The fine print...

I feel like I owe my potential clients a sort of disclaimer, or a caveat emptor of sorts, before they really jump into care with me. Making a commitment to join together - whether for continued primary care or prenatal care - seems like kind of a big deal.  Maybe not quite as significant as, say, a marriage or civil union, but important none the less. The health care relationship needs to be built on a good foundation of trust, openness, and understanding from both partners, and I definitely don't want to lure patients in with a false idea of who I am as a provider (or a person).

Now, I don't quite think I need to explain to them that I am the queen of running five minutes late (no matter how I try, I can't quite to make it anywhere when I need to be there... I can leave fifteen minutes early, and still hit roadblock after roadblock), or that I crave naps more than anything else in the world. But I do want to pass on other tidbits; I want women to know where on I stand on their care what I have to offer them. I want the women I care for to know that I value them, I acknowledge their pain and their history, that I'm willing to work with them.

But.

I also want them to know - regardless of whether this is perceived as negative or positive - that in caring for them, I'm investing in them. (Side note: I'm not very financially literate - I can manage to sign the right forms with my work-related retirement and, um, usually get my taxes filed on time, those kinds of things, but stocks and bonds are waaaaay out of my sphere - yet even I recognize that when you invest in something, financially/emotionally/otherwise ... you want to see it grow and be well.) I want to see my patients be well; I want to see them improve their health, their families, their relationships. I won't prescribe narcotics or any medications that are known to be abusable to a client that is new to me, and I'm very, very slow prescribe them to anyone in general. I encourage, prod, preach, discuss, promote, celebrate exercise and meditation and the "right" diet and good sleep habits and physical therapy, massage, chiropractor, acupressure, so many other complementary therapies. I empathize with chronic disease, mental illness, family struggles, but also emphasize the importance of working to address problems from a multifaceted approach rather than simply a pharmaceutical one.

As a midwife caring for women during the prenatal and intrapartum period, I specifically want the expectant and new mothers I meet to know that I will be with them every step of the way.* I am honored to walk with them, step by step, as they journey through the path of creation, and ready to meet any obstacle along the way together. We will embrace the normal and address the rest, but together. I won't prescribe Vicodin for low back pain, I won't induce at 39 wks "just because" ... but I will be there.

*(I feel like, maybe, I should also warn many of my prenatal women that, at one point or another during labor and delivery, they will all likely hate me... does that seem fair??)

~*~*~*~*~*~*~*~

Medicines are not meat to live by.  ~German Proverb

Long time gone...

Hey, nice to see ya! Where've you been?!  Oh, wait, I guess maybe it's where I been, eh?

So, needless to say, this post is loooooong overdue.  I think this blog's last posting was somewhere around, oh, six months ago?  Huh.  I guess it's been a busy half-year.  Since our last rendevous, old friend, I've packed up and picked up everything to move half a days drive away, officially gaining entry into the world of a practicing (and paid!!!) nurse-midwife, and gloriously helped a powerful mama pull her newest into her arms, standing alongside her bed... (my first out-of-bed birth - woohoo!). I've said goodbye to so many friends --- and in a heartbreaking moment that doesn't end, to my baby brother, standing alongside each of my family members as we realize the swiftness with which goodbye can be missed; I've lain awake at night and struggled with my own internal guilt, fears, remorse, anxieties - both professional and personal.  I worry about meeting the expectations of my clinic administrators, meeting the needs of my clients, about being thorough yet not over-ordering or falling behind; I fret about when the golden hospital privileges will finally be mine, how stressed my partners are in the meantime while they await that day and how tiring it must be to have to back me up until then.

And, of course - I yawn, I drag, I sleep only halfway 98% of the time, hoping/not hoping my pager will go off... if it does, if that next mama's water finally breaks, it will be one more babe closer to independent privileges and a bit of relief for everyone all around (but if it doesn't, of course, it means a bit more sleep for everyone on the home front.) Officially, I'm on call something like four nights a week - but unofficially I've been sleeping with my pager under my pillow just about 24/7 since starting in April - or at least since getting permission to get near hospital patients a month or two ago. It doesn't beep at me often ... yet I still dream that it does, or that it did and I slept through it, or that the batteries died and someone's been frantically trying to find me, yadda yadda....

