Can I feel all of these things at once? Sure.
Third year started with a (loud) bang for me. We started off the first week of September with a 6-day intensive that I was totally looking forward to. It was definitely nice to see classmates again, but I hadn't really thought too hard about the level of content that was going to be covered in those 6 days - they mean it when they say intense! What struck me most about it, though, was the switch from "Normal" (our first two years) to "abnormal". It jarred me a bit, to go from figuring out how to get my hands to do the right things when I'm catching a baby, to managing obstetrical emergencies, just like that.
After that, we began our interprofessional placements - a series of 2-4 week placements with other professionals in the field learning clinical skills from them and discovering their role and the unique benefits and demands of being a part of their profession. What a unique opportunity this really is. Its a great chance to learn clinical skills more quickly than I would with midwives. Its also a great chance for me to see how really happy I am to be in midwifery. I'm placed with a labor and delivery nurse first, and although I've only had a couple of shifts, I'm noticing quite a few differences that make me very thankful that we as midwives have such a wide scope and flexibility so we can maximize continuity of care. Just when you really get attached to a woman, your shift ends and you might never see her again. But then again, your shift ends, and your family knows when you expect you - and if you've read any of my previous posts, you'll know how happy they are about that!
Rather unfortunately, we had a major childcare crisis and a threat to my son's safety to deal with after my first day at the hospital when I came to pick him up. I also was faced with the much-greater reality of relocating for my senior year placement - something that I've always been afraid of, despite being aware that it could be a real possibility, but it now seems to be a much greater one. Couple that with some OSAP complications as well, and I had me a pretty emotional week. Thankfully the childcare problem is all cleared up now and the summer-long quest to find a replacement for our much loved (but now far away) home daycare provider came to a close the other day when we met "the one". Phew! There's a load off. I'm also working days this week and got to be part of some really great experiences today, so things are looking up!
Monday, 17 September 2012
Tuesday, 21 August 2012
Another summer day....
has come and passed. The breeze is cooling and the end of the summer is approaching.
In all honesty, I spent most of my time in school dreading this summer. It is the only long period of time that I will have off throughout the entire program. For someone like me, who has increasingly identified myself as a bit of a workaholic, this was terrifying. I figured out a long time ago that I'm not cut out for stay-at-home parenting. Four months of it felt like a bit of a nightmare.
And then April came along in placement. In my last two weeks of placement, I attended 9 births. What a way to go out with a bang! And what a way to make me really appreciate the benefits of a long vacation. By the end of it, despite the amazing variety of mostly positive birth experiences I got to witness in that long string of births, I was exhausted, drained, and desperate for sleep and a good meal (or ten!). The day my summer vacation started, was the day I stopped dreading it.
We have made it work so far. The kids have been in daycare part time, which gives me a chance to do a little bit of work and allow myself the space to get other things done that I had completely let go of last semester. And here we are in August and I feel all caught up. Dare I say, I'm almost starting to feel an inkling of excitement for third year to begin. But not before I get some more fun out. Oh, and a few births, but that's beside the point.
This summer, I've had to very realistically reflect on how the midwifery lifestyle impacts my life. When I was entering the program, I felt like I had a good handle on what it would be like - after all, I had been a doula for a number of years and was used to being on call and making backup childcare arrangements. But the midwifery lifestyle is much more demanding than the one I led as a doula, and it is particularly demanding for students. Students, who need as much experience as they can get, get very few days off and (if they're lucky) will be very busy on the days that they are on. I know this, and I accept and eve love this, but it is much more difficult in practice than it is in theory.
I have grown used to the unpredictability of birth and midwifery already. It feels selfless, it feels purposeful. I know it is making a difference in people's lives. I've grown incredibly fond of it. Although it has its dark moments, I look forward to hearing from clients. I enjoy not knowing where I will be an hour from now. I love surprises, the spontaneity of picking up and changing everything.
My family, however, does not. Throughout the course of my studies last semester, I grew to learn that no amount of preparation I did could have prepared my family for what it was really like. It wasn't my absence - they anticipated that. They knew I would be away much more than I'd be home, and they knew I'd need to rest much of the time that I was home. No, it wasn't how busy I was. It was how unpredictable it was.
I can't say how many times I arrived home just in time for dinner, only to get paged away 20 minutes later, kids on my lap. Or right in the middle of the bedtime routine. Or just as I'm preparing them for the morning. People, I cannot stress it enough - prepare your family for this. Make them read this if you want! It is so important.
Kids are so resilient, though. They got used to Daddy doing just about everything for them - he cooked them dinner pretty much every day, put them to bed most nights, took them to school and daycare, made lunches. Everything that they were used to me doing, or at least used to us sharing. My partner pulled through for me in so many ways, and I know (because I know him) that he will continue to do so, but it is not easy for him! Many of us midwifey folk have discussed trying to band our men together so that they can form a support network of deserted midwife husbands. And while I was aware that he was struggling a great deal during my placement, it wasn't until I was off and had the time and energy to check in with him that I realized just how hard it had hit him. Our relationship had become extremely fragile because amidst how busy I was, and my efforts to compensate for it by taking over household chores and childminding while I was home, I had nothing left at all to put into our relationship. The result is that we found ourselves in a crisis.
