Friday, February 22, 2008

What a week

I try to take things one day at a time, but lately several lifetimes have hit me at once.

OK so its an old saying, but this week has been MAD! I don't know whether I'm Arthur or Martha.
Don's away. I've worked four shifts since Sunday. We seem to be a bit in 'shit magnet' mode. Nothing earth-shattering, but just stressful, and a lot to take in all at once. I'm not sleeping too well either, so if I seem a bit whiny...sorry.
My daughter has had a meltdown at TAFE and needs a Disability Support Advisor meeting - which had to wait until today because I've worked every day this week. Also last week our son Patty was told his co-lessee wasn't willing to sign with him again, so he would have to live elsewhere. Sigh. The Perth rental market is appallingly expensive and rare and it had taken 6 weeks for them to find that dogbox anyway. What a pain for him, rejection and facing the prospect of moving back home to his sister's music at deafening volumes on the other side of the wall from his bed. GAH! The gall of it. He says it's his only objection to moving back (do you hear the empty nest dream slipping away?).
So last Friday I had a wobbly nearly 19 year old, a downcast 22 year old, a cabin-fevered re-entry post nightshift me trying to figure out WHEN in March would be a good time to deal with all the appointments, weddings and required presents, travel away to Japan (and shop for host gifts) AND move our large son and his stuff back into a single room in our house at the exact time we were away, and have him start uni again doing 3 subjects for the first time in years, and work night shift....lah, lah, lah....feeling of rising panic.....

So, today, I was on my way to the TAFE appointment (via a lightning lunch with Lesley and the girls) and Steff messaged me to bring her correct kitchen shoes - Gah - already late - then on backtrack home I realised that I hadn't brought the whole Stephanie reports file I had got out to take to the meeting anyway - double Gah!

Flew in the door, grabbed stuff, got stuck in roadworks on way there, took a call from my rostering manager who had LOST my 5 months old note about going to Japan in the March roster and wanted me to work night shift in that fortnight O.M.G. (calm blue ocean, calm blue ocean). I could fit in 2 before I left and only had to do 3 afterwards if I did nightshift so I said yes.

Screeched up the driveway to TAFE 15 mins late, briefly tried again to call the DSA to tell her of lateness, and she answered this time - and told me she was stuck 3/4 hour away as she had just had a (minor) car accident and wasn't going to get back in time so we would have to reschedule. Phew. Threw daughter out of car again, pouting, back to class with money for the drink machine (small sop to sulks to prevent repeat of last weeks meltdown). Bye hon, pick you up at 9.15 tonight!

Drove home again, regretting having left lunch at all, sigh, but anticipating having some time to myself for the first time in 2 weeks. NO. Adorable son home, eating his way through food earmarked for other purposes, including my dinner of leftovers for when I was home by myself, praise the Lord! No such luck. Lucky his Mum loves him.
I then went to mark the nightshifts on my calendar and realised I had unwittingly agreed to work ALL OVER EASTER ON NIGHT SHIFT prior to going on holidays for 2 weeks. Sigh. Save me from myself, someone. Please. Anyone? What a moron. However as I had little other choices due to not being in the country for most of the roster I just chalked it up to shit happens and laughed. I did call her back and tell her that I was laughing at my own expense. Quite hard. If you don't laugh you'll cry. And it might (might) save me from eating so much chocolate - oh who am I kidding.... May I introduce my current coping method.

I also have a houseguest at the moment who is delightful and I never get to see enough of her (because she lives on the other side of the country), and now she is here I have worked 4 shifts since she arrived - go figure. She is with us because her daughter has had a prem baby last weekend. A dear little fellow called Max, who is sweet and scrawny, but his Mum has a good milk supply so hopefully he will be fattening up soon and be able to head home where they can enjoy him all to themselves (because that's where parents and babies should be). It is so good to have her here, as we live close to the maternity hospital and she can see the little family readily, and ask lots of questions about prem babies (some of which I can help with). She is also very warm and wise and is lovely with Steff who is missing her Dad and her morning routine of getting off to TAFE with him. And she knows what it is like to have a touchy daughter with little niggly habits, and doesn't interfere just helps debrief after the flurry is over. Always positive. Very wise.

