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Thursday
Jul142005

NRP and More

I passed my NRP this morning.

The room was filled with 18 NICU RNs from Children’s Hospital, one Pediatrician, and me. The instructors are all NICU nurses. One I’ve known from previous testing, but the other… the one who tested me on my skills… well, she was a snot.

“A midwife? Oh, god. At home?! That’s scarier than the hospital.”

“Not to my clients.”

“Well, that’s just… just…” trailing off to nothing.

“You don’t have to have a homebirth.” (said matter-of-factly and looking her right in the eye)

When I explained that I didn’t do medications, intubate or do endotracheal suctioning, she asked me, incredulously, “what DO you do?” I said, “We do PPV and CPR,” and she gasped, “You don’t dry off the baby or suction?!?” I looked at her with a “get real” look and said, “I thought you were asking in the ‘What training do you need to review’ way.”

She paired me with the Pediatrician to demonstrate skills.

She asked me to set up the warming table (it was a regular long table) and then she looked at me and said, “where is your radiant warmer in the home?” and I explained my CPR board that has the heating pad on it with the blankets on top of that, etc. She seemed relieved for the moment. When I set the table up with the stethoscope, bulb syringe (that I originally left away from the set-up until she nearly had a coronary), the electric suction tube (“you don’t have electric suction?”), the Ambu-Bag (“do you have just one size mask? Or do you carry more?” “Yes, I have two sizes of masks.”), and more blankets, she wasn’t satisfied. She said that even though I don’t have to administer meds or intubate, etc., I still needed to set-up for it. I just looked at her and said I didn’t because I don’t even own these things and don’t set-up for anyone that would use them. She snorted and huffed and moved on.

I did my part with the Ped and then we switched places and she got a really complicated 25 weeker (imaginary, of course) and we had to do full-on resuscitation, my doing chest compressions.

I pray I never have to do these things.

But, I am so glad I review as I drive to every birth. I usually get nervous before this class. This time I knew what I was doing and it felt good. I came home and called the midwife I work with most and told her we need to have a practice scenario… just so we don’t have to do one for real.

whew

I have so much skin it is scary. I was leaning over to get a bra out this morning and thought about taking a picture from my viewpoint, but didn’t want to break my new camera. There is no way to describe the amount of flesh that hangs off my body. Wrinkles, swirls, folds. All combined to add about 3 sizes on the clothes I wear.

One of my postpartum clients – the one that continues having so many issues – has a double ear thing happening. One of her ears was bleeding today so she went to Urgent Care. So, in 2 weeks, she has been to the ER for herself once, the baby once, Urgent Care once for herself, the Ped once for the baby, and the Doctor once for herself. She has systemic yeast (and starts Keflex today… one of the granddaddies of yeast production) and now needs to wait to take the Diflucan until this next course of abx is completed. I told her today that I want her to spend some time with my co-teacher, a hypnotherapist, to find what might be going on and to tap into the inner healing abilities.

She is doing so much towards care naturally – probiotics, meticulous diet, garlic oil in her ears, all the natural things she could for herself and the baby – yet, something is off. I told her I didn’t want her to think she is creating it (is she?), but that some reflection needed to be had. I keep admonishing her to sit still and the next thing I know, off to the hospital she goes again. And she is not neurotic at all! She is a very evolved and very natural-oriented woman. She has re-begun chiropractic and is doing homeopathy as well.

I see the doctor tomorrow and haven’t done my Symptom Spreadsheet yet.

My brother has to remain in his leg cast another 6 weeks. Why docs ever say people get out of casts at 6 weeks is beyond me. I never know anyone who has leg/ankle casts who get out of them at 6 weeks. He's rather depressed. No work. No money.

Off to bed. I’m really, really tired.

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  • Response
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Reader Comments (3)

Barbara,

Thanks for the comments you left on my board. I stopped by to give your site a look. You have my admiration. I know I could never work in peds. It has the highest of highs, but the lowest of lows, as well.

All of my children ended up having to be born by cesarean due to CPD (that's what ahappens when a 6'4" guy marries a 5'0" woman), but I was lucky to attend the birth of two of my sister's kids with a midwife, and thought the experience was amazingly less "sterile"

John

July 15, 2005 | Unregistered CommenterDisappearingJohn

Oh, but I don't do Peds nearly at all! I do birth.

Potential midwives come to me and say they want to be a midwife because they want to hold babies. I tell them that if we ever hold a baby at all, we hold it from vagina to mom's belly and that's it. And lately, most of our moms and dads are catching their own babies! That if they want to hold babies, they should head down to the hospital and volunteer to hold the babies whose moms did drugs during the pregnancy (formerly called "crack babies").

I hold women. Sometimes their partners. Mostly, my camera.

And not to discount your experience, but I have seen MANY women shorter than 5' with husbands over 6' birth perfectly fine. The head is a fluid, not a solid - the pelvis is a fluid, not a solid. And unless the mama is up and around and wiggling and swaying and squatting and such, a TRUE CPD dx simply cannot be made. If she was on the bed, especially with medication (pit/epidural/sedation), then bed CPD was, in my non-doctor opinion, the dx.

But, who am I? Just a lowly midwife. *winking smile*

Thanks for reading! I love it! Thanks for yours, too. AND NO EDITING!

July 15, 2005 | Unregistered CommenterNavelgazing Midwife

Who, ME Edit????

When I said "peds", I mean dealing with babies IN ANY WAY,SHAPE, or FORM.

I love kids of all ages (my own push that limit sometimes, but I digress) I just get too attached to them, to quickly, and to lose one would devestate me...

I sort of agree with you on the CPD thing... Our first was born 19 years ago. After being 2 weeks late, they sent her in for 12 hours of pit induction (no epidural for us "natural" parent, please!). The induction went no where, with only 2 cm of dilation in 12 hours, so they sent us home to "se what that started".

Three days later, after 8 more hours of pit, the FHR started crashing, and They went in to get her... (on a side note, I actually got to stand by the anesthesologist's shoulder and watch, something was pretty unheard of back then)

The "diagnosis" of CPD was made with an X-ray a few years later for an unrealted issue, where our primary doctor said she had an "abnormally small pelvic outlet"

Our other two were scheduled C-sections due to the uterine incision from the emergency C.

I hope you are feeling better soon. I share your exhaustion pain! Think good, strong blood building thoughts!

John

July 17, 2005 | Unregistered CommenterDisappearingJohn

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