Hospital Privileges, clinic #10 &11, births, etc....
Well, I'm back from a great month off. Many people have been amazed that I have gotten a whole month off so soon in my career. The reason is that we take 4 clients per month (and back up for four as well) for ten months for a total of 40 (80) births per year. That leaves two months without births. The month of November in the practice was very slow, so I was offered the month off and took it. It actually turned out very well - turns out that I needed a holiday. Getting oriented to a new job is very stressful, and having the month off after three months on was a perfect break for me. So I decorated my apartment (with my sister and mother's help), travelled to Texas and visited the birth centre where I had trained (and had a GREAT time seeing everybody), and had a graduation/congratulations-on-starting-to-practice party put on by my parents, which was fun.
Shortly after getting back from Texas I visited the general hospital in our area where in my absence I had (finally!) been granted privileges. I got my badge, did a computer orientation, got the speech about keeping up on chart deficiencies, and was generally welcomed. A very good feeling. (When a patient is discharged, the chart goes down to medical records. They look it over and invariably find places that you forgot to sign or a box that you forgot to check. They then stick a note in your box to inform you of the 'deficiency'. If that goes longer than 2 weeks, you get notice in the mail and if it goes longer than a month your privileges are suspended. The University hospital at any given time has around 10,000 chart deficiencies because it is such a huge hospital!)
It felt sort of strange to see my clients again - they have all grown (of course) and having missed one or two appointments, I took a bit extra time to 'get to know' them again.
I had one pregnant client that I thought would deliver while I was gone. She was booked for me as due on the 8th, but with 3 weeks cycles she was actually due on the first. Well, she went on the 8th, so I was back for her care. I thought she would be quite an interesting case, but she turned out to do quite well. The Children's Aid Society was involved (they wanted a drug test for the babe), and that is always a bit of a wild card. Turns out that during the month I was gone, she passed a drug test and got her 10 year old daughter back. The birth went well, she did well and her partner was very supportive. She didn't progress well at the end and wanted an epidural, so care was transferred to the OB (at General hospital that's the way it works, we don't have epidural privileges). Once she got the epidural, it was no time at all that she was delivered. The next day I talked to her CAS worker, who said that she had no concerns, so I went to see her and she was doing really well, so I discharged her home. Over the past few days she has done well and baby is gaining really well, and I have no concerns.
My next delivery isn't due until the 27th, but I am backing up for a few, and I need to get my epidural certification at University hospital, and my oxytocin certification at General hospital. I also need to finish writing our home birth handout. It should be a busy month.
Shortly after getting back from Texas I visited the general hospital in our area where in my absence I had (finally!) been granted privileges. I got my badge, did a computer orientation, got the speech about keeping up on chart deficiencies, and was generally welcomed. A very good feeling. (When a patient is discharged, the chart goes down to medical records. They look it over and invariably find places that you forgot to sign or a box that you forgot to check. They then stick a note in your box to inform you of the 'deficiency'. If that goes longer than 2 weeks, you get notice in the mail and if it goes longer than a month your privileges are suspended. The University hospital at any given time has around 10,000 chart deficiencies because it is such a huge hospital!)
It felt sort of strange to see my clients again - they have all grown (of course) and having missed one or two appointments, I took a bit extra time to 'get to know' them again.
I had one pregnant client that I thought would deliver while I was gone. She was booked for me as due on the 8th, but with 3 weeks cycles she was actually due on the first. Well, she went on the 8th, so I was back for her care. I thought she would be quite an interesting case, but she turned out to do quite well. The Children's Aid Society was involved (they wanted a drug test for the babe), and that is always a bit of a wild card. Turns out that during the month I was gone, she passed a drug test and got her 10 year old daughter back. The birth went well, she did well and her partner was very supportive. She didn't progress well at the end and wanted an epidural, so care was transferred to the OB (at General hospital that's the way it works, we don't have epidural privileges). Once she got the epidural, it was no time at all that she was delivered. The next day I talked to her CAS worker, who said that she had no concerns, so I went to see her and she was doing really well, so I discharged her home. Over the past few days she has done well and baby is gaining really well, and I have no concerns.
My next delivery isn't due until the 27th, but I am backing up for a few, and I need to get my epidural certification at University hospital, and my oxytocin certification at General hospital. I also need to finish writing our home birth handout. It should be a busy month.
posted by Stork at 9:38 AM
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