Baby Max is about 5 weeks prem, and being so little I feel he needed a tiny cot-friend that doesn't dwarf him, so I made him a little rabbit. I had an old yukata (a Japanese bathrobe) with lovely fine stripes, and teamed it with some fine cotton twill. I got the pattern here. Isn't he sweet?
He has a dear little tail too. See?
I think i'll make his Mum and Dad a journal covered in that little stripe for their thoughts about the time of his birth.

I've also had a pretty average week at work, STILL no babies to call my own since Jan 6th (I'll whine and whine until I get one - you know this don't you? And then I'll want MORE). And I have only seen 2 normal births (one of which had a PPH as I described, and the student midwife got the birth) The other had a beautiful natural fast birth (her fourth, and the resident doctor got the birth) and then the Mum cried out "what's wrong with my baby's hand?" It turned out she had a congenital hand defect with fused and absent digits so it looked like a flipper. All else was fine, the baby vigorous, and fed quickly after birth, but I'll never forget the tone of shock in the mother's voice as she was the first to notice the individuality her daughter was born with. She was quite withdrawn for the next half an hour, then after the feed we checked her out thoroughly and Mum felt the finger bones within the hand and we started thinking she would have a very usable hand after a few tweaks and divisions of skin. Mum was cheering up a bit by then, and decided she wouldn't tell her husband until he came for a visit later that day. That was some really fast adaptation I witnessed. Good for her.

I've had a mum with really severe pre-eclampsia at 27-ish weeks who was too sick to wait and had to have the baby by CS that day. I also had another woman from the country by ambulance labouring with a transverse lying baby at 32 weeks who needed a CS quick smart! I had almost NOTHING with me and the poor little mite went to the nursery with a blood gas syringe wrapper around his leg stuck together with a Mum's label as his ID tag, and his history literally on the back of an envelope. I just smiled and handed him over real quick!

Yesterday I had another large woman in early labour following an induction for postdates. Her hubby sat on the couch and played an electronic game for the first two hours. I nearly kicked him. I needed all my skills to keep him engaged, but she was really willing to work with me, and we kept her out of bed and upright for hours at a time. I needed to hold the FHR on to her tummy most of the time, but she never once complained. She moved from bed to walking and swaying, and gradually really got going. I reminded her that just because she wasn't allowed to birth at her local hospital it didn't mean that she wasn't capable of giving birth beautifully, and that I loved the way she was doing all the right things, and staying upright, and working with me and her body to surrender to the process. I gradually drew him in to massage and support her on the birthing ball and reminded them that this was the completion of the togetherness that had created this baby. Things were going to get hot and heavy and they needed each other to stick with it. By the time I left he was firmly by her side, slightly in awe of the trance like state she was in, and the evident heavy breathing. However by the time I left the docs insisted on a fetal scalp electrode and an intrauterine pressure transducer for monitoring, which was effective, but she found painful. They also heavily recommended an epidural for her which she clearly hadn't wanted to have, but after having her rythm disturbed in that last 30 minutes by the examinations and invasive monitoring she was agreeing to. We had a big hug and a bit more slow dancing and I left her to the night staff with a prediction that she would have her baby vaginally around 1-ish in the morning and that she would show those docs that big gorgeous girls had beautiful bodies that could BIRTH!!!! This morning I woke and couldn't settle until I rang and found out the outcome - a vaginal birth at 1.52am!!! just on 4kg. A boy!! I was doing the happy dance! I'm so glad for them both, I really wish I could have been there. I almost feel I can claim him. She unfortunately had a PPH (which is an increased risk after heaps of syntocinon for induction) but it wasn't too catastrophic (only one litre, only :( poor love ). I am so proud of her.

