Living life and figuring it out, one little piece at a time

Friday, 31 October 2014

To the midwives-to-be


I just found this in my archives.  I wrote it back in March, and meant to publish it, but didn't!  How weird is that?!  Anyway, I read over it and felt like it could still be useful to people so here it is, more than 6 months "overdue" :)

That's it.  Just one week.  On Friday night at midnight, this girl is going off call and will never again be on call as a student.  That's pretty surreal.

The last few months have been a whirlwind.  I was determined to blog more often in this last semester but it just didn't happen.  I ended up following extra midwives over the course of the semester, which has been enormously enriching but also made for being even busier than before.  I actually even started keeping track of my hours, just to see.  Word of advice: don't do that.  It just gives you more leverage to feel sorry for yourself. (i.e. the slowest week I've had since I started doing that was 55 hours.  The buiest so far was 80 - and most of them lean more towards the busier side).

And now here I am almost done, with a lot to say and very little capacity to actually say it.
More than anything, this week I have reflected on what I would tell someone that was walking into the shoes that I wore at the beginning of this year. So I wanted today to share a few "pearls of wisdom" from the light at the end of the tunnel (which actually just feels like the beginning of another tunnel). 

#1.  I know, I've said it in almost every entry I've made in the last few years.  But please, don't forget to take care of yourself.  Make sure you enforce your need to do the things that you love. At least once a week!  Whether its exercising, or snuggling up with a good book, or whatever.  You need to do it.  I let that one go this semester (I  know, despite all of my preaching) but I paid for it again.  It's probably the most common mistake that midwifery students and midwives make, and I strongly believe carrying that habit over the long term is a recipe for burnout. 

#2.  Read the Policy and Information Handbook *very* carefully. It was created to give you guidance on expectations in the course.  It changes over the years.  It's meant to support you. It says very clearly that students are expected to have the clinical load of "slightly less than one midwife".  It lists your minimum and maximum numbers of births for each course, tells you the number of clinic visits you should be doing each week (15), and clearly states how much off call time you are entitled to (4 days per month).  Why is this important, you ask?  Because your preceptors may not pay as close attention to this - as they should'nt - because you are an adult learner and it is your responsibility to regulate your learning.  Many clinics are based on shared care models, where you are sharing your time between two or more midwives (who are probably not in constant communication about how many hours you're spending with each of them). In these scenarios, clinic loads may be high and birth numbers may also be high.  Its your responsibility as an adult learner to  make sure you are meeting expected requirements, to keep track of them for your own records, and to advise your preceptor(s) if you are going over or under these expectations.  The most important reason for this is that more often than not, the clinic/birth load in your placement will be higher than what is expected of you by the program.  

Ah, you say, so what?  I'll work hard, and then I'll play hard when the semester is over.  And the more I do, the more experience I will get!  I've heard that a lot lately, and while I understand it (at least theoretically, I have a lot of reasons to disagree with this (the most relevant personally being that because I'm a mom, my family responsibilities mean that when I work hard, I only have to work harder when it's "play" time)  First off, academic responsibilities are as important as clinical responsibilities.  Most semesters, "one half-day per week to prepare for assignments and tutorials" (given to us by the program) is *not* enough to meet academic responsibilities and expect to excel.  You might need more time than this sometimes, and you might not get it at your clinic if you haven't set the precedent that you are doing more than what is expected by the program of you.  Your preceptors probably won't even realize that you are doing too much unless you tell them, so this is a hard one to go back on.  As per my point #1, you also need to take care of yourself, and even with the guidelines you will feel overworked sometimes, so try to make sure you are balancing it when things are slow without feeling guilty.  But also, make sure to think about the next students that your preceptor is going to be teaching.  You might be able to handle a heavier workload, but the student that comes in after you're finished might have very young children, be caring for an aging parent, have a learning issue, be suffering from mental health concerns, or any other situation that might mean that she *needs* those guidelines to be able to make it through the program.  And your preceptors most recent experience, and the expectations that she will place on that student, will be the foundation that was set with you.   

