Clinical Update May 22, 2015

Welcome to Summer!
Hopefully you're enjoying your semester and making time for relaxing fun over this long weekend. It's been an unusually wet spring in Utah and we're looking forward to some sun! This clinical update comes to you in seven very special parts.

1. Clinical Orientation
For new students (and students who'd like a review), one more session of Clinical Orientation is still available: Wednesday, May 27, 2015 10:00 AM MDT. See your upcoming events board for details and the link to sign up.
If you are unable to attend a live orientation, you can download and view a recording (in Class Documents for CLNC 100, under Recorded Live Sessions).

2. Optional Live Sessions
We also have 2 optional Live Sessions being scheduled for later this month. They are for specific situations, so if they seem applicable to you this semester, please plan to attend. They will be recorded for later viewing as well!
-Starting Your Clinical Placement
This is a session for students who are starting or about to start their first clinical placement. We'll go over applying to the clinical program, preceptor approval, clinical training agreements and filling out log forms.
-Preparing for Primary Births
This is a session for students who are hoping to start primary births in the next year. We'll go over what classes, skills and forms need to be sent in to be approved for primary births, and what forms students will want to have once they begin that phase.

3. Clinical Training Opportunities
Check the bulletin board titled Clinical Training Opportunities--I’m always posting new opportunities around the country for students seeking clinical placement. In the last month we've seen clinical opportunities in Oregon, Washington, Michigan and I just posted another in Virginia.

4. Upcoming Rounds Sessions
Tuesday, June 16, 2015 at 11:00 am MDT ViviAnne Fischer will be presenting and Wednesday, June 17, 2015 at 10:00 am MDT Karin Peacock will be presenting. See the Upcoming events bulletin boards for signup links to these presentation. There was a Clinical Rounds scheduled for next week, but we needed to move it to July 1. These are going to be great presentations--please plan to join us if you can!

5. OFFICE HOURS this semester will be Mondays from 1-3 pm Mountain time (although not Memorial Day!). You can also call our shiny new clinical extension and someone from the clinical department will respond to you ASAP.

6. Just a reminder, all of your “assignments” for CLNC 100 and any lab classes should be uploaded via the class as PDF files if possible. If you need to send a file you can’t upload or send multiple files, please send them to Clinical Dean Assistant (Kaylee Ridd).

7. Finally: You can visit the Clinical Department blog for updates like these as well as helpful tips, events and news. The address is: http://midwifingmidwives.blogspot.com/ and I highly recommend bookmarking or subscribing to it--it has pictures!

Successful Field Study

This helpful tip post comes from a senior student preparing for graduation: ViviAnne Fischer.

If there is one piece of advice I could impart to a student beginning an apprenticeship, it would be to lay the foundation from the beginning and communicate any and all expectations. In addition to discussing things like on-call time, clinic days, financial arrangements, the length of the apprenticeship, etc.; you need to discuss time she will set aside to teach you and sign off on skills, vacations and personal days, what will happen if you are sick, what you need to move from assistant to primary stage and anticipated timing, how difficult births will be debriefed, how criticism will be communicated, and when time will be set aside to communicate new expectations when you are ready for more responsibility or move to a new stage. Open and clear communication will minimize conflicts and create a more successful relationship.

The student-preceptor relationship has an inherent power imbalance, anytime there is a power imbalance the relationship is susceptible to abuse. Ideally, equal energy/resources should be exchanged between the preceptor and student to minimize this. We give our time and offer them a free assistant and they teach us and give us access to their clients to learn. At the heart of a healthy relationship is respect for one another. Too often students stay in apprenticeships when the mutual respect is not there. The feelings this leads to within a student does not prepare them to be competent and confident midwives…..it is better to leave and find a new way. If you apprentice with more than one midwife you will likely have some wonderful experiences and some terrible ones, each will teach you important lessons, but you do not need to tough it out when the fit isn't right. My hope is that midwifery programs, students, and midwives will not tolerate this behavior that ultimately undermines the heart of midwifery.

photo courtesy of Wikimedia

Be patient with yourself, be kind to yourself, and recognize that hands on learning takes time and practice. Many of us begin our journey to midwifery after we have successfully navigated other areas of life. It is odd to be in the position of learning and fumbling again. Obviously it is important to get these skills down and know them, but each time we fumble it is an important lesson…..we need to reflect and learn. Recently a friend started a new relationship with a midwife. After learning that each midwife does things differently and believes their way is the right way, she discussed how it is her goal to learn how this midwife wants things done and never have to be corrected more than once. As a new student she used to agonize if she had to be corrected, she has grown past this. As we build skills we will make some mistakes, be kind to yourself and aim to not make them more than once.

It is obviously important to not make mistakes that jeopardize lives, you should know enough before you attend births alone with a midwife to not find yourself in this situation. Ask the midwife to set aside a few hours to review your role if NRP is needed, if there is a shoulder dystocia, what she will need you to do if there is a postpartum hemorrhage, etc. Know your NRP well and practice. I used to go over steps in my head on the way to births or as I was setting up the oxygen and baby tray. Be prepared and then sit on your hands until action is needed. Trust that your preparation is enough to be competent in emergencies. With preparation these situations will build your confidence.

Last but not least, I will leave you with this quote by Vicki Penwell “Smart midwifery is using all your senses to observe while doing nothing to help when birth is working, using all your skills to do everything needed to help when birth becomes life-threatening, and honing the astute ability to always know the difference.” Learning this art is the goal of our clinical experience. Keep your eye on the destination up ahead and trust you will get there if you stay on the path, however rugged it may be at times.