Wednesday, June 3, 2009

Wow, long time between posts!

I've been remiss in not updating on here, I've just not had the energy to do so. But, now exam time is upon me, here I am procrastinating instead of studying :)

I won't write an essay, I will come back after the exams and babble for a while about uni and my observations and feelings. And the state of play regarding the MSR and the latest budget that looks on the surface to be great for midwives and women, yet still has a lot of murk that needs to be clarified.

I have placement at a local private hospital in early July, which will be interesting. I won't get anywhere near the maternity ward though on this placement. Which is sort of good- this hospital has a close to 80% caesar rate! (vomit)

I will finish up by saying that I have managed 3 high distinctions and 1 distinction for my essays. So, I can analyse a question, I can write, I can research, I can stick to a study plan!

Sunday, March 15, 2009

First week

Well, I made it through the first week without freaking out! I have a great mix of people in my tutes and pracs. I have to smile though, the number of fresh school leavers who when asked why they want to become midwives say that they love babies, is astounding. Then one young student nurse asks me whether childbirth hurts, and if I was scared for my first, I look at her and have a quick silent war within myself. Do I launch ito an impassioned babble about the beauty and power of pregnancy and childbirth, or do I give a quick one liner with a promise to myself to lay the seeds gently over the next 4 months (she is only in one of my pracs). I decided to lay the seeds gently, so I told her it is a very powerful event where the woman needs to be adequately educated and supported by care providers who trust in birth. I told her that I wasn't scared with my first child, that I was trusting of my bodies capability to birth and also of the hospital doctor and midwives ability to take care of me. Then I bit my tongue and swallowed mention of my 4th degree tear and subsequent history. Though I did say I went on to have 2 more children and 1 of them at home :D She nodded politely and gave me the wide eyed look of an 18 year old who is nowhere near the stage of breeding..

Anyway, there are some great tutors and lecturers who are in charge of my learning so I feel really confident that I can (and will) use them to help me if I hit a blank spot. The only unit that has me squirming is the A&P one, so much information to soak in and understand, then be able to sit an exam on it in about 5 weeks. I am confident that my approach to study for this unit will get me through and I'm not a stupid person, so I feel that I'll be able to scrape through with some degree of certainty. The other units are right up my alley, the theory and politics behind nursing. I can't wait to get my teeth stuck into the theory and politics behind midwifery! (Where is that devil emoticon when I need it!)

Anyway, I must go and do some prep for tomorrow, before friends arrive for lunch. Then tonight I can have a skim read over lecture notes and go to sleep thinking of the 'determinants of health' and the cell membrane.

Sunday, March 8, 2009

My first year units

In the first trimester-

Understanding Health
Human Structure and Function
Foundations of Nursing Practice 1 (includes 1 week clinical)
Disciplines of Nursing: Contemporary Issues and Trends

In the second trimester-

Foundations of Nursing Practice 2 (includes 2 week clinical)
Physical Examination and Health Assessment
Introduction to Professional Midwifery Practice (includes 1 week clinical)

I start tomorrow!

Tomorrow is my first day of lectures. How do I feel? Nervous, prepared, confident, a bit apprehensive. I've done the readings and printed what lecture notes I can. One of the topics has an error appearing regarding something about Acrobat not loading, but I'll sort it out tomorrow. I have sorted out my study timetable, though I already have a feeling that I won't be in bed most nights before 11pm, if not midnight. There is so much reading and processing of information, especially for the A&P unit. We'll see how it pans out. I promise to share my joy and distress at the workloads LOL.

