Saturday, August 25, 2007

I wanted to share this post with you...an awesome birth story (with pics) that took place in *gasp* omg! a hospital. There's a bit of a negative undertone towards CNMs which may or may not be intended. I don't know the author so can't really say. It's unfortunate that there seems to be such a need to divide LMs and CNMs. We are all midwives...why can't we support each other as such? An interesting question I plan to ponder at a later date but need to head to the gym now with my hubby.

Lotus Birth

I've just been learning about Lotus birth and thought I would share with you all...

Apparently this is a practice where instead of cutting the cord once baby is birthed, the cord is left intact ...meaning the placenta will deliver still attached to the baby. The cord and placenta are left this way until the cord detaches from baby on its own. The placenta can be treated with salt and herbs to dry it and decrease smell (although If you have a cat they may be very interested). The concept behind this practice is that the baby has a slow transition to detachment from mother's body. A midwife I spoke to has researched this and found no evidence that it has been used in other cultures nor is their any 'scientific' evidence to back the validity of the claim that it also allows baby to get maximal blood volume (beyond what is achieved with just waiting til the cord stops pulsating). But some people just like the concept, which is ok. To each his own. I'm a firm believer in delayed cord clamping/cutting...but not quite this delayed. I'm clamping that sucker once the pulsation stops (unless momma wants otherwise).

Here are some links to check out if you are interested in Lotus birthing...

Dr Sarah Buckley She has written some other great articles which you can find on her website http://www.sarahjbuckley.com/ .

Sarah Wickham

Tuesday, August 21, 2007

Birth I

I was just over at Sage Femme's blog checking out her latest posts and she has a really powerful story about hospital birth...it will make you uncomfortable...but being uncomfortable can lead to change I hope.

One of her readers posted a comment about the lack of requests and desire for a low intervention birth from the women she serves. I think this is interesting because I have seen it. Some women really do believe that hospitals are the safest place for having a baby. Hell, I don't even want to be in the hospital if I were sick. They are filthy, disgusting places. I shuddered at letting my kids come to visit my husband when he stayed overnight at one after his AICD was put in.

The problem is one of education...for society as well as for providers of care. I could sit here and go on and on about the awful things I have seen but there are plenty of negative stories out there. We need more women telling about their wonderful, beautiful experiences. People are always so quick to share the bad, but we need to get the good experiences out there too. We need to stop ruminating on how bad hospital birth is and figure out what are we going to do to change it.

*sigh* I've got to get off here but stay tuned for part II of Birth.

Quick thoughts

No word yet on the job.

Clinicals with the students are over! Woohoo! I get a break from trekking all over the valley, listening to whining and bitching that I could just as easily hear at home.

The most commonly heard phrases from students...

"It's too much paperwork" Well, if it was easy everyone would be doing it.

"Why do we have so many clinical hours?" Uh, because we prefer to train you sufficiently to not kill a patient.

"Why do we have to pick a patient the day before? Real nurses don't do that" Hmmm, you aren't a real nurse and it's really questionable about whether you ever will be!

Me to students asking these questions "Is it possible that maybe your faculty know something about nursing education that you don't?"

FACULTY = nurses with MSNs, BSNs, MEds, PhDs, and a combined total of like 200 years experience in various fields.

Student = CNAs, LPNs, bartenders

Go figure.

Seriously though, I love working with the students for the most part - but you can definitely tell those adult learners from the 'others'.

So we have a great faculty - really smart people who all get along and have fun...except for the one I will call the Lone Dinghy. LD for short.

LD likes monkies...she went to Borneo recently for two weeks to play with the monkies. She brings cat food to work to feed the occasional stray. No children. Likes horses. Loves to sunbathe - even after having 2 cancerous growths removed. She looks a little like a prune. She wears outfits to work that I wouldn't wear outside my home, to even water the plants. We had a faculty meeting last week, from which she was absent (she doesn't attend any meetings, nor have lunch with any of the rest of the staff). The dress code for faculty was discussed as complaints had arisen that someone was wearing streetclothes to clinicals - and not even appropriate street clothes. See-through stuff...no bra (like LD today)...open toe shoes...etc. We are all looking at each other wearing scrubs, wondering what planet this person is from.

Now, this all wouldn't be so bad if LD was a good teacher. I did the evaluations last sequence...I felt incredibly sorry for her as the students tore her apart. Apparently she was cussing in class, telling graphic personal stories, etc. Her syllabus? Out the window apparently. Tests on knowledge required of seniors, not freshman.