And so, this summer, our partnership has been the real focus. Sure, I've caught up on chores and fun with the kids. But most of my transformative energy has been put into building steel bonds with the man who has proven himself to be the backbone that holds me (and our entire family) up when I feel I might crumble to the ground. The crisis that we found ourselves in allowed us to realize that we don't just need eachother, but we want to be there for eachother and understand one another better, always.
In all honesty, I spent most of my time in school dreading this summer. It is the only long period of time that I will have off throughout the entire program. For someone like me, who has increasingly identified myself as a bit of a workaholic, this was terrifying. I figured out a long time ago that I'm not cut out for stay-at-home parenting. Four months of it felt like a bit of a nightmare.
And then April came along in placement. In my last two weeks of placement, I attended 9 births. What a way to go out with a bang! And what a way to make me really appreciate the benefits of a long vacation. By the end of it, despite the amazing variety of mostly positive birth experiences I got to witness in that long string of births, I was exhausted, drained, and desperate for sleep and a good meal (or ten!). The day my summer vacation started, was the day I stopped dreading it.
We have made it work so far. The kids have been in daycare part time, which gives me a chance to do a little bit of work and allow myself the space to get other things done that I had completely let go of last semester. And here we are in August and I feel all caught up. Dare I say, I'm almost starting to feel an inkling of excitement for third year to begin. But not before I get some more fun out. Oh, and a few births, but that's beside the point.
This summer, I've had to very realistically reflect on how the midwifery lifestyle impacts my life. When I was entering the program, I felt like I had a good handle on what it would be like - after all, I had been a doula for a number of years and was used to being on call and making backup childcare arrangements. But the midwifery lifestyle is much more demanding than the one I led as a doula, and it is particularly demanding for students. Students, who need as much experience as they can get, get very few days off and (if they're lucky) will be very busy on the days that they are on. I know this, and I accept and eve love this, but it is much more difficult in practice than it is in theory.
I have grown used to the unpredictability of birth and midwifery already. It feels selfless, it feels purposeful. I know it is making a difference in people's lives. I've grown incredibly fond of it. Although it has its dark moments, I look forward to hearing from clients. I enjoy not knowing where I will be an hour from now. I love surprises, the spontaneity of picking up and changing everything.
My family, however, does not. Throughout the course of my studies last semester, I grew to learn that no amount of preparation I did could have prepared my family for what it was really like. It wasn't my absence - they anticipated that. They knew I would be away much more than I'd be home, and they knew I'd need to rest much of the time that I was home. No, it wasn't how busy I was. It was how unpredictable it was.
I can't say how many times I arrived home just in time for dinner, only to get paged away 20 minutes later, kids on my lap. Or right in the middle of the bedtime routine. Or just as I'm preparing them for the morning. People, I cannot stress it enough - prepare your family for this. Make them read this if you want! It is so important.
Kids are so resilient, though. They got used to Daddy doing just about everything for them - he cooked them dinner pretty much every day, put them to bed most nights, took them to school and daycare, made lunches. Everything that they were used to me doing, or at least used to us sharing. My partner pulled through for me in so many ways, and I know (because I know him) that he will continue to do so, but it is not easy for him! Many of us midwifey folk have discussed trying to band our men together so that they can form a support network of deserted midwife husbands. And while I was aware that he was struggling a great deal during my placement, it wasn't until I was off and had the time and energy to check in with him that I realized just how hard it had hit him. Our relationship had become extremely fragile because amidst how busy I was, and my efforts to compensate for it by taking over household chores and childminding while I was home, I had nothing left at all to put into our relationship. The result is that we found ourselves in a crisis.
And so, this summer, our partnership has been the real focus. Sure, I've caught up on chores and fun with the kids. But most of my transformative energy has been put into building steel bonds with the man who has proven himself to be the backbone that holds me (and our entire family) up when I feel I might crumble to the ground. The crisis that we found ourselves in allowed us to realize that we don't just need eachother, but we want to be there for eachother and understand one another better, always.
Saturday, 19 May 2012
Reflecting on second year
Ahh...the summer. The breeze, the warmth, the kicking and screaming children. I had almost forgotten this part of life existed!
Normal Childbearing is done - all 16 weeks, assignments, and exams. We're done! I am officially halfway through the program - although, given how much of a challenge the program was and knowing the rest of school is placements - I kind of still feel like I just finished the introduction.
I fully intended to have a new blog post out the second I finished placement. But just before I finished placement, I had a string of 8 days where I went to ....oh gosh... I cant even remember now, something like 10 births?! Needless to say, once I finished my last day of placement (and some very interesting detours getting home thanks to my GPS), I fell into recovery mode, and 3-4 weeks later I'm starting to get my head back on straight. That being said, I'm out of midwife mode for the next little while and totally forget what questions most people have been dying to know about the placement, even though I know there are many. So please dont hesitate to ask away!
