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The Diary of a New Midwife

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Filed under: Education, Clinicals — The Midwife at 9:54 pm on Wednesday, February 15, 2006

I wish I could say that my transition from the academic/theoretical portion of the semester to the clinical portion was going smoothly, but alas, ’tis not the case. The hospital I will be doing my clinicals in (a well-known certain Bronx hospital, for all you curious, saavy New York types) has at least two miles of bureacratic red tape to get through before they actually let students begin their clinical rotations: health clearance, security clearance, a policies and procedure class and a computer class—all of which is a real pain in the ass, but pretty standard for most hospitals. The only problem is that this year, I’ve been referred to a woman who works in the nursing department named Ms. V (obviously not her real name) to help me sort out my administrivial clearances, and unfortunately, it seems as if she is rather unfamiliar with my school, and with our clinical rotations. I am under the impression that previous students who did their clinicals at this site went through a different person. Somehow, Ms. V is a new player in this game. She’s asked for copies of my nursing license and registration, my BCLS certification, and my NRP certification—all of which is pretty standard if you’re trying to become employeed as a labor and delivery nurse, but I explained to her that 1) I won’t be working in an RN capacity, 2) my NRP is my neonatal resuscitation certification, which will be unnecessary since I’ll be doing ambulatory prenatal care and well-woman gynecology, and not actually resuscitating any babies at all, and 3) there are direct-entry students in my program who are not nurses, and wouldn’t be able to provide her with all of this documentation—if I didn’t just happen to already be an RN, how would I meet all of these requests? I think part of the problem is that the contact my school has been using for the past few years seems to no longer be working for this hospital, and Ms. V is unfamiliar with my school’s midwifery program, and with the different paths by which people can become midwives (i.e., nursing or direct-entry). This is something my school should have already addressed, and is definitely something that needs to be explained to her so that if future students at this hospital are referred to her, she’ll have a better understanding of what student midwives do, and hopefully their clearances will go much more smoothly—however, I don’t feel it’s my place as a student to be doing this explaining. This is something my school needs to work out with her.

In any case, I provided her with all of the documents she requested, and I wish I could say that was the end of it. However, Ms. V has also requested copies of the master contracts between my school and her hospital, as well as the malpractice insurance policy that covers me as a student, which is again a totally standard and acceptable thing to request. Again, this is something I should have absolutely NOTHING to do with, as a student; these are details that should have been worked out between my program and this hospital long ago. My school has told me that both of these things have been on file with this hospital for over three years now, and this has never been a problem for any of the previous midwifery students from my school who have done their rotations at this hospital. However, this year, because Ms. V is unfamiliar with my school and with this rotation, all of this has come up, and unfortunately, I’ve been somewhat stuck in the middle of it. And finally, add to this some other minor glitches, such as my inability to get the necessary computer class scheduled last week or this week, and the net result is one very frustrated student midwife.

The long and the short of it is this: I was supposed to start clinicals this week, but I will be unable to do so because I haven’t managed to get all of the administrivia cleared yet, so I will officially be a week behind in my clinical hours, from the very start. Nevermind the fact that I’ve been working on getting all of this taken care of for over a month now, or the fact that I have been calling/e-mailing Ms. V and my preceptor and my program directors and clinical coordinator for over a month now. I am going to the hospital again tomorrow to try once again to get all of this sorted out (this will be my third 2+ hour commute to this not-so-close-to-me Bronx hospital in the past three weeks). I have spoken to my preceptor, and will hopefully begin my clinicals next Tuesday, despite the fact that I will need to take a 2-3 hour break from the clinic in order to attend the computer class which I was supposed to take last week, and was hoping to take this week. I am doing my best not to let any of this administrivia color my perception of my actual clinical site, because I’m sure the midwives I will be working with (none of whom have anything to do with Ms. V, or the nursing office, or the administrive process, in general) are all fabulous, lovely people, and I’m sure the site is going to rock (I’ve heard good things about it)…but even so, for the love of filing cabinets, enough with the administrivia already!!!! Urrrrgh!

