Seriously people!!! EVERYBODY out there has an STI. This has probably been the most eye opening experience of my clinical practicum. I knew STI's were a public health problem but I had no idea it was a freakin epidemic! I have seen patients from age 15-50 with trichomoniasis and even sent a gal to the hospital for some IV antibiotics for severe PID. All of those with trich (except the 15 y/o) were in supposed "monogamous" relationships as was the gal with PID. Gonorrhea and Chlamydia are rampant as well, have treated a 14 y/o for those and she thought it was funny that she had to come in and get a shot for something she caught from having sex........her mom was there laughing right along with her, just disgusting! And don't even get me started on HSV..........
Condoms are not 100% but they sure are better than nothing! And if you can't afford condoms (as a distraught young woman with HSV told me) you most certainly can't afford to be having sex. So don't be an idiot, use condoms and get yourself tested!
Friday, November 13, 2009
Tuesday, November 10, 2009
"Catching" up....
Oh wow, have I been busy! I went to Clinical Bound (CB) the first of August and really had a great time! It was fun catching up with some of my classmates and making new friends. The last night of CB was the best. We had dinner at Wendover, the home of Mary Breckenridge and then afterwards were all in a circle and were each given our "hat" or "lap blankets"......the hats are crotched baby boggins given to the midwifery students to give to the first baby they catch, or one they have a special connection to. The NP students are given a hand-made lap blanket to give away to a patient they care for during clinical that is special to them. When giving away our hat or blanket we tell the story of Mary Breckenridge and her vision for healthy moms, babies and families.......
Well, I was given my hat by my preceptor who has been my mentor and encourager in this journey for almost ten years now. Needless to say, it was extremely emotional for the both of us. I don't think there was a dry eye in the room when it was all over.
After CB I came home and finished up my classes and immediately started in the clinical setting. My preceptor let me just observe the first day but the second day put me right to work. I have been in the clinic now for seven weeks and am becoming very comfortable and am completely providing care for the majority of patients that come in with just reassurance and back-up from my preceptor.
I need lots more hours and lots more baby-catching. My preceptor only works two days per week so getting my hours has been difficult but starting last week I am spending two other days a week with one of the other midwives in the practice. I haven't had any problem getting my numbers (FSMFN requires a certain minimum number of each type of office visit, birth, exam etc. as well as a minimum number of clinical hours) since my preceptor sees about 25 patients a day.....that's alot of patients and I am exhausted at the end of each day. I will be in the office four days a week starting next week and will be on call every-other weekend. I am going to like being with two midwives as preceptors.....they both have their strengths and I am learning more than one way to do things, it really is a plus having more than one preceptor.
I need more babies....only have 7 catches so far but my preceptor alone has 8 babies due around Christmas time so December should be a good month for me. My favorite catch so far was catch number 5. My preceptor has been great with pretty much being hands-off and letting me to the catches on my own. She stands there gloved up and ready to assist at any moment but lets me handle it on my own unless I ask for help. Anyway, catch number 5 wasn't even one of our patients, she was one of the other midwives patients (there are 4 mw's in this practice and 3 md's). We were on call on the patient's primary midwife had a migraine so she asked us to care for her. When the patient arrived at the hospital she was 7cm and her water broke. I went to the hospital as soon as the call came. The patient had been in the shower and was in the bathroom leaning on the sink when I arrived. Her doula (whom I have worked with numerous times and consider a friend) was with her as well as her grandmother and two other female friends/relatives (she is a single mom). We remained in the bathroom for a while and then she started feeling pushy.....I checked her cervix and she was complete and +1. I encouraged her to just bend slightly at the knees and bear down during her contractions and go with that urge to push (she was still in the bathroom leaning over the sink). After about 30 minutes of this the baby was visible on the perineum so I asked the patient to just move into the room by the bed when she could to allow more room for the birth. She had no problem with this and went out and leaned forward on the bed. I gloved and positioned myself on my knees behind the patient in preparation to catch the baby. With just a few more pushes a slippery little boy slid into my hands and I handed him to his mother between her legs. This was the first time I had caught in this position and honestly it was a little nerve-racking not having a soft bed underneath her when this kiddo came out. She had two small bilateral labial skid marks that did not need repair. She breastfed wonderfully.
