The Job

Pregnant on the wards – part 1: the practical.

I hadn’t thought about writing this so thankyou for the suggestion Shedidwhatnext.  First of all, and absolutely first of all, if you’re a pregnant medical registrar, or about-to-be medical registrar, congratulations!!  This is a good thing!  Babies are wonderful!

But that wasn’t your first thought, was it?  In spite of this happy news, your first thought was oh shit.  Oh shit, what have I done?   Now you’re wondering if you’ve thrown a nuclear weapon under your career, you’re wondering if your DPT is going to disown you, if you’re going to be that pregnant medical registrar who everyone whines about slacking off at work ‘just because they’re pregnant’ and mutter about ‘special treatment’.

I repeat, congratulations!  It’s still a good thing in spite of those scary thoughts.

Everything I am going to tell you is with the benefit of hindsight.  Take my advice or don’t take it (because advice is cheap), but know that I learned everything the hard way, and this is what I wish I had of done and known.  Here it is in list form because I struggle to think in any other way these days.

  1.  Being pregnant is a special state of existence.  I’m not being self-entitled, I’m not being earth-mothery, I am being practical.  Pregnancy is a unique, physiological condition that people cannot understand unless they have been there or unless they’ve had loved ones go through it.  The hormonal fluctuations, the fluid shifts are insane.  The fatigue is insane.  The sleep deprivation intense.  The mental fog from all those biochemical changes and the stress you’re under.  And then all sorts of other things can happen that we wont talk about because it may not.  The point is that you DESERVE special treatment because of it.  Those people who mutter words like ‘unfair’ and ‘special treatment’ are ignorant.  They might sound very certain, as ignorant people tend to do, but they’re not.  They’re not in your world so they don’t count.
  2. YOUR pregnancy is unique and there is no such thing as a perfect one.  It. does. not. exist.  So when you develop SPD, or the nausea doesn’t go away, or you get intercostal nerve pain and the muscles rip off your ribs because your kids head is off the chart thanks to Dad’s noggin (not bitter or anything;) ), don’t beat yourself up.  It’s okay, it will be over in a few months.
  3. Tell your DPT.  Especially if the exams are coming up.  Even if it’s before 12 weeks.  I made the mistake of not saying anything.  I was doing relief, I was on nights, I was sneaking Maxalon, I was finishing my round and going to my car and sleeping whenever I could.  I didn’t know you could write a letter to the college and they would give you special dispensation for a seat near the bathroom during the exam.  I wish I had of done this.  I will explain in my next post.  This is a personal decision and I understand if you don’t want to do it, because telling someone means untelling them so I leave it up to you, but I wish I had of.
  4. Join the AMA in your state.  Right now.  Especially if you’re at a hospital with a less-than-supportive medical workforce.  They are amazing.  Most doctors don’t know their rights.  Most are led to believe that speaking up about unfair working conditions will harm their career which is one of the last greatest myths in the job.  It wont hurt your career but it WILL hurt the career of the person trying to pull it off.  There are people in the AMA who have the power to make or break careers, and they’re there to protect your rights.  I have a few very good examples of the AMA stepping in with legal advice and representation and not only ridding the unfair request made on the pregnant/new parent, but actually improving the workplace for the better.  It’s expensive but it’s tax deductible.  I wish I had of.  I wish I hadn’t of worked those 7 nights in a row with 2 days off and then back to the day job at 32 weeks pregnant because the terrible SPD and migraines with vision loss wasn’t worth it.
  5. If you’re struggling, talk to your obstetrician about your work conditions.  They are very helpful and will write you a letter in support.  Mine offered to call my DPT and demand I not work in the conditions I was asked to.  Again, I wish I’d said yes.
  6. You need people on your team.  See points 4 and 5.  The AMA, your obstetrician, your family, and supportive colleagues.  The hospital is FULL of people who have kids who’ve been treated badly and will look out for you.
  7. Prepare to be pleasantly surprised.  Most people don’t think you’re lazy and getting special treatment.  Most people love a pregnant lady and want to help in any way they can.  Let them help.  Shoulders to cry on, cups of tea, interns who will go the extra mile for you, they’re all there.
  8. You don’t get to not drink water all day and not go to the bathroom all day anymore.  Yes we all do it when we’re not pregnant, but the placenta needs blood flow and so does your brain.  Please buy a giant water bottle and drink a lot of water.  Don’t faint at work.  Don’t deprive the placenta.  The placenta needs you.
  9. CALL IN SICK. CALL IN SICK.  CALL IN SICK.  CALL IN SICK.  Do I need to repeat myself?  You WILL thank me.  This job is not worth you or your babies health or life.  If you can’t do it you can’t do it so CALL IN SICK.  You have my permission.  Blame me.  This is what sick leave is FOR.
  10. There will come a point when you DO feel like that lazy registrar.  When you can hardly walk anymore, when you haven’t slept, when your back hurts.  If you need to go on maternity leave early, just go.  Better to leave a good impression than a bad one to people who just don’t bloody get it.  It’s not the end of the world if you don’t cover yourself in glory at work in the final trimester, most people are pretty understanding, and…
  11. When you come back to work for a visit while you’re on mat leave, with a tiny little baby (and make sure that you do), all of those people who made you cups of tea or let you cry on their shoulder, or who did a bit of extra work to give you a break and maybe even grumbled about it, will feel like they had a hand in that babies creation, and that will make them feel good, and suddenly all the mutterings about ‘special treatment’ will be replaced with a little bit of guilt.  The people who didn’t treat you right, who see the new mother with the little, entirely dependent on you human, will also treat the next new mother with a little more grace next time too.  Or a lot more grace if the hospital’s management has hauled them into a meeting after the AMA got involved and made them look like a despot 😉