Oh, and if she goes near a computer, it explodes apparently. She won't check her email, use the website, etc. She relies on everyone else to clue her in to what is going on.

Ok ok, the bitchfest is over. I love my job :) Not as much as I would love a midwifery job but close.

Sunday, August 19, 2007

Withdrawal

*banging my head against the wall*

I've decided that I am having withdrawal from school. I need to be stressed out and overworked and spread as thin (this is the only kind of thin I will ever be) as possible by the demands of a full-time job, full-time family, and full-time school. School will fill the empty void left in my life upon graduating from midwifery school. Let's face it - I've become addicted to knowledge. I have even contemplated med school! But I realize I would be doing that for the wrong reasons (mainly my desire to not be beholden to a medical establishment, and not being able to get a job so far). Forget med school - I just don't want to even get sucked into that system. And I want to give a little more time and attention to my family than med school would allow for.

Now, the PhD on the other hand...I have said for quite some time I would pursue this. I can do it at my own pace and there is no oral defense for the dissertation (woohoo). I chose Clayton College of Natural Health to do a PhD in Naturopathy. I plan to get started in the next couple months...just gotta get the finances situated so I can make the down payment for the tuition payment plan. Once I finish this I am done. No more school...

Well, maybe the FNP program at Frontier...

Saturday, August 18, 2007

Do you ever wonder what cats are staring at - it appears they are staring at a blank wall or some other inanimate object and are totally fascinated by something. Being a cat-lover and having had cats all my life I have often pondered this. I have come to the conclusion through much ...uh pondering and soul-searching....that cats are insane or seeing otherworldly things. The cat stares at the wall...there's nothing there...no bug...no fuzzy...nothing. So is the cat seeing something scary like that movie where only the little kid sees the creepy things? Or is the cat mentally unbalanced?

On that note...what about this cat Oscar who curls up beside residents in a nursing home shortly before they die, essentially predicting their death? Maybe this cat is evil....mwwhhhhuuuaaaa!

Maybe we don't understand cats like we think do...

A Cat's Diary

Day 183 of my captivity.
My captors continued to taunt me with bizarre little dangling objects. They dine lavishly on fresh meat while I am forced to eat dry cereal. The only thing that keeps me going is the hope of escape and the mild satisfaction I get from clawing the furniture. Tomorrow I may eat another house plant.

Today my attempt to kill my captors by weaving around their feet while they were walking almost succeeded. Maybe I should try this at the top of the stairs. In an attempt to disgust and repulse these vile oppressors; I once again induced myself to vomit on their favorite chair. I must try this on their bed. Decapitated a mouse and brought them the headless body in an attempt to make them aware of what I am capable of and to try to strike fear into their hearts. They only cooed and condescended about what a good little kitty cat I was. This is not working according to plan.

There was some sort of gathering of their accomplices. I was placed in solitary confinement throughout the event. However, I could hear the noise and smell the food. More important, I overheard that my confinement was due to my powers of inducing something called "allergies." Must learn what this is and how to use it to my advantage. I am convinced the other captives are flunkies and maybe snitches.

The dog is routinely released and seems more than happy to return. He is obviously a half-wit. The bird, on the other hand, has got to be an informant. He speaks with them regularly and I am certain he reports my every move. Due to his current placement in the metal room, his safety is assured. But I can wait.
I had my second interview last Thursday for this practice I would really like to join. I am cautiously optimistic. I say this because the last two jobs I really really really wanted didn't come through. Now I know you are saying to yourself, well that happens. But I was led to believe that they were very serious about me. The first one was in Pennsylvania - the director told me over the phone that she wanted to offer me a position and if I couldn't get out there for an interview they could work around that. I was able to go for an interview so I met her and the Chief OB (this was a hospital-based midwifery service). Befre I left that day she said she was ready to offer the position but would need to talk to the OB as a courtesy. I must have bombed that interview (although I didn't feel like it went that bad) because the following week, I got a Dear John letter from her saying they just didn't want to hire another new graduate (they had hired another one not too long ago)! I was so bummed out because I was ready to accept the position. But in hindsight, it was for the best. We decided that moving out of state was a financial burden we were not willing to take on at this time. Besides, we like it here.

I had another job offer in NJ while I was out in PA making rounds - was interested but decided for the above mentioned reasons not to take it.