Well, I am still taking two didactic classes this term....Advanced Intrapartum and Advanced Women's Health. Next term the only thing I have to do besides clinicals is write my proposal for a birth center. I am really not looking forward to that since I have heard so many other students complain about how much of a pain it is. After I finish my hours I will take about two weeks and study for comprehensive exams and then hopefully within just a couple of weeks take boards......wow, this has really flown by and if things continue to go as planned I will have completed the program and taken boards in 24 months of starting. It really has been a roller-coaster ride but will be worth every sleepless night and the endless hours of studying......
Well, I was given my hat by my preceptor who has been my mentor and encourager in this journey for almost ten years now. Needless to say, it was extremely emotional for the both of us. I don't think there was a dry eye in the room when it was all over.
After CB I came home and finished up my classes and immediately started in the clinical setting. My preceptor let me just observe the first day but the second day put me right to work. I have been in the clinic now for seven weeks and am becoming very comfortable and am completely providing care for the majority of patients that come in with just reassurance and back-up from my preceptor.
I need lots more hours and lots more baby-catching. My preceptor only works two days per week so getting my hours has been difficult but starting last week I am spending two other days a week with one of the other midwives in the practice. I haven't had any problem getting my numbers (FSMFN requires a certain minimum number of each type of office visit, birth, exam etc. as well as a minimum number of clinical hours) since my preceptor sees about 25 patients a day.....that's alot of patients and I am exhausted at the end of each day. I will be in the office four days a week starting next week and will be on call every-other weekend. I am going to like being with two midwives as preceptors.....they both have their strengths and I am learning more than one way to do things, it really is a plus having more than one preceptor.
I need more babies....only have 7 catches so far but my preceptor alone has 8 babies due around Christmas time so December should be a good month for me. My favorite catch so far was catch number 5. My preceptor has been great with pretty much being hands-off and letting me to the catches on my own. She stands there gloved up and ready to assist at any moment but lets me handle it on my own unless I ask for help. Anyway, catch number 5 wasn't even one of our patients, she was one of the other midwives patients (there are 4 mw's in this practice and 3 md's). We were on call on the patient's primary midwife had a migraine so she asked us to care for her. When the patient arrived at the hospital she was 7cm and her water broke. I went to the hospital as soon as the call came. The patient had been in the shower and was in the bathroom leaning on the sink when I arrived. Her doula (whom I have worked with numerous times and consider a friend) was with her as well as her grandmother and two other female friends/relatives (she is a single mom). We remained in the bathroom for a while and then she started feeling pushy.....I checked her cervix and she was complete and +1. I encouraged her to just bend slightly at the knees and bear down during her contractions and go with that urge to push (she was still in the bathroom leaning over the sink). After about 30 minutes of this the baby was visible on the perineum so I asked the patient to just move into the room by the bed when she could to allow more room for the birth. She had no problem with this and went out and leaned forward on the bed. I gloved and positioned myself on my knees behind the patient in preparation to catch the baby. With just a few more pushes a slippery little boy slid into my hands and I handed him to his mother between her legs. This was the first time I had caught in this position and honestly it was a little nerve-racking not having a soft bed underneath her when this kiddo came out. She had two small bilateral labial skid marks that did not need repair. She breastfed wonderfully.
Well, I am still taking two didactic classes this term....Advanced Intrapartum and Advanced Women's Health. Next term the only thing I have to do besides clinicals is write my proposal for a birth center. I am really not looking forward to that since I have heard so many other students complain about how much of a pain it is. After I finish my hours I will take about two weeks and study for comprehensive exams and then hopefully within just a couple of weeks take boards......wow, this has really flown by and if things continue to go as planned I will have completed the program and taken boards in 24 months of starting. It really has been a roller-coaster ride but will be worth every sleepless night and the endless hours of studying......
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