Friday, April 25, 2008

Caught Up In The Last Days

Yes, I am aware that many of you check in here to see how I am doing and right now I am hanging on by a thread. I am a week and half away from being finished with the first semester of this journey. I mostly can't believe I have made it. This week I had a great clinical week. I took care of a 31 year old woman that had a stroke hours after she found out she was pregnant with her second child. Very sad! However, she is doing "relatively" well and they were working on getting her to a place where she can go to rehab. She really responded to me and that was exciting. Her mother who was there the majority of the time, told me she thought I wast he "real deal" not a student nurse. That was a good feeling, knowing I can pull off the whole gig confidently enough, and the truth is that I am getting more competent and confident in doing all the things nurses do.

So although I am learning a lot I am looking forward to getting through this summer and getting on to the baby's and moms that I am looking forward to working with. It will come and I am settling into the fact that this is a long journey ahead of me and I am trying to figure out a way to enjoy the journey and not be so focused on the end results. Because I have this feeling it's going to be a while before I arrive!

Sunday, April 6, 2008

The Downside of Caring

Moment after moment this week, I felt myself assuming the identity of a nurse. Two early morning train rides before the bustle of the morning commute. It is a completely different world filled with other types of shift workers riding alongside me, often dressed very specifically for their jobs. Wearing my scrubs, filling all those big pockets with the gear for the day. And experiencing my day unfolding as I watch people move through the agony of their various diseases and complications – sharing a few of those moments with them, but fully aware that I am a champion and supporter, but really they must continue to do the hard work of living. I am merely a quiet observer as they live out this life they live.
I have felt this feeling of hopelessness often as a parent . . . knowing that I cannot and will not always be present when the teasing on the playground is occurring, when feelings are hurt, when they have climbed to far and they are just out of reach as they fall. It is this same feeling that I felt often at the hospital. People can only live for themselves. I can augment it, I can be there when I can, and I can try to make them comfortable, and I can use my knowledge to help solve problems. But the limiting reality is that I cannot be them! I am one of those people who has muttered the words, “why couldn’t this be me? I could handle this. I could make it through.” I guess this is what makes me a fighter. The will to get through whatever faces me, however I don’t recommend it for others, so much so I would rather take their place. Why? Because it is hard. Although my gut reaction is to want to take everything over, I must remember that really the journey through many of the trials are often the richest experiences of life. This week I was faced with the reality of having to let my patients, who I am caring for, live in the middle of what they have going on. Not to deny them this journey through illness. I have a role, in my new identity, that has the ability (should I choose to use it) to honor them by helping, relieving, comforting them through the journey. In a medical environment, where fixing things is often the desired outcome, I must remember the power of the journey. As a nurse I have a special ability to be with people along the journey, walking through the struggles and the successes, through the brokenness and the healing.
My struggle this week has been finding the balance of caring and alleviating problems with helping honor the role that sickness has in life and the natural progression of age and the slow decline of our bodies (and fast decline in the case of some of our patients). How do I honor these processes without submitting to their grim power?

Friday, March 28, 2008

The Daily Uniform


So for a South African girl who grew up wearing a uniform to school it is actually quite refreshing to wake up and know right away what one is going to wear. And truth be told since I have to put this on at 5am to make the train it's great to cut down on early morning decision making. And scrubs really are comfortable and I can understand why people wear them all the time and advocate for them to become real clothes. Of course, the white leather shoes on the other hand . . . those could go as far as I am concerned . . . but my dear friend Joyce has promised she will make sure that I never feel it is "ok" to wear them anywhere else besides the hospital!

