Saturday, November 22, 2008

These cows do not realize what beautiful scenery they share each day!

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Dawson Water Falls on Taranaki

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Obstetrics and Gynecology in New Zealand

Well I suppose I should talk about work. Obstetrics in New Zealand is completely different than in the US. New Zealand has a Nurse Midwife based system. A pregnant patient is followed through out her pregnancy by the Nurse Midwife. This includes all prenatal care,even home visits. She can labor and deliver at home, or in the hospital. She will be followed throughtout her labor by the midwife. The patient "goes natural" most of the time. Analgesia is occasionally used which includes pethidine(somewhat like stadol) or nitrous oxide (laughing gas) and on occasion fentenyl(don't use those in the US for labor!). The nurse must consult the Consultant Doctor for fentenyl or an epidural. They have a very low rate of epidurals.
Continous electronic fetal monitoring is not used unless there are complication. Just intermittent auscultation. I do not think they have intrauterine pressure catheters(I have yet to see one). They do have internal fetal monitoring but only when there is a problem. Patients do not always get IVs and IV fluids. But any complications get a hep lock. They continue to eat, drink, and ambulate especially in early labor.
Induction of labor happens at 42 weeks or when medically indicated complications occur. In these cases the Consultant OB becomes involved.
We have OB Registars (Residents) who cover L&D. There are six registars at the present at Palmerston North. Throughout New Zealand there is only one O&G Residency Program. The residents rotate through the main teritary and secondary care hospitals throughout New Zealand (Auchland, Wellington, Hastings, Hamilton, Palmerston North, Nelson, Dunedin, Christchurch...) for their experience. No real academic structure like in the US. But the residency program is actually six years instead of the four year programs in the US. The residents have to set exams both written and oral to be able to complete the program. The program is governed by the New Zealand Medical Council and the New Zealand/Australian College of Obstetrics and Gynecology of which they will become Fellows.

Pictures from Taranaki

Tuesday, November 18, 2008

New Plymouth Weekend

Left Palmerston on Friday afternoon about 3:00 for a wonderful drive up to New Plymouth, a town billed as the best place to live in New Zealand. I stopped along the way in a small town Patea to see the quaint church and the coastal beach with overlook. The cliffs remind me of the Cliffs of Mohr in Ireland. Mount Taranaki is just breathtaking---majestically rising to the heavens. It is still snow capped and beautiful.

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Saturday, November 8, 2008

Weekend in Napier

It was a beautiful day with sunshine, so I decided to drive to the East Coast and visit the Art Deco town of Napier. (Also in the heart of wine country.) You must visit the website for Napier and see the video/photo gallery, The city was destroyed by an earthquake in 1931 but was rebuilt during the depression. Beautiful city!!! I have a hotel overlooking the ocean. The hotel was built in the 60's of concrete and metal. A concentric semi-circle of contemporary architecture. The restaurant, the furnishings, the entrance are all my style, modern and simplistic but with wonderful taste.
Beautiful buildings throughout the town. The beach is beautiful, the bay serene, and the flowers and fountains gorgeous.
Just out of town is wine country, with many vineyards within biking distance. They have bike tours like California. It is a smaller area so one can visit many vineyards in one day.
I will return for a long weekend!!

Saturday, November 1, 2008