On this last day of 2013...
... I welcomed five new people into the world!... My mother lovingly reminded me that I need to work on my self care.... I had to turn down a woman's request for the hydrotherapy tub because nursing was understaffed and I had another patient, so could not give her the safe, one-on-one care required for the labor tub. And I felt terrible about it.... I thanked nurses and scrub techs as often as I could get the words out.... A mother apologized unnecessarily for yelling at me, and then thanked me for being calm and kind.... I cut one cord, had a mother cut her cord, instructed a Resident to delay cutting a cord, and showed two partners how to cut cords.... I thought about eating lunch often, but didn't get to it until 1630.... I finished closing yesterday's clinic charts.... I felt proud of one very delicate repair, and frustrated by a very difficult repair that I wanted to have done better.... I acted as Attending for a Resident's delivery, and with each midwife-y action I encouraged her to do (stopping suctioning for a vigorous, crying baby; placing baby on mom's chest; delaying cutting the cord, talking with mom through everything, etc.) she responded, "I'm not comfortable with that." And afterward we had a conversation about learning different styles of OB providers, practicing evidence-based care and not just 'how we learned to do it,' and defending that there are reasons why midwives do things differently.... I argued that it is (and if not, it should be) illegal for a doctor to bill for a delivery that they did not attend. I was told that I could not bill or sign-off on a delivery I attended because the Attending arrived within 30minutes of the birth of the placenta, and they would be billing under their name for the work. Hogwash. I billed for my work and encouraged us to both look into the legality of billing when not present.... A nurse with a history of magic fingers made magic happen for a woman with the most dense epidural I have ever seen. Quite the caput, and a beautiful baby and birth. She was a midwife back home, but you probably already guessed that.... I talked with nurses about how the status quo, the 'that's how we do it here' mindset, is only because we mostly work with a population who doesn't know they aren't being treated correctly, don't know they should ask for more, and/or providers know they can take advantage. Lack of respect, ignoring evidence-informed care, sidelining basic legal requirements... I can only hope that this happens less with other populations, but I demand more for my work here.... I made plans to do better, to advocate for better, to empower others to advocate for themselves, to improve my motivational techniques to have other providers seek for better, and to keep in touch with my midwifery core, in 2014.How was your last day in 2013?