The next job that really disappointed me was for a Women's Health Nurse Practitioner. They are a holistic integrated practice and I really liked the OB and office manager. They were intrigued by the possibility of adding a midwife as the OB backs lay midwives. Unfortunately the hospital they were moving to (brand new state of the art blah blah blah) does not credential midwives. I assured them that I would be interested in a in-office position (something is better than nothing since I can feel the knowledge seeping out of my brain as we speak!). They said they were very much interested. Then I got an email that they decided to continue to look but if something changed at the hospital they would give me a call. Again, I was really upset.

So here I am being cautiously optimistic - which means I am assuming I won't get the job even though I really want it and it went really well. They will let me know next week. Even if it happens it could take up to 3 months to get credentialed :P

Monday, August 13, 2007

Nursing students

I love adult learners. I hate pseudo-college-students-who-still-believe-they-are-in-high-school.

I teach nursing students at an associate degree level...meaning they have an associate degree and can take the NCLEX to become a Registered Nurse when they are done with the program. Now, please remember that I ultimately really like my job (even though I would much rather be working as a midwife!).

Adult learners = students who have obtained the maturity, either through age or through having been a student previously (such as getting a degree in biology, etc). to realize that learning is their responsibility.

Pseudo-college-students...= students who think faculty should spoon feed everything to them, that everything in the program should be changed to accomodate them, we are all so unfair, it's too hard, etc.

Nursing school = If it was easy, everyone would be doing it, do you really want the person responsible for making sure you don't die to go to an easy school?

Please don't get me wrong, I love teaching. But they can drive me insane some days. I wish I could make a deal with them...you be responsible, I'll make it interesting!

You can tell it's the end of the semester...I'm burned out and so are they.

Sunday, August 12, 2007

My third child

My third child is my best birth story...but sadly, it wasn't what I wanted, and I regret it. This birth was a huge inspiration to keep plugging away towards my midwifery education. I don't want other women to have regrets about their birth experience.

By the time this kid rolled around (again unexpectedly but wanted - we wanted three children but the girls both came when I was on birth control and to this day, still don't do things my way!), I was an RN and working on general education requirements for my bachelor's degree.

I had switched at about 16 weeks to a private ob/gyn (I was seeing the family practice group which involved seeing residents *ugh*). There were no midwives anywhere in the reasonably near area. I liked the idea of seeing one provider throughout my pregnancy and that provider being present for the birth. I wanted to establish a bond. I really wanted a female provider however, I found none in practice in anything but large groups. My provider was very nice - although he kinda laughed off my wanting to have natural childbirth. I prepared myself during the pregnancy by reading Penny Simkin's Pregnancy, Childbirth, and the Newborn: the Complete Guide, and the Birth Partner. Unfortunately, my husband is a birth idiot and had no idea what he was supposed to be doing or how he could help. So the hospital I would be having my baby at had doulas on call and it was at no cost to me. So I planned to have a doula.

I was feeling cranky, crampy, and tired so took some benadryl on a Tuesday evening to help me sleep. I had a five hour chemistry class (and test) the next day. I had been studying that evening and wasn't feeling good about the material!! So I went to bed about ten pm. I woke up at midnight, banging out hard contractions. I had had several bouts of 'false labor' (how I hate that term now) previously but felt like this had to be the real thing. My husband was calling his sister to come stay with the kids so we could go to the hospital. I decided to take a warm bath for pain relief while waiting (she lived almost 45 minutes away).

I couldn't stand it...being in the tub was incredibly uncomfortable. Which was a bummer cuz I really wanted to shave my legs. Now I haven't met a laboring mom yet who cared whether we noticed if her legs were hairy or not at the time a 7-8 pound baby is coming out of her cootchie. It usually seems to be the least of her concerns (and I certainly couldn't care less). But I wasn't at that point yet.

So I got out of the tub and got ready - my sister-in-law arrived and we headed out to the hospital. By the this time it's almost 2am and even though the streets were deserted, we hit every red light. We finally arrived at the hospital. I'm tolerating contraction pretty good as long as I'm upright and moving...we danced in the parking lot several times :)

Mistake #1 - I let the receptionist lady put me in a wheelchair to ride up to L&D. I could feel the intensity of my contractions so much more! So by the time we get to a room...

