Level 4: 4th year exams – how the f*ck do you get through them?

This is not an advice blog. I don’t know how to tell you how to study for the 4th year exams because I’m still making it up as I go. My midterm. My final. I never know how to study for these things, because its all scenario-focused. You study the content, and the exam makes you apply it in a scenario that has very little contextual information because it’s not actually real. It’s not the most fun.

What I can tell you is how I get my confused little brain through an exam.

Most of the questions are things like, “What is the first, most important action?” While others are matching … or even fucking worse, true or false (my arch enemy).

These questions always make me want to bash my head against a brick wall. What is the most important? What would I do first? Is it true, or not?!

What is the right answer?

To solve the riddle, I usually close my eyes and try to imagine the real-life me in this situation, but suddenly all I can think of is how I meant to clean the cat litter that morning. Refocus, Sonia, refocus! Would I first call for help and then do something to address my birth concern, or vice-versa? Will Gemini wait 3 hours before using the litter box? Would I give the medication first or rub a client’s uterus? Is my house going to smell something-awful when I get home because Gemini is the stinkiest cat in the world?

Then there is the time-old debate of REAL LIFE versus what they want you to answer on the exam. Theoretically, I would first want to set up my birth equipment if I came in to a bombing birth where the head is visible, but in actual fact, do I have time to even get gloves on? No!

So what do I put on the exam? What I would actually do or what the book says I’m supposed to do? Because you bet your perineum I’d be deep diving down below that baby, glove-free … but is that the right answer!?

How do I combat exam exhaustion?

The questions are all like this and the tests are long, so I always reach an interlude where I sink my head into the desk and sigh a great big sigh. I then flutter the pages to determine how many are left, only to be inevitably disappointed in the thickness of the flutter. Then, when I realize I can’t read while lying down, I sit up and force myself to carry on.

To combat ennui, my strategy is usually to flip to the back of the exam and do half of the true/false (T/F). The problem with this strategy is that I always reach a point of feeling annoyed at how vague/poorly worded the T/F questions are. So I flop back to the front of the exam for inspiration, thinking that maybe somehow I will be triggered to have knowledge by reading the rest of the exam, or, that maybe the magical exam fairy will come by and remove the other page of T/F that I have yet to conquer. I’d be pleased with either, really.

Should I go over my exam again?

Finishing the exam is a great moment, but arguably the hardest part of the whole testing process. I’ve circled several questions that I was unsure of … should I go back and go over all of them? This age-old debate usually lasts at least 5 minutes. Why? Well, what if I change a question that I got right initially based on gut-instinct, but changed because I stupidly went over my exam again? OR! What if I go over the exam and change 5 answers to the right ones? What if I misread a question and picked a totally wrong answer? Oh, but what if I misread the question the second time and then picked the wrong answer?

Inevitably, I always go back over the circled ones. I’ll never know if that helps or not. The only feedback I get is my exam mark. Good thing I spent so much time overthinking it?

Is there a way to tell my grade before I leave the exam?

If you can tell this, then I think you should drop midwifery immediately and pursue being a psychic. No jokes. I do not have this skill, but I try to pretend I do by tallying the total number of circled questions and dividing that by the total number of exam questions. The percentage is what I assume I would get if I got all of the circled questions wrong. If I’m satisfied that I got 70%, I close up the booklet and get the heck outta there. (Also, let’s be real, even if I don’t think I’m getting a 70%, I still get the fuck out of there in order to clean the cat litter and initiate my 18 hour post-exam nap.)

When grades come, sometimes they give me an A, sometimes not, and I set myself up to do it all again.

Midterm for MNP is on October 20th. Then there are “only” 5 more exams left before graduation … I can’t wait!



Level 4: Placement Break Phases

As we quizzed each other for our final exam, a classmate of mine casually tells me she can’t wait for the initiation of the Placement Break Phases. Curious, I ask her to expand: “You know, the phases after the final exam is over and we aren’t in placement anymore,” she says to me matter-of-factly. “My partner has them memorized.

Here they are, see if you agree!

  1. Hibernation. Occurs immediately after final exam and may last up to 72 hours. Student midwives may be confused, hungry, and emotional/anti-social-yet-wanting-your-company. They may require frequent vital checks and food delivery.
  2. Binge watching. The student midwife wakes. She now requires all your best Netflix recommendations. Common side-effects include: sore body’s from back-to-back hibernation-to-binge watching phases.
  3. Reintroduction. Hello society, how are you? The student-midwife begins to relearn how to engage with others in normal social situations. She may require guidance, as she no longer understands the boundaries of normal social conversation. What do you mean, bulging perineum isn’t something people say in normal conversation? Well rested, she may even dabble in a few of her favourite activities.
  4. Back to normal. That brief period where the student midwife has fully recovered her mental, physical, and emotional energy and feels like herself again. This is living! This is what it’s like to be alive!
  5. Complaining of no hobbies. After months of declining participation in normal social events because being a student midwife makes having hobbies very difficult, student midwives begin to realize they need more hobbies. Now that they feel normal again, they ponder whether to start a new hobby. Unfortunately, they can’t have hobbies just now because school is going to start again soon and their main hobby then will be homework. So, in this phase, while the desire to hobby is there, the student will just have nothing to do other than to complain about lack of hobbies.
  6. Anxious about placement. The student midwife realizes she has to go back to the unpredictable, exhausted, confused, ghost-shell version of herself that did nothing other than try to survive. She becomes irrationally nervous about everything. Plus, there’s so much left to learn! Will he be able to learn it all? Best to lie awake at night the week before placement and think about it.

