Tuesday, January 15, 2008

La salud Materno y la salud publica

This semester looks tough, but I'm feeling quite calm about it so far.

Maternity – I’m going to have to really work on checking myself in this course. Angry notes on the first Powerpoint like when the prof said quite cheerfully that “the lithotomy position is essentially pushing uphill” and that it’s really designed to help “the provider deliver the mother”. Oh. Ouch. On one hand, thanks for being frank. I agree, as do a thousand other mothers who are on their backs right now, pushing uphill for the benefit of their providers. On the other, WHY ARE WE SITTING IN THIS CLASSROOM AND NOT WRITING LETTERS AND MARCHING UP AND DOWN THE STREETS AND WHATNOT? I was trying to explain this to my mom tonight and I could just hear my voice ratcheting up and getting nasty-mean. I wonder sometimes when I will feel less angry about my son’s birth. It’s certainly not going to be Fridays 1-4 or Mondays 2-9p.

Tonight, in my first clinical, we worked in the newborn nursery, and I got to give a Hep B shot, take vitals, and hold a couple babies. It was good. It was a little weird to realize how new in the world they were, and how calm, relatively, you know? There were two babies who had just come from being circumscised that day and one hadn’t nursed since, coming up on five hours. The other had some bleeding at the site, and diaper change was really hard, with the Vaseline gauze to wrap around a bleeding penis smaller than my pinkie.

My hard-to-leave-it-there moment was with a mom who was wheeling her daughter back to the NBN from having fed her in the room. The baby needed to go back under the bililights, and I said that the sunglasses they used here were much more stylish (and more effective-looking) than the ones my son had when he was under the lights. I told her about the little velcro stickers they put on his temples and how I wanted to scream because that was my new baby that they had just stuck stickers on! She smiled, but still looked so sad, and I said, It's hard when they're under the lights - it feels like they're so far away, like you can't pick them up or snuggle. She nodded, and teared up.

I wasn't really expecting the tears (note to me: expect tears). I definitely wasn't expecting the staff nurse to come roaring around the corner, demanding to know if John or I knew why that mother just left here sobbing (ie, what did one of you fools say to her on your very first night on the floor!). I told about what I’d said, and the staff nurse suggested we try to get an order for one of the bilibeds they have.

I told my clinical instructor, she's on board, but she won't let me call the pediatrician to ask for the order bc I can't take a verbal order. So the staff nurse tracked down the ped. He said that he hadn't seen the beds and didn't know enough about them to order it. I was really crushed, and wanted to run down to the mom's room, and tell HER to call the ped and make him order it right now. Hard to leave knowing that she'll feel that sad or sadder for at least another 12 hours, if not longer, if breastfeeding doesn't pick up and she doesn't pink up.

Community Health - which is also full of import, since I think that may be where I'd like to practice, and I'm worried about saying that too many more times before I actually start clinicals! I'll be doing prenatal home visits with a nurse based at a local health clinic. I meet her tomorrow, and I hope I like her!

Both of those are the five hour courses, and they both have a couple of big papers/assignments/careplans/critical incident writeups.

Then there's two one hour courses - Disciplines of Nursing: Professional Roles and Disciplines of Nursing: Eight Touchy Feely Concepts That Needed to Be Incorporated into the Curriculum.

I'm looking forward to both of them - the profs look good and sharp and we appear to be on the same page that the class is not the most important thing happening this semester, but the most important thing that you're doing from 11-2 Thursdays or 2-3 Fridays.

I'm also taking Spanish for Health Care Professionals. I placed into the advanced section and I'm hoping that I can hold my own. It's online for assignments, and if I come to conversation hour (which sounds a little scary), I won't have to call in for conversation one on one with the instructor (which sounds scarier).


Emory Student Midwife said...

We are taking almost all the same classes! I'm doing my maternity/peds rotation. I'm also taking Spanish for Health Care Providers. And I'm taking a public health class.

As a midwife-to-be, I'm glad to hear your teacher is discussing the absolute *lack* of evidence-based practice that plagues OB/GYN care. ((sigh))

I also agree that we should be marching. Or at least be more angry about the state of practice.

Emory Student Midwife said...

And another thing...providers don't "deliver the baby." The mother delivers her own baby with or without the help of the provider. That phrasing irks me more than works can describe. Providers are merely baby catchers!!