Sore feet with a smile

My feet hurt. The office has been really, really busy. Seeing 3 to 4 new patients each day along with a completely booked schedule of existing patients.

My feet hurt. The shortest day has been 13 hours. I feel bad having the nurses call patients regarding their lab results (yet, this is the norm for the practice). I am trying to
keep up with them and even making some calls on the weekend.

My feet hurt. This wearing real clothes with real shoes is not so comfy. After many years of wearing my pajamas (those stylish blue hospital scrubs) to work, my feet are not used to such torture.

My feet hurt. Running down seven flights to L&D, because one elevator is broken and I don't have the time to wait for the other one because they called to say "the head's right there".

My feet hurt but I'm smiling!!!!

The definition of medical emergency

12:30 am--

Message on pager

Had baby in August and now has a rash. Please call immediately.

Yup, she has a rash. Her PCP can take care of this at 9 am in the morning-- no need for both of us to be awake and knowing about her rash.
The definition of perception--rash="medical or obstetrical emergency"

Be very, very careful!

Yes, the BIG BAD MIDWIFE is in town. She is here to steal your patients. The most important thing is that you don't let her talk to your patients.

We will be miserable that we don't have an extra person to answer the pager or share rounds with but we would not want to risk it. We will continue to rant to the nursing staff that we will lose 1/3 of our patients to the BIG BAD MIDWIFE.

We have heard that she actually sat on the edge of the bed and held a hand while a woman cried. It has been reported that she calls patients with their results when they are not what they expected. There have also been rumors that she cares about how things are going at home-are the kids well? everything good with your husband? are you sleeping okay? It's also been overheard that there are grumblings among the women she has seen that they think "she is nice".


Today, when I fed a pregnant woman that doesn't have enough money for food and had social services see her I was told by an Ob (not the doc I work with) that my job is to practice obstetrics and to practice gynecology and that it was not to "save" someone. He was mistaken my job is to practice midwifery and that is exactly what I did. Watch out--the BIG BAD MIDWIFE is here.

Interesting appointments

Here are two of the better ones

Post-menopausal -- Follow-up for no period

Okay, isn't that menopause? I know I am new but---and that truly was the complaint. "I have been menopausal for a year and a half and I haven't got my period." We did some physiology education for that appointment. She was relieved.

Patient wants to find out who FOB is (that's "father of baby")

This young lady had two options and wanted me to tell her which one I thought she should pick. One was out of state and had been a bit of an ass lately but she liked him the best. The other one was around more but, eh-she wasn't so thrilled about him. "Can you help me choose?"


and I can't say anything about the secretary's because truly, that's what the appointment was. And, I did meet some wonderful women this week.

A really nice view

So my first day was last Thursday and what happens Wednesday night--sick! Major sinus issue. Perfect! Anyways, made it through Thursday and Friday and then spent Saturday in bed. My first full week has been very busy and thrown right into it. The doc that I am working with was in the office on Thursday and then left the country to visit family for this whole week. She deserves it but it was tough being the new kid by yourself. The office staff, MA's and RN's have been fabulous though, so no complaints.

My first challenge last week was sitting on the right side of my desk. I know it sounds stupid but it just didn't feel right. This doc has a beautiful office suite-not your typical drab medical office. My office is decent size, great desk, big comfy leather chair with a view to die for. Nurses don't get that. When I came in the beginning of the week to move some stuff in and organize some paperwork I sat in the two chairs on the side of the desk where the patient's would sit. That leather chair felt like it should be for someone else--someone way more important. I did this for three days. I think both her and the office staff were probably thinking --what's up with the midwife?? So this week I sat in the chair. I finished some charts. I drank my coffee and gazed out at the awesome view. I am slowly coming to the realization that I can enjoy the benefits of my new job and still be the nurse I am.

One of the biggest challenges for me is to let go and not feel like I need to save the world. Over the years I have cared for women who many have found difficult to take care of. I was usually nominated to take care of them or everyone else was "fired" and they were stuck with me. I have always been confident that I have given them the same care I would have given a family member.

But, it does begin to wear on me. I think of these women long after I have cared for them--are they in the same situation?, are their children safe?, did I do enough? did I miss some resource they should have been matched with?

I wonder about--

• the mail-order bride who spoke no English, no family, no friends and pregnant.
• the woman who had no prenatal care, gave an alias and we found out her other six babies had been taken away.
• the young pregnant runaway who was being abused by her boyfriend.
• the high-school girl who showed up fully, had her baby (no one knew), and left the baby at the hospital. She needed to get home before her parents found out
• the parents of three children who gave their baby up for adoption because they could not afford another child.
• the woman who had a psychotic break in labor.
• the mother of two who was abusing prescription narcotics and didn't want her husband to know.
• the new mother who knew that her husband was not the father of her baby.
• the woman saying she is contracting to get out of jail.
  

I think about these women. I wish I could have made their lives better. I did my best but my best is no where near enough to solve these problems. I hate that.

Did I miss something?

I always thought that when you needed a refill on a prescription (no refills left) you called the office of whoever prescribed the medication for you. Is this not true anymore? That's what I do. In fact, my PCP has a convenient answering machine set up so I just leave a message and don't have to bother anyone. But--

Recently I was at "big chain pharmacy" with neglected teen daughter waiting for a prescription. Middle-aged man and his mother are there picking up half the pharmacy. Middle-aged man proceeds to berate very young looking pharmacy tech about a missing prescription. Why isn't it there? He called the PHARMACY this morning for THEM to call HIS doctor to get refills. This took 20 minutes with a huge line behind him. I had a front row seat to this (next to a woman who I think coughed up her right lung into her HANDS). Am I missing the new way to get refills?


I have called to refill medication, discovered that there were no refills left and the pharmacy tech offered to call my doctor. I promptly declined. Isn't that my job? Why are pharmacy's even offering? Aren't they strapped enough for time and people? Customer service??--please we are creating a culture of people who can't take care of themselves. This guy was old enough to know better but now he clearly has come to expect this. I paid for my prescription and also threw in a pocket-sized spray hand sanitizer. Out in the parking lot I sprayed myself and neglected teen daughter down and shook my head in amazement.