Oh, but the catches - the sweet, slippery, lovely babes!  (Really, isn't that what it's all about??) When it's down to that moment, the rest of the stress, the worrying, the anxiety melts away.  Until, that is, the hemorrhaging afterwards... or the placenta sticks... or mama passes out later on.... you know, those sorts of things....  But the catch itself, usually, is a rush!
 
I pledge, from this point forward, to stay more loyal to this blog.And I hope you'll stay here, too.  Like any good things, any journey worth taking, it may be a long road, but hopefully worth the travel....

My "birthingway" necklace ... or "mamalove" necklace... or "I Catch" necklace" ... or ??? 
(I'm open to suggestions!) ... for every babe, a bead <3 

 

North by North West...

That - is the question.

At the end of the last post, I alluded to some internal conflict between the two sites where I recently had interviews. The first site, dibbed "North", is located about 5-6 hours from where my family has always called home. It's got quite a few things going for it; the pay is nice (relatively - I don't know what the other nurse-midwives that graduated in my peer group are being paid, for the most part, but the rough starting pay I was quoted for this position is about what I was expecting based on my searches for this area). The site is also a HRSA (Health Resource Service Administration) designated site, and the position is eligible for loan reimbursement --- which means that by committing to work in the role for at least two years, I would say buh-bye to a nice chunk of my student loans (and by working a third year, one more of those big ole monkeys would also take a hike... leaving me just about free and clear on the loan front). My partner would be a midwife who developed the nurse-midwifery practice at the site ten years ago, and has worked to build a great relationship with the handful of family practice doctors who she works alongside (by the way, I LOVE family practice doctors - not such a fan of OB's --- most likely because I simply have worked with very few, but also what I have heard of them hasn't been so favorable...). The main clinic at this site is located in a rural area and is very full-service, offering clients a range of services from x-ray and lab to WIC and massage; the practice also has a secondary site in a large city about 30 minutes away, with limited services (but just as vital care for recipients in the urban area). Call would be shared, possibly 2-2.5 days a week and 1 weekend a month (with an estimated 50 births annually); clinic would be 4 days a week split between the two clinic sites. After visiting "North" --- I felt good, confident, ready to go. I had a strong feeling that I was going to be offered the position, and that I would probably take it.

But. (That "but" is always there, now, isn't it?) In the days that followed our return from our visit, a few things nagged at me. At the end of my visit with the midwife at "North", I asked a few questions (thankfully) regarding the specifics of her midwifery practice. Did she feel that she did a lot of inductions? (She felt like she actually probably did more than she should... red flag?! red flag!! Her rationale? She did take days off - understandable, since she was a solo midwife and had been for the past 10+ years; she stated that she did offer induction at times to her patients before she went on vacation. Hmmm. So - on one hand, this seemed OK. On the other... something to ponder.) What about continuous monitoring versus intermittent? (Answer: If a woman specifically wanted to be off the monitors, she was good with that - but if there was no preference either way, she didn't push for intermittent monitoring either... ???!!? Rationale for this one --- The nursing staff tended to be low, and this made IA difficult to impossible at times. The unit did have telemetry, so continuous monitoring didn't necessarily =/= a patient that was stuck in bed --- but then again, MY unit also has a telemetry unit... which sucks. As much as I'd like to say telemetry means a patient can labor while ambulating, or in the shower, or on the toilet or squatting or standing on her head --- not necessarily. Especially if she's on continuous EFM for nursing/provider convenience in the first place. S0 - another thing to ponder. While again I can understand the reasoning behind using EFM versus the additional time necessary to IA --- and am glad she had that explanation rather than that she needed the security blanket of the paper/electronic strip to ensure babe was doing all right --- I still get nervous at the idea of having hours and hours of paper strips staring at the nurse... and resident... and whoever looks at them and starts seeing oogie-boogie monsters in the shadows of innocent variability or the occasional benign decel.) Those were the two biggies on my "hmmm" list... From just a facility point of view, it would take a while to get used to LDRP's that are half the size of the ones at "my" rural critical access hospital, some of which have shared bathrooms. And residents (I've never worked with residents in my life - they seem like a whole different species!). And - while I won't say specifically which states, I will say that "North" is in a neighboring state which has a longstanding, sometimes vicious football rivalry with our NFL football team. And the Warm One is a diehard football fan.

