The God Complex...

What is it with midwives/nurses/doctors that think they know everything and you know nothing? What is it with all the egotistical health care workers out there?

I am having such a difficult time working with a midwife that takes everything personally. From a great birth, to a suggestion-- everything is a reflection of her. I get pushed down if I even bring up something new that I learned. Now I have learned that I have to keep my mouth shut. Belittling someone does not help you to be a better doctor or midwife or nurse.

I have to remember that when I am a nurse and a midwife I can still learn from the people "under" me, I can learn from everyone. I can be open to new ideas and knowledge and it doesn't necessarily mean that I am doing anything wrong. I will respect everyone, even the pee-on birth assistant.

I won't give any examples of the midwife I work with now, because I don't want to jeopardize my job yet. But, to illustrate my point I will give an example from the nurse I work with. She was demonstrating to these new parents how to take their babies temp. She explained that a rectal temp is the most accurate and this is how you do it... Later I casually mentioned that in my class at school we actually learned that axillary was the recommended way to take a child's temp until they are at least 3 years old (I didn't even explain how its actually less accurate because new babies usually have stool in their rectum, so it reads lower than it is. Nor did I mention that its actually more dangerous because you can perforate their bowel or how invasive it is or that in my conservative text book it says "axillary temps are the preferred method to rectal temps...). I didn't belittle her in front of anyone or push my idea, but her reply was "really? I didn't know that... Well, I don't even believe that because rectal is much more accurate and thats how we were taught..." and then I got the cold shoulder for awhile. Now, this is this nurses first job out of nursing school and she has been at this hospital for 10 years (in fact, I found this to be a common thread-- first job, closed minded, not evidenced-based etc...). She has no children and I bet you she has never read one book on birth or taking any childbirth classes. But, she's the expert telling new parents what to do? And she won't even open her mind to consider using axillary temps vs. rectal temps or even look it up to see the research? Wow...

Nursing School...

I am so overwhelmed right now that I haven't had time to write. In fact, I should be studying right now for a test on Wednesday, oh well... I have been to clinical two more times-- one day in the nursery and one day in postpartum. Yeah, they are all separate there. Its so funny because in their information booklet they say they practice mother-baby nursing, yeah right. Anyway, I have to come up with a project to do and it can be a scholarly paper or a project to implement a new practice at your clinical site. So, now I'm working on what I want to do, I will post my ideas when I have them and we can take a vote.

I'm Now Entering the Dark Ages...

My first day at my new clinical... Absolutely horrible, horrific I would even say. I should have taken notes, I was trying to remember all of the ridiculous things I saw done. I knew this hospital would be bad, but I had no idea it would be this bad. While its fresh on my mind I will list some of the things I can remember below and I am sure I will add more later.

• The dreaded cascade: continuous EFM, epidural, labor slows down, pitocin to speed it up, baby's heart rate drops to the 70s, uncomfortable positions and oxygen, internal monitor placed by screwing electrode into baby's head, finally she's complete(even though its only been 8 hours and she is a primip), pushing semi-fowlers using stirrups (I can't believe they still use those!) for 3+ hours
• Stern male OB stands in front of women... Contractions space out. Coincidence? I think not.
• OB can't keep his hands out of her yoni, he pulls down so hard on her perineum that she is bleeding a little. His encouragement is "drive that baby! Get mad! Get mad!"
• Forceps or Cesarean?
• They decide on forceps first (at this point I was actually hoping for a c-section, it seemed less traumatic, can you believe it?) Big scary looking blades are inserted into her and with the next contraction the OB pulls and shimmies and pulls and cuts a episiotomy without any warning, mom screams, the baby's head is out. Finally this poor little soul is brought into this world.
• Mom sees baby for a minute, doesn't really hold him, then placed in warmer.
• Mom is being stitched while baby is poked and prodded. Ointment to eyes before even being able to gaze at mom, Vit K, and rectal temps (what the fuck!)
• Mom finally gets to feed baby (breastfeeding, yeah ;-) Then he is whisked off to the nursery to be monitored, bathed, and get temp stabilized (how about with mom instead). Baby will be spending most his time in the nursery, mom moved to recovery (yeah, not in the same room).

I'm so pissed right now that I need to take a break and write more later.