Sunday, March 16, 2008

Keeping an eye on the goal

This week to keep my eye on the goal of becoming a midwife in the middle of starting clinicals and hubby being away for work all week I have been reading an amazing book. The Baby Catcher . . . mostly I can't believe that I had never read this book before. A dear friend Jenn gave it to me for my birthday. It is the story of Peggy Vincent, here's the back cover blurb:

"She never tired of the miracle. Each time she knelt to "catch" another baby, beloved California mid-wife Peggy Vincent paid homage to the moment when pain bows to joy, one person becomes two, woman turns to goddess, and the world moves aside to make room for one more soul. Trained as a nurse at Duke University in the early 1960s, Vincent begins working in the delivery room of a local hospital in the San Francisco Bay area. Even after establishing an alternative birth center at the hospital, however, she is still frustrated with her lack of autonomy. Too often she witnesses births changing from normal to high risk because of routine obstetrical interventions. Vincent then devotes herself to creating unique birth experiences for her clients and their families. She becomes a licensed midwife, opens her own practice, and delivers nearly three thousand babies during her remarkable career. With every birth comes an unforgettable story. Each time Vincent "catches" a wet and wriggling baby, she encounters another memorable woman busy negotiating her unique path through the labyrinth of childbirth. Meet Catherine as she rides out her labor in a car careening down a mountain road, her husband clueless at the wheel. Megan delivers on a leaky sailboat during the storm of the decade. Susannah gives birth so quietly and effortlessly, neither husband nor midwife notice much of anything until they see a baby lying on the bed, and Sofia spends her labor trying to keep her hyper doctor-father from burning down the house. More than just a collection of birth stories, Baby Catcher is a provocative, moving, and highly personal account of the ongoing difficulties midwives face in the United States. With vivid portraits of courage, perseverance, and love, this is a passionate call to rethink today's technological hospital births in favor of a more individualized and profound experience in which mothers and fathers take the stage in the timeless drama of birth and renewal."


It has been extremely refreshing to get excited about the future babycatching that I will be a part of. I highly recommend picking up this book and being inspired !

Thursday, March 6, 2008

“This is really happening!” is what I thought to myself in an epiphany as I sat through 4 hours of “Powerchart” training on Tuesday (charting software in the hospital). It was just one of those moments when the reality of all the skills and labs that have begun to be furniture in my confined live quarters of the last two months, begin to take shape in a much larger context. I don’t know what it was about that moment, learning to enter data that one day soon I will be collecting and entering into Powerchart, that brought about the clarity. It may have been the actually being in the hospital, actually having a clue about what the various not long ago foreign words and acronyms meant. But there is was the reality that I actually am going to be a nurse.

Then it happened today again at “Research Day” . . . which in many ways I scorn, because I am a feeler, not a knower . . . I think most of life is on a need to know basis (a google expert!). I am most interested in learning things that pertain to what is meaningful and important to me in the here and now. So I was kind of dreading listening to a whole bunch of academic theories being spread around, but today I did get a glimpse into why the theory of nursing might be a little bit different and more appealing to me . . .because evidence based practice is just that . . . the theories actually have a shot at becoming practice. So despite myself, I must admit sitting in that room full of nursing students and faculty I felt a little bit of pride for my new profession. Internally there was an acknowledgement that although I do not believe I fit fully yet and I feel very infantile, that one day I will share the deep heritage and history and unwritten rules of these people and that really they do not appear to be too bad.

Another positive note this week was the physical assessment test, I aced it and I felt so proud and was really affirmed by the testing instructor. I don’t know if it’s merely the fact that this experience starves us of affirmation, but it felt so good to be celebrated for a job well done. I was told that I was going to be a good nurse (something admittedly I believe about myself, but it’s hard to keep believing as I am surviving GEP). It was encouraging to hear: “if you kept on doing just what you had done and that through doing it you would learn many things that would make you an even better nurse”.

Overall, this week has been a mile marker for me. It closes off eight intense weeks of steep learning curves and feeling completely inadequate, never-mind physically, emotionally and mentally exhausted. I am walking away with a slightly clearer identity as a nurse and a little bit of a thrill to walk into the hospital next week and meet my next terrifying experience head on with the hopes that I will indeed make a great nurse and a great future midwife.

Saturday, February 23, 2008

Footloose and fancy free . . .