So there are at least a handful of things that "stick", if that makes sense. Not that I'm not seriously considering things --- it's just not 100%, yet...

And then - there's "West". I flew out there last week and fell in love. I texted the Warm One immediately (or maybe it was after dinner with the midwives - either way, I hadn't been there long) and emphatically told him that I would cry if I didn't get the position. Throughout the course of my two days with the midwives at the "West" practice, my position on the area and their care philosophy didn't change. At all. I want to go there. The town where this practice is located? Beautiful. It's twice the size of the small town I live in; I'm a small town girl, so I can handle that. Their practice? Gorgeous. Clinic exam rooms that are spacious, with huge, full-sized "beds" (seriously, I have no other way to describe them) covered in pillows created for expectant mothers to lounge --- alongside big brothers and sisters, or dads-to-be as well --- and chat, listen to that precious heartbeat, and learn. Beautiful birth-inspired, earthy artwork everywhere. No sterile white walls or ugly, plain paintings meant to be aesthetically neutral. All of my questions - "Do you induce a lot?" "How do you feel about VBAC's?" "Are you open to a new grad?" - are met with just the right answers ... yes, inductions are necessary sometimes --- but not just 'because'! And they do VBAC's, and waterbirths, and LOVE students. It's amazing just to pick up the calm, reassuring vibes as they answer questions - to picture these two women as mentors is mindblowing. The call/clinic schedule is specifically geared to give each of the three midwives a rejuvenating period frequently; at least once every three weeks, each midwife gets a 5-day off stretch (that is, five STRAIGHT DAYS OFF in a row. Heaven. No clinic, no call, nothing, for five days.). Clinic and call are intermixed, often with stretches of 3 days off in a row as well. As one of the midwives stated, "When we are on-call, we usually work hard (the group of three midwives delivers between 250-300 babies annually) - but when we're off, we also 'rest hard'." I can dig that. To be able to serve my patients AND my family? Awesome-sauce. And the hospital is about 2-2.5 larger than 'my' OB unit --- so larger, but not as large as "North"; the nurses were great, and loved the midwives. Downfalls? Cost of living! To find a house under $200k may be impossible, and we would have to trade in one of our cars for an AWD or four-wheel drive; the pay "West" is also significantly ($10-$15k - ish) less than "North", with 2 weeks less vacation time and likely less benefits in other areas, particularly no loan forgiveness. Big things the Warm One is concerned about. And, of course, being a plane ride away from Home. Where the hearts are.

Speaking of home.... And hearts. It's a hard thought to think of leaving everyone that I/we love behind us. As much as I always suck at returning messages, emails, phone calls, etc --- it's even harder with all of this going on. Part of me wants to ignore that any of this is happening - that any changes are coming - but to do that it also means ignoring any references to change. Whether we go "North" or "West" ... or anywhere else ... it hurts. And it's scary. But it will be okay, too.

For the time being, I'm waiting for a phone call. A phone call from "West" could be making a decision that we go that way - throwing caution to the wind and hoping that the cost of living will balance out - or the other way. Or, perhaps, no call, but a "thank you, but no thank you" letter (as they did have two other candidates yet to interview...) leading us "North" ...

~*~*~*

In the meantime, I'm content to be back on the edge of that abyss, arms wide open, and leaning in, knowing that wherever the fall leads, I will land gently...

Opening

That last post? It was the darkening before the dawn... the cold, bitter rains of March right before springs first tentative blooms poke through the thawing ground... the tensing of every last muscle, stressed, fearful, fatigued -- and then a loved one's arms are there to encircle and release it all to the universe itself.

Do I need to step back a mile or three? Maybe that would help...

