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Cruising right along

Posted Nov 11 2012 1:27pm
I'm coming up on the halfway point of my clinical hours.  I really am just moving right along on my hours, type of patient encounters, and some continuity clients.  It's not easy getting true continuity when you do clinicals in a big practice.  There are a total of ten providers in the group (MD, CNM, NPs) and the prenatal visits are basically rotated through everyone.  I've had quite a few births where I have never even met the woman before she enters labor :-(    <---- face="face" p="p" sad="sad">
My preceptor is wicked cool though.  When we get morning report in the hospital on the postpartum clients, she let's me choose who I want to round on and see.  That way I get at least *some* continuity with clients I have seen prenatally.  For the great majority of my time on call, I also take first call, which means that when a woman comes in, I assess her first, then give a full breakdown of the clinical scenario to my preceptor, along with what I think the differential diagnosis is, what testing we might want to do, and how to proceed/treat (if needed).

I'm certainly getting the hang of how a midwife's life really feels.  I run on very little (or lack thereof) sleep most times I am doing a 24 hr call shift.  I definitely feel my stamina slipping by the end of the call shift if I haven't gotten even a little nap/rest.  When we're busy, my adrenalin keeps me running.  When we're not busy, my 8 bajillion cups of coffee are what keeps me going.

I'm almost at the halfway point for my minimum required number of births --- yeah!!  But, I'm not on call at the hospital for another week or so.  Boo.  Doing some office hours this coming week though.  Yeah!

My best advice for those who are considering the midwife pursuit as a career --- it's more like a lifestyle.  As for clinicals and working an RN job --- now I am truly seeing why it's best to try to not work as much as possible while doing your clinical practicum.  I am TIRED.  I currently work three shifts per week for my paycheck (we truly need it, or I would not be working), and then I have to try to schedule my clinical hours around that.  Not easy to do when my schedule is due to be finalized at work before I have a copy of my preceptor's schedule!!  I do clinical hours anywhere from 8 hours in one week (one office day), up to 50 hours in one week.  And anywhere in between.  I think my average is about 24 hours of clinical time per week (office and/or hospital call).  I think my preceptor's full time schedule is about 48-60+ hours per week, depending upon her call schedule that week.  It would be so awesome if I could just totally follow her schedule, and not have to work at my RN job at all.

So, to sum it up --- if you are seriously considering going to midwifery school, see if you can get away with not working a paying job (or very minimally working) so you can follow your preceptor's schedule as much as possible.  I think that I would get more out of my clinical time if I could follow her schedule more than what I do right now.
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