Networking 101

This post has been percolating for a while…in part because I know there’s probably a post out there in the world already that is very similar to what I’ve been thinking. But you know, sometimes, it’s just easier to write your own instead of spending hours trying to find that perfect link to share.

Over the past two years that I’ve been writing this blog I’ve connected with students, prospective students, as well as currently practicing midwives and other health professionals. These connections have been both personally and professionally enriching in ways I could not have imagined. I had no idea when I started this blog how many people it might reach. As a student or prospective student, it’s easy to feel like you’re out there all alone on your journey, especially when your politics may veer in a slightly different direction than the mainstream culture of your profession.

I’ve loved connecting with the many prospective students who have reached out, hearing their stories, hopes, and dreams about midwifery, while also sharing my own experiences and bits of insight gleaned along the way. I know when I was in the midst of researching and applying, I was so hungry to hear those stories and use that information to help me decide what my own path to midwifery was going to look like.

One of the things I’ve noticed is that many folks start out their emails in a general, “Hey, I’d love to connect and hear more about your experience!” kind of fashion. While I would love to sit down with each person and have a heart to heart about midwifery, the reality is everyone is super busy. So, in the spirit of encouraging effective communication, I thought I’d share some tips on how to reach out to other students or practicing midwives and get the most out of those “cold calls” or “cold emails.”

Do your research. Before you write that email, that is. While I love helping folks connect with each other and with good resources, I think it’s also just good manners to do your own research before you send that first email. Know the lay of the land, which for prospective midwifery students, means researching the professional organizations, knowing the pathways to midwifery, and having a sense of what appeals to you about those pathways. If there are things that are unclear as you peruse the professional websites (and student blogs, etc!), write those questions down! Which leads me to my next tip:

Get specific. I get a lot of emails from folks asking something along the lines of, “I’m thinking about midwifery school, can you tell me more about your program?” I could tell you a lot, for sure…but realistically, each program is a universe unto itself and I could spend days talking about the ins and outs of my programs and the ones I’m familiar with. So think about what you really need to know. Get really clear on how you think the person you’re reaching out to could help you. Is it that they know something about a specific program, or faculty member and their research, or practice climate in their state? It’s okay to ask several questions, but it sure is helpful to have a concrete list. An email asking me to share my experience and thoughts on my program leaves me feeling overwhelmed about where to even start. An email with two or three bulleted questions is much more manageable.

Think about timing. When you reach out and make an ask, it’s really helpful to have a sense of both your own timeline and that of the person you’re connecting with. Emailing at the beginning and end of terms, for example, may not be ideal…and you should know that those emails may not get the speediest reply (as badly as we students feel about that!). Also, tell us what your timeline is, and if a reply is more urgent, it’s ok to be honest about that. I’d rather know that you’re coming up against a deadline and then I, in turn, can be honest about whether I realistically have the time in that moment to give a thoughtful response…or whether I might need to pass your request on to someone else who might be better situated to answer your question.

Keep it brief. The shorter, the better, really. When I’m sending these kinds of emails, I try to keep it to what can fit on one window without scrolling, in easy to read paragraphs.

Don’t be afraid to reach out. Having said all that…I want to underscore how valuable I think it can be to reach out to someone you may not know personally but suspect could help shed light on your path. My philosophy when I was applying to programs was the more perspectives I could hear, the better. That’s also part of how I make decisions, too…and I would say that knowing your own decision-making process is a really useful insight that you can use to your advantage when considering midwifery and midwifery programs and how you craft those emails.

I think all these points apply to midwifery students networking with other students…and with connecting with midwives in practice, too. I’d love to hear your thoughts, whether you’ve been on the reaching out or responding end. What’s worked well for you, what would you add to this list? What have you learned about networking over the years?

The Final Five: Day 1

NFASM_Final Five Countdown 1A mini-reflection series to celebrate the final five days of my undergraduate nursing program. Each day I’ll share both a high and low of the last 15 months…because, let’s be honest, an accelerated nursing program is not always easy. That said, it’s been a year of incredible growth and learning, and I’m ready to bring some closure to this stage of my journey and clear the space for the learning and growth that lies ahead in the next two years as a graduate student in nurse-midwifery.