2 Comments »

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Comment by mamasun

February 18, 2006 @ 9:50 pm

I am also a student midwife, yet I attend an undisclosed public university in New England, I am also an RN. I decided to become a midwife after the birth of my first child in 1995 and then actually pursued this thought in 1998. I gave birth to my second child in 1999. Since the program in my state requires a BSN and RN license I decided this was the route to take (and also the fact that I wanted to know what I was getting into). I graduated from the same public university that I am attending now, in 2002, and have been a practicing RN since Jan. 2003. I have a great respect for nurses and the profession. The midwifery program I am attending includes four RN students, each with a BSN. I went to Professional Issues I yesterday, which was hosted by the unsaid public university. It was us (the four students from the public university), 2 students from Bay State (who are also RN’s, I’m not sure if BSN, students) and about 10 students from Yale (mostly non-nurses and 1 nurse). I found the entire day to be exhausting, not only from the lengthy discsussions from faculty, but also from the the endless “Yale this, Yale that” crap we had to listen to all day while the rest of us from our middle-class public university had absolultely no recognition or respect from the attendants. We were supposed to be the hosts but I felt as if we were the guests. I could not believe the negativity and snobbery from the Yale students. When I asked one Yale student how the program fit in one year of education to complete the objectives toward earning an RN license, her reply was, “they fit it in some how”. It’s very discouraging and disappointing that Yale gives these students the absolute minimal education and clinicals in nursing to earn the license of RN, only in order to fulfill the requirements to become midwives. Nursing IS important, whether they want to belive it or not. When this program is complete, we are Advanced Practice NURSES. I felt as if what I do as a labor and delivery nurse in a community hospital (where there are no physicians or midwives present on off hours) is completely insigificant. As a Registered Nurse who values her profession I find it really upsetting that the professors of Yale/public university in New England/ Bay State do not recognize our role in labor and delivery. I’m really tired of hearing how negative nurses are and how they hurt the outcome. This is untrue and unfounded. If we didn’t have RN’s to assist with birth, midwifery would be in an even worse state than it already is. I listened to Helen Varney and I still believe we need nurses, contrary to what the instructors and program directors wish to believe. They talk about the system of medicine being driven by money, try the education of midwifery. It’s all about $$$$.

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Comment by The Student

February 18, 2006 @ 11:15 pm

There is a lot of controversy that exists in midwifery about how beholden midwifery should be to nursing: should we continue to acknowledge our nursing roots, or continue to strive for independent direct-entry midwifery education? Should we remain the American College of Nurse-Midwives, or become the American College of Midwives instead, in order to be more inclusive to direct-entry midwives? I know this has been an ongoing debate in the ACNM for decades.

For my own part, I’m not entirely sure what side of the debate I fall on. Obviously I am a nurse, and I’ve worked as an RN for the past three years, and my labor and delivery experience has been *invaluable* to me. There are many, many aspects of nursing that I really enjoy, and I wouldn’t trade this experience for anything. However, I am definitely at a point in my education and development where I am very eager to move on to the next step, and to have *midwife* become my primary identification, rather than nurse. I also find myself becoming increasingly frustrated by the hospital system, and by some of the work that I do as a nurse which aids and abets this system, but maybe that’s just my inner homebirth midwife finally emerging in protest.

This post was written out of frustration from all of the stumbling-blocks I have encountered so far at my clinical site, but I certainly wasn’t trying to denigrate the profession of nursing. If other students from my program who are direct-entry do get assigned to this clinical site, though, and end up going through the nursing office, they may encounter even more stumbling-blocks than I did, and this is something I think my midwifery program needs to be aware of, and something they need to clear up with this clinical site, since we are a mixed program of both nurses and direct-entry students.

Anyway, I’m sorry you had such a bad experience with the direct-entry students. I’ve certainly encountered a few midwives with chips on their shoulders in my relatively short exposure to this profession, and I’ve also sadly encountered a few nurses who probably do hurt the outcome, or who are so burnt-out they should probably find a new job. I’m sure it’s the same in every profession. I don’t think there’s any one right way to become a midwife, and the politically correct thing to say is that maybe if all of us just tried harder to recognize the myriad paths and backgrounds we all come from, we could unite and get a lot more work accomplished towards our common goal, i.e. the promotion of midwifery in the US, period. However, I do think that right now, all of these different paths towards midwifery, and all of the different midwifery licenses that exist, are very confusing to others who are not familiar with the profession (who am I kidding? It’s confusing to those of us who ARE familiar with the profession, too!), and maybe if there *was* indeed one standard of education, such as exists for MDs, and to a lesser extent, nursing, it would be easier to explain and promote our profession to the public. But then the next question is: what should that standard of education be? BSN in nursing? Direct-entry program? It’s all good food for thought.

In any case, good luck with your class. I hope it gets easier for you, or at the very least, you get better at tuning out the snarkiness.

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