Time to Journal

My reflective journal writing this year has been erratic. I guess I have been scared off by I*'s cautionary words. Other than getting an experience off my mind, I don't see much benefit from not using first names because as time passes it will be even more difficult to recall the people and the event.

Where I was once confortable and enjoying journalling, I now put it off because the purpose is clouded.

However, I feel more relaxed relating learning events at university. Today was the assessment. The woman who assessed me was difficult to read and I don't even know if I've passed. I know I checked everything, but did I articulate these sufficiently?

I have updated my son’s

I have updated my son’s page with some rugby photos from his game yesterday. You could visit his site and sign his guestbook. I am sure he would like that =)

Safe Journalling?

It has been far too long since I have written in my journal. It is interesting the caution with which journals are used because of the potential for them to be used against a midwife. It all comes down to communication. I consider a journal to be a conversation with myself that I can read later and learn from and chart progress. However, a lawyer would probably read it differently.

I am not sure whether I will use a reflective journal as an independent midwife. A comment in my conversation to myself could be misconstrued by a third party. I enjoy and appreciate the value of journalling but only if I feel safe.

I am a little bit frustrated at doing so few births this year but can appreciate the benefits for my family. I* put it really will when she said some of us are getting quality instead of quantity. However, one good thing about quantity is that you remember and build habits from repetition.

A great experience for me has been L*'s use of accupuncture. The most incredible evidence of its effectiveness was during F*'s labour where she was contrcting 1:10 and immediately following.during needling contractions jumped to 4:10. Then unfortunately following removal of the needles, contractions became incoordinate and irregular again. I was so amazed that I asked the couple if I could photocopy the relevant section of the CTG tracing.

Lots of other things about that labour were difficult, but at least I have a high point to recall. One try with the prostin, accupuncture, two days, and ARM, more accupuncture, two tries at cannulation, syntocinon, entonox, three tries at an epidural, a dural tap, and finally a forceps delivery. No wonder midwives practise defensively and don't write reflective journals. Mustn't forget the resuscitation because baby stopped breathing and the blood patches required for the spinal tap headaches.

I know I still feel the anger at the outcome of my stitches with my first birth and that the scars and damage is permanent. For something relatively minor I still felt cheated . So how does a woman with a traumatic birth deal with it? Interestingly there is a group dealing with birth related post-traumatic stress. Maybe F* might be interested.

I got great feedback from L* on my evaluation form. I got two passes so far so I am getting through. The only cloud on the horizon are the exams.

I just have to include

I just have to include a link to Get Organized At Home! Tips and Tools from OrganizedHome.Com because this site is great. I have started little steps to getting this family and household organised. I think a little bit of distraction tactics from assignments and exam swot.

Only thing it doesn’t have is a solution to prevent kids from unrolling an entire roll of toilet paper and how to roll it up so it looks like it never happened. Why is it that re-rolled toilet paper somehow seems recycled or not as safe/perfect/clean as the pristine roll the kids haven’t played with?

12 Feb 2001 -

12 Feb 2001 - Jury duty - one of those democratic institutions that has probably operated the same for eons.

Last time I did jury service I was selected for two trials. Maybe something about me comes across as being good jury material.

Mine was the first name out of the ballot […]

“Hello!” *wave*I’m still here. I

“Hello!” *wave*

I’m still here. I just happen to be flat out busy with university. All I have time for is clearing my email, running the New Zealand midwives list, and some graphic work. Squeezed time has eliminated my own web page maintenance and my Net Sisters work.

Some fun web news - I have now got kiwinessie.com, and nzmidwife.net even though I have no time to set them up. I couldn’t resist the low fees charged by Go Daddy so now maybe I am officially a domain addict?

Another piece of news. I am 1/3 of the way to achieving the 30 births required for my midwifery degree. 10 down and it’s a relief to have progressed that far. I’ve got some Little Gems to add but they can wait until another day. Time for some sleep

Different Expectations

I didn't get much written last night because I had kids climbing all over me. It's not much easier now, but best to get it done.

I'm not meant to use full names, or even any form of recognisable identifier, in my journal for privacy reasons. I find this difficult in some ways because at the least a first name aids recollection. I think I will continue using a first initial and careful editing for my online journal.

S*'s birth was arduous. We first saw S* at 8:30 am on Thursday and she was contracting regularly but was still comfortable with them.

Later on in the day L* attended J*'s home birth. A lovely home birth that I didn't attend because J* had plenty of support, a lack of space, and I hadn't met J* earlier.

L* phoned at about 8:30 pm and let me know that S* was anxious and in pain with regular contractions and we were meeting her in the hospital at 9:45 pm. S* was 1 cm dilated.

S*'s anxiety and pain perception dictates a slow process. On arriving, contractions slowed, and were further slowed by a bath. However, S* was in pain to the extent that she requested and was given pethidine.

On vaginal examination she was still 1 cm. Further on through the night it was decided that syntocinon would be required to augment labour. S* was not coping well because she would not consider returning home, has a needle phobia, and was objecting to the need for vaginal exams and absolutely refused an artificial rupture of membranes.

It was a slow process to talk S* through the importance and need for these interventions in consideration of her dilatation and pain tolerance. We almost had a meltdown when L* suggested that S* was heading towards a caesarean section.

J* was consulted about S*'s labour.

S* surprised all of us when she dilated from 3cm to 6cm as it was unexpected. So a vaginal birth was back within reach. The trickiest part was managing the epidural as even with a full block S* was not receiving relief for right hip pain.

L* left at midday because she was exhausted. I stayed for two reasons. I wanted to be there as a familiar face and for some form of continuity for S* and L*. The second reason irritated me because I considered that if I left before the birth I couldn't actually count it in my numbers even though I had been in attendance for 15 hours.

It was such a relief that in the end S* had a vaginal delivery of baby assisted by J* using forceps. It looked like S* was bleeding heavily and L* confirmed that S* had a PPH.

A* commented to L* that I wasn't acting in a strictly observing capacity and something I did was inappropriate. I'm not clear what it was, so will try and gt the information from A*.

I was quite upset and tried to take it on board as something to consider and learn from, but without specifics it's a bit difficult. Some factors I have since rationalised about include the fact that I was tired, I had established a relationship with S* and L*, and that for S* and L* my communication was acceptable. What I need to think about is the colleague and professional relationships where two-way support and respect is crucial. Further to this is that I feel that L* is satisfied with my level os interaction, otherwise I feel that she would have said something further in respect to her perspective of the birth.

Our relationship is developing and I am really enjoying watching and learning from L*. Life is crazy busy but I really love what I'm doing.