There is so much to share about what these last four months have been like for my classmates and I. All of us have had such diverse experiences from one another, though, that I can only really speak for my own experience. I'll probably make a number of posts over the summer in little bits and pieces. I'm also planning to post a couple of the papers I wrote, as they're in pretty understandable language and I think they're pretty darn interesting (I try not to write a paper about boring things, generally).
For today's post, I wanted to follow up on where my learning is at now, compared to where it was when I was only two weeks into my first midwifery placement. At that point, I was already being directly involved in all aspects of almost all clients care, from prenatal visits, to birth and postpartum visits. I felt awkward, didn't know what to say often, fumbled, made lots of mistakes. I also was undergoing a humongous adjustment to the midwifery lifestyle. The scale of change for me was so big - easily as big of a change in life as the birth of my first child. And for anyone who's got kids, you might imagine that means every aspect of your entire life is different. My family had a major adjustment to go through as well, especially my partner, who had to give up a great deal of his work and identity to be only Dad. For a man as passionate about his music as I am about midwifery, this was a huge challenge for him. Musicians often get gigs at night. (no childcare) Midwives often go to births at night. (no way to predict which night) You get the picture.
Everything that we are learning and capable of handling with minimal assistance is within the scope of Normal Childbearing - normal, common, or variations of normal. Obviously, though, we can't always predict when that'll be, so most of us were exposed to a hearty share of not-so-normal situations as well. I mentioned in my last post that my faith in the process had gotten seriously put to the test in my first few weeks of placement after a string of situations that I had never viewed from the care providers perspective before. Thank goodness (for myself and my future clients!) that faith got restored with many, many positive, straightforward beautiful strong women and their births to show me that birth is a normal life event.
Of course, the focus of our later courses will be on managing and consulting for some of the various complications that came up over the course of our learning. By the end of the term, I found myself REALLY curious about those complications. This, to me, is a sign that I'm comfortable with the "normal" stuff.
Seriously, I feel like I've said absolutely nothing. But there's so much more to say! Since I got into recovery mode, my writing hasn't been as strong as usual! Please post unanswered questions in the comments. I just might make another post about it!
Thursday, 19 January 2012
What my first two weeks of Normal Childbearing looked like
Okay, so I've been facing lots of pressure to get some blog posts up here! Sorry to anyone who may have been itching to know what placement was like...I was too, until a couple weeks ago when it started. But suffice to say that my absense in posting is because placement is VERY BUSY! I am going to try and make this post as thorough as possible but please know I might not post again until close to the end of term. This is the one-stop shop, "Heres what a couple of weeks in placement looks like"
Disclaimer: As I'm sure you understand, I have to maintain full confidentiality of all clients. I can't give any details that might reveal dates, names or any form of detail that could identify someone. Therefore I'm trying to remain extremely vague about my experiences.
In our Normal Childbearing placement, which is 16 weeks in duration, we must attend a minimum of 18 births and a maximum of 30. There is variation due to the nature of the clinic workings, but also because we need to act as primary midwife for some of those births, second midwife for some, and are allowed only a small number of observed births (2). Since all women who need oxytocin IV or epidurals are transferred out of our care and we can't conduct the birth (to a certain extent), there will inevitably be more than two observed births. Therefore I anticipate nobody could really make all their other necessary numbers with only 18 births. We're expected to be on call for these births at all times, aside from 4 days per month and every Friday morning for tutorial.
Anyway, on top of the births, we are supposed to attend 15 pre- or post-natal visits per week. This is also something very variable, since some practices have 15-30 minute appointments and can get 15 clinic visits into one or two days. My practice's appointment times are 45 minutes - *such* a treat to have the time to spend with the women, but definitely a bigger challenge to get those numbers in. I've only successfully gotten an entire 15 visits in one of the three weeks I've been there, and I've attended every single visit I could, unless I've been at a birth.
In addition to the clinical duties, we have tutorial duties. The PBL format that I hopefully described about Repro from last semester is used for the rest of the duration of the programming at the MEP - so we're given a situation and we have to extract issues from the situation and go out and learn about them to teach eachother at the next tutorial. Therefore, we need to prepare each week a presentation to share what we learned about the topic that we were to work on for that week. In addition to that, we have to present an informed choice discussion on a basic pregnancy intervention (testing, etc), write a couple of papers about learning issues, create learning plans, write midterm and final exams, and probably some other things that I'm not aware of yet. Realistically, it doesn't look THAT heavy to me at this point. The academic load seems similar to that of ONE course - which is very fortunate since the clinical side of things feels equivalent to 7 or 8. We are also required to have a reserved half-day each week during business hours to work on our assignments. So far, I've been able to keep my assignment obligations within that half day, but I'm sure there'll be weeks where its not enough.