{Please excuse the slight delay in this post’s publication…some very important relaxation was necessary post-graduation before I could resume writing!}

The Low: Navigating challenging relationships among faculty and established health care providers

This one’s tricky to write about, because for the most part, I’ve really enjoyed my experience and have learned so much from the interactions I’ve had with various care providers and faculty. But I’d be deceiving myself if I didn’t acknowledge that there have definitely been some challenges on the way as well, as there are bound to be in any program. And, isn’t this a typical job interview question: “Describe a particularly challenging conflict you’ve had and talk about what you did to navigate it.”

What I’ll say about conflict in nursing school is this: It’s good to go into nursing school knowing something about the history of nursing as a profession. Understanding history is crucial to have any grasp on the present, let alone imagine the future. The history of nursing is brimming with strong, empowered women who broke down barriers and advanced the health of millions of people around the world. At the same time, nursing has primarily been a profession of women. I think the impact of how gendered this profession has been continues to play out today in inter-professional dynamics. As a feminist, I see a lot of communication and problem-solving styles that suggest a history of power struggles. It has a formal name: lateral violence and it is a well-researched phenomenon within the field of nursing.

Another challenge of being in an accelerated program is that the students all come with tons of previous life and work experience…with expertise. Returning to the state of novice is challenging, and some faculty understand that challenge better than others. While overall, I felt very supported, I also recognized some pretty big challenges that accelerated faculty face in trying to condense a three-year program into 15 months. The fact of the matter is, accelerated programs are fairly new and there’s not a ton of research on the unique learning needs of accelerated students. Some faculty are great at adjusting and have a keen sense of how to help us navigate this journey. Others are still used to teaching in a more traditional three-year program and that mental shift is more challenging.

As someone with formal background in education, I found it fascinating and frustrating to realize that not all nurses come to teaching with formal training in education, especially when it comes to accelerated programs. While I certainly don’t regret my decision and feel like I am just as competent as the next new grad, I also am leaving the program with a strong desire to continue doing more research on the pedagogical demands of an accelerated program. More and more nursing programs will be moving in this direction and I think it’s important to be thoughtful in how we design and implement the accelerated learning experience.

The High: My amazing, amazing cohort, all of whom are going to make excellent nurses.

I have felt this from Day 1 of my program: the strongest asset of my program was not the facilities or computer lab or clinical opportunities, it was my fellow students. All 64 of us busted our butts off to get into, pay for, and graduate from nursing school. I’m leaving this program with a renewed sense of faith in the future possibilities of health care in our country. Despite the huge obstacles we’ll continue to face in providing quality, accessible, equitable care…I know that there are at least 63 more nurses in the world who are passionate about their work, who genuinely care and want to make a difference. I know they’ll study late into the night to understand an unfamiliar illness or new drug or procedure. I know they’ll have a sense of humor and ability to establish meaningful relationships with their patients. I know they’ll go above and beyond to ensure their patients’ safety. I know this because I’ve already seen them in action, heard their stories, and witnessed their transformation, just as they’ve witnessed mine.

One important piece of advice I got when applying to nursing programs was to consider the people who would be in school with you. You’re not just picking a program based on its curriculum or facilities, although those are definitely important. You’re also selecting the people you’ll be working and learning with, the future leaders of your profession. It’s important to figure out whether you’re a good match for the community of folks you’ll be learning with over these intense 15 months. Nursing school is impossible to do alone. You’re always part of a team and I can say without a doubt that I had a pretty amazing team.

Congratulations to my fellow classmates. We made it! I can’t wait to see you all fly through NCLEX and into your first jobs.

The Final Five: Day 2

NFASM_Final Five Countdown 2A mini-reflection series to celebrate the final five days of my undergraduate nursing program. Each day I’ll share both a high and low of the last 15 months…because, let’s be honest, an accelerated nursing program is not always easy. That said, it’s been a year of incredible growth and learning, and I’m ready to bring some closure to this stage of my journey and clear the space for the learning and growth that lies ahead in the next two years as a graduate student in nurse-midwifery.

The Low: Getting through the less than helpful assignments

There’s no skirting around the truth, friends: you will complete assignments that make you roll your eyes. You’ll reflect on the clinical judgment model more times than you think possible. You’ll wonder, as you write the umpteenth paper, why it all matters, and who cares about APA format anyway? To be sure, there will be a few helpful assignments…but you’ll learn how to figure out which ones are helpful and which ones aren’t. Maybe you’ll be like me and join the curriculum committee and try to help offer feedback on some of those assignments. But regardless…like in any program, there will be busywork.

