Okay, so the midwife is finally fully birthed!! I graduated with MSN the first week in June, passed my AMCB boards the first week of July and started a new job the first week of August......now, I wonder what the first week of September will hold?
This blog was totally neglected during the last part of my education simply due to the amount of time I was spending in clinicals and studying for comps and boards. I really didn't want it to turn into a pity party and I was afraid that is what would happen given the amount of stress I was feeling and the precariousness of taking all those exams and then searching for a job! Fortunately that is all behind me now and I can breathe a little easier. I have joined a solo physician in his practice and since he has never had a midwife and I have never been employed as one we are kind of figuring things out as we go. Fortunately, he is a super nice guy and very encouraging. We have a very diverse clientele and I am really enjoying it! Haven't started catching babies yet, the paperwork for credentialing and hospital privileges is ridiculous! It will happen soon enough, just like in every other aspect of this midwifery journey I am learning to be more and more patient. Patience is a wonderful quality to have and I am taking all of this in as a life lesson that will make me a better person and midwife.
On a different note, I have loved summer but it sure has been hot! I am looking so forward to fall, the cool crisp mornings and changing colors of the leaves. What is your favorite season???
Sunday, August 22, 2010
Wednesday, January 13, 2010
Welcome 2010
My first post of 2010.......it's gonna be a good year! If I can get out of the funk I am in, that is.
I am tired, overwhelmed, annoyed, anxious and just plain crabby!
I am finished with my numbers except for deliveries and 10 more new OB visits. The hours are another story....I am in the office 4 days a week but most of the patients want to be induced so I don't get many hours outside of the daily 9-5. So, it seems I am never going to get done!
I have 16 more babies to catch and was cheated out of one last night because the nurse who admitted the laboring woman called the MD on call instead of the midwife on call and the MD did not realize that she was a midwife patient. Grrrrrr!
I have no motivation to write this birth center paper, or finish up my soap notes and turn them in, or do my required forum postings for my clinical classes.
I need to look for a job. I don't even know where to start! I haven't had to job hunt in 10 years........guess I need to start with getting my resume together. Any sure-fire techniques for landing a job with a great practice is welcome!
Again, 2010 is going to be a great year! I am going to repeat that until it sinks in and I get out of this foul mood.
I am tired, overwhelmed, annoyed, anxious and just plain crabby!
I am finished with my numbers except for deliveries and 10 more new OB visits. The hours are another story....I am in the office 4 days a week but most of the patients want to be induced so I don't get many hours outside of the daily 9-5. So, it seems I am never going to get done!
I have 16 more babies to catch and was cheated out of one last night because the nurse who admitted the laboring woman called the MD on call instead of the midwife on call and the MD did not realize that she was a midwife patient. Grrrrrr!
I have no motivation to write this birth center paper, or finish up my soap notes and turn them in, or do my required forum postings for my clinical classes.
I need to look for a job. I don't even know where to start! I haven't had to job hunt in 10 years........guess I need to start with getting my resume together. Any sure-fire techniques for landing a job with a great practice is welcome!
Again, 2010 is going to be a great year! I am going to repeat that until it sinks in and I get out of this foul mood.
Wednesday, December 2, 2009
Catchin' babies
Okay, school requires 40 catches to complete clinicals and so far I have 14.....still have a long way to go.
So here are some stats so far: 6 girls 8 boys, 5 unmedicated births (2 of these were standing with me on my knees) only 4 perineal repairs (none worse than slight 2nd degree), smallest baby was 6#9oz and the largest 8#15oz. There were 7 first time moms, 4 second babies and 3 that are baby #4.
I expect to have more than 20 by the first of the year.....my preceptor has 6 or 7 due between now and then and I am also taking call with another midwife in the practice so that I can get these catches in sooner rather than later!
Seeing alot of interesting stuff in the office and really enjoying getting to know the patients and really bonding with some of them......now, just gotta convince the docs in this practice to hire me when I am finished.