By the end of the term, we are expected to have attended our required births and clinic visits, and to have exhibited basic skill in all areas of caring for normal, healthy pregnant women and their babies. This is a very diverse thing to accomplish, I have learned. Midwifery is a dynamic profession that requires creativity and an open mind at all times. This was probably my first lesson.
My first day in placement was lovely - an orientation of sorts. I joined the group for their practice meeting and got to meet a lovely set of women who work together to create the web of midwifery care that this clinic provides. This particular practice is split into two teams - the team I'm working with has approximately 22 births from the time I started until the end of my placement, but they also back-up the other team, which probably has an equal number of births planned. Before I realized that my team attends all the births in the clinic (and I would be expected to do the same), I was concerned that if I missed any on my day off, I might not make my numbers. Now I'm starting to wonder if I might need to taper the numbers down close to the end of the term as I might hit my maximum.
My first weeks have been busy. I live a good distance from my practice, which is in a pretty rural setting. This means that it takes me at least 45 minutes to get to clinic every day, and the home and hospital visits we do for our new mothers after birth can involve one heck of a commute, since this practice serves an enormous catchment area. Not one word of a lie, I have had days where I've covered almost 600km. And please, let me allow you to think about what it is like to drive the hour to get home, and then get paged right back (especially if its right after a long birth). I also can't begin to describe how hard it is to come home at 1am and leave again at 6am, only to return home at 10pm. I've gone days without seeing my kids or partner. Ladies anticipating placement or considering the program, let it be known that there is blood, sweat, and tears involved in this profession, and they're not only coming from birthing mothers. I could NOT get through days like those without rock solid support (and I mean it, undending, unconditional support), good nutrition available at all times, and a plan to make sure I get sleep at some point in the next day or two. ALL of those things wouldn't be anywhere near within my reach if it weren't for the fact that my partner is pretty much putting his career on hold and acting as stay at home dad. He's cooked almost every day, taken the kids away when its necessary, put them to bed almost every night, washed most of the dishes and laundry, gotten our daughter off to school every morning, and cared for our son on his days home as well. There is no way I'd be able to do this without him.
So really, I shouldn't complain. I knew what I was getting myself into when I signed up for a practice so far away from me, but I also knew the philosophies of these midwives and I wanted very much to be influenced by their practices. I can't say enough good things about my preceptors. Its definitely a challenge having two who have two different teaching styles, schedules, and expectations for me, but its an awesome privilege to glean the best from both of these wonderful, caring midwives.
There's so much learning to be done in the clinic days. I feel so awkward in those visits. Its such a privilege to be sitting in on them. The fact that these midwives are opening their clients up to me, and that these clients are opening themselves up for my learning, is a real gift. I definitely feel pretty stupid most of the time though. I know most of what is being said in the visits, but I almost never remember it when everyone turns to me and says "Do you have anything to add?". I usually remember lots to say AFTER, though, so at least its coming at some point. I need to start writing out scripts for various discussions that take place so that eventually I can take over the midwife's side of the conversation and begin teaching and learning from the client more directly. That process, here in my third week of placement, is starting. Very slowly, but its starting.
So what do we do with women aside from talking? Everything I learned in clinical skills has been put to the test aside from one or two that I've chickened out on so far (I chickened out on IV insertion, and I havent' had a chance to do a Pap). I've already had ample opportunities to feel bellies, measure fundal height, take blood pressure, listen to the babies heart, draw blood, do injections, perform cervical exams, break membranes in labor, catch babies (!! with the help of my preceptors), catch placentas, suture, assess the newborn, administer vitamin K and erythromycin to the newborn, provide breastfeeding support (or rather, mostly observe my awesome preceptor giving her breastfeeding support), and probably a hundred more things that I can't even think of. I've also been witness to a number of complications in labor and birth. As I said - very diverse!! Never a dull day.
Bearing in mind that this has all been within the 17 days that I have been in placement - - lots of clinic days, and SIX births already.
The last thing that I mentioned in the list were pretty hard to swallow. As much as I have learned from some of these complicated births, they weren't exactly typical examples of "Normal Childbearing". I have to admit that, just as I had feared might happen, my faith in the process has definitely been put to the test and I've found myself wondering at a birth what will go wrong at this one. I used to loathe this in birth professionals when I was a mother. I wanted someone with utmost confidence in me. And I still have utmost confidence in women. But now that I've been on the other side of the fence, I've begun to understand that by putting your utmost faith into your midwife or attending physician, the mother (or the doula, in my case) is able to release most of the fear of complications that surround childbirth. But those risks don't go away just because you let go of the fear - you've just got someone well equipped to handle them if they come along. Stepping into the place of someone who is learning how to be responsible for handing those risks is a heavy burden and an enormous privilege. It brings me a new sense of purpose to the profession. It also, sadly, makes me realize that I cannot prevent every unnecessary intervention put upon a mother or her baby, because sometimes we don't know if an intervention is necessary or not, but only that it lowers risk.
ANYWAY! As you might be able to tell, my thoughts are scattered and my brain is tired. The last couple of days there have been no births, and I have been thankful for the chance to catch up on sleep and gain my brain back.
