One Rotation Down

Well, I completed my NICU rotation - and 5 L&D calls!  (For this rotation we do week days in the NICU, and then weekends we are part of the ob call pool).  What an adjustment from being a medical student.  You question things a whole lot more when you have to sign your name at the bottom.  Can she have another dose of tylenol - uh, I think so?  Starting on NICU I think is a good way to adjust more slowly to residency.  When you are on an "off service" rotation, they expectations aren't quite as high and you aren't in charge of the super sick patients - like the babies on a ventilator, of ones less than 1000 grams.  And the hours are a little better.  I only had to get to work before 5am on my call days.  I have average 60-70hrs/week on this rotation (by regulations, we have to record our hours).  I was on days for 3 weeks and then nights for 2 weeks.  What is a typical day as a NICU intern?
See your babies:
I would arrive between 6&7am, and would see my babies (I typically had 4 - although real NICU interns had 6-8).  You look at their flow sheet to see if they are gaining weight, see if they had any events, if they are feeding etc... Examine your babies.
Rounding:
Around 8:30-9am we meet with our team and intern and start rounding on the patients (go to each baby on the team and which ever resident has the baby presents how the baby is doing to the attending, and proposes a plan of care for the baby).
Attend deliveries:
At the same time, any baby born less then 34 weeks, or with anomalies, we have to go to their deliveries.  On a good day, we are done with rounds by lunch, on a day with a lot of deliveries or sick babies, it can by late afternoon.  After rounds you work on paperwork, notes, calling parents, circumcisions, checking your orders etc...  Also adjusting your babies plan of care if new issues arise during the day.
Go home!
You can technically leave at 4 if all of your stuff is done.
Conferences:
I attend all the ob educational activities.  Grand Rounds, Team Based Learning Hour, Stats
I also had my continuity clinic (this is one morning a week where you see patients, and over you residency those patients come back to your clinic, so you have your own patients...)
Nights are different, you attend all deliveries, and help with resuscitation.  And of course the night team is kind of over all the babies, so you deal with any issues the babies are having.

It was neat taking L&D call as some the babies I delivered I could then take care of them in the NICU.  Also, I knew a lot of the moms of the babies we were caring for.  I've personally delivered 9 babies!  I think I'm getting slightly less awkward...

How is the family taking this change?  Pretty good (I think).  Josh steps up to the plate (as usual).  And the girls would actually let me sleep during the day when I was on nights.  Josh says whenever the girls find a play phone they call me.  And they definitely get super excited when I get home.  We've been working on an earlier bedtime and getting up time as I have to go to bed earlier...