Another Meme...can you believe it?

I don’t usually do these meme things…a little too much like chain letters (OK, I know I am dating myself when I talk about chain letters) But Alldredge family tagged me. This one has been rattling around in my brain so I will just have to see if I rattled out seven random things about myself.

#1 I have won every belching contest in my family for as long as I can remember…and anyone who has been around my house long enough to no longer be “company” will attest to the fact that I keep in practice. It’s the reason I don’t drink any soda.

#2 I stuck a penny into an electrical outlet when I was a small child. I still have the burnt penny...and all my fingers.

#3. My little toes on my feet are about half the size of any of the other toes. I guess I just didn’t grow them very well.

#4. I wanted to be a veterinarian when I grew up.

#5. I’ve worked as a clown, bunny, witch and with magicians. I do know how many of the magic tricks are done but I promised not to tell…it drives my husband nuts!

#6 I wake up with anxiety every morning. I’ve had trouble with anxiety all my life. When I was really young I was terrified of going any place new. My brownie troop was going to the Ice Follies and I really, really wanted to go. I decided I was not going to let my fears get the better of me. I went, bought a soda, dumped out the cup, and used it to throw up in because the anxiety was so bad. But I got to see the Ice Follies! I’ve been making myself get out of bed and face my fears every morning since then. I still get terrified every time I talk in front a group, go to work, make a phone call, or take a test….the funny part? People think I am always calm and reassured! (I guess all the drama training for my job in #5 paid off).

#7 I can touch my nose with my tongue and wiggle my ears.

OK, I want to know seven random things about you...lets hear it!

Meme's and Awesome Mom

Many months ago I was tagged by Awesome Mom with a meme. I am such a lame blogger that it is just now that I am managing to actually do the meme. (the truth is it took me this long to finally figure out how to post links) So here it goes...

Rules: Go back through your archives and post the links to your five favorite blog posts that you’ve written.

Link one must be about family
Link two must be about friends
Link three must be about yourself
Link four must be about something you love
Link five can be about anything you choose
Post your five links and then tag five other people. At least two of the people you tag must be newer acquaintances so that you get to know each other better


So link one about my family is: My granddaughter's birth.

Link two about my friends is about my new "friends" who still come to my house to see the Rare Amazon Bird.

Link three about myself: This is where I tell some of my deepest secrets about myself.

Link four about something I love: Heartbeats

Link five about anything: Miracles.


I'm not big on making people do memes...cuz they might be like me and spend months worrying about it before they finally get around to it. So if you are reading this and feel adventurous...consider yourself tagged. The only thing is you have to send a comment to say you are going to do this so we can go to your blog and read your five things.

A friend comes to see me

One of my dear friends came to see me as a patient today. She was a bright spot in a tough Friday. She wonders if I will blog about her....I just did.

FMLA fun

Normally I hate filling out FMLA and disability paperwork. She was in great shape. It was easy to see that she was athletic. I had just confirmed her pregnancy when she handed me her disability paperwork. I inwardly groaned and went into my usual spiel about how pregnancy isn’t a disability and that FMLA paperwork would only cover her six week maternity leave or complications of the pregnancy. It wouldn’t cover her if she just wasn’t feeling well, or wanted to take extra time off just because she was pregnant.

She smiled at me and said, “Oh, just look at my job description and tell me what parts I can’t do.” Then she told me that she was a circus performer. And do you know what? It was fun to fill out her paperwork. It was great to write things like:

“Patient is not disabled but patient can not fulfill the duties of her job. Patient can not do high wire acts, can not wear tight safety harnesses around abdomen, unable to hang up side down and do sit ups, unable to do bungee cord jumping”…and the list went on.

For once, I did enjoy filling out the paperwork. Yes, she wasn’t disabled, but she wasn’t able to do her job. So guess what? She will be off on full disability from her job for the full nine months. Pretty smart of her to check for maternity coverage on disability insurance before she ever joined the circus.

So what do I do differently?