Mistake #2 - the nurse (who knows I want to go natural) gets me in the bed and checks my cervix (I know I looked pretty active), which was 5-6cm. She asks me if I still want to go natural or do I want an epidural now. I would have not ever have asked for an epidural but when she offered it I said yes. Oh wise readers, you are probably asking yourself what exactly she did wrong. You don't ask someone who is strapped in a bed experiencing intense contractions if they want you to make it go away. Well, no sh*t sherlock, the answer will be yes. Instead, she could have been supportive and helped me cope. And if she wasn't capable of doing that, then get the doula there ASAP.

Anyway, I got the epidural - which at least I can say was a great one. I had good leg control and absolutely no pain. My water broke and I was ten centimeters. I labored down so much that the baby almost fell out. I didn't tell the nurse I was pushing...*giggles*...I just kinda did the grunty thing because it felt so good. Wehn I felt like my body was starting to really push though I asked to come on in. She had me push once to see if she needed to call my doctor...

Ok, I'm a multip stating I really need to push....naturally she says "whoa, wait a minute, I have to get the doctor here". I'm telling her ok but you had better hurry.

The doctor arrives, the tech is setting up the table, and he asks me to go ahead and push. I do. He says "stop, wait until she's done setting up the table". What on that table do I need to have a baby??????

So I had a 7 pound 10 ounce baby :) The doctor had offered to let my husband catch the baby but he declined. I kinda wish he had though...I think it's so awesome to know that the first hands to touch this baby are mommy and daddy's.

Overall, it was a nice birth experience but I do regret that I didn't go natural. I know I could have. It was my last baby though, so no more opportunities. I don't want women to experience those regrets. I had a woman who wanted natural childbirth, second baby. She told me in the beginning not to get her an epidural even if she asked for one. She labored wonderfully and quickly, but towards the end did ask for something for pain. I checked her and found her to be 9 centimeters. I got her standing upright and she had the baby in 15-20 minutes. The position change was all she needed.

I don't know why there is such a general mistrust of a woman's body. Our bodies are so capable and strong, but this seems to scare others (read: mostly men). Well more on that later...(soapbox).

Breast implants: Cause of suicide?

Several studies have apparently shown that there is a correaltion between breast implants and increased suicide rates. The literature has proposed that these women started out with something screwy prior to breast implantation. On the Women's Bioethic's Blog , they are proposing wit the latest study that the difficulties following the implantation are the cause of increased suicide rates.

While I do agree that those difficulties (development of autoimmune disorders, surgeries, pain, etc) could certainly contribute to the increased incidence of suicide, I disagree that it could be the cause. I do believe these women had issues prior to the procedure - mental health issues to be exact. One has to ask what drives women to plastic surgery? Why do some women feel that in order to be happy, they need bigger breasts? Is it in part because our society places such a huge sexual emphasis on the breasts (breasts are for sex not feeding our babies)? Is it a self-esteem issue? I certainly think it is a combination - I just struggle with the notion that it could be 'normal' to want to surgically alter the parts of our bodies that we are unhappy with.

So what I am getting at is I believe that these women who committ suicide after implantation, were likely suffering from mental health issues prior to the procedure. We all know there are many unscrupulous plastic surgeons out there who will do whatever a woman wants for that dollar, even to her detriment.

Anyway, would love to hear what others think!

Thursday, August 9, 2007

Anniversary

Today is the 1st anniversary of my stepfather's death. It's not really affecting me as I don't normally pay attention to death anniversaries. But my mother, who moved in with us (which is also the time we moved here to Arizona), naturally is feeling a bit down. So we are going out for drinks when she gets off work. Drowning your sorrows - woohoo!

He was a psychiatrist and incredibly intelligent. He was 25 years older than my mother so she knew it was quite likely that he would die before she did. But it was a bit of a shock because it happened fairly quickly. He was diagnosed with lung cancer, which had metasticized from his kidney, last July. He died less than a month later in hospice. I flew out here for a couple weeks when he was admitted into the hospice inpatient unit. We didn't quite realize that it would be over soon - but he deteriorated rapidly and I thank god that I was able to be here for her and him...see him once last time.

Sh*t....now I'm crying. What bothers me more than his dying...we WEREN'T THERE WHEN HE DIED. We had been doing the bedside vigil for a few days, but my mom and I were getting stressed so we decreased the amount of time we visited. It bothers me so much, I feel so guilty. I never asked if he died alone because I didn't want to know.

It's funny, we weren't very close. I hadn't actually seen him in a few years, just talked on the phone occasionally. When he and my mom met I was 15. We didn't get along very well (I was a tough teenager to deal with sometimes). We got a little closer when I got older (and more mature).

