Friday, August 1, 2014

Five Tips for a Great Apprenticeship

This blog post was written especially for new clinical students by one of our students nearing graduation, Lindsay Kinman. Thanks, Lindsay!

Finding a preceptor is one of the scariest and most exciting experiences for a student midwife.  It is the opportunity to finally perform the skills that you have been preparing for.  For many of us we have waited a long time for this to come.  Although we are eager to do whatever is asked of us it is also important to remember a few things before jumping in.  Here is my advice for a good apprenticeship.
 
photo courtesy of Wikimedia
1.)   Know your boundaries!  Before discussing with the midwife what her expectations are it is important to discuss with your family (spouse, partner, kids, etc.) what their needs and expectations are.  Many midwives have sacrificed their lives on the altar of midwifery by pretending that they can be all things to all people.  The truth is that everyone has limits.  If you lose the most important relationships in your life to midwifery you help no one.  How can we be promoters of health and not have emotional, physical, and spiritual health in our own lives?  Here is a list of questions to begin the discussion with those closest to you:
·         How many clinic days will fit in our schedule?
·         How many births are too many?
·         How far am I willing to travel for a birth?
·         How will the household responsibilities change? Who will handle what?
·         Who will watch the kids? Do we have to pay?  Is it in the budget?
·         When will we have “us time”?
2.)   Know your preceptor! Once you have figured out your boundaries then you will be in a more secure place when talking with your preceptor.  Before meeting with her, try and find out more about her.  Many midwives have a “baby counter” on their website and you can average how many births they do a month.  Also what is her area of coverage?  Maybe she is at a birth center close by but she averages 10 births a month.  Maybe she is a rural midwife and she has a huge coverage area.  Are you willing to drive 2 hours to a birth if there is a chance you are going to be gone for 3 days?  Meet with her and discuss what she needs in a student.  Here is a list of potential questions:
·         How many births do you average a month?
·         How far do you travel for births?
·         Would you expect me to be at every birth?
·         What is your philosophy on home birth?
·         What is your philosophy on interventions? (For example: abx, transfer, breaking water, etc.)
·         What do you need from a student?
·         How do you handle conflicts with other midwives?
·         Do you work with any other midwives?
3.)   Know your area! It is important for you to understand the types of clients that you will attend as a student.  Are you in an urban area where home birth is trendy?  Are you in a rural area where clients are more conservative? Understanding clientele will help limit frustrations with your apprenticeship.  Ask your preceptor the following questions:
·         What are the demographics of your clients?
·         What do clients expect from you?
·         What is your transfer rate?
·         Why do you transfer most often?
photo courtesy of Wikimedia
4.)   Know your goals.  When first looking at all the things to check off it can be overwhelming.  You also can be delusional to think that these things are going to happen in a nice neat order.  It is important to look at the whole book and group things together.  It is not your preceptor’s responsibility to make things happen for you.  It is yours. Here are some suggestions for grouping things together:
·         What are tasks that I can do outside an actual clinical setting (sterile gloves, hand washing, etc.)
·         What are tasks that run together in a clinical setting (at a birth, at a prenatal appointment, at a postpartum)
·         What do I need to work on?
·         Are there continuing education classes where I can practice and get further instruction?
5.)   Know why you are there!  Why are you becoming a midwife?  My guess is because you want to have the personal, non-interventive, and peaceful practice.  If this is the case then DO NOT TREAT your apprenticeships like numbers that need to be met.  This means that you may have to be at more appointments and spend more time than you want to in order to “get your numbers”; however, this is what midwifery is: taking more time.  You are not entering someone’s hospital room you are most likely entering someone’s living room.  Most clients do not want strangers in their living rooms.
·         Why do you want to be a midwife?
·         Where do you want to practice?