. During initial interview in ED she said there was no chance she could be pregnant. She was overweight and had irregular periods so she did not notice any vast changes in her well being throughout the past couple of months. After a workup, her preliminary estimated gestational age was 34 weeks. She was admitted to OB floor because of non-reassuring NST tracing and because of her history of anxiety and possible undiagnosed mental health disorder since she had tangential though process and was pulling out her hair, pulling out her IVs and breaking her nails. I have spent quite a bit of time with her because of my interest in psychiatry but also because I found to have a soothing effect on her. The news that she might deliver a baby soon was a lot to handle and I empathized with her. When she went into labor, no one called me and I walked into her room when she was approaching stage II of labor. Despite midwives not being too excited about me being there, the patient pointed at me and said “I want her to hold my hand”. Everyone made room for me and I held her hand talking her through the process. This was the first birth I’ve ever witnessed and it was magical. She delivered a beautiful healthy full term baby.
This past year I’ve seen more death than I ever did in my life, especially in Trauma. OB experience allowed me to witness bringing a new life into the world and it was one of the most incredible things I’ve ever witnessed, which made it a perfect ending to my clinical year.