FRUSTRATION

Alas, yesterday I put a patient in the hospital for an elective induction.  A process I really disagree with in my core. (I'm inducing to satisfy the patient.)   The hospital was really busy and essentially nothing happened.  They called me at 2a.m. to ask what I wanted to do and I let them know that I just wanted to start pitocin.  I went back to sleep, knowing that I would need to get up early to see my patient, because if they started pitocin, she would be uncomfortable and would want midwifery support.  I arrived at the hospital only to discover that they did not start the pitocin, so now my patient has had nothing to facilitate her labor for greater than 12 hours AND the nurse who has chosen to take my patient today is someone that I dislike and do not respect.  She is difficult to work with, does not follow my suggestions or my orders and she does not provide good care!!!!  There is way too much drama associated with her.  She often creates problems so she can save the day.  ARGGGGG.  I want to go home and read a book to escape.  While I'm on this vent, let me say that I also have tons of charting as I was the office midwife yesterday and saw two people's patients for some part of the day and when that happens, no computer charting happens and then it has to be done retrospectively. 

Life goes on and on

I am continuing to work crazy hours with my midwifery practice.  As I work crazy hours, I think about retirement, I think about a different population, I think about moving and working somewhere else.  I think about the neat people I have met here.  I think about my desire to just take care of low risk Mom's who are healthy and who want to birth safely, but without lots of interventions.  I try to weigh the pros and cons of moving on versus staying where I am.  I have decided you cannot compare apples to oranges.  So the quandary continues.  Do I look elsewhere.  Do I stay here until I retire?  I'm not sure.  I don't know.  Worse yet, I don't know how to make the decision.

Feast or Famine

This week I had a flurry of births.  I did 6 deliveries in 36 hours.  It was exhausting.  I did 4 vaginal deliveries and 2 cesarean sections, one of which was emergent.  I had good babies.  I had happy Mommies.  For the most part I was pretty pleased.  I was sad about the cesarean deliveries, but sometimes it is necessary to assist the baby into the world when all is not going well.  I am in the recovery period now.  I firmly believe that for every hour of sleep I miss, I need to sleep two hours to recover.  As I age, maybe I need to sleep three hours to recover.  Anyway, I'm recovering and all Moms going home with their babies.  Life is good.  I'm on call this weekend, so we will see what life brings.

Waiting. . . .

Today started early, and rainy.  I had OB/GYN staff meeting at 0730.  I also had 2 people in labor and loads of people to see at the office.  Got the people in the hospital settled and went to the office.  Went back to the hospital to help with epidural placement.  Went back to the office and saw patients.  Had a multip (more than the first baby) come in obviously in early labor.  Sent her home to walk with instructions to come in when contractions are harder and more regular.  She returned to the hospital while I was delivering the first of my ladies.  She was admitted.  While she was laboring down in preparation for pushing, I had a young woman walk in who was far to early to be delivering, but she was obviously in labor.  Got the team here from another city to take care of the baby, started pitocin and am awaiting the delivery.  In the mean time the laboring down Mom got ready to deliver and so we did deliver.  Still I am waiting for the very early baby.  I now also have two other ladies in labor and a cesarean delivery for lunch time tomorrow.   Hurry up and wait, Hurry, Hurry, Hurry Oh yea, wait, wait wait.  At least the office for tomorrow - later today is not too bad.  AND it is still rainy.

Staff Meetings

Staff meeting today with the "front" office (where insurance, billing, coding, and appointments are handled) and back office (where patients are actually seen, labs are drawn, and charting takes place).  What a difference of opinion.  The front office sees the flow from their point of view.  The back office sees the flow from their point of view.  Since different things are handled in both the front and the back never the twain shall meet.  For example:  We actually close our office down from noon to 1:30 so that we can have some time to decompress and regroup for the afternoon.  Some people see this as a huge inconvenience for the patients.  Some people see this as self preservation.  There is no middle ground.  When we close the office for lunch, we also turn off the phones and calls are routed thru the Answering Service to the practitioner on call.  This is disruptive if the practitioner has run over to the hospital to see a patient and is trying to get back in time for afternoon office.  We have been in business for 10 years.  I'm not sure why these things have become an issue now, but they have.  There is a huge difference of opinion about whether we are to be constantly available, or whether we have the right to a bit of down time in the middle of the day.  Interesting times, these.

Numbers.

I am currently the C-section queen.  I have done one vaginal delivery and 3 cesarean assists this year and I have two more cesarean assists scheduled this week.  My partner on the other hand has done 7 vaginal deliveries and no cesarean assists this year.  I wish it were the other way, but it is not.  I feel that I am disengaging from this business.  I am wanting more time to be with my husband and my family and it is a challenge to be at a birth for 36 hours while the birth mother has a fair chance to get her baby out her way.  I still believe she deserves that chance, I just don't want it to be me sitting at the bedside all those hours.  I'm not sure how to settle this discrepancy.  I guess I'll just keep working and thinking and life will (as it usually does) figure itself out.

And on into a New Year!!

So the 2010 year is over and we are started into 2011.  I have had some beautiful births, some heart aches and some neutral experiences.  The good news is that I have more positive experiences than negative experiences.  The bad news is that I still get hurt feelings over things that probably should not bother me, but do.  I have worked hard.  I have played hard.  I have walked on the beach.  I have cried over things I cannot control.  I have survived a law suit and continued to be a midwife. 
2010 has been filled with lots of changes, lots of growth, and another year under my belt.  I miss my daughter and my grand kids in England.  My heart aches for my daughter who is trying to conceive.  My heart sings for my little sister who is fighting her way back from mental illness and doing a grand job.  I realize that my Mom and my In Laws are another year older and we cannot know how much more time we have to share with them.  I love having time  with my husband.  He is fun to be with, funny to be with and all in all one of the most supportive, loving people on the face of this earth.  When we are both working, it is hard because we are both mentally doing our own thing.  I want to be sure that nothing ever disrupts the love and respect I have for him.  I want to insure, to the best of my ability, that we spend the remainder of our lives together.  I love to walk on the beach with him.  I love to cook a meal with him.  I love to sit quietly next to him and read a book.  I love to work crossword puzzles with him.  He is my muse, my love, and my soul mate.  I cannot imagine life without him.
2011 brings me new opportunities to live and to learn.  2011 offers me more time to be with my lover and life mate.  I plan to be more diligent about my exercise and eating well to insure that I continue to remain healthy.  No broken bones this year!  No joint replacements this year!  I want to continue to master my emotions and not allow events to catch me up and cause me to lose sleep and be cranky.  I plan only to worry about the important things.  I want to be motivated to take action and see the results.  I want to have an impact on the world in a good way.  I will continue to offer the very best care that I can to the women who choose to see me for their maternity episode.  I will strive to create significant emotional events for the women and their families in order to help build strong families and create beautiful birth experiences.
I wish the very best for the world and the people that I come into contact with.  I wish for beautiful births.  I pray for healthy families.