This week has been a tough one for me. On Monday on the way to the train I fell, and I knew it was bad when I realized I was going to need help to get up. Instead of going to lab that morning I spent it in the ER. I remember sitting on the ice thinking, “is this the moment that takes me out of the GEP program.” What I was excited about was that thought was but a 30second flash through my mind, and I tossed it out as an option. I had just been feeling like this was all beginning to really feel manageable.

Kind strangers trudging through the ice to the Loyola El practically carried me into a bookstore (after having banged on the door begging them to let us in before opening hours) to wait for my husband. Then I sat on a chair, with my foot elevated just sat watching my foot expand. Thinking, I am a student nurse and yet I am completely stumped by what I should do (I did have it elevated and I did ask for some ice, but it’s the “extras” I felt I should know).

I have to admit it was kind of exciting to be in the hospital after having learned even the smallest amount I have about nursing – feeling that much closer to being on the “inside”. Of course I was catching all the discrepancies about practice versus evidence-based practice that we have been learning; and it was a busy morning there with all sorts of patients with similar complaints like mine. I was hoping for the "you win free healthcare today for being the 100th person to fall on the ice" award.

The other thing to come of this experience has been my support network emerging from the woodwork. I had friends bringing my family dinner, a friend who drove me to school everyday, people who came to watch my kids, tidy my house, and pitching in to make my daughter’s birthday party still happen this weekend. It was through this unfortunate series of events that I became aware of just how I am getting through this program in the first place, all of these people who believe in me and are there in the background ready to come around me in the moment I need them.

It has been so real for me how much of a person’s life is spun out of control when things like this happen, not to even compare a simple sprain that has laid me up for a while to anything chronic. I have been amazed at how many other tiny things in my life began to unravel from the simple injury. The perpetuating impacts of small inconvenient hiccups that life sends ones way, that can have larger repercussions. I am so grateful for the amazing support of family, friends and other students, but it makes me consider even more how many go through these things without those support networks and how quickly various parts of life would fall apart.

It has been a very difficult week and staying positive, motivated and upbeat has been a struggle, but I thankfully made a decision moments after that fall that I would fight inconvenience the whole way down, and that I would be on top. And although I am somewhat fatigued and battle torn I feel that I have done just that. Now if a three-year-old birthday party doesn’t do me in I will be ready to sail into next week better than ever!

Wednesday, February 6, 2008

Happy Birthday Cayden

In honor of Cayden's birthday I decided to post his birth story which we read every year on his birthday. It was written by our wonderful friend and doula . . . who was with us most of the 40hours of his birth.

Dear Cayden,

It was almost 8:30 a.m. February 5th when your mom called me to tell me that she thought she might be in labor. She had been having contractions since 7:00 a.m. but felt like she was doing fine by herself. When we talked again at around noon, your dad had come home from work and the contractions were now about 6 minutes apart. I headed over to your home where I met your parents at about 2:15p.m. They were both very excited that the time to met you had finally come.

Soon after I arrived we went for walk in the cold outdoors and got some coffee. When your mom would have a contraction, we would all stop until it passed. Sometimes your mom would lean on your dad a little. When we got back to your house your mom had a bite to eat, we closed the shades, turned on some nice music, and got out the aromatherapy. You mom really liked being on her knees lying over the birth ball. She tried lying on the couch while your dad gently stroked her legs and I talked her through some deep relaxation. Around dinnertime, they called the midwife who said to continue laboring at home.

Labor continued with steady contractions every 4 or 5minutes all minutes all night. Your mom tried all sorts of positions to keep labor moving – she sat on the birth ball while leaning on your dad, walked around the apartment, kneeling doing the pelvic rock, sitting in the rocking chair, doing hip swings, lying on the bed and even talking two relaxing baths. You dad stayed right by your mom’s side, holding her hand and your mom would close her eyes and breathe deeply, making a “Shhhhh” noise with each breath out. It was her birthing ritual that she kept up for the entire labor.

