13Dec

End of the Semester

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Today I have my first day of rest in months. I have no homework, no papers, no tests, nothing to do.  But not really.

I still have two days at the hospital this week, and I need to prepare.

I need to update the website and prepare my business accounts for the end of the year to get ready for taxes.

I actually have reading for the spring semester already assigned, and when I get back from visiting my extended family for the first time in a year I have two solid weeks of daily clinical time to complete the semester that ends today.

So here is the truth, being in school and on the later half of my thirties is hard.  Balancing classwork and family is hard. Staying motivated to get up ridiculously early when I am tired all the time is hard. Keeping a business while going to school is hard.

BUT…

School is temporary, it will end and my life will continue.  The skills I am learning will help families all over the world. My family is supportive and understanding, and will help me finish.

Yes it is hard.  But I can do this.

28Nov

Semester Nearly Ended

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I wish I could tell you that I was excited about the semester being nearly over, but honestly I’m not.  I have one last paper to write (an issue brief on suggested policy change for midwifery) and two exams, so the workload is not a big deal.  It is the clinical time that is overwhelming me.  I got a late start with both midwifery and family practice clinicals, which everyone says is no big deal because I can make up the missing time over the summer or with my “extra” semester.  But not really.

I want to apply to do an internship with a department of public health in maternal child health over the summer.  This would be a 12 week program, and will leave me a total of 2-4 weeks in Honduras and then classes begin again.  Not time to make up clinicals this summer.

My final semester will be all public heath classes, and I will have two days a week without classes (I think).  But I will also be finishing my amazing thesis, so I cannot plan to be at clinicals on my days off class.

Which leads me to the problem with this semester.  I’m at clinical every day I don’t have class, right through the break until classes start again.  I will get no break, no breathing room.  Quite frankly, I’m exhausted.

But clinical doesn’t have homework like classes do, and I won’t have to write papers.  And a very nice midwife explained that I can do a half-shift at the hospital if it works better for me, or to call in and see if anyone is on the board before I make the trip to sit around for five hours.  I know I can survive this!

18Oct

The World Didn’t End?!

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Just a reminder to myself that I stepped away from my internet “duties” and the world kept right on spinning.  Good thing to keep in mind when the birth world gets a little hectic.

17Oct

Unplugging

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So last night I couldn’t sleep.  I have a few busy weeks coming up and my mind would not let go of all the work I need to do.  I hate nights like that, when I am so tired but my body will not fall asleep.

Needless to say, I am finding it hard to find anything worthwhile to share today. I’ll just be doing finishing touches on projects and papers and preparing for tests. Not exciting, but it is my life. Time to unplug from the digital world and live in the real one.

14Oct

Memorizing Medications

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Sometimes I think I must be really smart.  I understand so much, I have learned so much. Then, I have to prescribe a medication and I realize I’m not quite as brilliant as I would like to be.

I wish I knew why medications were so hard for me, but I don’t.  There are just so many names, and they are so similar, and there is so much to remember about each medication.  It feels like I’ll never have a good grasp of this knowledge, so how could I ever provide good care to my clients. Then I wonder why I ever thought I could be a nurse, a nurse-midwife or a family nurse practitioner.

OK, pity party is over.  I know the only way to really learn them is to use the information.  It is hard, but I’ll get it…eventually.

13Oct

Food Allergies

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I went to a conference recently because I wanted to attend the session on food allergies.  I like conferences, but sometimes they can be too similar to school.  This one was no exception, but the review was good.

Anyway, what I wanted to share was some amazing advice from the physician who shared about allergies.  They are changing the standards and the recommendations against staring allergy causing foods later.  Apparently the delayed introduction is not working to prevent allergies, so they say there is no reason to hold the foods back.  If a child is going to be allergic, they will be allergic.

Second big news, no reason to screen for a food allergy unless a child has had a reaction to the food.  It seems it wasn’t effective enough at identifying those most at risk for bad reactions, and wrongly identified some children as allergic who were not.

You can read the new clinical guidelines here: http://www.niaid.nih.gov/topics/foodallergy/clinical/pages/default.aspx

Enjoy!

12Oct

Certified Educator, Again?

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I think sometimes I must be a glutton for punishment.  There can be no other explanation.  This summer, while assisting a friend at a doula training in Nairobi, we talked about the things we have done, and the things we plan to do.  As we talked I realized how important some things look on a resume–especially the right trainings when you are trying to work overseas. I had let my childbirth education certification lapse a long time ago.  Suddenly I see value in getting certified again.