Oh, for all of you full scope midwives out there......how many patients do you typically see in the office on an average day? My preceptor usually has 25-30 patients scheduled per day and that number TOTALLY overwhelms me! I do great and feel competent (as competent as a SNM can feel anyway) with about 12-15 and my preceptor is great about making sure I only do as many as I am comfortable doing and not get overwhelmed.
So here are some stats so far: 6 girls 8 boys, 5 unmedicated births (2 of these were standing with me on my knees) only 4 perineal repairs (none worse than slight 2nd degree), smallest baby was 6#9oz and the largest 8#15oz. There were 7 first time moms, 4 second babies and 3 that are baby #4.
I expect to have more than 20 by the first of the year.....my preceptor has 6 or 7 due between now and then and I am also taking call with another midwife in the practice so that I can get these catches in sooner rather than later!
Seeing alot of interesting stuff in the office and really enjoying getting to know the patients and really bonding with some of them......now, just gotta convince the docs in this practice to hire me when I am finished.
Oh, for all of you full scope midwives out there......how many patients do you typically see in the office on an average day? My preceptor usually has 25-30 patients scheduled per day and that number TOTALLY overwhelms me! I do great and feel competent (as competent as a SNM can feel anyway) with about 12-15 and my preceptor is great about making sure I only do as many as I am comfortable doing and not get overwhelmed.
Friday, November 13, 2009
If you can't afford condoms, you can't afford to have sex.
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!
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!
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......
Sunday, June 14, 2009
If I would quit being a slacker, I wouldn't have to play catch up!
Has it really been since January that I posted last?!! Good grief, I have been slacking terribly with this blog.
Well, honestly not much has changed since January......work is the same, school is kinda the same and the kids are growing by leaps and bounds.....
I managed to finish up the winter term with and A in Postpartum/Newborn an A in Community Assessment and a freakin B in Antepartum. I was so mad about that grade......the only B I have made in the program so far and the only one I plan to make. What makes me mad is that class was not hard but it seemed the instructors just nit-picked everything to death. The tests in that class were absolutely ridiculous! Most tests cover the info you really need to know and leave some of the more obscure stuff alone.....not this class, they expected you to know every minute detail about everything...grrrrrrr!
Okay, so the spring term is actually winding down right now. The intrapartum class has been a breeze and honestly could have easily been completed in 6 weeks but they have absolutely drug this thing out as much as they possibly could.....a bit annoying! Just the final exam left in that class and I am taking it this week. The Women's Health class has been interesting and enjoyable. I am doing well in it and only have the final exam left in this class as well, will probably take it tomorrow or Wednesday. I still have my marketing research paper to finish writing but am giving myself until the 21st to get it written and submitted.....it's just kind of tortorous because it's just alot of plugging in and explaining survey results.
Next term has Advanced Antepartum (same instructors, not really looking forward to it!), Advanced Postpartum/Newborn and Research (yuck!!!!).
On an exciting note, I am attending Clinical Bound this summer and will be starting clinicals the first of October........woo hoo! I can't wait to start putting all the stuff I am learning into practice so it gels in my little head. So, the count down is beginning and my goal is to finish clinicals in February (if not sooner) and hopefully have comps and boards behind me by mid April.
Well, honestly not much has changed since January......work is the same, school is kinda the same and the kids are growing by leaps and bounds.....
I managed to finish up the winter term with and A in Postpartum/Newborn an A in Community Assessment and a freakin B in Antepartum. I was so mad about that grade......the only B I have made in the program so far and the only one I plan to make. What makes me mad is that class was not hard but it seemed the instructors just nit-picked everything to death. The tests in that class were absolutely ridiculous! Most tests cover the info you really need to know and leave some of the more obscure stuff alone.....not this class, they expected you to know every minute detail about everything...grrrrrrr!