Finally, at 2:45 a.m. your mom’s water broke and we all headed out to the hospital. The midwife, Kathy, arrived and checked your mom, only to find that she was only 1 cm dilated. The news was very discouraging for your parents after all the hard work that they had done. Your mom shed a few tears and Kathy gave her a pep talk to keep going. Despite her discouragement, your mom found strength and kept going like a champion. For the next 12 hours your mom, dad, and I tried everything possible to move labor along. Your mom walked the halls, sat on the birth ball, relaxed in bed, did hip swing, while your dad held her, praised her and all the while she kept her breathing ritual strong and steady.

Finally, at about 2:15 p.m., February 6th, Kathy checked your mom again, only to find that she was still at 1cm. This news was devastating to your mom and dad. Your mom had been laboring for so long, with such strength and courage and at this point, it was hard to believe that you would ever come. Kathy, your mom, and dad, decided that it was time to start Pitocin and some Stadol so that you mom could get some rest. After all that work and no sleep, she was really exhausted. The Stadol allowed your mom to rest for about 45 minutes. When it began to wear off the pain got pretty intense for you mom. The Pitocin was making the contractions come one on top of the other and your mom did a fantastic job maintaining control through a very challenging time. At 4:30 p.m. she decided she wanted an epidural, which, once she got it, began to take effect close to 5:00p.m.

At this point, your mom had been in hard labor for about 36 hours. She had been working hard and was so tired. Your dad was exhausted too. He had stayed up with your mom by her side the entire time. I was touched to see how he entered into the labor with your mom, feeling her pain with her. You could see how much he loved her as he spoke sweetly to her, touched her tenderly, and cried with her. With the epidural, your mom (and your dad) got some relief, but that only lasted for about 2 hours.

Before 7:00 p.m. the epidural was already starting to wear off. The contractions were very close and very strong. Your mom was amazing. She continued her breathing while your dad and I stood on either side of her, each holding a hand. Although it was hard, she continued to stay focused as we took turns talking to her through each contraction. The nurses were rushing around trying to fix the epidural, but nothing they did worked. Time seemed to go by slowly, but by 8:15 p.m. your mom was starting to grunt with the contractions.

When Kathy checked her at 8:30 p.m. she said that your mom was only at 5-6 cm and so should not push, but blow out or pant instead. Your dad was behind her rubbing her back, and I stood in front of her helping her blow out with the contractions. This worked for about 10 minutes until she stared to really want to push. For another 15 minutes your mom did a combination of grunting and blowing, fighting the pushing that her body wanted so desperately to do. The nurses came in and out as your mom struggled. Even the anesthesiologist came in and took your moms hand. When your mom told him that she wanted to push, he got a scared look on his face and left the room. It was pretty comical.

By 8:55 p.m. a nurse finally got Kathy. Kathy didn’t think that your mom needed to be checked again since it had only been 25 minutes since she was only 5cm. However, when Kathy lifted up the sheet she saw a bit of your head and said what your mom had been feeling all along – that it was time to push!

At this point, everyone got a burst of energy as the end was finally in sight. Your dad put on an Enya CD to set a beautiful mood for your birth. During the pushing stage your mom seemed to know exactly what to do. She breathed and bore down with such incredible strength. Your dad was encouraging her while holding one of her legs. Within minutes your head began to emerge. Your mom gently reached down and felt your head. After all the many hours of hard work, you were almost here. And then, at 9:17 p.m., the moment your parents had waited for finally arrived – HAPPY BIRTHDAY CAYDEN.

Cayden that moment was one of the most beautiful that I have ever witnessed. I think it was made so much sweeter because of all that your mom and dad had gone through to make it to that time. Your mom was amazing! She labored for so long, dealing with several challenges with such strength, endurance, and courage. She defined the beauty of what being a woman is all about. You are so lucky to have such a fantastic mother!! And your dad was such an amazing support to her through the whole labor. He said such loving and encouraging things to her, gave her reassuring and calming touches, and emotionally went each step of the labor with her. He was so sweet to watch. You are also lucky to have such a caring father!!

I feel so privileged to have been a part of such a special time.

Your mommy’s doula (and friend)
Katharine Broberg