A turning point

Today was such a great day.  The last few days, I've been able to get a sense of accomplishment with what I've done over my time off, tying up loose ends, getting all my paperwork in order for the college, and hospital privileges.  I've always said, the month between placements is absolutely evil.  I spend the first 3 weeks recovering; then I spend 1 week learning how to be myself again (the real myself, not the "doing whatever anyone wants me to be because I'm a student" self - which admittedly often involves some growing pains that take the form of defiance).  And then its over and I'm back in knee deep.  I'm 4 weeks into my time off now (I think).  And I've got over a month before I'll go back on call.  I'm in "rediscovery" mode.  And loving the level of introspection that I'm allowing myself.

Today, for the first time in a long long time, I let my guard down for the entire day.  Not the guard that protects you from people or bad things happening.  The guard that I build myself to protect me from time.  And most particularly, from "wasting" it.  Over these years I have become very focused on using my time well, and becoming more efficient or productive (something that's particularly important as a young midwife because your thought processes work slowly at first and it takes longer to come to certain conclusions than it does for more experienced practitioners).  I allowed myself a moment to wonder, why do I feel this need to be so "productive" all the time in my life?  And what do I use to define productivity?  And most importantly, why do I let that take away from my ability to enjoy my life? 

I turned 29 a couple of weeks ago, which has caused me to look beyond, to the big 3-0.  And when I reflect on it, I think that I have made a lot out of my twenties!  I've got two kids and a supportive family.  I've got an amazing partner who has been able to follow his dreams and has enabled me to follow my own.  We've built an ever-growing support network of people around us, near us, and supporting us, who I can use no other word to describe except AWESOME. A great home.  A promising career.  The list goes on and on. 

Why, then, do I spend most of my days focused inward on what I don't like about what is happening?  If I'm perfectly honest, I'm usually so focused on what could be done *better* that I don't ALLOW myself to enjoy how great things already are!  I haven't been allowing myself to get swept up in the moment and JUST BE.  Just play!  Just enjoy the outdoors!  Just enjoy the company of other people!

Like I was THERE. (Hillside 2012)

Well, today I did.  I dropped in on a friend and he asked me to stay for coffee and my brain did the usual - "Melissa, its a long drive home, and you only have two days of childcare this week and you should really get this and that and the other thing done before its over".  And instead, I listened to the OTHER voice that said "Yes!!  I would really really LOVE to!"  I know it probably sounds silly to some people, but maybe to those couple who get where my brain has been at, it makes sense.  And I let that feeling last the rest of the day.  Got swept up in some "low-key spontaneity".  Enjoyed the moment.  And (to appease the other side of my brain) - the "stuff" still got done!  The only difference is I *ENJOYED* it. 

Lots of little messages fell into place for me today.  And they all culminated in me realizing that my next life lesson - which is the one I've been trying to learn all along but haven't had the mental capacity to learn anything else - is to learn how to step back, slow down, and enjoy life more.  Not a little more.  But a lot more.  Because really, how we spent the moments of our day, becomes how we spend our lives. 



Also, for some extra motivational reading, I stumbled upon the blog of a wonderful midwife today, local to an area that I once called home, today, whose words were one of those messages that helped things fall into place for my brain space today.  Highly recommended reading!

Finished and moving forward

Done.  I'm done. 

It feels so, so good to be able to declare that to the world.  I'm DONE!!! 

Placement finished a few weeks ago.  The most gruelling exam I've ever written followed shortly after.  And a few days ago I got the notice that I passed it.  Which means I'm done. 

On a more challenging note, my grandfather has been ill with esophageal cancer, a particularly invasive and awful cancer, since the winter. He's undergone some really difficult chemo and radiation, and last week he had some very invasive surgery to remove his esophagus, with the hopeful end result of kicking it in the bucket. So please, think of him and wish him a speedy recovery. He's been very much a father to me for my whole life and it is hard to see him suffering.

What's next? 