But…

The High: The brilliant aha moments that literally take your breath away

Somehow, often fairly late in the game, things start coming together. Random lab values that you were told you don’t need to memorize (but then later discover in clinical you DO need to memorize) start to make sense in the context of a patient’s story. You’ll have moments of intense connection, of incredible synergy, moments that release oxytocin and endorphins and all the happy hormones that leave you feeling so blissful you can hardly stand it. You’ll marvel at how lucky you are to be privileged enough to care for others, even as a student. You’ll encounter a few of those “favorite patients” (I know, I know, we don’t have favorites…except, we kinda do), the ones that your heart aches for when they receive the diagnosis they knew in their hearts they already had. Your heart will ache when you’re there for the birth of their much-desired second daughter…when they climb out of bed to the bathroom for the first time post-op…as you wheel them downstairs and out the front doors to be discharged home.

Your heart will ache with a fullness you didn’t know possible. Your heart will overflow with the richness of the human experience, this journey we’re all on through health and wellness. You’ll savor the moments in which you feel like you made a difference, even if it was as simple as a warm blanket. These brilliant aha moments will take your breath away, make you pause, make you grateful for your health, your body, your life. They’ll re-center you in the here and now. They’ll serve as the nourishment you need to continue on your path as a nurse and healer.

The Final Five Countdown: Day 4

NFASM_Final Five Countdown 4A mini-reflection series to celebrate the final five days of my undergraduate nursing program. Each day I’ll share both a high and low of the last 15 months…because, let’s be honest, an accelerated nursing program is not always easy. That said, it’s been a year of incredible growth and learning, and I’m ready to bring some closure to this stage of my journey and clear the space for the learning and growth that lies ahead in the next two years as a graduate student in nurse-midwifery.

 

 

The Low: Giving up my doula practice and the connection to what brought me to nursing school.

This was a really tough decision, but one that I never doubted, especially after school started. As much as I wanted to be that nursing student who had her stuff together 100% of the time, that was pretty much the first thing I had to let go of as soon as school started. Although passing my doula practice on was sad, and I was definitely missing being involved in the doula community for the 15+ months I went without attending a birth, it was also good for me to expand my mind.

The High: Being exposed to the power of nursing care in a variety of contexts I’d never considered before.

Not working or volunteering gave me the ability to really delve into my experience as a student…and I was surprised by how much I loved experiences that I really had no understanding of prior to starting nursing school. Med-surg nursing, for example…although it’s not what I would want to do full-time, I learned so much by observing the compassionate care that these nurses offer for patients. Med-surg is often seen as the bread and butter of nursing practice, the default position many nurses look for after graduation. While I would argue that that’s not necessarily true anymore…and I wish there were waaaay more emphasis on community-based nursing in our program, there is something to be said for the skills I gained in my med-surg rotation. No matter how someone presents to you, whether as a post-op patient after gallbladder surgery, as a patient coping with COPD, or as a patient about to give birth, nurses are there. This recent article really hit it home for me how much nurses do…and how much better I now understand how vital nurses are to health care in general.

The Final Five Countdown: Day 5

NFASM_Final Five Countdown 5A mini-reflection series to celebrate the final five days of my undergraduate nursing program. Each day I’ll share both a high and low of the last 15 months…because, let’s be honest, an accelerated nursing program is not always easy. That said, it’s been a year of incredible growth and learning, and I’m ready to bring some closure to this stage of my journey and clear the space for the learning and growth that lies ahead in the next two years as a graduate student in nurse-midwifery.

 

The Low: Feeling like a bumbling klutz about 90% of the time who’s always on the verge of potentially killing her patients.

There’s no getting around the fact that much of the last 15 months has been a humbling experience. I went from being an expert (in Montessori education and doula care) to being a complete novice (what exactly do nurses do?), pretty much overnight. The first term was tough, being slammed with both pharmacology and pathophysiology…but ultimately, this being a novice thing turned into…

The High: Free license to ask all the questions you could possibly want without anyone wondering why you don’t have the answer already.

