Halfway there!

I am almost halfway to my RN license! I am so proud and excited about my personal and professional growth throughout this year. I can't believe how much things have changed since I first started this blog -- about to move to Atlanta. It was really hard to uproot my entire life and change scenery. But I've slowly adjusted to my new life, added new friends, and really enjoy living in Atlanta.

On the school front, we're in our spring semester until the first week of May. Then I have a week off. Then I start back for three weeks for my community health class. I applied to participate in our Migrant Farmworkers Family Health project and was accepted. We then travel to South GA and provide care to their migrant farm worker population. It's a really awesome project! I'm glad I was chosen to participate. We will be in South GA for 2 weeks, then return home. After that, we have a take home final or something of the sort, then I'm finished! (Probably sometime around the end of June...) I know it sounds time-consuming, but doing it this way, I will get 4 weeks off at the end of next year's spring semester. So I think it's a fair exchange. Plus some of us may rent a condo in FL during the weekend between our two weeks in South GA. And that would be fun! Also, all of my good friends in the program are going.

My pediatric rotation has been surprisingly easier (emotionally) than I had thought. In general, I really enjoy working with children and their families. Of all of the places I have been thus far, I feel that pediatric nurses really advocate for their patients. Also, the nurses on my clinical rotation are amazingly bright and wonderful. I had a really awesome patient this week -- Spanish-speaking only -- so I really worked hard to communicate effectively with her. I even called Beloved's mother to learn a nursery rhyme in Spanish. (Beloved's entire family is Puerto Rican -- her mother has been delighted I'm learning Spanish and will answer any questions I have.) So I learned "Que Linda Manito" to sing to this little baby I had this week. It goes like this:

Que linda manito (what a cute little hand)
Que tiene el bebé (that the baby has)
Que linda, que bella (how cute, how beautiful)
Que bonita es (how pretty it is)
Pequeños deditos (small little fingers)
Rayitos de sol (little rays of sunshine)
Que gire, que gire (that go around and around)
Como un girasol (like a sunflower)

My patient really enjoyed it. Her mother was very patient with my Spanish. At then end of my shift, she asked if I was coming back tomorrow because she liked me a lot. Clinically, I did a lot of patient advocacy for this patient. Because of the difficulty communicating, there had been some miscommunication about the patients immunization status. So I was going to talk to the mom about the importance of vaccinations, but lo and behold, my patient was totally up to date on her vaccines. It was just poor communication! She also was breastfeeding and had no standard tray of food. So I had that changed immediately. A breastfeeding mom *has* to eat! Because she was unable to ask for things (again, communication) and no one offered assistance. So I helped out a lot with that as well. I showed her how to order, gave her a menu in Spanish, and hassled her until she ordered some food.

In other news, I just purchased a bicycle from a local bike shop. We get a pretty good deal from the school. If you purchase a bike, they throw in a lock, helmet, lights, and water bottle in for free. They also put it together for you. So I've been riding 9-10 miles/day back and forth from school. The weather has been beautiful (save the horrific, awful pollen) and I've been enjoying learning new appropriate "bike routes" to school. On my first trial run, I thought I would follow the main roads I would use to get to school. Very. Bad. Idea. It was awful. I like to arbitrarily decide to take an alternate street contrary to my previously outlined meticulous directions. Getting lost on a bicycle is a totally different story than getting lost in a car. So I've now found a very specific route consisting of cut-thrus, residential streets, roads for alternatively fueled vehicles (that's me, right?), and a nice path through our Lullwater Park. Overall it takes about 40-45 minutes. Not bad, eh? For the rest of the school year, I will ride about 3 times a week to/from school. After that, I expect I will ride every day during my 3 weeks of class prior to our going to South GA.

Since I was accepted into the summer class, I wasn't able to get an externship so I've been thinking a lot about money. I haven't worked -- really -- since I left VA in July. And I do need to work. As a result, I've been maniacally searching for and applying to jobs. I think I'd like to work as a tech in one of the very close hospitals. I could ride my bike and would get some additional clinical, direct patient-care experience. I'd really like to work at the children's hospital I'm at right now (just because kids are so much fun) but I heard they wouldn't be too keen to hire me because I'm not growing up to be a pediatric nurse. ((Sigh)) But the floor where I had my very very first clinical (general surgery) is hiring a new PM/weekend tech. I think I'd love to do that as well. I already know the floor, where everything is, am approved to work in that hospital (with their immunization, background screen, HIPPA, and OSHA requirements) so I asked my former clinical instructor (who still works on that floor PRN) if she'd put in a good word for me. It seems as if with these clinical jobs, you've got to know someone directly. But she did recommend me and I am to call the floor director.