Well, there's the job interviews. That harrowing process where you have to put your heart and soul on the table and await judgement. There was a very difficult decision about where to start working because I was lucky enough to receive multiple offers.  Problem is I got the offers before I attended the interview in Orangeville, the town that my kids grew up in, that we spent ten years in. And the people giving me the offers needed answers before that interview. Sadly, staying here in Guelph is also not an option, because even though there are two practices here, neither of them are taking a new registrant. So we (our whole family) made the decision to accept one of the offers.  What a hard decision this was!  So many things to balance out!  I do feel like we've made the right decision though.  The interview went really well, I got along great with them, and the practice seems like an excellent model that I'm frankly very excited to try out.  It's also only 30 minutes from my home right now - which is probably too far away to commute but its also close enough that I have enough flexibility that I won't have to move immediately, we can let the kids finish school, maybe play out the summer with the childcare resources we already have in place, before moving. 

What else is next?
A long line of paperwork.  Registering with the College of Midwives (lots of money).  And the Association of Ontario Midwives (also lots of money).  Getting ready to order my equipment (lots of money that luckily will be reimbursed). Getting ready for the national exam whicih allows us to practice in all provinces (also lots of money). And starting to put my ducks together to get hospital privileges in my new community.  I'm still working at this a couple of days a week.  And in the meantime, my partner gets to work as many hours as he wants and not worry about childcare, or logistics, or overtired mommy. I get to hold the fort down for a while - which feels weird!  I've missed the kids a lot, but in that time I also forgot how hard it is to keep the house and family functioning. 

Best of all, despite how burnt out I felt by the end of my very very busy final semester, I miss it already.  I actually went to the Newman Breastfeeding Clinic and Institute yesterday for a day of observation to pick up some extra tips for breastfeeding challenges and it really made me miss taking care of women and babies.  And its been less than a month since I finished! 

I figure that's a  pretty good sign ;) 

 

"Captain Midwife", as Jamie has called me since the day I received that most

wonderful phone call telling me I was accepted into the midwifery program.

The real home stretch.

So, winter break blew by in a heartbeat, as always.  Tomorrow is New Years Day, and the following day I go back for my last 12 weeks of student life (at least, as long as things go well it'll be my last 12 weeks!). 

I've had a lot of people noticing how little time there is until the end, and many folks already offering congratulations and comments of wonder of how amazing it must feel to be so close to the end. 

 Being at this point in my education is like a mixed bag.  Every minute I feel differently about it.  So how am I really feeling about this?


Afraid.  There are so many things to be afraid of.  I keep courting this strange feeling that there is some very deep inadequacy in me that nobody has yet spotted.  That maybe I'm actually a total bumbling idiot, and that when I get out on my own and am not having my every move being shadowed and mentored, I might make a fatal mistake. 

Overwhelmed.  The thought of walking back into a clinic has changed over this time.  I went from an excited Normal Childbearing student, where every birth was an adventure and every client a pleasure to meet - to where I am now - and don't get me wrong, every birth is still an adventure, and every client is still a pleasure to meet.  But the level of responsibility that I see is so much more than I had realized it to be before.  It can be overwhelming.  Couple that with the idea that there's a high likelihood I may need to scoop up the family and move to a new community again in order to work, and  Melissa tries not to think about how overwhelming this is.


Introspective:  I chose certain placements over the course of my education because I wanted to be shaped into the type of midwife that I dreamed I would become before I came into this.  I understood right from the outset that the placements students are in drastically affect the type of midwife they will become.  And yet, not all of these experiences were of my choice, or done in my style.  And now I am left to question - am I still becoming the type of midwife that I imagined I would be five years ago?  Will I really even make a good midwife?   Should I even be focused on that, when my main objective is just getting through this year?

Relieved - I'm relieved that I've made it this far; I know that I have enough resolve and determination left in me to make it to the end. I have always felt like I have a strong sense of determination and commitment, but many points over the last six months have brought me to my knees and caused me to question whether or not I'm making the right career choices. But now, although I know the learning curve of the first few weeks back will be steep, because I always seem to forget most of what I learned when I have a vacation, I know Im on the TRUE home stretch now, and with that comes an immense sense of relief. I will live to see the spring, and all being well graduation will follow shortly after that.