The reputed, hardest placement of the entire 4 years is coming for me on September 12 … Maternal and Neonatal Pathology (MNP).

Cue “anxious about placement” phase. Can I do it? Stay tuned … Here we go!

When She Met Her Baby

I walk into the hospital room with my preceptor to back-up a birth. I have not met this client before, but she had told the primary midwife that she was okay with having a senior student attend her baby. I creak open the door. The room is quiet, the woman between contractions. Her partner is sipping water, everything is very calm. The primary midwife sees us. She turns to the client and encourages her to follow her body and keep pushing on her own for a bit. Then she steps aside to give me and my midwife preceptor report. When she finishes updating us on the progress of the birth, she goes back to coaching the woman in her pushing. Acting as the back-up midwife, I find the infant resuscitation area and begin to set-up all the equipment.Best to be prepared for anything, because you never really know how a baby will come out until … well, after it’s out. I turn on the suction, oxygen, warmer, confirm the mask size, and do a series of other checks. I end by flicking open the intubation blade to ensure the light works and pass a hope to myself that no one has to use it today.

I throw the infant stethoscope and a baby blanket around my neck and walk toward the bed. I take over documenting the fetal heart rates and settle into my role as a back-up midwife. My job is monitoring baby before and after birth, and supporting the primary midwife in whatever she needs. The woman is still pushing on the bed in the centre of the room and the pushes are not effective. The midwives and I discuss different positions we can try with an epidural in order to encourage fetal descent, and the mom compliantly flips from hands and knees, to side-lying, and then to waterski.

Hours pass, more things are tried, descent is still poor. OB is consulted to assist with the vaginal, instrumental delivery. The baby is born. It needs help to breathe. It is brought to the warmer – the same warmer that I set-up earlier. Pediatrics is there to assess baby. The baby is breathing on its own but poorly – the decision is made to take it across the hallway to the more advanced resuscitation area. Dad follows baby, Mom is in shock.

Respiratory therapy is in charge of the resuscitation. I am running between rooms, providing Mom updates on what is going with baby and providing Dad updates on what is going on with Mom. After a while, the baby is stable enough to breathe on its own, but the pediatrician recommends the baby be monitored in the special care nursery for 12-24 hours. The Dad agrees, and the nurse offers a quick stop to see Mom before heading to special care.

She hasn’t, after all, met her first child yet.

I hustle over to Mom’s room to give her the update. She looks obliterated with exhaustion. We hear Dad walking in and calling Mom’s name. He gently pulls the curtain aside and reveals a little, blanket-enveloped, human burrito. As soon as they make eye contact, Mom and Dad both start crying and reaching for each other. Mom is hysterical with joy. She longingly stretches out her hands toward her baby, frantically waving them back and forth to encourage her partner to walk faster toward her. It’s hard not to take a direct hit to the heart from all the grief and love in her voice as she cries out for her newborn; as if those 20 minutes of separation were the longest, most grueling 20 minutes of her life.

Maybe, they were.

I’m completely stunned and overrun with emotion. I started crying the moment she reached her hands out for her baby. Mom and Dad grip each other and their baby with such an intense relief that I can physically feel it. Their united sobs are accented with exploding moments of pride: “Isn’t our baby perfect?” I want so badly to make this moment last as long as possible for them.

Eventually baby goes to nursery and Dad goes with. I wrap up my duties as a back-up midwife, which are minimal considering we transferred to OB care and baby is now in the nursery.  I convince Mom to eat a little something. I grab her an orange Jell-O from the kitchen. I tell her that I am leaving, and thank her for allowing me to support her in such an important moment. She looks up at me, a stranger she met merely 5 hours prior, with tears in her eyes. “Thank you for being here and for your help. I am so happy you were here.” Then she hugs me. I mean, she really hugs me. The kind of hug you reserve for the people you want to receive a deep loving intent from your soul. I almost start crying but instead put together my feelings:

“I’ll never forget you, or your family. You inspired me today, and I’m so grateful.” 

She nods.

As I exit the door I yell, “I’ll hear about it if you don’t eat that Jell-O! Get to it!”

She smiles as I duck behind the curtain and out the door. Back to the real world. Although, I don’t think it gets much more real that what I was just doing for the last 5 hours.