From a career/baby-catching standpoint - you could say that the last post was somewhat colored by the sludginess I've felt in my job search. (Which, in itself --- seems somewhat silly... I didn't expect to come out of school with a job in hand, as nice as it would have been. But still - now that it's been five months, I'm getting a little antsy...) Every day that I go without that delightful weight sliding into my hands, without gifting mothers with the words "here's your beautiful child" ... it weighs on me. Sure - I can still go to work as an L&D nurse; I can still whisper forbidden encouragement into the ears of hardworking mama's ("go ahead... eat some crackers... nibble on that granola bar..." ), but it's not the same. The mothers, the fathers - they know I am the nurse; they have only just met me, and even if we have "clicked" and even if they can sense that I am there for them and their babe --- I am still, just, the nurse.

I've sent resumes, CV's, emails of inquiry. I've had an ongoing email chain, complete with an powerpoint proposal, to the physician group that I've worked with for the past five and a half years - a handful of great family doctors who practice this close to the midwifery model of care. Throughout my clinical rotation with Dee, there was the shadow of a promise of her practice adding a second CNM. Nothing. Zipzilchzerozuess. "My" doctors decided that while they felt there would be interest in a CNM in our area, they feared "there would not be enough demand for a full-time position". A few attempts to get in touch with Dee (after a promising email before the holidays that her administrator was going to start the process to try to get the wheels going...) weren't returned. A promising position - complete with loan forgiveness via the HRSA program - seemed very likely and suddenly... *poof*! Que sera, sera.

But. On top of this, I live in the Midwest. In winter. A gray, long, cold Midwestern winter. The task of looking for a job - refreshing the same search engines, day after day (many times multiple times daily) - combined with more and more student loan payments being auto-debited as the days stayed devoid of sunshine ... you get the picture. Little by little, negativity begins to replace the fresh enthusiasm of graduation; did I really just sacrifice three arduous years and an incredible sum of blood/sweat/tears/trees/memories/etc (not to mention indebtness to the good old Department of Education/Loan Repayment Program), only to continue to work very part-time as a labor and delivery nurse?! Am I undesirable as a CNM?? Is there something that screams "don't hire this girl, for pete's sake!!" on my resume? Do I need to eat more chocolate - will that help??

So - anyway. It was a long couple of weeks, and maybe that post reflected some of that. In the end, I resigned myself -- or liberated myself -- to the old "letting go, and letting God" (or the Creating, or the Universe, or destiny, or karma, or what have you... I'm not entirely sure, myself) take over.

And - it worked.

Not long afterwards, I heard back from the site that seemed like it could be the "perfect" fit (we'll call that site "North" for the sake of, well, easy-ness). It turned out the midwife's mother had been ill and unfortunately passed away; that had prolonged the interview process, but ultimately within the next week or so I spoke with the midwife and HR folks, and set up a time to go up and meet them all in person and tour the site. I also sent a CV to a second site - this one a private midwife practice out west (we'll call this one "West" for those of you following along), and had some nice back-and-forth communications with them via email. After my first Skype interview (interesting enough), I was invited to fly out there and meet them in person as well. Both visits/meetings went great, and now I sit with one likely offer (from "North", pending the approval of one final committee) and a call back next week from "West", where there were still 2-3 other applicants to be interviewed.

My dilemma may or may not be solved by next week's call by "West" ... but that's another post!

The Abyss

I waver between two different realities. One, I stand on the edge of a total, all-encompassing darkness. My bare skin is chilled - goosebumped - but invigorated. Behind me is all I know, everything familiar, the things that have always been. In front of me is... what? Nothing? The steep, sudden chasm at my toes should frighten me, yet I feel nothing but an overwhelming sense of calm now; that fear - fear that should envelope my entire self - has vanished along with the light from this space. I know that to step off could end everything - but it could also be the beginning of everything. With the slightest step into the unknown I will open my wings and fly to the place of my dreams, or simply land where I'm meant to be: a pillow of soft clouds, the waiting arms of a One who created me, or the place of my family's future. A soft wind's push, a strong legged-leap, a quick stumble... any of these things would move me on, and yet - I pause at the edge of the question marks beyond.