I do love being a midwife, just not mid-machina. Slow dancing and whispering encouragement to that woman last night was the best shift I've had in ages. And still the docs barged in and took her over. Was it me? Was I not advocating strongly enough? Was I challenging them too much when I said I was happy to hold the FHR and palpate the contractions. Her progress was slow-ish but fine. Baby was OP, we were mobilising well, give us time and feck off! I only have 3 more shifts in LBS, and I am beginning to wonder whether I need to start looking for a move into a more low-risk environment - but who will support and work positively with high -risk women in that setting, and can I leave my stretched and exhausted sister midwives to struggle on without my additional shoulder to the wheel?

But where is that wheel heading? I want to put it in reverse! Who is steering? I am beginning to feel less in control in that environment. Sadly I know there are those who will say..."welcome to the real world" in a hard-bitten tone. I don't want to lose my enthusiasm, or my zeal, or my passion, but it is not always rewarded in the workplace, just regarded as a temporary oddity, or with pity waiting for me to wake up and surrender my passion to the machine. I feel under threat from the system. I don't want to abandon colleagues at the pointy end, it feels like a cop-out, but I don't want to lose my gloss or radiance. It must be possible to practise woman centred holistic care in these places. I have much thinking to do. In my spare time...

SO...sorry to whine so much. Its taken me nearly 2.5 hours to post this. You'll all (6 of you) turn off and un-link me, I don't blame you. I'm over myself too! I'll try and be more sunny next time you visit. (hmm ...I can hear the freezer calling).

I have nearly TWO more hours of me time !


Lisa W. said...

aaack....LOTS of stuff in your head right now...or out of it now you've written it out! Good for you! I so look forward to empty nest, but the girl
s thinking she's gonna stay home and do some local university for the first year or two...or else move to New Mexico for a 2 year farrier training program before starting up academia...whatever...she'll be an adult but still our're such a good supportive mom...which is one reason you're a good supportive midwife. just take the's all experience..and once you've gained the sincere unequivocal trust of your peers, nurses and really can/do make a huge difference because they will respect the sacred space you've created for birth knowing you'll call them only if truly needed. it takes a couple years but it can happen...and then you start teaching the residents which can be exasperating and rewarding when they realize that doing nothing is often the best intervention of all.
hugs to you! sleep as best you can and then have a WONDERFUL time on vacation! the bunny! will steal your idea and make one for the granny and the kiddo for easter this year!

widget said...

What a week. Was it only a week? Felt like so much more and you do have lots going on but it sounds like calm is coming. I love your descriptions of your job and I know the women you work with appreciate you a lot.

Here's to you having some time with your friend, some alone time where you can just be and to you finding your inner calm. (calm blue ocean thoughts being sent)

alice said...

Your schedule made me feel tired just reading. Hope you get some down time and some good frienship moments. Be good to yourself :) x

Natalie said...

Here is a ((((Hug))))
And thank you. No, I didn't have the honor of your presence at any of my 4 labor/deliveries, but I know you would have made all the difference in the world to me. And I can feel the strength of your wisdom, convictions and kindness and it does me good to know that you are sharing your skills and love. Carry on. We need you.

Jennifer said...

Your energy to keep moving, to keep helping, to keep writing about your experiences and managing all the while to just. get. it. done. is an inspiration. Wish I could buzz over and drop you off a casserole or pot of soup (and then make plans to really get together once things slow down, as of course they will. eventually.)

Laura Jane said...

Thanks for the cyber love and hugs my really helps.

Hubby home this afternoon, doing some craft this morning to level me out.

Just bitchin about it all kinda helps too! And resident friend and cousin Susan is also an absolute Godsend.

The idea of a catch-up with y'all is a really good one. Anytime!

Lesley said...

Cooee- M&D's computer went B-A-N-G! when I turned it on when I got back to Albany from the Bay, but we're back online now. Still okay for lunch on Friday (tomorrow)??? Love love love these tales. Mwah!