Independent Midwifery

My first day with N* was fantastic. The first woman we visited was the first woman whose birth I would attend. N* asked me to take D*'s blood pressure. I felt like a complete wally when I couldn't hear anything and Noreen turned the stethoscope head around.

D* was 38 weeks, gravida 3, and easily palpable. Next time I do a palpation I should really do it without watching N*, or before N*. D* will have a planned induction on 8 August if she does not go into labour prior to 40 weeks gestation. Baby was ROL. D* may not have much support for rest prior to the birth.

A* is gravida 2 and at 24/40. She had an amniocentesis to identify risk of Down's Syndrome. Amnio came back negative and identified baby is a boy. She has difficulty with her daughter C* who requires a special diet. The concern is in respect to family dynamics and risk of problems if baby is difficult. Constipation a problem. Decision points covered.

Back to School

Back at school. I am relieved to be back on track after a wonderful, but somewhat tedious, school holidays.

It already looks as though assignments are going to be very heavy going in September and October, and we're to plan to do the births then too.

We get pagers to use this half. It seems to somehow raise the importance of our courses by being on call.

I've contacted N* and briefly outlined what I need to achieve. She is absolutely fantastic and we have scheduled a meeting for this Saturday to go over my schedule and discuss goals and objectives. N* will also permit me to attend all of her Monday scheduled visits. Lucky me!

A 'B'

I was really disappointed in getting a 'B' pass in Introduction to Midwifery for the health concepts assignment. I shouldn't be, because of the amount of time I spent on it, but the marking indicates that I was marked down mainly because of layout. I have learnt something, but a 'B' for the assignment means a 'B' for the course. I'm worried because I made the same mistakes in my interview assignment.

Shaped by Practice

Nearly the end of my clinical practice. It has been fantastic and I have learnt from every midwife I've worked with. Even though J* had had a large break in her career she had heaps of experience. While she respected the old school midwives, she tended to a social model and definitely believed that less intervention was better, but didn't mind the odd formula feed if that was the woman's choice.

I got a completely different perspective about autonomy and safe practice observing and working with J* (a different one). As an independent midwife working as a casual resource at the hospital she was very cautious in her measures when caring for women. This included expressing breast milk and giving it to babies on a spoon if baby had not had a reasonable feeding atttempt before 8 hours. Also in respect to autonomy she believes that midwives working hospital shifts do not really have the same right to make care decisions when they go home at the end of a shift and leave care of the woman to the next midwife.

My most enjoyable experience was working with B*. She was a direct entry midwifery graduate and is really easy to talk to and understands my perspective because she's been through it. She was accomodating, helpful and friendly. What I most liked was the response she got from women. Everyone seemed relaxed and confident in the care and advice she provided. Out of the three she, I believe, best served the needs of all women she cared for.

I will continue to experience different ways of practising and differend personalities. I can see that i will take it all in over the next three years and mould and shape my own unique style and methods for practice.

I am slightly curious about how I will react in my first emergency, at the first caesarean, at the first normal delivery, and after my first big mistake. Needles are another area of wariness and nervousness. Lots of firsts to come, but at least I survived my first clinical practice.

Experience

Two things I learnt today. First, when talking to a woman only relate a personal experience if it will create a sense of empathy for her. Relating my experience is midwife-centred instead of woman-centred. I could hear myself relating something and realised that it didn't contribute much value.

Second, and most valuable! It has been obvious and reinforced time and time again. Don't ever overlook or ignore experience just because I might have learnt differently, being proud, be feeling stupid, cocky and confident. Experience counts for more than the fresh new learning. Reading a book, doing an assignment or test, don't count for as much as years and years of experience. And remember that on the ward we are a team providing care. Remember all the bad, sad and silly stories whenever I go out on practice or after I graduate.

A good point J* mentioned was to trust my instincts. Also reinforcing the classes to look at "the whole person" not just taking obs. Consider their mood and coping and support as well.

Hospital Placement

I knew I would have heaps to write today. I didn't sleep very well last night because I'm worried about Adrian and nervous about today. I felt very guilty about waking Adrian up and getting him to take me to the hospital. This is exactly what I was worried about when I realised we would not have a second car before my clinical placement.

I was really nervous but felt prepared because I had read up in my practice handbook and planned to do the activity book that we had been given by our lecturer. I ended up working with J* and we were far too busy for me to even consider being nervous.

Everything seemed very haphazard. Apart from how busy we were I really enjoyed the day. Mums care for their babies and we care for the mums. I need to try and find some tomorrow to go over my goals with J*.

Assignments

On the rollercoaster ride now. I'm very pleased that so far I am getting A's. I know the first B or C will be a shock. I guess it's easier to do a good job when you enjoy the course material. Midwifery feels right every step of the way.

I have three assessments due next Friday and a life sciences test on the 13th of June. I really need to get the essays out of the way quickly so I can concentrate on the sciences.

I'm really looking forward to getting the stethoscope and sphygmomanometer this week. Then I can get lots of practice.