Transition

I can't believe I'm sitting here writing a blog entry right now.  It's my first day off in almost an entire month, and for some reason it was my first instinct today.  Probably because I've gotten some subtle comments from people who are curious about how my life is going since I dropped off the planet.  Probably also because this is my own little journalling exercise and a little bit of therapeutic relief for me as well. 

So, where the course is at:  this term, the course we are in is called Maternal Newborn Pathology.  The course component, much like the other placement terms, consists of learning objectives that each student has to independently research each week and create study notes, and the class teaches one another by using what we learned through our research by enacting a scenario.  The emphasis now has shifted slightly from learning about conditions to learning how to manage them (although there's definitely still learning about the conditions too).  And as you might guess by the name of the course, the theme is mortality and morbidity - serious conditions that are way outside of midwifery scope, but that may happen to our clients so we need to be able to identify them and initiate care.  It's heavy.  But really, what part of this degree hasn't been heavy?

The great part about it is that it's the last academic semester.  Clerkship, the final semester, does not involve assignments and no new objectives (as far as I know) will be introduced.  I have a paper due November 11.  It's my last paper for this degree.  This is very exciting.  Watch me dance.  Oh wait, I'm too tired. 

I looked back on my older posts about my early placements describing what we do in those placements and chuckle that I had the impression that in normal childbearing we do "everything that a midwife does".  Clearly we are sheltered (probably on purpose, so as not to scare us off) from many of the extra responsibilities that midwives have.  In Normal Childbearing we learn to conduct prenatal appointments and births, and we learn basic clinical skills.  But the senior year expects that those skills are concreted (which they often are not) and focuses more on management - consults, writing letters, making hard decisions and having to be accountable for them, and learning gradually to do this job without someone telling you what it is that you are supposed to do next.  It's intense.  The number of births is about the same as all of the other placements, although of course that ebbs and flows as births always do.  Sometimes it feels really unbalanced, and sometimes you're so worried about your numbers that you're afraid you won't be able to graduate on time.  The responsibility burden is high and a bit of a shock sometimes.

There's the practical part of it.  In living this, it's been a real emotional challenge.  I'm thinking of this point in my education as "transition" in labour - the hardest part, the part where I feel like I'm drowning and I don't know if I will make it out the other side.  It can be isolating sometimes - all of my blogging about work life balance sometimes just does not account for the fact that when the pager rings, you still have to go.  Even if you just stepped out the door to go for ice cream with your kids after not seeing them for a week.  Even if your family just arrived at your house after driving two and a half hours to come and see you.  The reality of it is really hard. 

I know I sound like I'm complaining a lot.  I am. Even half way through 4th year, I still feel like I am adjusting to this lifestyle, tweaking the challenges of meeting my needs (food, exercise, social interaction) with those of my family (quality time, housework, food preparation) and my placement which basically has to take priority over everything. 

I am close enough to the end, though, that I can see the light at the end of the tunnel.  Sometimes I reflect on the privilege it will be to finally be able to offer midwifery care in my own style, after having learned the styles of many other midwives along the way.  I am still continually amazed by the hard work that birthing women and new mothers are willing to put into their experience, and that inspires me.  Its incredible how similar the process of becoming a midwife is to becoming a mother.  And these women do it, over and over again they show me that they can surpass what they thought they were capable of and come through on top of it.  And if they can do it, so can I. 

On being a learner and making mistakes

There are many points in my life where I have found myself in the position of being a learner.  Some times are easier to step into this position than others.  Of late, I have found that the majority of my time awake is spent in the role of the learner. Much of this, of course, is because I am a student, but I'm also a student of drumming and would be a much more diligent student of yoga and dance as well -  if midwifery and drumming did not occupy so much of my time and head space. And above all of these, I have my children - likely the greatest learning adventure of all, and often the area that I feel I have the most that I still need to learn.  In all of these things I consider myself fully a learner - not only am I not an expert, but most of my time practicing these is still spent struggling with self-doubt or actively learning a new skill - with a small amount of this time being spent consolidating skills that have already been learned.

