Okay, too many thoughtful posts on this topic for me to think about
and construct coherent thoughts on, but I wanted to briefly comment on
Jennifer's and Sam's responses to my responsibilities when I'm on call
to make sure that I've seen every mom and had them open their mouth
for me.  I KNOW it sounds awful, and I'm STILL trying to come up with
some kind of lighthearted dialogue so that I DON'T freak out these
moms -- but it is something I am required to do.  I hate it -- I can
see the patients' confusion when I walk in and introduce myself as the
anesthesia resident on call.  I think I'm very reassuring, but I do
need to work on my "spiel".

Anesthesia is a strange profession -- about 90% of the time,
everything we do is controlled/planned/etc.  But the other 10% of the
time can be extremely scary.    We're trained to be "ready for
anything anytime."  Moms at our institution, by virtue of simply being
there (and depending on which OB is on call), are setting themselves
up for at least a 30% chance of cesarean delivery -- and frankly,
knowing we've got a working epidural in place makes everybody feel
better for when that happens (far too frequently!).  We're taught to
think of every patient (again, awful, I recognize) as a potential stat
c/s, and if general anesthesia is needed, we need to know what their
airway looks like -- intubating a laboring patient can be
*disastrous*.

And I may be mistaken, but I still think that epidural placement for
vag delivery is not a good source of revenue for a department.  Our
head of OB anesthesia recently told me that their reimbursement rate
from Medicaid does not even cover the cost of the epidural kit.

Anyway, gotta walk over and try to feed my little pumpkin again. :)

-Sarah

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome