The sucky part

So, during every learning curve (and especially in health care), you go through the godawful phase where you know nothing, everything is difficult, your work is incredibly slow and laborious, you feel pathetically inept and incompetant, you are continually overwhelmed, and generally, find yourself wondering why in the world you ever wanted to be a nurse/doctor/midwife etc. etc. in the first place. Well…at the moment, I am RIGHT in the middle of this phase, and it SUCKS. Big time.

I remember going through this as a new nurse. My first six months on L&D were TERRIBLE. I made a gazillion mistakes. I got yelled at by doctors, charge nurses, and patients—sometimes all three in one day. I blew at least 10 IVs before I could start one, and each blown IV brought my dwindling confidence to a new low. Patients would ask me questions and I would have NO idea what the answer was. In general, I felt like the world’s biggest idiot, and a pretender, at that. There were so many nights when I would come home exhausted while still adjusting to 12 hour shifts and just cry into my pillow, or cry on the phone to a friend, or cry in person with a friend over coffee…and then have to wake up the next morning and do it all over again. It was torturous. I thought it would never get better.

However, it did. I stuck with it, dragging my sorry ass to work each shift, and after about 6 months, I started to feel like I had a clue. By 8 months, I was enjoying myself. I became the IV queen on my unit, able to start those hard-to-get IVs that other nurses couldn’t start. By a year, I finally felt like I was a good nurse—competant, caring, able to get things done well, but also in a very timely manner. I had made friends on the unit, the charge nurses had grudgingly started to like me, I had earned the doctors’ respect and liked working with many of them, my patients would send me thank you cards and chocolates and champagne, and generally, I loved my job and felt like I was doing it well.

The point being, after working so hard to get to that place as a nurse, it’s really difficult to go back to square one as a midwife, and start all over again. I know nothing, especially when it comes to prenatal care, ambulatory clinic, or managing clinic patients. I can’t do anything well, or quickly. The management process seems to be beyond me. SOAP notes are the bane of my existence. One of my patients at clinicals yesterday complained because I was so slow (it took me 1.5 hours to do an initial prenatal visit, including complete health history and exam. My preceptor said that in general, a revisit should take about 15 minutes long, and an initial visit half an hour… … … uh…right…). It’s a vicious circle. I am uncertain and don’t manage my patients or my visits well, which only makes me feel even more incompetant, and then I manage my patients and visits even more poorly. I left the clinic last night in tears, wondering why in the world I wanted to be a midwife.

This morning, at least I can remember why I want to be a midwife, but being a doula or childbirth educator and forgetting this whole midwifery thing still seems pretty appealing. I left clinicals yesterday thinking that I never wanted to go back. I’m sure I will go back (next week, in fact), and I’m sure it will get better eventually, but ouch. At the moment, it just sucks.

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6 Comments

  1. k
    Posted March 9, 2006 at 8:28 am | Permalink

    Hope the day dawned a little brighter this morning. Last night I was at a hospital tour with the doula class. One of the other gals was talking about her textbooks and classes she is taking to become a midwife… sigh…. I sat up half the night wondering if I would ever get to that point. Let alone if I’d ever be able to “fit” that mold. She even is going through the same program that I looked into (correspondance). Big heaving sigh…. so the aspiring midwife to the NW of you is rooting for you! Hoping you have a better time of it. And I loved the long drawn out intake meetings I had! First one was two hours of nothing but birth talk! =) K

  2. The Student
    Posted March 9, 2006 at 9:16 am | Permalink

    Sounds like fun! Still somewhat in “why am I becoming a midwife?” mode. Doula-ing would be so up my alley, too, and just think, so much less responsibility! All of the joy of attending births, and helping women, with so much less responsibility on your shoulders, or a license on the line if there’s a bad outcome and you get sued, or the faff of dealing with malpractice insurance (or not), or any of the rest of it….blah. Blah x 10.

  3. Posted March 12, 2006 at 2:48 pm | Permalink

    Ok, so here is the good news: It gets easier!
    I truly understand your woes, because I, as an integration student, am still struggling with time management. But…slowly but surely, you get better with history taking and PE skills…and before you know it, you really become skilled and efficient. Being in the clinic is difficult with all the patients and the backup of patients… that’s what I love about L&D. I’m with the patient for hours and hours… so it’s a lot more relaxed in some ways…and a lot LESS relaxed in some ways. Don’t worry, you’ll get better at the time factor. It’s part of the normal learning curve. Yo’ure going to be fine :) Take some big deep breaths when you feel like the pressure is being put on you, and don’t let it affect your performance. Better to be thorough and catch something, then to be all rushed and missing important information or PE findings, right?
    Take care!

  4. Posted March 15, 2006 at 2:18 pm | Permalink

    I’ll bet that as soon as you do reach that level of competance/confidence, which you will, the frustrations of being limited to a doula’s role (as marvelous and as essential as they are) would get to you. Just a guess. Hugs for the meantime…

  5. mamasun
    Posted March 17, 2006 at 6:31 pm | Permalink

    I am in the exact same place. I am in the midst of my first rotation of clinicals and it takes me an hour to get through a positive pregancy test visit. A PE takes me a good hour and I am still having a hard time finding a cervix during a speculum exam (it’s amazing how different every uterus is). I’ve only delivered two babies because I’m on a 24/7 call schedule with my preceptor (she averages 5-10 births per month) and I missed two deliveries last night because I had to work (RN). I like working, but I really want to be available for my L&D clinical but the 24/7 call really impinges on life (scheduling work, kid time, husband time). The GYN/Prenatal clinic is great, but as I said before it is hard. There are days that I wish I was like other people and just wanted a normal job. What is it about this midwife thing that runs so deeply into my system? Why am I not satified just being a nurse??

  6. Posted March 19, 2006 at 9:44 am | Permalink

    I went through that as a new doula 15 years ago, as a childbirth educator in training years ago…and now in nursing school. When I caught a baby (one of my doula client’s nearly two years ago) I went through this high–and a crisis of “should I go to midwifery school instead of nursing?” It seemed easy!

    It’s not. None of it is; there is that learning curve, as you say with _anything_. Different levels of responsibility, different tasks to learn, different everything.

    You can do it. We can all do it. It’ll just take time.

    Hh

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