Just Pickin' Em Up & Puttin' Em Down...

Yep, I think that's what I'll do. Every day, if that's what I need to reduce my focus to, I can do it - one step at at time. Simple, easy, as little stress as can be. Starting with lifting each foot, and then putting it down again a little bit further ahead than it started. I have a keychain that is engraved "Learn in Baby Steps" --- one of my new mottos, I believe.

Sounds easy enough, right?! I can do this - and I know I will. Patience is a virtue... but it's sooooo hard! The end of this road still seems far off, though I can tell it is getting closer. This week has been challenging; Dee has been out of the office for a much-needed vacation - although you can't really call it that since she is still functioning in a nurse-practitioner role, only volunteering her time (though she is at least enjoying herself I think) - and so I am working with some of her backup doc's and *trying* to make a good impression on them so they will agree that expanding her practice and adding a second CNM --- that is, moi --- is a splendid idea.

From my perspective, it's been great; I've been enjoying seeing things from the MD point of view and also observing visits that aren't typical nurse-midwife cases. However, on Tuesday I was hit by the WORST migraine I've had in a long, long time; the timing could not have been worse. How do you make a good impression, when you go from meeting someone and being eager to soak up all their knowledge to begging to go home with an "invisible" affliction in a matter of minutes-to-hours? It was awful; the worst part was, one of Dee's patients (who I've met several times in the office, as well as in the L&D setting) ended up presenting to L&D that day in labor, and the MD I was meeting that afternoon had offered to let me work with her during her labor. Prior to the onset of my killer headache, I was pumped to be able to follow her through, especially since Dee wouldn't be able to... until, that is, the hot flashes, nausea, and vomiting started while I was still seeing patients in the clinic. By the time I made it home that evening (after pitifully and ashamedly declining to accompany the doctor to see this particular laboring mama), I was miserable; the migraine didn't pass until later the next day, after 14.5 hours of solid sleep in my dark, window-less bedroom, with constant ice packs/hot rice bags, multiple doses of vicodin, and several doses of maxalt. Two words: it SUCKED. And, I was not impressed with myself.

(I've had migraines since I was five. They are something that are just there, and for the most part, I recognize that I have to live with them. A year or two ago, I started taking topamax and was thrilled at how well it seemed to 'calm' them; I also found that maxalt was actually reliable for knocking them out if I could take it when I first started getting an aura... these were the first meds that actually worked for me, after 20+ years of trying to find something. Now, in the past few months, they are steadily creeping back. To have two in the past two weeks, however, to the point that they disrupted my functioning - at clinicals no less - is NOT acceptable for me.... so I guess I will be in touch with my care provider.... *sigh*)

On a happier note --- things have been interesting with the MD preceptors. Again, I've seen several types of client cases that I might not normally see as a CNM: complex chronic health problems, many, many well child visits, and ---- wait for it... --- MEN! I haven't dealt with penises longer than a pinky-joint since I was a nursing student. Crazy, huh?

Tomorrow finishes off my week with the docs... fingers crossed that if nothing else, they think having an extra pair of hands could be good for something or other...

~*~*~*~*~

This can be a glass half-empty/half-full kind of pondering.... I think I posted last week that I had sent out an email to the doctors that I work with - as an OB nurse - just to sort of "feel them out"regarding how they might feel about hiring a CNM into their practice (as there are no nurse-midwives other than Dee delivering within 60-75 miles of our area). I received this response from the 'head' of this OB group today, and took it to be a good sign; it's of course impossible to read, but the gist of it is that most of the MD's in the group think that nurse-midwifery care may be a plausible option, but there are questions that would need to be discussed; it does not give any indication that they are not supportive of CNM care, and that they are willing to entertain the idea... the logistics of it may need to be explored, but it "could be interesting". (Again --- this email certainly could be read with optimism or pessimism, since it doesn't go strongly either way... but tiny seeds, no?)