He had done amazing things in his life - he really led a full and exciting life. He backpacked through the uncharted areas of the Cascade Mountains, liked sailing, gourmet chef, was a pilot in the Royal Canadian Airforce. Amazing man. He was 86 when he died.

Monday, August 6, 2007

Gimme that Rx pad!

I'm so excited!!!!!!! I got my prescription privileges Friday!!!! Woohooo!!!!! No DEA number yet - that's a wee bit expensive and I figure can wait until I get a job (???? Maybe 20 or 30 years from now) where I may actually need to write for controlled substances. So I have my certification, a licnse to practice in this state and the prescription deal...now if I just had the job to go with it!

But wait! I have a job interview next Monday...they had a birth center but have closed it. The practice however, continues - deliveries at a local hospital now.

Oh gotta go meet my daughter's new teacher.....see ya!

What happens in Vegas...

...stays in Vegas! Seriously though, we had a great time! We went to a couple shows, had a few drinks, and played some games :) The shows were great - we saw Thunder from Down Under (which was incredibly...stimulating) and the Cirque de Soleil's O (which was awesome and worth every penny). We came home ahead in terms of gambling (a couple hundred - woohoo!) and behind in terms of shopping (:p). Fun fun fun!!!!!

Now back to the grind tomorrow :(

Friday, August 3, 2007

HPV: Not always sexually transmitted?

Check this out...HPV has been discovered under men's fingernails . Is this really any surprise? Men sometimes have disgusting hand hygiene...there's probably a lot more than just HPV under those fingernails! Ewwwwwww!

Seriously though, check out the post on this cuz it's going to throw another wrench in the HPV vaccination works. First you had the deaths related to HPV and undiagnosed cardiac problems and now this. But maybe the men have it because...well, I hate to be vulgar...they are putting their fingers in certain places - namely women's vaginas. Is this going to be like a carrier state maybe? Interesting stuff and well worth keeping an eye on.

My oldest daughter is only 7...so I still have some time to sit and watch how this unfolds. Initially I was excited about the possibility but then the cardiac + HPV deaths freaked me out a bit. With the strong history of heart problems in my husband's side of the family I am not real keen on it anymore. We shall see...

For more info on HPV and the vaccination go to the CDC website .

Las Vegas

I'm heading to Las Vegas this afternoon for the weekend - woohoo! I need a break from the nursing students.

The students are burned out for the semester and so are the faculty. The seniors in particular are whiny. The freshman have been refreshing (no pun attended) - they are eager and excited to learn, which is fun. I will only be working with them next semester. I will miss teaching the seniors (some of them anyway) though. At least I will see them at the school pretty often. It seems that the seniors have gooten dumber as they go along. Their desire for independence sometimes gets them in trouble...

"Ms X, I went and performed open-heart surgery. It was so cool!"

"Uh, you did? And was someone there to hold your hand?"

"No, I didn't know I couldn't do this invasive procedure all on my lonesome."

*Bang my head against the wall a couple times*

"You must always have a RN or myself present for any invasive procedure as I mentioned at orientation and is also included in your student handbook"

*astounded expression appears on the student's face*

And so this is why I have brain damage by the end of the semester!

Did I find a job you ask? Why no, of course f*cking not. Although, I sent an email to the local ACNM chapter president asking for her help. She sent me an email back saying she had found me a job - this was Monday night. She gave me the contact info, so Tuesday morning I sent my resume and called and left a message. Haven't heard a word naturally. Do you think people are sensing my desperation? It's not like I beg over the phone or get down on my hands and knees begging. Well, not much anyway. So in the meantime I said to hell with it for right now...I signed up full-time with the school again to teach. I'm hoping that there will be a couple positions opening up at a local IHS facility at the end of the year. My old preceptor will become the director then and I think she plans to hire me. I would be totally cool with this.

I went to see a movie last night with my mom - 1408, which is based on a Stephen King short story. They usually butcher any movie made out of his stories but this was pretty good. The ending was a little screwed up - there obviously was some 'creative license' there to get a happier ending. Otherwise this was well-done. It would have been a difficult story to do because the whole movie is essentially about a man in a room...John Cusack really pulled this off. He had the whole to trip to the edge of insanity down really good - I mean, I do it all the time but I'm very practiced.

So Las Vegas here I come!!!!!!