Going from pediatrics to my Ob/gyn rotation was not the easiest transition for me. Peds has proven to be one of my favorite fields of medicine, being that I got to work with children and dealt with a broad set of diagnoses. When I began my Ob/gyn rotation I quickly realized that this was very different than what I had just gotten used to, specifically because it is a very specialized field of medicine. As always, I put my best foot forward with hopes of learning a lot and growing into the best possible PA I can be.

I began this rotation with a 2 week block at the clinic. This was most enjoyable for me and I felt that I learned the most in these 2 weeks. I found it very interesting to be able to work with different practitioners (MDs, PAs, NPs and midwives) every day and learn the different roles that they each play. I learned that the PAs mainly focus on gyn, the midwives deal with prenatal care while the MDs get a mix of it all. It was a unique way to learn how different health care professionals lend to the team that they make up. This was also the first time I got to do a speculum exam, bimanual exam, pap smear and cultures for STDs. As always, I was very nervous to do it for the first time. I remained questioning my ability to locate the cervix for a few more times until I gained more confidence. I realized through that experience that I would like to continue to work on becoming more confident with new skills earlier on. I know that I am capable, and I just have to remind myself to believe in myself. Throughout these 2 weeks I got to participate in antenatal visits which included measuring the fundal height, fetal heart rate and prenatal ultrasounds. I got to assist and observe in several colposcopies and endometrial biopsies which enlightened me to how important communicating with your patient is. These patients were in vulnerable situations and by telling them exactly what was being done and validating their emotions, it made them relax immediately.

The next 2 weeks were for labor and delivery. To my surprise, the unit was not as hectic as I imagined. At times, it got busy, but other times were pretty quiet. I never realized how long of a process labor actually is. But, when I realized that patients were at 4 cm dilated at the beginning of my shift and then still didn’t have their baby at the end of my 8 hour shift, it reminded me just how long the process is. At Woodhull, the labor and delivery unit was midwife run. It was inspiring to see that advanced practice providers can and do have much autonomy and can lead complicated situations such as a birth.

My last week was gyn, where I was with a PA who was on call for gyn consults. This firther showed me how each member of the healthcare team is unique and provides a special role. The PAs do not deliver babies, but they do stay on call and are first assist in c-sections. It gave me a perfect example of what I’ve learned throughout school that we all play a different part of a big system, and we are all important. During this week, I saw a patient in the ED for a consult. She was 11 weeks pregnant, however on ultrasound no fetal heart rate was obtained and the fetus was only measuring 8 weeks gestation. The patient had a missed spontaneous abortion. I was completely shocked at the nonchalant way that the information was relayed to the patient. I was as if she was given the news that she had an ear infection. Her husband was not allowed in the room and when she mentioned that she was sad the PA did not really acknowledge her emotions. I was totally surprised at this behavior and I strive to continue to maintain the empathy that I have for my patients and treat them with respect for the rest of my career.