And now, its 10pm, and I'm probably committing suicide by staying up so late!
Disclaimer: As I'm sure you understand, I have to maintain full confidentiality of all clients. I can't give any details that might reveal dates, names or any form of detail that could identify someone. Therefore I'm trying to remain extremely vague about my experiences.
In our Normal Childbearing placement, which is 16 weeks in duration, we must attend a minimum of 18 births and a maximum of 30. There is variation due to the nature of the clinic workings, but also because we need to act as primary midwife for some of those births, second midwife for some, and are allowed only a small number of observed births (2). Since all women who need oxytocin IV or epidurals are transferred out of our care and we can't conduct the birth (to a certain extent), there will inevitably be more than two observed births. Therefore I anticipate nobody could really make all their other necessary numbers with only 18 births. We're expected to be on call for these births at all times, aside from 4 days per month and every Friday morning for tutorial.
Anyway, on top of the births, we are supposed to attend 15 pre- or post-natal visits per week. This is also something very variable, since some practices have 15-30 minute appointments and can get 15 clinic visits into one or two days. My practice's appointment times are 45 minutes - *such* a treat to have the time to spend with the women, but definitely a bigger challenge to get those numbers in. I've only successfully gotten an entire 15 visits in one of the three weeks I've been there, and I've attended every single visit I could, unless I've been at a birth.
In addition to the clinical duties, we have tutorial duties. The PBL format that I hopefully described about Repro from last semester is used for the rest of the duration of the programming at the MEP - so we're given a situation and we have to extract issues from the situation and go out and learn about them to teach eachother at the next tutorial. Therefore, we need to prepare each week a presentation to share what we learned about the topic that we were to work on for that week. In addition to that, we have to present an informed choice discussion on a basic pregnancy intervention (testing, etc), write a couple of papers about learning issues, create learning plans, write midterm and final exams, and probably some other things that I'm not aware of yet. Realistically, it doesn't look THAT heavy to me at this point. The academic load seems similar to that of ONE course - which is very fortunate since the clinical side of things feels equivalent to 7 or 8. We are also required to have a reserved half-day each week during business hours to work on our assignments. So far, I've been able to keep my assignment obligations within that half day, but I'm sure there'll be weeks where its not enough.
By the end of the term, we are expected to have attended our required births and clinic visits, and to have exhibited basic skill in all areas of caring for normal, healthy pregnant women and their babies. This is a very diverse thing to accomplish, I have learned. Midwifery is a dynamic profession that requires creativity and an open mind at all times. This was probably my first lesson.
My first day in placement was lovely - an orientation of sorts. I joined the group for their practice meeting and got to meet a lovely set of women who work together to create the web of midwifery care that this clinic provides. This particular practice is split into two teams - the team I'm working with has approximately 22 births from the time I started until the end of my placement, but they also back-up the other team, which probably has an equal number of births planned. Before I realized that my team attends all the births in the clinic (and I would be expected to do the same), I was concerned that if I missed any on my day off, I might not make my numbers. Now I'm starting to wonder if I might need to taper the numbers down close to the end of the term as I might hit my maximum.
My first weeks have been busy. I live a good distance from my practice, which is in a pretty rural setting. This means that it takes me at least 45 minutes to get to clinic every day, and the home and hospital visits we do for our new mothers after birth can involve one heck of a commute, since this practice serves an enormous catchment area. Not one word of a lie, I have had days where I've covered almost 600km. And please, let me allow you to think about what it is like to drive the hour to get home, and then get paged right back (especially if its right after a long birth). I also can't begin to describe how hard it is to come home at 1am and leave again at 6am, only to return home at 10pm. I've gone days without seeing my kids or partner. Ladies anticipating placement or considering the program, let it be known that there is blood, sweat, and tears involved in this profession, and they're not only coming from birthing mothers. I could NOT get through days like those without rock solid support (and I mean it, undending, unconditional support), good nutrition available at all times, and a plan to make sure I get sleep at some point in the next day or two. ALL of those things wouldn't be anywhere near within my reach if it weren't for the fact that my partner is pretty much putting his career on hold and acting as stay at home dad. He's cooked almost every day, taken the kids away when its necessary, put them to bed almost every night, washed most of the dishes and laundry, gotten our daughter off to school every morning, and cared for our son on his days home as well. There is no way I'd be able to do this without him.
So really, I shouldn't complain. I knew what I was getting myself into when I signed up for a practice so far away from me, but I also knew the philosophies of these midwives and I wanted very much to be influenced by their practices. I can't say enough good things about my preceptors. Its definitely a challenge having two who have two different teaching styles, schedules, and expectations for me, but its an awesome privilege to glean the best from both of these wonderful, caring midwives.