#3 The last thing is - relish in those moments of success. I know sometimes it can feel overwhelming when your failures feel like they are outnumbering your successes.  It can be really therapeutic to go back to your evaluations from earlier courses and see how far you've come, how much you've really learned.  Save every encouraging evaluation or card you get from clients so that when you have a hard day, you've got a pile of evidence in front of you that you're actually GREAT and having just that - one hard day (or week). 

Settling in

Well, here we are.  It's been four  months since I've made a blog entry and trust me, it's not for lack of thinking about writing one.  The last few months have been very busy and hectic.  I started working at my new practice in July, which as you might remember from my last post was unbelievably overwhelming at first.  I'm very happy to report, though, that settling in didn't take very long and I have quickly come to find myself very comfortable there.  I'm feeling immensely lucky that I have found such a great practice that is supportive, friendly, and shares my agenda for what is most important to me in providing midwifery care.

Sadly, after a torrent battle with esophageal cancer, my Grampa - who was basically my father and mentor - passed away a few weeks later, with all of his closest family by his side.  I will forever be thankful that I could be counted among those people.  Time since then has had a strange way of moving - like molasses in the days that followed, and yet somehow one has to return to normal life as though nothing has happened.  He's the first person that I've ever loved that has passed away, so this journey into grief has been so painful but also full of discovery.  It's given me a deeper sense of compassion and understanding towards those who are dealing with their own grief.  I'm so thankful that he was with us as long as he was.  He's always been a bright star, with laughter and silly faces, even when everyone around him is glum.  I will miss his hugs the most.

About a month after he passed away, we moved. I'm so thankful for the friends that came to help us on that weekend, because I know it was far from an easy job.  Apparently a year and a half is *just about* enough time to forget how hard it is to move.  From the challenge of moving all the furniture, to the cleanup, and the going back to work two days later, it was a busy weekend.  I think the hardest part has been finding connections - luckily I know the people in my clinic but other than that we don't really know anyone around here.  It has been lonely at times, but I remember that feeling in Guelph as well and eventually we found our connections and it started to feel like home.  I'm hopeful that that feeling will come soon. 

 And now it's the end of October - I've had the whole month off call to sit back and relax unpack my basement.  It's been truly great to catch up on life, and yes I actually have had some time (for the first time since I was accepted into the program) where I could sit back and do *nothing* and not feel guilty about it.  I had the wonderful opportunity to go to a conference that renewed my passion for herbal remedies, was lucky enough to sit in on a day of a doula training with my favourite doula in the world and share space with a room full of keen and excited new doulas.  We also made it to my Grampa's special memorial, apple picking, Wonderland, my Mom's 50th birthday party.  It has been really nice to be avaiable and able to say "yes" to just about everything this month. 

It's also been a great opportunity for me to reflect on how lucky I am to be living my heart's desire and actualizing my dreams.  To know that now, we settle into "normal life" (for us), rather than coping with a constant stream of transitions - from classroom, to clinical and the hours it makes me keep, from practice to practice, from city to city.  Now we can relish in how far we've come in the last five years and start building new dreams  - like paying off debt  buying a house!  And travel!  And hopefully the strange version of stability that I've been waiting to be able to provide for the kids as far as financial and living arrangements go. 

Anyhow, it's Halloween, and the school bell will be ringing soon!  Snow is forecasted for this afternoon, which surprisingly is delightful to my Halloween-obsessed son.  It's time to get bundled up and get ready for a night of trick or treating (and maybe a cider or two for Mommy, since, you know, I'm still off call for three more days...)

Friday, 11 July 2014

Reflections from a one week old midwife

The day that I've waited over four years to begin came last week.  After over 3 months completely off call, I got an email saying that ministry funding had come through and I was a registered midwife last Wednesday afternoon, and bright and early the next morning I was in the clinic to start my first day working as a midwife. 

The last week has been a very big one in my life.  The drama of waiting for funding, and therefore not knowing my start date, was starting to become pretty stressful by the end.  We'd had plans in place for the kids to make sure I could work, but as time kept ticking by and I still wasn't working, we started cancelling some of those childcare plans.  The notice was very quick though once it all came through! 

