My midterm review was last week and it was a sobering reawakening that I know nothing.
Zilch. Zero. NADA.
Perhaps it has been amplified by the lack of sleep from weeks like the one at the end of February, but my sense of inadequacy is leaving me feeling unbelievably overwhelmed. That midterm list says I should be doing more, and, if you’re curious, it’s 5 pages long.
To make sure I’m not telling falsehoods, I have to admit that I did receive a ‘satisfactory’ on all accounts. My preceptor noted that I’m making improvements and that she thinks I’m where I should be when you consider that I’m only 2 months in. However, throughout the moments of “you’re doing what we think you should” there were several “you should be doing this already and you’re not”. It was those latter items that really what made me sink low into my chair and want to die a slow, slow death.
Those latter items are really intimidating, but I’m ready to step up.
- I need to be making the plan of care, every time, before my preceptor, and checking in where appropriate.
- There are still things I don’t know. I don’t know what I don’t know, so making a care plan on the spot is pretty intimidating. Gotta increase the pre-birth and clinic prep so that I can improve this.
- I need to be answering client questions in every visit, and trouble shooting their problems without help.
- This is already getting better, but, not without speed bumps. Picture me, ready to take responsibility and help a client struggling with engorged breasts: just as I begin pouring out advice and guidance, I come to the sudden realization that it’s quite possibly the very worst and unintelligent thing I could be saying at that moment. It’s as though a little demon student midwife takes over and makes me say things like, “Pumping will help with engorgement!” when I know that’s just simply, unforgivably WRONG. (Pumping makes it way, way worse). Most midwives gently correct me (some not so gently) and then the client usually doesn’t believe anything I have to say for at least 20 minutes afterward. Doh. There’s no time to feel shitty though, because I’m already on to the next thing, flailing through my preceptors bag for the prescription pad for nipple ointment while awkwardly trying to keep my thighs on the cloth scale to pre-warm it for baby’s impending weight check.
- I need to take pages.
- This. Is. Terrifying. People will call me in the middle of the night in labour and I have to try to best generate a differential diagnosis for them while simultaneously wiping sleep-drool from my cheek. Or worse, call my preceptor in a 3-way call, and wipe-drool and give advice in front of everyone. I’m most scared of this learning need, because again, I don’t know what I don’t know. Also, I’m nervous because I’m barely sleeping as it is, three hours here and there, and now this added responsibility will remove even more of those precious sleeping hours – plus, I have to think on my toes. If I’m giving bad advice while fully conscious at 2pm, what the hell is going to happen at 3:15am? I knew it was coming, but that doesn’t make it easier to get started. Here is me, jumping in to this learning need head first:
- I need to organize everything. For everyone.
- My preceptor is off this month so I am now following 5 midwives. Each of them do clinic on different days. Each of them have a different set of clients. Each of them do things in a different way and don’t like it when I do things the other way. It’s making my head spin, already. I’m sure this in itself is a post yet to be written … I am already feeling the panic that I can’t stay on top of all this. I took last weekend off to study for the midterm but also to organize myself for the entire month of March to ensure I keep up.
- I need… more cheat sheets and to know more level of detail in many topics. I need to do more IVs. I need to be 80% accurate in my vaginal exams. I need to be so many more things that I am not yet.
When you’re learning something like a health care profession, it takes years to reach mastery, and years of feeling like you have a long way to go. I guess the only way to meet these needs is to dive face-first into error. Make a plan, get it wrong, be corrected. Take a page, give bad advice, be corrected. Organize weekly visits and miss one, be prompted to do better next time. It’s incredibly humbling, especially for me, as I am someone whose personality doesn’t like to do things wrong more than once. It’s like I’m learning to bowl and I have the bumpers on the edge of the lane to keep me from veering into the gutter. Eventually, my ball will hit the pins, but right now it’s smacking up against the bumpers several hundred times and not hitting the pins at all … at some point, I will reach that golden, smooth strike.
Ironically, yesterday (as I was daydreaming of sleep in the office and trying to prep charts) one of the senior midwives said to me that midwifery is just a humbling profession, even when you are years in; so I guess I had better get used to this feeling and just keep givin’er with whatever confidence I can muster. Someday, I won’t need those bumpers, right?