Last week was O-Week, or Week Zero, or in laymans terms, orientation week. I went for the first two days, did the tours, had my uniform fitting (thankfully they are only for placements and not every day wear, they aren't the best looking shirts), worked out the important stuff- where the cafe is, where the library is, that the computers are USB friendly, started the vaxxing process, found where the toilets are, where parking is easy and where the shady spots for lunch are. I met another mature age nurse/midder who is lovely. Funnily enough her parents know my in-laws, so we sort of have a 6th degree of seperation thing happening. Not hard in Geelong.. There are a few others who are mature age that I spotted, I'm really looking forward to getting to know them over the next few months. The fresh school leavers, I'll reserve my judgement on them, till they appear in the 2nd year, in case they drop out of the course when they realise that midwifery isn't all about looking at perfectly round pregnant bellies and cuddling clean and sleepy babies.

I have a sick baby today, who has been vomitting and leaving snot trails everywhere. I'm trying not to imagine myself into being sick, I just can't be a puking sneezing mess for my first day! Thankfully my husband is home tomorrow for the Labour Day public holiday, as I can't send my little one to daycare being sick as he is, though they are closed anyway for the holiday.

Anyway, time to go and get dinner sorted and relax until I think it is time for bed. I really should go to bed early, get a good nights sleep, especially if I'm going to have a child disturbing my sleep like last night..

I promise to report in about my first week, each night. Though I may be quite monosyllabic :)

Tuesday, February 24, 2009

Maternity Services Review - the report

Well, what can I say apart from I am hopefully distressed. Yes, the two don't really go, but I am torn. On one hand I am pleased to see the mention of midwives being extended the ability to access Medicare and the PBS, which to me spells out practicing rights in hospitals. On the other I am really down seeing that home birth has not been recommended to be funded by the Commonwealth- really, how much will it cost? A pittance in the scheme of costs that are generated by hospitals admitting healthy pregnant women and managing her pregnancy/birth.. Admittedly the numbers of women actually home birthing are small, but if it was funded, more would use it. Look at the waiting lists for birth centres and MGP type models, the women waiting would be the ones who would investigate home birthing. *sigh* And what about PI??

The term 'collaborative team' is splashed through the report. It isn't defined. Does it mean a team of birth professionals are on record saying they are a collaborating in order to satisfy the birthing woman's needs? Is it a midwife who has a transfer policy lodged with a hospital, or an obstetrician? Is it an OB who has a midwife in his employ with a GP/OB who refers to the Midwife/OB team as per the womans needs? Is it as simple as a woman chosing who her care providers are and filling out a form saying who she has chosen to deal with ear infections during pregnancy (GP), who will be her lead care provider (midwife) and who her preferred obstetric specialist is in the unfortunate event that she needs medical intervention? Or is it a health service of an area, allocating an OB to oversee the practice and client load of a (hoop jumping) midwife..

Collaboration already occurs, though it is very top heavy and backwards, with the majority of midwives basically employed as glorified nurses. OB's make the policies, OB's employ the midwives, hospitals employ the midwives to be with woman during her labour but (in the case of private hospitals) the OB is the one to oversee the birth. It is a rare hospital indeed, that has a working relationship with a midwife in the community, who, if required by the woman, will transfer in for assistance, while still retaining her position as lead carer, working in collaboration with the necessary specialist. The number of times I have heard anaesthetists and hospital midwives talking about the trainwreck or horrendous transfers that come in. Instead of welcoming and attending with a professional manner to the midwife and transferred woman, passive aggressive and disdainful attitudes poison the collaboration. So what does the report's 'collaborative team' mean?? Turf wars are in evidence every single day, in every single hospital, with the turf being the woman, baby and their health.

The report is also sounding the death knell for true private practice midwifery. Depending upon the term 'collaborative team', it could mean that a private practice midwife (who does not want to fit with that definition, which will most likely be a medically heavy one) will be unable to access PI insurance that is subsidised by the Commonwealth. In July 2010, a National Registration and Accreditation System (NRAS) will be implemented, which will include all health professionals Australia-wide, including midwives. Part of the registration clause is that the health professional have current PI insurance. If a private midwife can't access PI, then she will be unregistered and unable to practice legally. At present the wording enables a midwife to be registered without proof of PI and the state regulatory bodies have usually turned a blind eye. All women who privately employ a midwife to attend her in the home, are well aware of the lack of affordable PI for private midwives. I wonder how many women have attempted to sue their midwife for negligence since July 2001, when PI was withdrawn from the reach of private midwives. I know a lot have been reported to their governing state nursing federation/union/body, yet the majority of reports are by other birth professionals who think that the private midwife needs to have a lesson taught to her.