I felt a lot of relief that the day had finally come, but also a lot of fear.  Three months is a long time to let your head play games with you.  Will I remember everything I've been taught?  Will I miss something really important?  How am I (and the family) going to cope with my being on call and all of the madness that sometimes brings to our schedule? 

I forgot, at that point, that once you're doing it, you just do it, and it all seems to work out.  And that is, indeed, the answers to those questions.  Yes, I had some things in my first week that I may not have remembered.  And the mad-crazy on call schedule and all of the logistical things that involves when you have kids has already come up (and there hasn't even been any births yet for me).  But in the moment, you just do it, and you keep doing it, and it all falls into place one way or another. 

I won't lie.  My first day of clinic was really hard.  I had no idea what to expect and it was a long and challenging day with very steep learning curves. So many things are done differently in this community and I'd forgotten how it felt to come into something so different.  Little things tripped me up all day long.  Ridiculous things like where's the light switch, how the chart opens is differently than how my old charts used to open, where the tape measure is, where's the bathroom, etc.  Meeting so many new people at once can be overwhelming - both the many midwives in my practice group and the many clients, some of whom have been waiting quite some time to meet me.   And being a week into it now, I definitely won't say Im over those learning curves but none of them feel nearly as steep as the ones I overcame in my senior year of school.  It didn't feel do-able on the first day, but only a week into it feels more than do-able.  My senior year preceptor gave me so many skills that I didn't even realize she gave me until I found myself using them to help me settle into this new environment and find my "place" and my "way" (or at least mostly "mine" - I'm sure it's at least a little bit preceptor-coloured). 

The great part about it is how much I already love this job.  I have fallen in love with midwifery all over again and it feels even better than when I had before.  I am looking forward to getting to know my clients and the other midwives in my group so much, and despite many of the newbie bumps along the road, I'm enjoying my days so much.  I know it won't feel like a dream come true every day, but today it does, and in reality - this WAS my dream, and it IS truth now!

Tuesday, 3 June 2014

Feeling so good

Do you ever just have those days where you just can't believe how sweet life is?  I'm having one of those kind of days.  I'm having them a lot lately, actually, and up until the last little while, I would have told you it's been a long time since I'd had any of these kinds of days.

The kids are in school.  One of them is home a couple days a week, but I still get at least 3 days a week to myself at home.  Sometimes with Jamie, sometimes on my own.  I'm indulging myself by going to the gym, or a run, or a good yoga session, pretty much daily.  I'm finally starting to feel stronger - in body, mind, and spirit.  This is EXACTLY what I had been hoping would happen during that transitional time between school and working.

All of the new midwives in Ontario right now are awaiting approval from the Ministry before we are allowed to work in the place that has offered us a job position, regardless of when that start time was intended to be (for me, that start time would have been a week ago).  Last year, approval came through at the end of May.  But this year, there's an election happening in Ontario, which apparently means that everything gets put on the backburner until the province's politics are sorted out.  I can feel the tension rising as each day passes and we get no news.  Personally, I'm not feeling surprised as each day passes and there's no news.  I'm setting my sights for a couple more weeks, to be realistic.  And although I'm missing midwifery, and really enjoy being busy, and am infinitely curious about what working in my new community is going to be like, and eager to get my feet wet as a midwife who can act on her own responsibility, I'm just taking a nice big breath, and savouring it.  Savouring the many opportunities that I'm getting to do whatever I feel like doing.  Savouring the ability to put my phone down and not pick it up until *never*. (Okay, I'm not quite there yet, but I relish the detachment I can have from it when I'm off call).  Savouring every school drop off and pickup, and bike ride to the park, and leisurely days with playdates, or crafts, or WHATEVER.  Because realistically, I probably won't have this much time off for a long long time. 

And so I am resetting myself.  Re-setting (gradually) my default to deep breathing rather than reacting with the kids.  Re-setting my feeling of equilibrium.  Re-setting my level of personal fitness.  Re-setting my cleanliness standards!  And mentally preparing myself and the family for yet another big, bittersweet change for all of us. 