As long as your in student scrubs, you have the freedom to not know everything and for that to be ok. Nursing school is the time to ask lots of questions, and get good at asking them quickly…over time, you lose the inhibition that comes with potentially “looking stupid”–there’s no such thing. Getting to be a beginner again ended up being a real gift. It didn’t mean that I lost my former knowledge…but I got to soak in the wisdom and experience of nurses and other health care professionals in a variety of disciplines, all of which will inform how I move through the world as a future nurse-midwife.

Countdown to RN

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Folks, it’s getting real over here. Four weeks from now I will be DONE with nursing school! Yup, done, done, done, done. Fini. Terminado. Finito. Can you tell I’m excited? I am SO excited to be done with nursing school! There’s a part of me that would like to just close my eyes and have four weeks whiz by.

But then I think about what’s expected of me and I think that actually, it still feels kinda cozy to be a nursing student. Don’t get me wrong, I’ll be ready to be done. But the responsibility of being the “licensed provider” that’s referred to in all the clinical guidelines is starting to sink in a little.

So what exactly do I have left between now and the letters RN after my name? Well, since I’m a Capricorn, I’ll make a list for you.

  • Approximately 120 more clinical hours (roughly equal to 10 more days on the unit)
  • One clinical issues paper (I’m going to write about the current evidence on treatment of hypertension during labor)
  • One teaching project (for the nurses on my unit–also on hypertension in labor)
  • One day shadowing the resuscitation nurse in the NICU at school
  • One more graded practice NCLEX
  • One more NCLEX study plan (and the studying that I plan to do…)
  • One afternoon of neonatal resuscitation training!
  • Four more submissions of my clinical hours (I’m kinda cheating here…it’s not really much work to document my hours…but it’s still an assignment, so on the list it goes!)
  • Two more mini-clinical reflections (thank god they’re mini!)
  • Two more post-clinical conferences with my midwifery cohort (plus one informal one with cocktails included!)
  • One teaching project presentation
  • One final clinical evaluation

I’ve already submitted my RN licensure application to the state board of nursing (with yet another round of fingerprints!)…so the only other thing left will be the NCLEX…and I’m taking my housemate Maureen’s advice about that.

She’s an RN, did the same program as me but a cohort ahead of me, and she decided she wasn’t going to tell anyone when she was taking her exam. I think it’s great advice, because I’m sure from here on out, the number one question I’ll get is “When are you gonna take the NCLEX?” Well…the last thing I need right now is more stress or anxiety about it. So…I’m not going to discuss it, except to say I’m studying (kind of) and it will be fine, and when I can add RN after my name, don’t worry, I’ll let everyone know!

As cliche as it sounds, I really can’t believe how fast things have flow since I started this blog in 2012 while working on nursing pre-reqs. In another two years, if all goes well, I’ll be a midwife. It’s both thrilling and overwhelming at the same time to think of how much I still have to learn…but if there’s any wisdom I’ve gleaned so far from nursing school, it’s this: It’s all going to be ok. Take one day at a time. Breathe. 

And with that, I head back to my lit search on hypertension and labor.

 

 

Learning to Fly

Oh, friends, I’ve been writing so many blog posts in my head, but somehow, they’re just not making it onto the [virtual] page. Lest you think I’ve been swallowed alive by clinical this summer, I’m taking a deep breath, settling in, and going to write a post about how things are going so far, because otherwise, I’m pretty sure I’ll forget what it feels like in this moment, to be on the cusp of learning how to fly more independently as a L&D/PP nursing student.

The Setting
My clinical site is a small, community hospital with about 150 beds total. 14 of those are in the Birth Place, a LDRP (Labor/Delivery/Recovery/Postpartum) unit. Some days all 14 beds are full…some days not so much. Except when I have other school stuff scheduled, I’m there when my preceptor is there, which is every Wednesday and Friday, every third weekend, and every third Monday (but the Monday’s are not the same week that we just worked a weekend, if that makes sense). My preceptor works a day shift, 7am to 7:30pm…so that’s when I’m there.

There’s anywhere from three to five nurses on any given day, sometimes more if they know procedures are scheduled. There are two scrub techs who double as HUCS, and they set up tables, do the hearing screens, help with vitals if needed…basically, know everything about the unit. There’s one OR, no NICU, and they really only take mostly low-risk patients after 36 weeks. So…lots of mostly normal birth going on here. Inductions and epidurals, to be sure…but not a lot of crazy complications or anomalies.