The MSR report mentions freebirth as being undesirable. If home birth becomes more difficult to obtain, either through expenses rising, or it becoming a crime for the midwife to attend, then more will occur. I am sure this isn't what the MSR team want to happen. Though the thought has been put out there that it is simply a stepping stone to legislating that freebirth is child abuse with the involvement of child protection being imminent. Whatever happened to a woman's right to choose her reproductive actions??

I was browsing a blog yesterday and the point was made that the medical fraternity/government are happy to 'allow' GP/OB's, nurses and midwives to be the funded care providers for rural and outback women (majority of indigenous women are outback), due the the undesirable locations. Surely you would think that because indigenous women and children have disgustingly high death rates compared to urban white women and children, specialist obstetricians would be racing out there to offer their life saving services instead of leaving them in the hands of midwives.. *shock/horror*

Hhmm, well, I'm going to put my head down and bum up to get my degrees. Maybe this MSR will amount to nothing, with nothing new being implemented except private midwifery being outlawed. I have till 2013 till I am going to be directly affected by the state of play. Though I do promise, while studying, I will keep writing letters and being involved with Maternity Coalition and Australian College of Midwives, to try and salvage my opportunity to become a registered and insured privately practicing midwifery professional, working with women in all places of birth.

Thursday, February 12, 2009

Why start blogging?

I'm about to embark on a 4 year double degree in nursing and midwifery, so I thought it would be interesting, helpful and an excellent way to debrief or vent. Also I have a few friends who are stickybeaks and have asked me to blog my way through the next few years :)

So a little about me-

I'm 32
I am married
I do not live in the city that I was born in
I have 3 children
I birthed one of them at home
I breastfed all of them for a combined total of 31 months
I love cats but don't have any at present
I totally fucked up my higher school certificate
I have worked in the public service, the travel industry and as a 000 police emergency calltaker
I am an only child from a dysfunctional family
I am pro-choice
I am against gential mutilation of any kind- M/F circumcision and routine episiotomy
I am a brunette
I am born in the year of the Dragon and am an Aries (I think I am a firey type..)
I love oysters
I hate raw onion
I think menstrual cups are an underutilised feminine hygene product
I trust my gut instinct when it comes to meeting people for the first time
I'm on the cusp of GenX/GenY- that makes me depressed and bad with money apparently LOL
I support the Fistula Hospitals founded by Dr Catherine Hamlin

Hhmm, that is enough for now.

I got my orientation information in the post yesterday and am getting more excited by the day regarding my journey into university. I want to become a midwife so I can work with women and their families, trying to enable them to have safe and instinctive births. The medicalisation of childbirth needs to be countered by midwives and other birth workers bringing it back to basics. There have been some wonderful advances made with regards to life saving interventions, yet it seems that defensive medicine has tainted the trust of women and their physiological capabilities. I am wary of the long slog through this degree perhaps dulling my passion for natural unhindered birth. I am hopeful that I have the support of others to help me ride out the scenes and happenings I am bound to see while undertaking placements in the 'system'. When I come out with my pieces of paper, I will find a private midwife, or a group of them, and be their understudy until I have soaked in enough to take on the responsibility and honour of being a primary care provider. For some strange reason I am also drawn to palliative care, as birth and death are feared in our society and are times when support, observation, understanding and assistance are needed. Is that weird?

Anyway, enough for today. I'll be back soon!

Wednesday, February 11, 2009

First entry!

How exciting, my blogging cherry is burst :)

I'll be back tomorrow when I'm not so tired, to elaborate more on my reasonings for getting this going!