Wednesday, 23 April 2014

A turning point

Today was such a great day.  The last few days, I've been able to get a sense of accomplishment with what I've done over my time off, tying up loose ends, getting all my paperwork in order for the college, and hospital privileges.  I've always said, the month between placements is absolutely evil.  I spend the first 3 weeks recovering; then I spend 1 week learning how to be myself again (the real myself, not the "doing whatever anyone wants me to be because I'm a student" self - which admittedly often involves some growing pains that take the form of defiance).  And then its over and I'm back in knee deep.  I'm 4 weeks into my time off now (I think).  And I've got over a month before I'll go back on call.  I'm in "rediscovery" mode.  And loving the level of introspection that I'm allowing myself.

Today, for the first time in a long long time, I let my guard down for the entire day.  Not the guard that protects you from people or bad things happening.  The guard that I build myself to protect me from time.  And most particularly, from "wasting" it.  Over these years I have become very focused on using my time well, and becoming more efficient or productive (something that's particularly important as a young midwife because your thought processes work slowly at first and it takes longer to come to certain conclusions than it does for more experienced practitioners).  I allowed myself a moment to wonder, why do I feel this need to be so "productive" all the time in my life?  And what do I use to define productivity?  And most importantly, why do I let that take away from my ability to enjoy my life? 

I turned 29 a couple of weeks ago, which has caused me to look beyond, to the big 3-0.  And when I reflect on it, I think that I have made a lot out of my twenties!  I've got two kids and a supportive family.  I've got an amazing partner who has been able to follow his dreams and has enabled me to follow my own.  We've built an ever-growing support network of people around us, near us, and supporting us, who I can use no other word to describe except AWESOME. A great home.  A promising career.  The list goes on and on. 

Why, then, do I spend most of my days focused inward on what I don't like about what is happening?  If I'm perfectly honest, I'm usually so focused on what could be done *better* that I don't ALLOW myself to enjoy how great things already are!  I haven't been allowing myself to get swept up in the moment and JUST BE.  Just play!  Just enjoy the outdoors!  Just enjoy the company of other people!

Like I was THERE. (Hillside 2012)

Well, today I did.  I dropped in on a friend and he asked me to stay for coffee and my brain did the usual - "Melissa, its a long drive home, and you only have two days of childcare this week and you should really get this and that and the other thing done before its over".  And instead, I listened to the OTHER voice that said "Yes!!  I would really really LOVE to!"  I know it probably sounds silly to some people, but maybe to those couple who get where my brain has been at, it makes sense.  And I let that feeling last the rest of the day.  Got swept up in some "low-key spontaneity".  Enjoyed the moment.  And (to appease the other side of my brain) - the "stuff" still got done!  The only difference is I *ENJOYED* it. 

Lots of little messages fell into place for me today.  And they all culminated in me realizing that my next life lesson - which is the one I've been trying to learn all along but haven't had the mental capacity to learn anything else - is to learn how to step back, slow down, and enjoy life more.  Not a little more.  But a lot more.  Because really, how we spent the moments of our day, becomes how we spend our lives. 

Also, for some extra motivational reading, I stumbled upon the blog of a wonderful midwife today, local to an area that I once called home, today, whose words were one of those messages that helped things fall into place for my brain space today.  Highly recommended reading!

Thursday, 17 April 2014

Finished and moving forward

Done.  I'm done. 

It feels so, so good to be able to declare that to the world.  I'm DONE!!! 

Placement finished a few weeks ago.  The most gruelling exam I've ever written followed shortly after.  And a few days ago I got the notice that I passed it.  Which means I'm done. 

On a more challenging note, my grandfather has been ill with esophageal cancer, a particularly invasive and awful cancer, since the winter. He's undergone some really difficult chemo and radiation, and last week he had some very invasive surgery to remove his esophagus, with the hopeful end result of kicking it in the bucket. So please, think of him and wish him a speedy recovery. He's been very much a father to me for my whole life and it is hard to see him suffering.

What's next? 

