Labour Ward

Daily Routine

Most days begin in the Labour Ward meeting room at 0830 where a safety brief/handover takes place.

When you are covering labour ward, your role is to do or assist with caesarean sections; review labour ward triage patients which can be found on Trak under “SJH Labour Suite Ward Attenders” in the OPD section, do difficult cannulas/bloods. You are welcome to be involved in normal labours and deliveries if you wish.

Workload is variable – and if you are not busy then it works well to help out on the wards as you will be covering all the wards after 1630.

Duties

Immediate discharge letters should be prepared by the junior doctor for all women having had elective/emergency LUSCS and instrumental deliveries. Please make sure you have  reviewed the operative notes for estimated blood loss and whether contraception was provided in theatre. The operating surgeons will later dictate or type a letter to explain the procedure, discuss contraception, give recommendations for future pregnancy and delivery etc. Operative notes will be done by the operating doctor and please make sure if PPH and HDU questionnaires need to be done.

Ward Plus

Daily routine

When on ward plus, you are covering ward 11 postnatal beds (usually Bay D, E and F), ward 11 ward attenders as well as Maternity Day Bed Unit. You are not required to attend the morning handover and can head straight to ward 11 at 0830 to start working on the job lists. The hot week junior may share work load after the ward round especially for antenatal patients. At the end of day, you can handover the remaining job to the hot week person and leave at 1630. 

Job lists are written by midwives over the course of the day in the ward diary.

• All women who have had a blood loss of more than 500ml should have their FBC checked on day 2 and if their Hb is <100, they will require oral iron supplements.

• All women should have a VTE risk assessment form filled in by the midwives. You need to double check the scoring and prescribe accordingly.

• You may be asked to prescribe postnatal contraception (POP, Nexplanon, depo provera).  There is a counselling checklist for each that needs to be completed. You can find the checklist forms in the filing cabinet in the duty room. There is a very useful Learnpro module covering postnatal contraception.

Ward 11 ward attenders can come from community MW, GP referrals, A&E or as self referrals. The midwives will bleep you for medical review when they arrive. Common scenarios include hyperemesis, headache, hypertension, pain, bleeding and post natal issues. They can be found on Trak under “SJH Ward 11 Ward Attenders” in the OPD section. Notes are typed in maternity Trak under all maternity questionnaires and you should use the same questionnaire that has been started by the midwife.

The Maternity Day Bed Unit is usually run by midwives. They take referrals from women directly as well as community midwives and GPs. There are also women booked for routine appointments, for example for BP monitoring and CTGs.  You will be asked to assess women with a range of issues, most often if patients have a medical problem.  Common examples are headache, calf pain and pv bleeding. The midwives will bleep you as required.