Being a learner comes with its own unique privileges and challenges.  Since I truly feel that I spend almost all of my time in life currently as a learner, I thought I would reflect on these today.

Making Mistakes
The learner has the immense privilege of being allowed to make mistakes without severe repercussion.  A patient teacher expects the learner to make mistakes because very little in life comes naturally without practice.  A patient student expects this of themselves as well; this is a concept that I understand theoretically.  Practically, however, swallowing your embarassment when making mistakes is not an easy thing to do - especially when it involves the bodies of the people you are trying to help.  Or the perception (whether it is true or false) that people are depending on you to do the right thing. Some how, we as learners have to find our own personal way of carrying on after a mistake has made.  The client still needs to receive care.  The music must continue.  I've also learned lately that I blush very deeply when I've made a mistake that I'm embarassed about.  Sometimes I get flustered or anxious - especially when the people around me expect me to continue my efforts despite the fact that I messed up the first (or tenth) time.  I'm happy to learn this about myself.  Overcoming it is a lifetime ambition :)

I wanted to write about humility as well, but I'm really not sure where its place is.  You have to humble yourself to learn from another person.  You have to step down from the things you think you know, and the things you think you are good at, in order to really hear what a teacher is saying to you.  That being said, I am also afraid of losing the things that I felt like I knew; the values that I held so dear.  I don't want the act of learning to also be accompanied by the act of forgetting what I knew before.  There must be a balance somewhere. 

Empowerment in GETTING IT RIGHT!
Fortunately I have gotten far enough into my education that I'm getting some things right.  I was happy when I looked back on my learning objectives for the beginning of the term to see that some skills, like vaginal exams, catheterizing, IVs, and catching babies in fantastic and interesting positions have become things that I actually feel very confident about now.  Doing these things without making so many mistakes is empowering.  Leaving a postpartum visit that I've done completely by myself, and reflecting on it thinking "Yup; I covered every base. I feel like I really helped those people!" and hearing similar praise when I check in with my preceptor is so satisfying. 



Even though I'm now in my fourth year of midwifery education, the learning curve this semester has been the steepest yet (if that is actually, physically, possible).  That's because this term, we had to shift from acting like "a learner" to acting like "the midwife" - making the decisions and plans, and most importantly, understanding the heavy repercussions that those decisions can have. This came with *many* challenges that I had no idea were coming until I stumbled upon them. It was *not* easy. But this term, folks, is DONE. And I'm still alive. Now, for a month, I can focus my learning more on things that I find recreational (but for which I have just as much learning to do).

 I have spent *so* much time learning this term, that part of me craves to be an expert about something.  I want to be able to answer a question with certainty, without turning to one teacher or another for reassurance. And the other part of me is terrified that I will actually have to reach a point where there *is* no teacher to look to for reassurance (at least, in midwifery anyway).   But learning, of course, is a lifelong journey. No one is ever really finished with it until they are finished with life.

It is a good day in the life

It feels so good to be writing what I'm writing tonight.  Midterms are the day after tomorrow, and I'm starting to feel ready for them.  Placement is going extremely well.  Actually, this week it has been a bit on the slow side, but if you've read my other blog posts you'll know I don't exactly have a problem with that! 

Now that I think about it this has probably been my first post since the senior year placements have begun.  What a story to tell!  I'm feeling good and settled into this new clinic.

By gosh there was one hell of a learning curve to move through before I got to this place of somewhat "balance". Hard enough that I even started to daydream about what my life would be like if I just quit school right now and became a stay at home mom again. (HA!). But no really, I guess that's just indicative of how big of an adjustment it is to move into a new role and back into a challenging lifestyle. Finding childcare in a brand new community was not easy. I think when all was said and done, we interviewed over 20 people. Right now, we are juggling 3 different childcare providers to make sure all times that my partner is away are covered.  I also chopped my dreadlocks off right before I started, because I was so darn worried about being judged by clients and preceptors and dripping wet hair on someone if I got paged right after a long shower.  I do have to say I miss them (I always do when I don't have them, I've cycled through this a couple of times now) but this is my first time with short(ish) hair and I'm enjoying it all right.  But really now that I'm here, I realize the dreds would have been just. fine. 