There's so much learning to be done in the clinic days. I feel so awkward in those visits. Its such a privilege to be sitting in on them. The fact that these midwives are opening their clients up to me, and that these clients are opening themselves up for my learning, is a real gift. I definitely feel pretty stupid most of the time though. I know most of what is being said in the visits, but I almost never remember it when everyone turns to me and says "Do you have anything to add?". I usually remember lots to say AFTER, though, so at least its coming at some point. I need to start writing out scripts for various discussions that take place so that eventually I can take over the midwife's side of the conversation and begin teaching and learning from the client more directly. That process, here in my third week of placement, is starting. Very slowly, but its starting.
So what do we do with women aside from talking? Everything I learned in clinical skills has been put to the test aside from one or two that I've chickened out on so far (I chickened out on IV insertion, and I havent' had a chance to do a Pap). I've already had ample opportunities to feel bellies, measure fundal height, take blood pressure, listen to the babies heart, draw blood, do injections, perform cervical exams, break membranes in labor, catch babies (!! with the help of my preceptors), catch placentas, suture, assess the newborn, administer vitamin K and erythromycin to the newborn, provide breastfeeding support (or rather, mostly observe my awesome preceptor giving her breastfeeding support), and probably a hundred more things that I can't even think of. I've also been witness to a number of complications in labor and birth. As I said - very diverse!! Never a dull day.
Bearing in mind that this has all been within the 17 days that I have been in placement - - lots of clinic days, and SIX births already.
The last thing that I mentioned in the list were pretty hard to swallow. As much as I have learned from some of these complicated births, they weren't exactly typical examples of "Normal Childbearing". I have to admit that, just as I had feared might happen, my faith in the process has definitely been put to the test and I've found myself wondering at a birth what will go wrong at this one. I used to loathe this in birth professionals when I was a mother. I wanted someone with utmost confidence in me. And I still have utmost confidence in women. But now that I've been on the other side of the fence, I've begun to understand that by putting your utmost faith into your midwife or attending physician, the mother (or the doula, in my case) is able to release most of the fear of complications that surround childbirth. But those risks don't go away just because you let go of the fear - you've just got someone well equipped to handle them if they come along. Stepping into the place of someone who is learning how to be responsible for handing those risks is a heavy burden and an enormous privilege. It brings me a new sense of purpose to the profession. It also, sadly, makes me realize that I cannot prevent every unnecessary intervention put upon a mother or her baby, because sometimes we don't know if an intervention is necessary or not, but only that it lowers risk.
ANYWAY! As you might be able to tell, my thoughts are scattered and my brain is tired. The last couple of days there have been no births, and I have been thankful for the chance to catch up on sleep and gain my brain back.
And now, its 10pm, and I'm probably committing suicide by staying up so late!
Wednesday, 21 December 2011
The final semester of academic-only learning
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Winter Break is finally upon us, and I have finally breathed. I think its been a couple of months since I've had a moment of guilt-free relaxation! Needless to say, this semester was very busy. Also needless to say, its going to get busier as I gear into placement first thing after New Years day. Between a demanding placement, the commuting issues that will accompany it, and my family, I don't anticipate many blogging opportunities during my placement. So perhaps I'll give it my best go and give you a big long one now that I have time to do it by summing up my third semester in school.
According to the Ryerson schedule, full-timers are to take Clinical Skills, Pharmacology, Reproduction & Physiology, and two elective social science courses. I've said it before, and I'll say it again - this is impossible. Nobody in their right mind can handle this kind of a course load and do well at any of it (as far as I can see, anyway). If you can get those electives out of the way (or even Pharm or Repro) in first year, during the summer break, or before you enter the program, do it!!! You will thank yourself later!
To sum them up fairly briefly:
Clinical Skills: Is a 3-credit course taught by two midwives with many guest instructors that come throughout the semester. Because its three credits, and there is an absolute TON of material to cover, class time is a full day plus a half day per week. This year it was Monday afternoons and all day Tuesdays - but sometimes we needed to do full days on Mondays as well. Assignments were simple and no stress. A few quizzes and a final exam - I didn't find any of the evaluations in this course to be a major challenge. The material, though, was overwhelming. This course covered just about everything that we will encounter in everyday clinic, home visits, and births.....
.... That's prenatal forms, breastfeeding, nutrition, physical assessment, prenatal screening, ultrasound, vitals, mechanisms of labor, telephone assessments, labor support, baby-catching, fetal monitoring, cervical exams, pap smears, suturing, newborn resusitation, newborn physical exam, IVs, administering meds, phlebotomy, infection control, and a million other things I can't think of off the top of my head....
As you can imagine, thats a LOT to cover in one semester. And a ton of reading to go along with it. Most topics only got a 3-hour lecture or workshop. Its a real glossing over of the whole thing, which I think was scary to many of us who want to walk into our first placement as competent students, but it turns out they dont really expect us to be competent when we begin placement. They only expect that we've seen the equipment before and have an idea of how to use it. For me, having had the experience both as a client of midwifery care and as a doula who is familiar with much of what I listed above, I found the course to be enjoyable, but a bit of a repeat on things that I already knew. I didn't miss a class and I definitely leared at every class, but the lecture portions were often a review. I really found myself feeling for those who have less experience in the field coming into the program, as it was a lot to absorb at once. Pretty much nobody could actually do all of the assigned readings, as some weeks were upward of 300-400 pages (only a couple were like that though). My challenge with this course was the hands-on skills - particularly IVs and suturing. I've got lots of hands on experience at things like labor support, but hand me a needle and I'm a bumbling idiot. Luckily we got rubber arms for IVs and beautiful little plush vaginas to practice suturing on. There were definitely lots of good times in this class!