Why?  Because this summer I’ll be working in hospitals in Honduras. Being an RN from the USA helps get my foot in the door, but if I want to make a difference I need to have credentials they can trust.  Honestly, to be successful at most things people are going to need to trust you. I can create a class for the hospital very easily. But I need to be someone they want to help them create a class, or it will just be something I make and they don’t do.

So next week, I’ll be skipping class to take a certification exam with a well-respected international childbirth education organization. I see it as a small investment in big changes.

Funny, I am now trying to be certified with an organization that was seen as the major competition for the organization I first trained with.  Shows you just how much you can learn and change in 12 years–and how much you can appreciate those changes.

11Oct

Apprenticeship

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I wanted to take a minute to share a frustration I have.  When my direct entry sisters criticize nurse midwifery because it does not follow the apprenticeship model, I’m not sure they understand how nurse-midwives are trained.

Nursing education is not like medical education.  There is classroom content, and there is clinical content, but these are not separated. You learn new things through reading and class, and then you go out and do them with your preceptor.  Sometimes things line up beautifully, and other times it doesn’t. When it doesn’t line up you may end up spending hours researching things you are doing in clinical before you get to them in class.

This is very similar to the apprenticeship system used by my CPM friends. Both systems provide the learner with opportunities for a new midwife to be trained by one midwife, or multiple midwives.  Both systems provide the learner with hands on learning.  Both systems expect the learner to be providing care long before they are proficient. Both systems provide the learner opportunities to learn about the interaction with families and how the presence of a midwife. Both systems usually expect the learner to be completing book learning at the same time.  The systems just use different titles.  Nursing calls the midwives who train you “preceptors,” but it doesn’t change the similarities to the direct entry apprenticeship.

All this to say, if you were thinking about a university nursing program but were turned off because you wanted an apprenticeship, you might want to look into the program again. You might be pleasantly surprised by what is possible–like apprenticing with midwives at a free-standing birth center or attending homebirths. Just pick a school close enough to midwives who offer these services and make sure it is a school where you can have a part in picking your clinical experiences.

 

10Oct

Menopause and several things like it

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Next week I will be presenting a workshop on menopause. This is to be my very time-consuming project at the end of my midwifery training. Except it isn’t the end, I still have a ways to go (combining degrees and all).

It is interesting to think about how I got to this point.  Ten years ago I would never have guessed I would want to present on menopause, I was still very birth focused.  But as I learned more about women’s health, my interests widened.  I never would have thought I’d like working with women to treat and prevent STIs, but I do.  Dealing with menstrual irregularities, love it. Birth, it is still there.  But it is only a piece of the whole woman, and I’ve always been about the whole woman.

I share this because as you consider your path to midwifery, I think it is important to think about all the aspects of working with women and families that appeal to you.  If I had chosen a path into midwifery with a more narrow scope, I know I would have longed for more and burnt out quickly.  For other women, having such a broad range of practice would only make them wish they could spend more time at births.  Who are you, and in what ways do you want to work with women?

07Oct

Into These Hands, Wisdom from Midwives

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I’ve been reading Into These Hands for one of my midwifery classes so I thought I would share a little about it with you.

The book is a collection of stories from a variety of midwives who have been involved in birth for over 20 years each.  They represent hospital, birth center and homebirth midwives. They represent DEMs, CPMs and CNMs.  They represent many ethnicities and work everywhere from rural areas to major urban centers.

I’m personally not liking the book as much as I had expected.  I find some of the stories difficult to read due to writing styles and the repetitive nature of the book.  But it is still interesting to learn about the different ways the highlighted women came into midwifery.

My struggle is not really due to the book as much as to who I am and what I am training for.  I am a public health midwife focusing on international issues.  This book is very much written with an agenda for one definition of a midwife that does not fit my international understanding. But that is to be expected.  It is a book for Americans exploring the growth and role of midwives in America.  Since that is my main struggle with the book, I have no reason to think those of you without an international focus will have any frustrations as you read.

You may enjoy this book if you are looking to be inspired by stories of women working against the medical system to promote homebirth.  You may enjoy this book if you would like to see how midwives follow the midwifery model in a variety of practice settings.  You may enjoy this book if you want to learn about personal stories in the evolution of midwifery in America.

 

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