An day in the life of a consultant obstetric anaesthetist
Danny Morland, consultant anaesthetist, Royal Victoria Infirmary, Newcastle, shares a typical day with us.
08:00: Receive handover from overnight resident. Congratulate/commiserate after another crazy night, check they're safe to get home.
08:10: Jostle for position seeing elective sections with multiple other professionals. Realise consultant privilege is a thing of the past.
08:35: Because of previous lack of privilege, appear five minutes late to theatre brief clutching illicit cup of coffee, incurring considerable wrath of theatre sister.
08:36: Recognise 'TUBAL LIGATION' missing from theatre list, again. Ask for a reprint.
08:37: 'TUBAL LIGATION' now appears as leading surgeon. Request reprint.
08:38: Patient now listed for 'CAESAREAN SECTION and NOITAGIL LABUT'. Reprint.
08:45: Attend multidisciplinary risk management in attempt to temper natural surgical tendencies.
09:00: Supervise new CT2 performing first ever obstetrics spinal. Share delight when CSF appears on first pass.
10:00: Supervise CT2 doing second ever obstetrics spinal. Sympathise and empathise over repeat passes while scrubbing hands, secretly suspecting one would have had it long ago.
10:30: Realise through tears of frustration that one definitely would not have had it long ago. Call senior colleague.
10:45: Recognise senior colleague would have had it hours ago. Thank senior colleague profusely and apologise to patient effusively, while silently fuming and despairing of own ineptitude.
11:00: Regain composure after sending trainee for coffee.
11:30: Greet familiar patient from clinic. Recap anaesthetic and delivery strategy, carefully crafted with multidisciplinary team and patient collaboration over preceding weeks.
12:15: Masterly execute complex anaesthetic with minimal fuss and remember this is what it's all about.
12:30: Briefly turn away because of 'something in my eye' when complex anaesthetic and delivery plan produces gorgeous, bawling baby to the delight of everyone in the room. Remember this really is what it's all about.
13:00: Consume a lunch consisting entirely of delivery suite chocolates.
14:30: Leap into action as the emergency alert sounds while teaching medical students. Race to attend an arrested parturient, before practically fainting with relief on seeing a manikin. Hold it together for the rest of the drill. Try to convince the team during debrief that it wasn't panic on one's face.
15:00: Rush to theatre with a real postpartum haemorrhage. Briefly marvel again at the improved laryngeal view with roc rather than sux before launching into resuscitation mode and coordinating successful multidisciplinary obstetric haemorrhage management.
16:00: Confirm resuscitation endpoints using Point Of Care testing before waking patient up. Congratulate and praise our team during debrief while sensitively discussing learning points for future cases.
16:15: Cup of tea and a handful of Heroes.
16:30: Attempt follow-ups, find half have gone home.
17:45: Category 3 section for unsuccessful induction in 5ft tall patient. Agonise over height-related, utterly insignificant modification of spinal Marcain dose. Momentarily also consider adjusting universal 300 mcg spinal diamorphine; dismiss out of hand.
18:00: Open two theatres as cord prolapse is rushed through just as Category 3 section started. Induce anaesthesia, thrill as baby cries on delivery. Wake patient after quadratus lumborum blocks. Familiar prickle of eyelids as mother is emotionally hugely relieved to meet a healthy baby.
20:00: Join evening obstetric ward round.
21:00: Sign off for the night, leaving labour ward in the capable hands of the night resident and pray for a quiet on-call.
This article was originally published in Anaesthesia News, June 2018.