Pharmacotherapy: I found my arch nemesis in this class. Not the instructor, who's been teaching this class since its inception 14 some odd years ago, but my brain. This course introduced all of the drugs that midwives can administer and prescribe as well as all the drugs we may encounter our clients taking, and the concepts of how they actually work at the cellular level. Really, really fascinating stuff. But really, really hard for a concept-based kinesthetic learner like me to memorize a gazillion drug names that sound the same and know the subtle differences. I think I made a come-back at the final exam (grades aren't up yet though), but the midterm knocked me on my butt-hocks (as Willow says).
Reproduction and Physiology: A great and fascinating class. This class introduces us to the method of learning we'll be using for the rest of our career as students: situation-based learning. So, the instructor (a scientist who also has been teaching this course since its inception many moons ago) gives us a situation at the end of class and we decide what we need to learn from it. Then we go out for the week and research it, and come together at the next class and teach eachother. There's very little teaching that the instructor does, mostly just mediating - its us that do the teaching. Its really interesting. Preparingn for this class was definitely my biggest time commitment, I'd say easily a full day of research to prepare for this class each week, but it was fascinating. It covered the ovarian and uterine cycles, embryological genital differentiation, embryogenesis, fertilization, implantation, placentation, maternal adaptations to pregnancy, fetal adaptations to extrauterine life, and the initiation of labor (parturition). Overall a great course (in my humble opinion).
There you have it! My novel for the semester. Thanks for tuning in!
p.s. I've had questions from a few people about applications and interviews into the program - to those of you asking, and others wondering - I'm so sorry I haven't had the opportunity to respond as I would like. I've been grabbing life by the horns and trailing behind trying to make sure I'm holding on tight! In a nutshell, my friends, the wait is stressful but show your true colours and keep your heart pure and that is the best that anyone can do.
Winter Break is finally upon us, and I have finally breathed. I think its been a couple of months since I've had a moment of guilt-free relaxation! Needless to say, this semester was very busy. Also needless to say, its going to get busier as I gear into placement first thing after New Years day. Between a demanding placement, the commuting issues that will accompany it, and my family, I don't anticipate many blogging opportunities during my placement. So perhaps I'll give it my best go and give you a big long one now that I have time to do it by summing up my third semester in school.
According to the Ryerson schedule, full-timers are to take Clinical Skills, Pharmacology, Reproduction & Physiology, and two elective social science courses. I've said it before, and I'll say it again - this is impossible. Nobody in their right mind can handle this kind of a course load and do well at any of it (as far as I can see, anyway). If you can get those electives out of the way (or even Pharm or Repro) in first year, during the summer break, or before you enter the program, do it!!! You will thank yourself later!
To sum them up fairly briefly:
Clinical Skills: Is a 3-credit course taught by two midwives with many guest instructors that come throughout the semester. Because its three credits, and there is an absolute TON of material to cover, class time is a full day plus a half day per week. This year it was Monday afternoons and all day Tuesdays - but sometimes we needed to do full days on Mondays as well. Assignments were simple and no stress. A few quizzes and a final exam - I didn't find any of the evaluations in this course to be a major challenge. The material, though, was overwhelming. This course covered just about everything that we will encounter in everyday clinic, home visits, and births.....
.... That's prenatal forms, breastfeeding, nutrition, physical assessment, prenatal screening, ultrasound, vitals, mechanisms of labor, telephone assessments, labor support, baby-catching, fetal monitoring, cervical exams, pap smears, suturing, newborn resusitation, newborn physical exam, IVs, administering meds, phlebotomy, infection control, and a million other things I can't think of off the top of my head....
As you can imagine, thats a LOT to cover in one semester. And a ton of reading to go along with it. Most topics only got a 3-hour lecture or workshop. Its a real glossing over of the whole thing, which I think was scary to many of us who want to walk into our first placement as competent students, but it turns out they dont really expect us to be competent when we begin placement. They only expect that we've seen the equipment before and have an idea of how to use it. For me, having had the experience both as a client of midwifery care and as a doula who is familiar with much of what I listed above, I found the course to be enjoyable, but a bit of a repeat on things that I already knew. I didn't miss a class and I definitely leared at every class, but the lecture portions were often a review. I really found myself feeling for those who have less experience in the field coming into the program, as it was a lot to absorb at once. Pretty much nobody could actually do all of the assigned readings, as some weeks were upward of 300-400 pages (only a couple were like that though). My challenge with this course was the hands-on skills - particularly IVs and suturing. I've got lots of hands on experience at things like labor support, but hand me a needle and I'm a bumbling idiot. Luckily we got rubber arms for IVs and beautiful little plush vaginas to practice suturing on. There were definitely lots of good times in this class!