So congratulations again!  And no, your career isn’t over – but don’t make any decisions until the baby is born.  Go on maternity leave, try to have a job to return to, but things may change for you.  I was always going to be that person who got a full time nanny and returned to work full time because career, but once she was born, it was like a new, incandescent universe opened up in my life and tossed out everything I’d ever thought about it.  Colleagues who’ve been super-maternal with plans of part time and/or staying at home, have found themselves putting the kidalid in full time daycare/nanny and returning to work full time, quite happily, for their own sanity.

There is no right answer, there is only the one that works for you and your family.  This is your new mantra, because everyone is going to have an opinion.  Take what works for you and unashamedly ditch the rest.  And congratulations again!

How to be a good intern.

I feel like I’m qualified to make this post now, having run the full gamut of medical interns from so-barely-there-I-don’t-your-name to here-take-my-job-you-awesome-machine.  When I was an intern I really really wanted to be that star intern that was just basically awesome in every domain that everyone raved about.  The only problem was that I had no idea how to achieve it, or really even how to define it.  I was pretty good, sometimes great, but never the full package the perfectionist in me wanted to be.  And Googling it was NOT helpful unless you’re an American intern where you’re actually expected to know stuff.  As an Australian medical intern, you’re expected to do more and know less.  Only you don’t know how to do more because you know less.  It’s a tough year, and I wanted to write my list on how to be a good intern.  As usual, a big chunk of it is tongue-in-cheek and not be taken seriously, but could be, and if you did that would be AWESOME.

How to be a good THE BEST intern.

  1. Your registrar needs coffee whenever you think of coffee.
  2. Don’t bake.  I bake.  I have to bake.  It’s procrastibaketion for exams.  If you bake then what will I do?  You can however, bring coffee.  All the coffee.  You may also bring chocolate.
  3. If you could have my patient list and all the blood & imaging results written out on them and a photocopy for yourself done before I get to work, then you’re a little bit awesome and a little bit frightening in equal measure.
  4. Telling the nurse/NUM/physio/OT/social worker our plan right after we’ve made the plan shoots you to the top of the list for star intern.  Bonus points if I see it.  Full winning points if the boss sees it.
  5. When I come to work and find new patients on our list and you say “yeah I’ve read the plans they wrote down in Emergency and I’ve done the plans” then I will hug you.  And again, full winning points if the boss is there when you say it.
  6. Say “I haven’t done that yet, I’ll get right on it” when I ask if x has been done, rather than “I dunno…”
  7. Your gut instinct is key.  If I or my boss or anyone asks you to do something you don’t feel comfortable with, whether that reason is real or just a lack of knowledge on your part, saying “I don’t feel comfortable” is actually really appreciated.  The swiss cheese model of error lines up when this doesn’t happen.
  8. Be cheerful.  Yes the job stinks some days.  Yes you get asked to do stupid administrative things or call for consults when you think it’s pointless.  There is actually a point I promise.  It takes years to see that point.  If I have to pull out the “if this were your mother…” argument, you are not heading towards a good evaluation.  A friendly attitude is everything and remember, the boss often has 30 years of experience.  You have months.
  9. Hurry me up.  Tell me to go faster.  Tell me to finish the round so I can study.  When the round is done, get my mobile number, kick me out and tell me to go study and call me while I’m studying with any questions you like.  Please don’t ask me to sit next to you to keep you company while you do all your jobs and check everyone’s results.
  10. Did I mention coffee?  Now is a good time for coffee.  Feel free to suggest it.
  11. If the ward clerk loves you then I know you’re good. Ditto the NUM, and the nurse named Dazzle whose been there for 30 years.