On OB Night Float

Thirteen deliveries in 16 days—16 deliveries if you count the ones where my hands weren’t on baby, but I was right there assisting. About a month ago, I embarked upon a rotation that was extremely important to me: OB night float. Prior to my arrival to the floor, I’d heard so many comments on what to expect from the rotation. I initially had my concerns because as a Family Medicine resident on OB, I thought it may be somewhat tricky to learn.

The OB team has their own residents they have to teach. The midwives have their own students they have to teach. Yes, my program has Family Medicine OB (FM OB) Attendings, but they typically do not work night float. At first, I absolutely felt like an orphan—completely out of place. How many Family Medicine residents can relate—always being on someone else’s service; always away from the home team?

Still, I was determined to show up and learn. I have been clear I want to be a women’s health practitioner. I have, however, been on the fence about practicing OB…until now.

I showed up and worked on OB night float like I never have on any other rotation. I CONSTANTLY asked to be put to work. I always asked the midwives and residents if they needed something. I gathered supplies for inductions. I saw triage patients. I admitted patients for induction. I presented to OB Attendings—residency-affiliated and private. I presented to midwives. Y’all, by my second week I went from constantly asking if I could help to being ASKED to help. I went from “actually, the cervical exam is this” to “Anya, your cervical exams are very good. I trust you.” I feel like I earned the team’s trust. I feel like I earned their respect. I cannot even tell y’all what that meant to me. Usually, I’m a G on rotations. Talk to me nice and don’t do too much. On OB??? I was absolutely at their service. Tony! Toni! Toné! with mine—“Whatever You Want!” Just teach me lol.

I also got to show up for my patients. This rotation was the first time I ever saw someone through their pregnancy and then delivered their baby. What a beautiful and sweet reward! I advocated for them. I stepped in for them. I spoke up for them. I stalked charts and slept less to ensure I didn’t miss the delivery. I feel like I helped grow those babies from scratch. To help deliver them and then hold them? Some of the most gratifying experiences of my life.

I have to say my FM OB Attendings ABSOLUTELY held me down!!! One stayed with me to deliver my first continuity patient. She had been there all night and stayed hours into the morning to ensure and oversee my patient’s delivery. Because of the circumstances, I asked her to stay and she did. Another FM OB would work all day and then stay with me a few hours into the night to see triage patients with me, orient me, reintroduce me to the team, and review cases with me. And yet another FM OB would show up in the mornings and remind various team members, “Oh, Dr. Bazzell wants to learn that.” She reminded them I’m interested and want to be involved. And ya know what? The team made sure to involve me. These women have families of their own. They have patients of their own. They have schedules of their own. They each made time to be there for me and I’m so very grateful for their presence and sacrifice.

And the midwives and OB team. I learned so much from them. They answered all my questions. They showed me their different delivery styles. I just love learning stylistic technique from others and picking and choosing what to incorporate in my own practice, especially on OB. They taught me best practices. They allowed me to be apart. Even the private Attendings let me admit and deliver a few patients with them. I must say I learned more on this one rotation than I did in all of my OB rotations thus far. Being on a night rotation was such a dope experience because there are fewer OB residents on the floor and another hand is actually very helpful. As a result, you get to do and see so much more.

Through this rotation, my love for OB was reawakened. For the first time, I was able to participate enough to see the specialty for what it is and determine if it’s for me. The practice is truly an art, a dance, such a beautiful language. I love being in the presence of such life-changing and delicate moments. As an OB, you are part of the most vulnerable experience for some. There is nothing like it. The grit, the grime, the tears, the Joy. I had one patient who ultimately had failure of descent which meant OB had to intervene and deliver with forceps, but I was with her the entire time. For 5+ hours, I never left her room. No bathroom break, no water, nothing until that baby was out the next morning. She was so grateful and beyond excited to let me hold her baby the next day. OB has so much meaning, so much purpose. I need more of that in my life. I WANT more of that in my life.

And y’all, the feedback!! I was so pleased and so blessed by the comments. I’m keeping those words close to my heart, just for me. But know I have never gotten that kind of evaluation on any other rotation. I didn’t get those kinds of comments on anything inpatient medicine. I’m not gon’ hold y’all. I probably won’t get that kind of feedback on outpatient pediatrics either. Ha! Generally, my evaluations are good, but it’s so nice to have feedback that is GREAT. I feel like I was finally seen. With all the ridiculously hard work and long hours it takes to be a resident physician, it’s nice to feel seen, you know? Especially on a rotation you really care about. For the past year and a half, I have honestly felt out of place because so much of the first year especially is all inpatient regular adult medicine. I’ve watched my peers be lauded for their performance while I’m over here planning an away rotation based on all my interests. But now? Just wow. What a difference passion makes.

I wanted to share this rotation experience specifically for all my Family Medicine folks who, too, are interested in women’s health. Now, I did have to wake up at 1:30am on home call one night to go in and deliver a patient. That definitely made me question my commitment to OB. Ha! But I do want to pursue it and see how I can make the practice work within the beautiful post-residency life I intend to curate. If you are interested in OB, definitely:

-Ensure your FM OB Attendings know and secure buy-in from the OB Team. Have them make introductions multiple times.

-Ask your FM OB Attendings to provide orientation on the floor (how to write notes, share dot phrases, go through a few patient cases). This way, you do not have to ask the OB team (which is already busy!) about these things. You can get right to work and start being helpful!

-See more, do MORE! Keep asking to help. Keep asking what you can do to assist. Introduce yourself to the (nice) private OB Attendings and ask if you can help them with admissions and deliveries. The more you see, the more the team will trust you and allow you to do. And if your residency doesn’t work with the midwives on the floor…you should. They are beyond incredible providers and my experience would not have existed without them.

-Keep a log of all your procedures and deliveries so you know your numbers and preparedness when considering next steps.

-Need and want more OB time? Seek out opportunities for away rotations. Network network network!

I hope this helps, y’all. This is for all the future women’s health practitioners who are trying their hardest to manage 15 page long medication lists, treat yet another AKI, and diagnose more aspiration pneumonia with enthusiasm. Know you can look forward to your OB rotation! You can and will learn even as a Family Medicine resident, especially as a Family Medicine resident. Live your life and do what interests YOU. Even the Internal Medicine gworls get tired of asthma every now and then. Remember that Family Medicine is and will forever be a viable, valuable option to pursue a career in women’s health. Be you always. Be great all ways.

xx,

Photos by Sweetie Mensah

Preset by Tina Smith