Thursday, February 4, 2010

Midwifery is... catching?

One of the things that was worrying me about having all placements at the same hospital so far was how disorienting it was going to be when I needed to move on to a different one.

It turns out I was right to worry (for once) - being in a new hospital is really, really tough! 

I started my OB placement this week.  However, the OB who will be my preceptor is not working much this week, so she arranged for me to work with her partner for a few shifts.  Yesterday she urged me to go find the partner OB at the hospital during her call shift.  I wasn't expected to stay for the whole thing, but just go and see if I could get some exposure to "interesting stuff" and stay for as long as I wanted.  It was a bit of a disaster, because she wanted me to go do a delivery while she was busy with something else.  I didn't have time to tell her I am not comfortable doing deliveries... 

... long story short, catching babies - the epitome of midwifery - is a skill I have not yet developed.  In the grand scheme of things, it is a small part of what midwives do, and so I have tried not to worry about the fact that I still need to work on it.  When the baby's head crowns, I get all kind of panicky, don't know where to put my hands and just generally end up freezing.  At this point, someone has always taken over.  I feel that all I need is a verbal cue to snap me back into action, but I haven't had that experience yet.  And so while I have been "hands on" in the catch of many babies... I have yet to get comfortable doing the catch entirely on my own.

This particular delivery ended up being precipitous, meaning FAST - and when I arrived in the room there were about a million nurses in there bustling about.  They told me the head was crowning.  Did I want to do the delivery or did I want them to do it?  Mustering all the false confidence I could, I said that I could do it.  I put my gloves on and went over.  I felt like I was on stage with all those nurses watching me.  I had never been inside this hospital prior to this, none of the nurses knew me and not one of them was a familiar face to me.  Everything felt foreign, and I didn't even have my real teacher there to support me.  The head was born, restituted and then... I froze.  Thankfully the OB had arrived, and she took over... she talked me through her actions, "anterior shoulder, posterior shoulder".  Then I grabbed the wrong things off the birth tray... she had to clamp and cut the cord, everything.  I was totally disoriented.  I appeared useless and pathetic - and I'm not just being hard on myself.  To top it all off, the mom had a second or third degree laceration that the OB repaired... although I know that is not my fault, I feel responsible, like maybe if I had known what I was doing I could have avoided it somehow.

I'm ashamed to even admit this happened.   

When it was over, the OB told me that I was free to go since there was nothing more going on.  I walked away from the hospital feeling humiliated.  Since it happened I have been trying to digest it and move forward, as I try to do with all "mistakes".  But this one is so overpowering.  So many factors intersect to make it worse than the experiences I've had before.  New hospital, new nurses, new teacher - not my real teacher and likely does not really want to have to be responsible for me - my most uncertain skill, and no ability to communicate about the experience afterward.  Why didn't I just tell the nurses to complete the catch when they asked?  I keep seeing that baby's head sitting on the perineum and my head just didn't tell me what to do as I expected it to.  Groooooaaaaan.  I can admit that I have grown leaps and bounds in so many other skills - why did this have to happen within the first couple of hours ever in this hospital?!

The real kicker is that just that morning I had told my actual teacher OB that catching is a skill I need guidance and support and practice with during this placement because I am still uncertain about it, and she was very supportive!  But no one at the delivery knew this - they only knew I said I could do it.  And then I clearly could not.

I barely slept last night because I kept waking up, remembering and feeling sick, then going through the scenario again and again, thinking of what I could have done differently, or of how embarrassed I feel.  I'm having such a hard time letting it go... I guess because as a third year - nearly fourth year - midwifery student I think it was fair of them to assume I would be able to catch a baby.  The fact I couldn't feels so humiliating. 

I have to meet my OB there in the morning because she told me she's to be in the OR... but weirdly, the assistants at the office didn't tell me about that... so I'm half expecting to arrive in the morning and no one will know what I'm talking about. 

I'm feeling really down and really disoriented.  But I'm trying to get back to being positive and laughing at myself!  I'm aware there is a good chance I am making it a bigger deal than it is.  But I can't seem to help it!  What a roller-coaster...

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