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Perhaps you have read about my experience in Maternity 2 as the oncall house officer. Maternity 2 which is also known as the antenatal ward.
Maternity 1 and Maternity 3 is where the postnatal patients go to right after delivery. Be it from normal delivery, assisted delivery or post lower segment caesarean section.
Maternity 1 and Maternity 3 are the places I was allocated to in the early days of my post tagging period. During my time as a house officer in the Department of Obstetrics and Gynaecology in the hospital I am practicing in, we were experiencing a shortage in house officers. Hence, only one house officer would be allocated per ward and if you are allocated to be in charge of Maternity 3, this means that you would need to handle both Maternity 1 and 3, at night.
Thus, how do I go about my night shift in these places?
Arriving 10-30 minutes prior to the start of my shift.
My shift begins at 7pm and ends at 9am. Similar to Maternity 2, I would arrive around 10-30 minutes earlier prior to the start of my shift and receive handover from the morning / AM team in Maternity 1 and Maternity 3.
This is followed by taking pictures of the patients’ allocation board and posting it in the “MO-HO” group. The patient count needs to be updated in the group every 7pm and 5am.
Next, I would start reviewing the acute beds in Maternity 3 followed by the post lower segment caesarean section (LSCS) patients who have been transferred in but yet to be seen by medical officers or those who are still on intravenous drips (IVD) and urinary catheter.
Next, while awaiting the medical officers on-call to come for rounds, I would settle the transfer ins of new patients.
Usually, patients who are transferred in requires “Plan D” which are prepped discharges as most post spontaneous vertex delivery patients otherwise known as patients who gave birth normally would usually be discharged the following day.
After rounds, I would go about the same joblists which are transfer-ins of new patients, doing the “Plan D” in both Maternity 1 and Maternity 3 as well as attending to acute cases. Usually the acute cases seen in Maternity 1 and 3 would be hypertensive patients and postpartum haemorrhage. Hypertensive crises patients are quite common and usually the control is more stricter postpartum. Postpartum haemorrhage occurring in ward is a rare case and usually if there is, the patients would have been managed and stabilised in labour ward prior to transferring out.
What used to irk me the most was the fact that I needed a medical officer to countersign my prescriptions prior to the nurses serving them. This serves a real issue as the post-caesarean section patients would be in pain and in order for me to manage the patients, I had to complete the transfer in review, find a medical officer who is free, present my case and then only get a countersign when I would very much prefer to just serve the analgesics immediately.
This of course continues on until the morning team comes for their review which is around 6am.
On good days, one thing happens at a time, meaning in Maternity 3 followed by Maternity 1. Sometimes there would be less transfer ins. On bad days, everything occurs simultaneously at once and I would be rushing between both wards continuously.
After the morning team arrives, it is time to complete the duties after being “summoned”. Most of the time, it is pharmacist referrals for injection technique for post caesarean section patient as they would be on subcutaneous clexane or social worker referrals, physiotherapy referrals or to prepare prepped discharges also known as “Plan D” for certain patients who are due to be discharged but the discharges are yet to be prepped till 9am.
Personally, I prefer Maternity 2 as compared to Maternity 1 and Maternity 3. As I mentioned in my previous article, on good days, it is extremely cold in the sense that when there is no active issues, we are able to sit for a bit and rest and perhaps even eat. However, on bad days, the ward could be burning with multiple issues as well.
Personally, it was an experience to be handling Maternity 1 and Maternity 3, provided that you work with good bosses of course, which may not always be the case.
Related Posts:
- Surviving On-Night In The Antenatal Ward (Maternity 2) As A House Officer In Sarawak General Hospital – Housemanship Diaries
- The Types Of Wards In The O&G Department Of Sarawak General Hospital – Housemanship Diaries
- Being An O&G Operating Theatre House Officer – Housemanship Diaries
- The Labour Ward, O&G Department – Housemanship Diaries
- The Orthopaedics Posting – Housemanship Diaries
- My “Coming Morning” Priority – Housemanship Diaries
- 8 Best Advices I Will Remember For The Longest Time – The Orthopaedic Posting
- My Second Posting During Housemanship – Obstetrics & Gynaecology
- I Survived 26 Days Of Tagging In O&G – Housemanship Diaries
The Theoretical Doctor 