Then there's the second place; the place where the Fear lurks. Down a constricted, narrow earthen tube - barely wide enough to descend, long enough to make the late afternoon light little more than a tarnished penny above - lies the insignificant yet crucial room. Constructed of thick steel, lined in double layers of thick and splintering wood, barely larger than a bathroom stall (and certainly less than five feet tall)... it smothers, it suffocates, it shrieks. Time stands still at the same moments that it races by; in the silence of the box, the deafening darkness threatens me with insanity. I stand at this fissure, knowing the only way to complete this journey - to pass this test - is to descend the long ladder downward, to endure my time inside with my Fear, and fight my way back up and through the long, tight passage back... and I struggle, I fight. I know I can do it, and I know I should do it - go down, do my time, and emerge victoriously, proud of my dirt and raw, rubbed skin; I know the struggle is the true origin of my Fear.

~*~*~*~*~*~

And yet - I still stand here, at the edges. Aquiver.

Will work for Food...

Seriously, I will... I certainly have a bit of a love affair with food. Especially this time of year, with the county fair in town: cream puffs, beer-battered cheese curds, funnel cakes.... Oh, my poor achin' arteries.

And summer. I love summer too. (Can it seriously be Labor Day already?! I want to cry! I do *not* do well with winter... sigh...) Anyway.... this blog has clearly been neglected for the past month or so. Oops.

I've been a little busy, to be fair. Since the last time we met, I scratched off each and every last clinical hour and visit I needed to meet the requirements of my program, as well as having a "declaration of safety" submitted by Dee (signifying that she feels I am a safe, beginning-level practitioner); one of my biggest feats was taking - and passing - the first of the last 3 big tests standing between myself and midwifery. I'm engaged, descended, and flexed - now on to finishing the rest of these cardinal movements, little by little...

(was that too corny?!)

From a personal standpoint, things have also been busy. Family life has been hectic as always, with ups and downs. My bigger-Mini started Kindergarten (!) last week, which seems incredible; I still remember the moment she was laid in my arms and the immense feelings of wonder and

awe I felt to be a mother to such a wondrous little being; my Mini-er is beginning preschool this week (and memories of her labor, and birth, are even more vivid; the moments in the shower, visualizing her path down to birth, and the moment when the Warm One proclaimed her as a "little girl"... so clear!). Harder to work through these past weeks have been the continuing struggles with my brother and his own battles (battles which he alone can fight, but that as a family we have been trying to find ways to support him in...), the diagnosis of Lyme's disease in my father, and acute, aggressive leukemia in my grandfather. It's painful and exhausting to see the toll, both physical and emotional, that's accumulated across the family lines in the past weeks and months; through hopes, prayers, and support (and communication), I'm waiting for a strengthening of the bonds that hold us together.

But, back to the "Work" thought that started this whole rambling... I'm starting to think more seriously about jobs again. (It's getting to be time, I suppose. I have one more "school" test - the competency/completion exam, after which I am officially a graduate nurse-midwife, and the final step is the national certification exam). I've realized, after doing a phone interview or two over the past few months - mind you I haven't interviewed in years! - that I need to brush up on my interviewing skills. I thought maybe I'd toss out a few random, jarbled thoughts on here, if nothing else, to help myself sort out a little more about myself (you know how they - "they" being interviewers, of course - always ask about your strengths/weaknesses, what you would like to improve on, etc...)

About Me...

* I'm not there yet, but I'll be there soon!

* I don't drink coffee... but I anticipate that I will start to do so soon...

* I run habitually late (not much, but just enough to be a few minutes late...)

* But - see above - I'm reliably late those few minutes!

* I learn by doing, not by reading/listening

* I'm quiet - but only for so long. I will open up (you may be sorry....)

* I do have a sarcastic streak... and a good sense of humor!

* I may hold back a bit at first - let my confidence build, and I will shine.

* I trust women, their bodies, their intuition, and their abilities.

* I am a very dedicated, motivated employee.

* I can't even come up with enough to write here! Man, I better hire myself out to a farm or

something instead....

And what goes around... (on depression and stress, too)

As they say.

Ebb and flow, yin and yang, yadda yadda. After my little meltdown Friday, things eventually lightened up. (If you've followed the blog at all, or know me, I'm sure you know this is nothing new... or maybe this isn't just me personally, but something that is a natural phenomenon of this thing called life. Maybe it's not unique to mothers, or women, or grad school, or th

ose of us who deal with depression. Maybe it is. Does it matter? Not really.)