And finally, Happy Birthday to my baby, Emmie Monroe! She's one year old today. Pictured above is her very first car ride with us when we brought her home. And next to it is how big she's gotten. In that picture, she's giving Graisen doxie kisses. To celebrate we're going to FL for a few days to spend some time in the sun by the pool at Beloved's parents' house. I'm excited!

Intersection of Identities

During my undergraduate education in Women's Studies, we always dicussed the intersection of identities such as race, class, sexual orientation, gender, etc. Last night I went to a discussion a book signing for the new Our Bodies, Ourselves: Pregnancy and Birth book. I haven't read the new book yet but I am excited to hear feminists begin to talk about this women's health issue. We always hear about reproductive choice -- as in the choice about deciding when/how/if a woman wants to get pregnant -- but no one has been discussing the poor state of choices available to women who are pregnant. Or the sub-par care this health care system is currently delivering to most pregnant women. So last night I found myself among a group of women where several of my identities intersected -- lesbian, feminist, and aspiring midwife. Also of interesting note, the Feminist Women's Health Clinic has a donor insemination program that works with lesbian couples (and I'm sure others as well.) But I would totally love to get involved with that aspect of women's health. For me, it's inspiring to see lesbians who are starting families, etc. I never got that sort of exposure before. And since having a family is very important to me, I would like to help others also achieve that.

My first "official" day of my pediatric clinical rotation was yesterday. I think I did pretty well despite having the clinical instructor who is "known" for trying to fail people. Hopefully I will remain on her good side. I did not do too much clinically but I did spend most of my day holding a baby who doesn't get held much. Which brings up my next ethical question...what quality of life do borderline viable preemies have? I took care of an ex-25 week preemie whose prognosis is quite poor. It brings a different perspective to just seeing the little babies in the NICU or PICU. A lot of the children are ex-preemies who have severe health problems stemming from their prematurity.

It's a two post kind of day

Ani DiFranco -- one of my most favorite artists ever -- had this to say about her reasoning behind giving birth at home:

"I would definitely choose a homebirth again despite the fear mongering of this patriarchal society, which convinces women that they are incapable of having babies without the intervention of men and their machines. I look at societies where women are marginalized and oppressed their whole lives (even covered head to toe in tarps!) but are still in control of birthing practice, in a whole new way now. I mean, who is really more advanced? To take birthing out of women’s hands and deny us the continuum of eons of wisdom and experience is to eject us from the very seat of our power. I believe that women in hospitals are prevented from being able to have normal, healthy birthing experiences because of the intimidation of being on the clock, being pressured to take drugs to make it quicker, being inhibited in their movement and activities, and alienated by a sterile, fluorescent lit, feet-in-the-air type environment. You know the classic 'performance anxiety' of not being able to pee or poo because somebody’s watching you? Multiply that by a million! A cervix is a sphincter after all! Then to add tragic insult to injury women are numbed through their great moment of revelation. I believe the act of giving birth to be the single most miraculous thing a human being can do and it is surely the moment when a lot of women finally understand the depth of their power and connection to all of nature. You think it can’t possibly be done, you think you can’t possibly take the pain, and then you do — and afterward you look at yourself in a whole new way. If you can do that, you can do anything. Check out the books on this subject by Ina May Gaskin. She’s one of my great heroes. P.S. I was in labor for 43 hours. Pushed for five hours. It was brutal and scary and prolonged, and if I was in a hospital, they would have definitely cut the baby out of me. I thank the goddesses that I was at home with patient midwives who knew how to go the distance. The memory of pain always recedes. The memory of triumph does not."

You can read more of her interview here.

TENS during Labor

I have a TENS (transcutaneous electrical nerve stimulator) that I use for my back pain. I recently thought it would be a good addition to my doula bag. I have a ton of extra (unused) TENS electrode pads. (The company sends me new ones like once a week!) Anyways -- I wanted to be able to offer this to my doula clients but I wasn't quite sure about how/where to put the electrodes. Does anyone know? Have prior experience with a TENS unit? Know where I can find some information?

Placenta anyone?

My maternity clinical rotation has officially ended. We got to examine a placenta which is really interesting. I had seen them before but never been able to get hands-on. It's a lot more sturdy than I had originally thought. Plus it's really cool to see where the baby grew, how it attached to the mom, etc.

I also realized that I've never had that much blood on my (gloved) hands before. Blood can be taboo -- indicating sickness, or disease -- but in the case of birth, (some) blood loss is normal. It somehow feels very wrong to have someone else's blood on your hands. I suppose since I will be catching babies for a living, I must get used to this new phenomenon. But not too much blood.

This week is packed full of exams before Spring Break. Tomorrow is ATI (a practice NCLEX) for maternity. Thursday is my pharmacology test. Friday is the maternity midterm. This week couldn't have come at a worse time. Today is mine & Beloved's 3 year anniversary and I'm stuck studying instead of enjoying a romantic day off with my beautiful girlfriend. It's alright though, she's fast asleep anyways.