Okay, so the spring term is actually winding down right now. The intrapartum class has been a breeze and honestly could have easily been completed in 6 weeks but they have absolutely drug this thing out as much as they possibly could.....a bit annoying! Just the final exam left in that class and I am taking it this week. The Women's Health class has been interesting and enjoyable. I am doing well in it and only have the final exam left in this class as well, will probably take it tomorrow or Wednesday. I still have my marketing research paper to finish writing but am giving myself until the 21st to get it written and submitted.....it's just kind of tortorous because it's just alot of plugging in and explaining survey results.
Next term has Advanced Antepartum (same instructors, not really looking forward to it!), Advanced Postpartum/Newborn and Research (yuck!!!!).
On an exciting note, I am attending Clinical Bound this summer and will be starting clinicals the first of October........woo hoo! I can't wait to start putting all the stuff I am learning into practice so it gels in my little head. So, the count down is beginning and my goal is to finish clinicals in February (if not sooner) and hopefully have comps and boards behind me by mid April.
Thursday, January 22, 2009
Work is getting crazy!
I am sooooo freakin tired!!!!
Last night was a total zoo at work! Our unit typically has 165-200 deliveries a month, so we are fairly steady. On the busiest night we will admit 5 or so scheduled procedures and have maybe 3 or 4 triages, that mostly go home. Well, last night we had 10 triages and I think only sent 1 or 2 home and had to call off the scheduled procedures because we had no more nurses and no more rooms! When I left this morning I had just put a laboring patient in the last empty room, the morning's scheduled c-section was being pre-opped in the PACU and we still had one patient being triaged in one of our three triage rooms. I hate to even think of what dayshift is like today!
The one bright spot was a great little couple I had the privilege of laboring. It was their fourth child and she came in to "just get checked" she said she had been having contractions every evening for the last three nights and just wanted to see if they were doing anything, she fully expected me to send her home.....NOT happening. She was 6cm! She was so surprised when I told her, it was great!
She had a wonderful unmedicated birth, two hours after she arrived at the hospital. She didn't get to labor in the shower like we had planned. I was warming up the water for her and getting her towels laid out when she started vomitting (she stood by the bed the whole time leaning over the bedside table) and her water broke, puddling between her legs. This is when she started getting some pressure during the peaks of contractions and we felt it best to hang close to the bed, she really didn't want to move much at this point anyway, it seemed like an insurmountable task to to her to get in and out of the shower at 8cm dilated!
On a less stressful note, I get to spend the evening having dinner with the local CNM's. I really enjoy getting together with these ladies, they are such a wonderful group and always keep me encouraged and pushing forward.
Last night was a total zoo at work! Our unit typically has 165-200 deliveries a month, so we are fairly steady. On the busiest night we will admit 5 or so scheduled procedures and have maybe 3 or 4 triages, that mostly go home. Well, last night we had 10 triages and I think only sent 1 or 2 home and had to call off the scheduled procedures because we had no more nurses and no more rooms! When I left this morning I had just put a laboring patient in the last empty room, the morning's scheduled c-section was being pre-opped in the PACU and we still had one patient being triaged in one of our three triage rooms. I hate to even think of what dayshift is like today!
The one bright spot was a great little couple I had the privilege of laboring. It was their fourth child and she came in to "just get checked" she said she had been having contractions every evening for the last three nights and just wanted to see if they were doing anything, she fully expected me to send her home.....NOT happening. She was 6cm! She was so surprised when I told her, it was great!
She had a wonderful unmedicated birth, two hours after she arrived at the hospital. She didn't get to labor in the shower like we had planned. I was warming up the water for her and getting her towels laid out when she started vomitting (she stood by the bed the whole time leaning over the bedside table) and her water broke, puddling between her legs. This is when she started getting some pressure during the peaks of contractions and we felt it best to hang close to the bed, she really didn't want to move much at this point anyway, it seemed like an insurmountable task to to her to get in and out of the shower at 8cm dilated!
On a less stressful note, I get to spend the evening having dinner with the local CNM's. I really enjoy getting together with these ladies, they are such a wonderful group and always keep me encouraged and pushing forward.
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