Curious Peas

Dear Blog,

I’ve mentioned in a few posts recently that I am an ODP (Operating Department Practitioner). It’s a very niche and unknown career that see me live predominantly in operating theatres of various kinds. I’m a duel trained practitioner who can both assist the Surgeon by passing instruments, getting the equipment they need and keeping the operating site sterile (the role of a typical ‘Scrub Nurse’) or I can assist the Anaesthetist, helping to put patients to sleep and often being one of the last people they see before their operation. My role changes day by day but It’s a great job that’s equally rewarding and exhausting.

In my line of work, it is expected that you cover a range of specialties; Thoracic’s (chest cavity and all that it contains besides the heart), Vascular (blood vessels), Paediatrics (kids) and many many more, holding a general knowledge of both surgical and the anaesthetic side. One of the specialities I enjoy the most is Obstetrics: assisting mums at the end of their pregnancies.

Our two Obstetric theatres are out of the department, across a bridge on Delivery Suit and usually, we are a very busy team. Unlike other operations that we do surplus amounts of such a cholecystectomies (It amazes me that there’s anyone left in Norfolk with a gallbladder), Obs patients will keep coming back. Despite how much each mother iterates the exact same phrase “I’m never having another”, they always come back for round 2.

From a practitioners point of view, Obs provides some additional challenges which earns it it’s love/hate relationship amongst my colleagues. It’s the only specialty we deal with that’s ‘Duel life’, there are multiple lives at risk and it’s also the only operations where you remove something that’s kicking and screaming from another living person. As an ODP, it’s drilled into us early on that we are there to support mum and the midwife is there for the baby. While we all want the same outcome, there’s an invisible line you aren’t meant to cross. Once that baby leaves the operating table and placed in the hands of the Midwife, it’s their responsibility. This can become quite challenging at times when you work in a multidisciplinary team. Ultimately, I don’t know anything about babies. Every time I get near on, they sense my fear and bawl their eyes out. Once it has been delivered, I copy the surgeons to dry the baby off, stimulate blood flow… I try my best but it just feels awkward. Equally out of their whole job role, Midwives spend very little time in theatre and admittedly, my team and I get very protective of our home. I’ve drawn a little diagram to explain how our main Obs theatre looks and runs:

I love Obs. Despite how busy it can get (and how bad I am with babies) there just this whole different vibe over there. For one, most of our patients in the main theatre department are asleep under general aneathesia however it’s only in true emergencies that an Obs patient will be put to sleep (if you put a pregnant person to sleep, you also put the baby to sleep as they share the same blood. It makes it a little bit harder to wake baby up once they have been born due to the anaesthetic). As the parents are usually awake, you generally form a bond with them, find out what they do for work, baby names etc… It’s quite nice to just talk to new people and Obs patients come in every shape and form. There really is no target market for babies. You get the teenagers, the mature parents, the ladies on their 6th section or the IVF babies. There are mums and dads who cry (I had one dad who did his best whale impression as he saw his son brought into the world) some who post on Facebook the moment the baby is born… and everyone’s birthing experience is different. Some people choose to have sections (we do not judge. There are many reasons a mum would choose this route), some mums have no choice and are surrounded by strangers as we desperately try to calm her and put her to sleep at the same time.

My hospital trust is quite unique as it is the theatre team that scrub and assist with sections rather than a Midwife which is the standard process across the most other hospitals. As a final year student in Pinderfields Hospital, I was always envious because despite half my career being dedicated to scrub, I wouldn’t be able to scrub for a c-section. It just wasn’t the done thing. Since being in Norfolk, I have scrubbed for countless Obs cases. I remember delivering my first set of twins, Jamie and Carter. That was incredible. I’ve delivered several premature babies (quite a few recently in fact) the youngest was only 25 weeks (to put that into prospective, that’s only 1 week after the abortion limit). For prems, we pop them into a special little plastic bag as soon as they are born to keep them warm and then the neonatal team take over. I don’t remember whether they were a boy or a girl as they were whisked away so quickly. The biggest baby I’ve seen delivered was just a few weeks ago, weighing in at a hefty 10lb 6oz. He was a bruiser. I’ve even seen babies born in their amniotic sac in what is called a ‘Mermaid Birth’ and it’s supposed to be good luck. It’s a breathtaking sight seeing a baby squirm as they would have been doing inside the mother belly.

I’d be lying if I said it was all sunshine and roses. Things do go wrong for lots of different reasons. Ultimately c-sections or instrumental deliveries aren’t natural procedures and unless you’re having an elective section, you’ll usually come to us in an emergency. Sometimes mum has been pushing for too long and just don’t have enough energy, other times baby isn’t behaving and it’s a matter of urgency to get them out. There are complication post birth too. Woman can tear if baby is too big or enters the world too fast and bleeding is another one. With any major operation, bleeding is a risk and throw in a very vascular organ plus a placenta into the mix and you could be looking at a real situation. The one and only time I have ever done chest compressions was on an obstetric patient (I have since been told she made a full recovery) and I’ve seen one baby death on a pre-term who wasn’t expected to live.

You have to be prepared to every eventually in obstetrics. In my whole career, I’ve seen only a few sh*t storms verses the countless happy customers that pass through our doors. That’s what makes it worth it. And it doesn’t matter to me how many bad cases I witness, I’ll still choose to go over the bridge. Who knows if this shift will carry 5 healthy babies or one disaster of a case. You may even get a fainting dad thrown in for good measure. It’s rewarding and I love it.

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Adam Kay, a former doctor turned comedian and author released a book a few years ago called “This is going to Hurt: the diary of a junior doctor” and in this book, Adam talks about his many experiences helping out on the delivery floor. I strongly recommend you read it for a bit of hospital/theatre insight.

No, I wasn’t paid to promote this.