Anyway. I posted a similar cry for help, bemoaning my situation on Facebook; basically, that the Warm One was at work, I was at the end of my rope with the girls and had no idea what happened to my patience, and the end of the weekend (the Warm One works a weekend program - Fri/Sat/Sun only, therefore leaving the girls and I to our own devices all weekend) seemed ages away. I was desperate.

And out of nowhere, a good friend came to my rescue. She invited the girls and I over, to visit, to play, to stay. It took us hours and hours to get moving and get packed, but eventually, we got there. She opened her home to us, the girls played (she has a daughter the same age as the Mini-est), and we were able to catch up. We spent Saturday together, just hanging out. Was I the most fun and exciting person to be around? No - but I hope I was a better mother and friend than I felt like I had been earlier that week. Little by little, I am crawling out of this miserable, stress-filled hole.

Before the girls and I left, I managed to pull myself up out of my funk enough to send a copy of my resume/cover letter to the physicians I work with as a labor/delivery nurse, simply to introduce the idea of adding a nurse-midwife to their practice (I've been hoping to have the 'right' moment to talk to some of them about this over the past year or so, but it just hasn't happened); I also emailed my nurse-manager to touch base. My fingers are crossed - even though my breath is far from held - that good things could grow from this tiny seed being planted.

The Warm One also came home last night and shared that another doctor, an incredibly sweet family physician working for a nearby tribal clinic, had asked where I was at with my job hunt; she mentioned that the tribal clinic had been trying to fill an open physician spot for the past year, and she was willing to bring up my name at the next physician's meeting to see what the interest there would be. Again, fingers crossed... I've worked at another nearby tribal health organization in the past, and love working with Native populations. The culture and history, combined with the deep relationships between families, make it a community I would be honored to be invited to work within. (I've requested information from the IHS about their loan repayment program, but have yet to complete the application process; it's on my radar as yet another thought...)

*And, if nothing else - this again cements to me the fact that I cannot - at least at this point in my life - function without antidepressants. I know that there are many different viewpoints on this and whether or not medication is something that is "right" or "necessary" but until I have one or two fewer things going on ... I can't let myself - and my family - go down this road. It never fails that when I manage to go without taking the pills for a short period of time - whether because I fail to get a refill in a timely manner, or because I miss one or two, and then tell myself I still feel "great!" - I find myself in a similar murky fog within a matter of days or a week. Someday, I will be able to truly dedicate the time to find other positive

lifestyle changes to experiment against this headgame, but as for now... I'm gonna take the easy way. I need to be able to accept sweet love notes from the Mini and appreciate them; I need to be able to have patience with my girls when they are being kids, instead of being over-anxious and stressed... I can't see the confusion and hurt in their eyes when they look to me for comfort, and don't get it; this parenting thing is hard. I feel like I hardly see the Mini's lately... and when I do, they're not my sweet little girls anymore! They don't listen... they're sassy... they fight. I don't know if it's a stage, or if it's related to not seeing me, or if it's how it's always been (and I'm just seeing things differently because I'm stressed), or if their actions are feeding off of me, or ...?!

Just keep swimming, just keep swimming...

It's seriously 99 degrees outside, with a heat index (whatever that is) another 10-15 degrees hotter. Wooooohooo. Swimming sounds amazing, no!?

At least in a symbolic sense (or a Finding Nemo sense), that's what I'm doing. I'm not sinking, I'm not thrashing wildly trying to get through these last few weeks of clinicals, and I'm doing more - at least, I think so - than just treading water. The end is in sight! I've just crossed the 600 hr mark (out of 675 required hours) of clinical experience; most of my numbers are met or very close. "Dee" keeps throwing this hope-rope to me about submitting a proposal to her administrators to add another midwife to her practice; several of her doctors are on board and supportive. I am so comfortable working with Dee, and with the women she sees - I think we are both praying that things work out and they (administration, that is) agree that expanding her midwifery practice would be beneficial all around. I also just had a phone interview - or at least, a short chat - with a midwife from another midwifery practice about an hour and a half from my home... it was encouraging and again gave me hope for a job opportunity in the near future.