I’ve been wondering. What is the difference between an OB visit with me and one with the other providers? I don’t think I do anything special. I can ask if the woman is feeling her baby move, if she is having contractions, cramping, leaking or bleeding. I can measure a fundal height to get a rough estimate of whether the baby is growing properly. I am able to find a baby heart tone with the Doppler to make sure baby is still alive. I can subtract their current weight from the weight at the last visit and figure out how much weight they have gained. I can look at a blood pressure or a urine dipstick result and see if it is in a “normal” range. I don’t to anything different. I can do that in less than five minutes. Actually, I can do it in less than three minutes.

So what do I do differently? Why can’t I seem to be able to see more than four patients in an hour? I’m the only midwife in our office. Why would anyone want to see me rather than any of the other providers? What makes my visits different?

So I’ve been asking my patients. I’ve been asking them about what their visits are like with the other providers. I see on the charts that someone has marked off all the “education” boxes on the OB chart for the second trimester. So I ask. Did you provider talk to you about choosing a pediatrician? “No….” Did your provider talk to you about birth control options for after your baby is born? “No….” Did they talk to you about the signs of preterm labor? “No…”

They often come and tell me about problems they are having. “I am having nightmares about my baby and I am worried…am I going crazy?” or “I have these funny movements on both sides of my belly…could it be twins?” or “My mum told me not to raise my hands above my head or I could wrap the baby’s cord around his neck.” They will tell me about a symptom they have been having for over a month. I ask them, “Did you tell the provider who saw you last time about your symptoms?” I often get the answer, “No, they were so busy and I was afraid to ask.”

I listen to the women. I listen to their complaints, worries, triumphs and sorrows. I listen to their partners. I listen to them tell me about the worries they have. If they tell me they are “fine” but don’t look my in the eye, or they say it in a sad voice, I say “OK, so you gave me the polite response, but you don’t sound fine. So tell me how you are really doing.” I am amazed at what they tell me.

I talk to the women and their families. I tell them “Why” something is important. I explain why they need to do fetal kick counts. I reinforce at each visit what symptoms to look out for. I point out everything I can that shows that their pregnancy is going well and explain why some things I see make me worry. I try to help them understand what is going on with their bodies.

I show them things. I have them feel for themselves how we can tell if a baby is breech or vertex (head down). I put their hands under mine so they can feel the hard lump that is the baby’s head. I show them how an IUD is inserted, or how big 3 centimeters dilated is.

I don’t think I do anything special. I can’t imagine practicing medicine any other way. This is just how I do it. So how do I explain to someone why it takes me longer to do a visit? And more importantly, how do I try and convince the money managers that what I do is really worth taking the extra time to do it? How can I distill what I do differently into rationales, statistical figures and financial responsibility?

Productivity bonuses....You can't have it all

New productivity bonus program rolled out at work today. I’m feeling the pinch. We get told to see more patients (increase number of visits) be more thorough with assessments and charting so they can bill for higher reimbursement (do better quality) Order less tests and bring the patients back less (do it cheaply) and maintain the highest level of compassion and caring. (Increase customer satisfaction). I am reminded of a poster I saw at a business:

You can have it fast
You can have it cheep
You can have it high quality

Choose two out of the three…you can’t have them all.

The nice part about the day? I went to my boss to talk to him about my stress over the push to do more, be more, produce more. He said I am already one of the best providers and to not worry about it. I already do more, see more, and provide good customer care. OK, I feel a little bit better about it all. It’s nice to be appreciated.

Student nurse during World War II

I have seen her every week for the last year at a place where we both volunteer.  Today she told me she had been a student nurse during World War II.  She worked in a 1000 bed hospital that was staffed almost entirely by student nurses. Most of the regular nurses were serving in the war effort.   This was when penicillin was first beginning to be used.  She said that the penicillin had to be injected every 3 hours into each patient around the clock.  In a normal shift on a unit with about 30 patients, she would give almost 100 injections.  That was on top of all the other patient care she did.  I asked her when she was going to write a book about her lifetime of experiences.  She laughed and said she has forgotten so much more than she can remember. 

 

How many of these stories of our history are being forgotten because no one has written them down?  Will our generation be the first to have daily stories collected in blogs that might survive after we are gone?