Also, although my third year was spent in many dynamic roles, what it wasn't strong in was clinical opportunities.  I learned a lot of things, more at some placements than others, and many of those things do inform how I'm learning right now, for sure.  But being a midwife felt like it was completely brand spanking new to me again.  It had been a year since I had given an informed choice discussion.  A year since I had taken blood.  Almost a year since I had even caught a baby! It was a bit unnerving. 

Thankfully the clinic I'm placed in has been fabulously supportive.  I'm in an environment of tremendously friendly and supportive people who know what kind of feedback helps me to learn and empowers me at the same time.  So, despite the challenging first couple of weeks where I felt like an idiot making a thousand mistakes on things that I used to be *SO GOOD* at, they got me through it and over the course of some of our busier points, had me feeling pretty darn good about things.

So I guess that's a pretty good way to end the note on things.  I almost wish that I could move back in time a month or two and read this so I could have worried less.

In memory of the departed dreadlocks.  May they rest in peace. 
And also in memory of that awesome retreat.  May I never forget the joy that rhythm and dance bring to me.

Work life balance has been the story of my life. 

It started when school started and I needed to "balance" my "I'm so sick of being home with my kids and not feeling productive" with the workaholic that emerged learning about something I love so much as midwifery.  Then it intensified when I started clinical placement and had to risk my kids forgetting what my face looked like because I was gone so much. 

Work life balance is a challenging concept for many people, in many kinds of careers.  But in a caring profession like midwifery, it can be more like a daily challenge.  How do I balance the needs of my clinical duties, with the needs of my school, with the needs of my children, with the needs of my partner....and, do I deserve needs at the end of this as well?  Having kids and being in this program is REALLY HARD.  There.  I said it! Sometimes, when I've been out for hours and hours (or days) and all I want (need) is a shower and a sleep, but instead I find myself again cooking dinner and reading bedtime stories, I find myself wondering if I have a right to have needs when so many other people need from me. 

You know what the answer is?  You are damn right that I deserve to have my needs met.  In fact, I'm not going to make it through the program (or as a midwife) if I do not.  The lesson is how to convey this to family and preceptors without sacrificing the family or a passing grade.  This, I have yet to master in practice - but I'm working on it. 

I deserve to dance!

(and do yoga!  And shower!  And sleep!  and eat (*every time I'm hungry*!)

And you do, too!

 

 

SO - I'm reciting such a mantra, and I haven't even started senior year yet.  I've been blessed with a month off between placements - which is a bit of a joke, since we moved right in the middle of that month, and searching for daycare in a brand new city in which I have no established connections is a nightmare and a half (we have interviewed 10 daycare providers so far - I guess I'm really picky...but it is my *kids*, after all).  I will be lucky if I'm able to *start* my pre-readings for next week's intensive on the train down to Toronto, which is completely unlike me.  In all honesty, folks, I've become cynical recently.  I've learned that part of what I love the most about midwifery was missing this entire last year (of non-midwifery related placements) and I've missed it terribly.  That being said, this new city that our family has dropped everything to move to is turning out to be very cool and I'm already dreaming about a future here.  But who knows about that, since I haven't even set foot in the clinic yet!

Anyway - the reason for my blog post is an essay that I wrote for third year.  Its' long, so I'm actually going to include it as a link here.  But there has been an immense amount of talk in the midwifery student community about work life balance and I actually wrote my third year paper on it.  SO - it hasn't been graded yet (so bear with me), but I thought it to be an appropriate time to post my own contribution to the discussion.  Happy reading! 
Life in Midwifery: Managing Work-Life Balance Through Alternative Call Models