So, while I'm trying desperately not to get too excited about any of these possibilities - and trust me, I really want to get excited... how great would it be to stay within an hour or so of our families?? - it does allow me to drift into the occasional daydream. House hunting... comparing elementary schools... thinking about future vacations and scheduling considerations... and, oh yeah, maybe a paycheck! (This whole "9 months of clinicals and little working" thing has really, really hurt our finances... I think anyone who's been in this spot can commiserate!)

Two more weeks - give or take - of clinicals; one more assignment (a client journal that I should have had done long ago, but had to start all over after the abrupt change in clinical sites); several uber-important tests. It's not that much, especially considering how far I've come this far - but when I look at it that way, it can easily overwhelm me. So, instead --- I'll just keep swimming.

(And, on a side-note, I'll keep looking forward to the end of September, when I will hopefully be an official nurse-midwife, and celebrating in Punta Cana...)

Paradise... or Alaska?

Jobs.

Everybody needs one, but a lotta people don't have them. I've been breezing (breezing?!) through this midwifery school thing, telling myself the whole time, "It doesn't really matter if I don't find a job right away, I'll keep working as an OB nurse until the right CNM job comes along..."...

(I don't know how to make a SCREECHING HALT noise appear on my blog, but if I could --- that would be the spot for it.)

Suddenly, almost two years into this thing - it hit me. I want to work as a midwife. Like, literally, the very second I can. I love being an OB nurse - but I hunger on such a much deeper level to be a nurse-midwife. The few shifts I've worked as a nurse since starting clinicals have been agggggoooonnnizzing. To stay in the background, trying to be encouraging while the (gasp) doctor gets to (gets to??) wheel in and yank the baby out?! Ridiculous! That's supposed to be me, sitting next to that mama, coaxing her babe out with her... not on that fun little wheely chair, with the bed broken down. Nope, I get on the bed, with her, and together, the four of us (mama, dad, baby, and me as an afterthought) we breathe, we push, we scream, we swear, we laugh, we grunt, we poop (well, maybe we don't all do that one...), and - eventually - mama delivers.

So, anyway, that's where I'm at today. And was yesterday, and the day before. Midwifejobs.com. Looking for - you guessed it! - a midwife job. (There are, of course, no midwife jobs in my near vicinity) New York? I'm too small-town. Florida? Ugh, too --- pan-handle. Paradise, CA? Bingo! I checked out the posting, and it sounds wonderful... looked at the attached link and website, and it's gorgeous. The more I snoop around on the site, the more I love it - especially when I learn one of the midwives is an alum of my school (not always a good thing, I suppose, but I love my school, so it seems like a good omen). But, my hi-how-are-you-hey-can-I-come-visit-and-maybe-do-some-clinical-hours-with-you-and-by-the-way-please-PLEASE-PLEASE-hire-me message is first rejected by their "contact us" form, and then by the email address listed.

Boo. Fail. Hiss.

I'm starting to think if Paradise won't work, maybe I should give up the whole darn thing, when I stumble across a listing for a tribal site in Alaska. (Now, I know what you're thinking... Alaska?! A girl who can't even handle the only-moderately cold, snowy, gloomy winters of the Northern Midwest would consider... Alaska?! And, you would be --- right. But, hey, Paradise is shooting me down, what do I have to lose?)

So, I started filling out the application. I've worked for tribal communities before. I've been a tribal games employee (I tried my damndest to know basic strategy for blackjack, but just never got it... even so, I seemed to make good tips), and a maternal child health nurse, so that seemed promising. I started having visions of pristine white snowfalls, Alaskan Natives and pure culture surrounding me... and then thought of having my closest family and friends being what google maps told me would be, officially, a 2 day, 15 hour car ride away.

Now, I won't say if that would be a good thing or bad thing - but it was enough to make me stop and think. And then, I realized, it was two o'clock, and time to get ready for work. And then I looked outside, at the pure, fat white snowflakes falling, and thought, "f*ck, it's going to be a cold walk to work."

I'm gonna hold out for Paradise.