My Day
It’s different every day, depending on if my preceptor gets assigned a labor patient or postpartum patient. If it’s a labor patient, we’re 1:1, for postpartum 3:1. At this point, I’m starting to do more independent care…so we’ll go in together and meet patients, but unless there’s something I don’t know how to do, I’m mostly doing stuff on my own. What is that stuff, you ask?

Skillz
Well, for laboring patients, I’m helping get them admitted and settled into their rooms. I put the monitors on, take their vitals, do a physical assessment (listen to heart, lungs, check deep tendon reflexes, assess edema). I talk about what an induction will look like. I (try to) start their IV site if they need one (most patients will get one unless they specifically ask otherwise). I chart all those things in Epic. I get them water, or juice, help them order meals. I bring them birth balls, rocking chairs, or telemetry units so they can walk around the unit if they’re on monitors. I give medications, for nausea or pain, or if they have other home meds they take. I’ll hang a bag of fluid, or antibiotics if they need it. I’m in the room every half hour if they’re in active labor and getting pitocin (which I’ll also hang), monitoring their EFM strip and charting it. Oh, and you know, providing labor support as needed. Many patients on our unit end up getting epidurals, so I help with that, too–hanging a bolus of fluid, all the charting involved, regular vitals, etc.

Before the actual birth, I help the scrub techs get the birth table in the room, which has all the supplies the midwife or OB will need–cord clamps, sutures, placenta bowl, hemostats, sponges, etc. I bring in a lamp for the provider, and a mirror for the mom if she wants it, and an extra trash bag and dirty linen container. I bring in the baby warmer, turn it on, and make sure all the resuscitation equipment is ready to go, just in case (usually, babies stay skin to skin with mom, unless they need a little help with breathing). And I’m helping the mama as she’s pushing. I’m checking in with the baby nurse, giving updates about how labor’s been going. If mama hasn’t peed in a while, I might insert a Foley catheter, or straight cath her, depending on the preference of the provider.

After birth, I’m helping the provider as they wait for the placenta, handing over suture materials during any laceration repair needed. Or I’m helping do vitals and physical assessment on baby, giving vitamin K and Hep B and erythromycin (or “eyes and thighs,” as those meds are referred to, as the first two are injected in the baby’s thighs and the other in the eyes). I’m assessing mom’s bleeding, palpating the fundus to make sure the uterus is clamped down. Sometimes I’m administering more pitocin, depending on bleeding. I’ll help get her up to the bathroom for the first time, teach her perineal care if she has stitches. I’ll get more pain medication to her.

Of course, then there’s breastfeeding support. I’m getting better at finding the most succinct way to explain baby latches, and learning the gentle art of more hands-on support as they try to nurse for the first time.

Looking back on all this now, it sounds so simple and straightforward…but in all honesty, it took me the first few weeks to figure out the general rhythm, where things are, when and how to chart that she moved positions in labor, or got in the tub, or successfully latched. Plus all the little secrets: where to find the stretchy belly bands to hold the monitors, which most mamas like better than the velcro belts…or how to put a wash cloth in with the monitor to hold it in place better. It hasn’t been until the past week that I felt I could even begin to contemplate walking into a room without my preceptor and feel remotely competent.

But friends, it’s starting to happen! I imagine myself a bit like those awkward, clumsy baby robins you see in the spring. You know the ones…they’re all huddled together in the yard, flapping ridiculously, with their mama watching nearby, peeping encouragement or advice. But she knows that she can’t do it for them, so mostly stands back, even as they flap and flap and start squawking with frustration as they watch their siblings get airborne for seconds at a time.

It’s the strangest of sensations, but I’m starting to feel more like a nurse each day. Of course, there’s still so much more to learn…but those little moments in which I notice my feet aren’t on the ground and my wings are flapping just so and I’m not crashing back to the nurse’s station in search of that thing that I swear I saw in the supply room the other day…those moments are worth all the long hours of lecture and papers and reading. I know that this feeling will be short-lived, because in a few weeks, I’ll wrap up clinical and then move on to grad school, where everything will be new again…but at least for these last four weeks, I’m going to relish this feeling.