Pharmacotherapy: I found my arch nemesis in this class. Not the instructor, who's been teaching this class since its inception 14 some odd years ago, but my brain. This course introduced all of the drugs that midwives can administer and prescribe as well as all the drugs we may encounter our clients taking, and the concepts of how they actually work at the cellular level. Really, really fascinating stuff. But really, really hard for a concept-based kinesthetic learner like me to memorize a gazillion drug names that sound the same and know the subtle differences. I think I made a come-back at the final exam (grades aren't up yet though), but the midterm knocked me on my butt-hocks (as Willow says).
Reproduction and Physiology: A great and fascinating class. This class introduces us to the method of learning we'll be using for the rest of our career as students: situation-based learning. So, the instructor (a scientist who also has been teaching this course since its inception many moons ago) gives us a situation at the end of class and we decide what we need to learn from it. Then we go out for the week and research it, and come together at the next class and teach eachother. There's very little teaching that the instructor does, mostly just mediating - its us that do the teaching. Its really interesting. Preparingn for this class was definitely my biggest time commitment, I'd say easily a full day of research to prepare for this class each week, but it was fascinating. It covered the ovarian and uterine cycles, embryological genital differentiation, embryogenesis, fertilization, implantation, placentation, maternal adaptations to pregnancy, fetal adaptations to extrauterine life, and the initiation of labor (parturition). Overall a great course (in my humble opinion).
There you have it! My novel for the semester. Thanks for tuning in!
p.s. I've had questions from a few people about applications and interviews into the program - to those of you asking, and others wondering - I'm so sorry I haven't had the opportunity to respond as I would like. I've been grabbing life by the horns and trailing behind trying to make sure I'm holding on tight! In a nutshell, my friends, the wait is stressful but show your true colours and keep your heart pure and that is the best that anyone can do.
Tuesday, 25 October 2011
Wow, this semester is flying by! Midterms are done, and our placement notices came into our emails very shortly after we finished the last midterm (I have a feeling it was planned that way). I'm happy to report that I got my first choice! I'm excited to have the opportunity to work with the midwife group that took care of my own most recent pregnancy and birth. But, my head is swimming with the details. Placement feels very real now. The grand "you get four days a month off call" is hanging over my head and childcare details are far from being finalized. There are definitely drawbacks to following your dreams, when you have a partner whose schedule is almost as wacky and unpredictable as a midwife's *and* two children (he is a musician). The practice that I'll be going to is also quite a distance from my home - more than what is typically allowable by the school (50 minutes away) - and the catchment area is even larger. I am far from most midwifery practices, though, because I live rurally, and I don't intend to relocate for this placement. My mom lives well within their catchment area and I know I can fall back on being there if I know I need to be available on short notice sometimes (or know I can't drive home *afterwards!*)
But those are details that only my head should swim with! I really am SO excited to embark on the next stage of the journey, and can't wait for the "real" experiences. In the meantime, we're being prepped by our clinical skills classes in all sorts of skills that we'll be learning more about in placement - some of those experiences have been INCREDIBLE.
More to come when I have time to breathe! (So, maybe Christmas at this rate!?)
But those are details that only my head should swim with! I really am SO excited to embark on the next stage of the journey, and can't wait for the "real" experiences. In the meantime, we're being prepped by our clinical skills classes in all sorts of skills that we'll be learning more about in placement - some of those experiences have been INCREDIBLE.
More to come when I have time to breathe! (So, maybe Christmas at this rate!?)
Tuesday, 4 October 2011
The placement lottery decisions begin
Wow, this last month has been so busy! Although I'm only working on three courses right now (repro, pharm, and clinical skills) the latter is worth three credits and is very heavy. I haven't been able to keep up with my readings let along updating blog posts.
Yesterday, though, we finally received "the list" - that list we've been waiting to see, that tells us which regions have placements available for this first clinical placement we are preparing to go into. We've got a little over a week to decide what our top 4 choices are, and then a maximum of a month to hear what the verdict is. Wow, what a feeling of foreboding! The options available are about what I expected..but it's definitely complicated by my intentions for summertime (and the possibility of having to take a placement in summer vs winter) and my distance from, well, anything substantial aside from one practice. Here is hopIng that it will all work out for the better!!!!
Yesterday, though, we finally received "the list" - that list we've been waiting to see, that tells us which regions have placements available for this first clinical placement we are preparing to go into. We've got a little over a week to decide what our top 4 choices are, and then a maximum of a month to hear what the verdict is. Wow, what a feeling of foreboding! The options available are about what I expected..but it's definitely complicated by my intentions for summertime (and the possibility of having to take a placement in summer vs winter) and my distance from, well, anything substantial aside from one practice. Here is hopIng that it will all work out for the better!!!!
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