I've committed myself to doing a birth this month so I'm not traveling during the break. It will be my first birth attended by midwives. I'm excited. I'm still processing my last doula birth. The parents were committed to a natural labor and birth. They did everything right and despite all we did...baby was born by emergency c-section. It was the first time I have seen birth just not work. Although it was disappointing that it ended in a c-section, it really did affirm to me the benefit this surgery can be when used appropriately. And please take my word that I have seen (in my short time in my maternity rotation), very unnecessary, poorly justified, almost malpractice c-sections. Contracted pelvis determined by clinical "pelvimetry" without a trial of labor. Sigh. That's another post entirely.

Another experience has really been bothering me. A classmate of mine was helping a woman who was getting ready to push. My classmate was holding her leg. The OB was quite temperamental and did not particularly like the way the classmate was holding the leg. So he swatted at the student. Repeatedly. In other words, this OB slapped the student, my classmate. Upon recounting the situation, my classmate was in tears. She has been so upset by the situation. I know it's not my battle to fight but I would think there would be greater recourse on a physician for assaulting a student but there hasn't been. I don't think it's ever acceptable for physical violence. But this situation has been continuing to bother me. I had never thought I could potentially be assaulted by a coworker and it would be shrugged off so simply. If the situation had been reversed...a student slapping/swatting an OB -- there would be hell to pay, perhaps even an expulsion. It also bothers me because it's a man hitting a woman. It was an unfortunate manifestation of an intersection of several power discrepancies.

It's a boy!

I will preface this post by saying that since I was probably 18, I have had the unrelenting desire to have children. I frequently dream about being pregnant, giving birth, or breastfeeding. It's quite odd -- I don't know anyone else who has dreams like this. I have had girls, boys, twins. Well anyways, last night I dreamt I had a baby boy. And he had red hair. What's more is that I had the baby in the car. On my way to the hospital. But there is no way in hell I would have my child at the hospital, unless there was a major emergency. I've never had a dream about my fantasy birth. So it's clear that I've thought about -- if I have an ideal birth situation. It was so strange because neither I or Beloved have anything near red hair. I told her about it this morning and she jokingly said that baby wasn't hers. So what would be your ideal birth?

My test last week went well. I should have studied more but I did get an A without too much of a problem. Last week's clinical rotation was hard -- teenagers having babies! I have a little sister who will be 16 in just a couple of days. It's interesting when you're caring for someone the same age as your sibling because I relate her care to the kind of care I'd want my sister to get. However, I did get to do some really great breastfeeding teaching. My first patient actually had a doula who helped her during labor and delivery as part of an organization that targets teen mothers. It was great to see her so well-supported. This week I will be doing my mother-baby rotation which I'm looking forward to. I want to have more clinical, hands-on time with the moms and babies. There's not a whole lot we're allowed to do in labor and delivery. The breastfeeding thing just came by as a fluke and I seized the opportunity.

I'm serving as backup for a fellow student who is in the doula co-op. She's a pretty new doula and has been asking for advice. I kind of like getting asked for help because it shows me that I know more than I think I do. I loaned her my doula bag of tricks too. I will be doing another birth in March. I have decided I want to get an externship this summer. There are two that I want to apply for -- so we'll see which one I get. I desperately need to get back to the workforce. I've never been unemployed before. Anyways -- I have to get back to class to see how I did on my test I took this morning. Wish me luck.

Off to a Great Start

I know I haven't updated in awhile. A lot has been on my plate as well as on my mind. I need to mull over my thoughts about a recent birth I attended as a doula. I still haven't quite made peace with that birth, but I'm working on it.

So yesterday was my first official day on labor and delivery. Although clinical started last week, I was on antepartum (high risk pregnancy) and then spent a little time in the intermediate nursery. No labor and delivery. It was kind of boring. But this week I got to be in the action. When I arrived on the floor, my clinical instructor told me they were about to have a twin vaginal birth, if I wanted to see it. I then hurried to the birth. When I got there, the doctor was telling mom that she could push if she wanted to. The first baby came out head first in about 2 pushes. A few minutes later, it looked as though her vagina had blown up a water balloon. It was the second baby's bag of waters, still intact. Inside the bag, you could see these little feet floating in the amniotic fluid. Doc broke the bag, then you saw the little feet in detail. About a push and a half later, the baby emerged. Everyone was fine. Who knew I would see a vaginal twin birth on my first day in L&D, let alone a double footling breech? My clinical instructor has never seen that. I took the birth as a sign that I'm right where I'm supposed to be.

I'm still debating on whether or not I want to get an externship this summer. I think I will get one -- just for the extra experience and the money doesn't hurt either. We'll see what ends up happening. Anyways -- I have a huge test in Patho/Pharmacology so I need to get to studying.