Well, there's the job interviews. That harrowing process where you have to put your heart and soul on the table and await judgement. There was a very difficult decision about where to start working because I was lucky enough to receive multiple offers.  Problem is I got the offers before I attended the interview in Orangeville, the town that my kids grew up in, that we spent ten years in. And the people giving me the offers needed answers before that interview. Sadly, staying here in Guelph is also not an option, because even though there are two practices here, neither of them are taking a new registrant. So we (our whole family) made the decision to accept one of the offers.  What a hard decision this was!  So many things to balance out!  I do feel like we've made the right decision though.  The interview went really well, I got along great with them, and the practice seems like an excellent model that I'm frankly very excited to try out.  It's also only 30 minutes from my home right now - which is probably too far away to commute but its also close enough that I have enough flexibility that I won't have to move immediately, we can let the kids finish school, maybe play out the summer with the childcare resources we already have in place, before moving. 

What else is next?
A long line of paperwork.  Registering with the College of Midwives (lots of money).  And the Association of Ontario Midwives (also lots of money).  Getting ready to order my equipment (lots of money that luckily will be reimbursed). Getting ready for the national exam whicih allows us to practice in all provinces (also lots of money). And starting to put my ducks together to get hospital privileges in my new community.  I'm still working at this a couple of days a week.  And in the meantime, my partner gets to work as many hours as he wants and not worry about childcare, or logistics, or overtired mommy. I get to hold the fort down for a while - which feels weird!  I've missed the kids a lot, but in that time I also forgot how hard it is to keep the house and family functioning. 

Best of all, despite how burnt out I felt by the end of my very very busy final semester, I miss it already.  I actually went to the Newman Breastfeeding Clinic and Institute yesterday for a day of observation to pick up some extra tips for breastfeeding challenges and it really made me miss taking care of women and babies.  And its been less than a month since I finished! 

I figure that's a  pretty good sign ;) 

"Captain Midwife", as Jamie has called me since the day I received that most
wonderful phone call telling me I was accepted into the midwifery program.

Tuesday, 31 December 2013

The real home stretch.

So, winter break blew by in a heartbeat, as always.  Tomorrow is New Years Day, and the following day I go back for my last 12 weeks of student life (at least, as long as things go well it'll be my last 12 weeks!). 

I've had a lot of people noticing how little time there is until the end, and many folks already offering congratulations and comments of wonder of how amazing it must feel to be so close to the end. 

 Being at this point in my education is like a mixed bag.  Every minute I feel differently about it.  So how am I really feeling about this?

Afraid.  There are so many things to be afraid of.  I keep courting this strange feeling that there is some very deep inadequacy in me that nobody has yet spotted.  That maybe I'm actually a total bumbling idiot, and that when I get out on my own and am not having my every move being shadowed and mentored, I might make a fatal mistake. 

Overwhelmed.  The thought of walking back into a clinic has changed over this time.  I went from an excited Normal Childbearing student, where every birth was an adventure and every client a pleasure to meet - to where I am now - and don't get me wrong, every birth is still an adventure, and every client is still a pleasure to meet.  But the level of responsibility that I see is so much more than I had realized it to be before.  It can be overwhelming.  Couple that with the idea that there's a high likelihood I may need to scoop up the family and move to a new community again in order to work, and  Melissa tries not to think about how overwhelming this is.

Introspective:  I chose certain placements over the course of my education because I wanted to be shaped into the type of midwife that I dreamed I would become before I came into this.  I understood right from the outset that the placements students are in drastically affect the type of midwife they will become.  And yet, not all of these experiences were of my choice, or done in my style.  And now I am left to question - am I still becoming the type of midwife that I imagined I would be five years ago?  Will I really even make a good midwife?   Should I even be focused on that, when my main objective is just getting through this year?

Relieved - I'm relieved that I've made it this far; I know that I have enough resolve and determination left in me to make it to the end. I have always felt like I have a strong sense of determination and commitment, but many points over the last six months have brought me to my knees and caused me to question whether or not I'm making the right career choices. But now, although I know the learning curve of the first few weeks back will be steep, because I always seem to forget most of what I learned when I have a vacation, I know Im on the TRUE home stretch now, and with that comes an immense sense of relief. I will live to see the spring, and all being well graduation will follow shortly after that.