We had the mother of all check-out exams today. Not that they’re actually called check-outs: they’re really called competence perfomance evaluations, but are known informally as check-out exams. Basically, you have to demonstrate your hands-on practical skills to your professors by going through the motions and talking her through the mechanisms of labor, an occiput-anterior delivery, mangement of the 3rd and 4th stage of labor, suturing, vaginal exams, amniotomy, placement of an internal scalp electrode, local anesthesia and a pudendal block. The check-out involves stating the reasons why you’re doing such and such action, how you would prepare the client for it, position her, drape her, coach her (if needed), how and when you’d time various maneuvers, the rationale behind putting your hands here v. there, the reason why you’re using such and such suturing material, when you’d cut an episiotomy, and how you’d do it, what the contraindications are, what the safety precautions are, what you’d look for and feel for and smell for, how you’d clamp the cord, assign apgars, hand tie, instrument tie, how a baby moves through a long arc rotation from left occiput posterior to left occiput anterior, etc. etc. etc.
As you can see, a totally easy, no-sweat, low-stress day, with very little information to know or master. No nerves involved. Nope. None.
SO, I set my alarm for 7:00 am. My first check-out is at 9:00 am. I leave on time, 8:20 am. Not late, but on time (but then again, not early, either—which, as you shall see, was my fatal flaw). My beloved boy and I stop to get coffee before heading to the train, as we usually do every morning. We get to the platform, and we wait. And wait. The wrong train arrives. No use to us, so we wait some more. A second wrong train arrives. Still no use. 15 minutes pass as we watch a procession of the wrong trains blithely sail by. Now getting anxious. Look at watch: time is 8:40. It usually takes me 30 – 35 minutes to get to school. I now have 20 minutes to get there. Slow realization that I’m going to be late. Stress begins to mount. This is not how I wanted to start the morning of my check-outs. Correct train finally arrives. Correct train is packed, because it’s so late. Takes twice as long to get onto train as it normally does, because train is stuffed, and people are moving in very slowly, and trying to squeeze on more passengers than comfortably should, and people keep holding the doors. 2 stops to my transfer, both very slow stops, because of packed conditions. Mad dash from one line at the transfer point to the second line. Enter platform just as the train I need (the train I need!!) is pulling out. Look at watch: 9:00 am. I should, at that exact moment, be at school, beginning my check-out exam. Panic, followed by despair, a good round of nail biting, stress, self-excoriation for not having left early instead of on time, a nice heaping of self-blame, followed by some more nail-biting. Correct train arrives. I spend most of the short ride trying to deep breathe, calm down, there’s nothing I can do now about being late, devise excuses, abandon excuses and need for excuses as weak and pathetic, prepare to face whatever the professors have to dish out about how a responsible student gets to her check-outs on time. Feel like the most irresponsible midwifery student ever to walk the face of the earth. Get out at final platform transfer to wait for final train to school. Usual delay. Correct train finally arrives. Emerge from subway (infernal, godforsaken) system at 9:20 am. Walk to school (5 minute walk). Get to correct floor. Professor who’s doing my first check-out of the morning (pudendal block) has been waiting for 30 minutes now. Informs me that she’s going to have to do my check-out at the end, because she can’t reschedule everyone else on the schedule to accomodate my lateness. I tell her I need to be at my clinical site this afternoon to meet with my preceptor and schedule my clinical rotations. She gives me the “well, you should have been on time” look, and says we’ll have to try to squeeze me in.
So, she goes off with the next student who was scheduled to do her pudendal check-out at 9:30, and I briefly flop in the hallway to bemoan my fate and receive some comfort from a fellow sister student, who’d had the presence of mind to arrive early to her check-outs. And then, punctually at 9:30 am, I begin my first check-out of the day (what should have been my second check-out, by then): Delivery Technique.
Just as I’ve started to get into my rythym, gloved and gowned and mid-sentence, a different professor pokes her head in the door to ask me why I’m not where I’m supposed to be. Baffled, I tell her I was where I thought I was supposed to be, i.e. doing my delivery technique check-out from 9:30-10:00. She tells me I’m supposed to be suturing with her. I tell her my suturing check-out wasn’t supposed to start until 10:00, but according to the schedule, from 9:30-10:00 I’m doing delivery technique. She tells me that I’m behind because I didn’t get my pudendal check-out done, and that I was late, and that they can’t change the schedule. Then she very gently says: well, this is why you can’t be late to your check-outs. That’s it. Very gently. She leaves…and I burst into tears.
Not my finest moment, by a long shot. The professor who was in the room with me doing my delivery technique check-out had me count to 10 a few times until I calmed down, as if she were coaching me through a contraction.
I’m happy to report that after all the drama, I was actually able to get through all my check-outs in one piece. I went to suturing next, and received an “excellent job” in the comments section, and was able to squeeze my pudendal check-out in next, because I finished my suturing early. All good comments. Nerves slowly dissipated. By noon, I was finished with all of my check-outs, and was so relieved I found myself humming to myself on the way back to the (infernal, godforsaken) subway.
However, needless to say, I’m a bit embarrassed by the tears. Especially given that none of my professors were horrible to me (I was much harder on myself than any of them were or probably ever would be), and even though I was late, I was able to get everything done on time AND get to my clinical site in the afternoon. Insert something here about all’s well that ends well etc. etc.
I almost didn’t post this post, because it’s that embarrassing. But this is supposed to be the chronicle of my adventures in midwifery school: the good, the bad, and the ugly embarrassing. So here you go. Enjoy. With bonus sage note to future midwives of the world (and duh, don’t you think this is something I should have known already?): on the day of your almighty check-out exams (or equivalent), make sure you leave early, and not on time.
