All those Practice Guidelines and Client Handouts

We are nearing the end of Winter Trimester, 2017. It was a great semester! I was able to complete the trimester way ahead of schedule which gave me a nice long break! I was not in a apprenticeship this trimester, so there was plenty of time to complete all assignments, and complete them well ahead of schedule. There was also time to take a one week break mid-trimester to visit my parents out-of-state.

This semester, I decided to create a schedule, in a notebook, for all classes and all assignments, including the required participations (no computer scheduling this time, because that has not worked in the past; I’m the pen and paper type!) I followed the schedule precisely, and it allowed me to submit assignments on time, and not fall behind, but to move far ahead in assignments.

This trimester was the trimester of practice guideline and client handouts: 42 total!! The three courses I took were Chemistry & Nutrition, Complications of the Prenatal Period, and Postpartum Care. Below is a list of the practice guidelines and handouts I created this trimester.

Chemistry & Nutrition Client Handouts:

1. Glycemic Index and Low Glycemic Diet Handout
2. Hydration in Pregnancy Handout
3. Prenatal Vitamins Research
4. Nutrition During Pre-Conception, Pregnancy, & Postpartum Handout
5. Take Charge of your Home Handout

Complications of the Prenatal Period Practice Guidelines and Client Handouts:

1. Group B Strep Practice Guideline 1. Group B Strep Handout
2. Ectopic Pregnancy Practice Guideline 2. Bleeding in 1st, 2nd, and 3rd Trimesters Handout
3. IUGR Practice Guideline 3. Miscarriage Handout
4. Placenta Previa Practice Guideline 4.  Gestational Diabetes Client Handout
5.  Abruptio Placentae Guideline 5. HELLP Client Handout
6. Miscarriage Practice Guideline 6. How to Prevent Preeclampsia
7. Gestational Diabetes Practice Guideline
8. HELLP Practice Guideline
9. Gestational Hypertension, Preeclampsia, Eclampsia Practice Guideline

Postpartum Care Practice Guidelines, Forms, and Client Handouts:

1. Immediate Postpartum Checklist 1.  Preparing for a Healthy Postpartum Handout
2. Postpartum Midwife Chart (a checkoff list) 2.  Postpartum Information for Parents Handout
3. Rh-negative Informed Consent & Waiver 3.  Nutrition for Postpartum Handout
4. Healthy Attachment of the Newborn and Mother Practice Guideline 4. Toning Your Body in the First 6 Weeks Postpartum Handout
5. Postpartum Depression Practice Guideline 5. Postpartum Depression Handout
6. Postpartum Needs of Women in Diverse Ethnic Cultures Practice Guideline 6. Sexuality in Postpartum Handout
7. Sexuality in the Postpartum Practice Guideline 7.  Healthy Attachment & Bonding Handout
8. Postpartum Visit Care Schedule Form 24 hour 8. Midwife Resource for Postpartum Services
9. Postpartum Visit Care Schedule Form 72 hour 9. Special Help Postpartum Handout
10.  Postpartum Visit Care Schedule Form 7 Day
11.  Postpartum Visit Care Schedule Form 2 Week
12.  Postpartum Visit Care Schedule Form 6 Week
13. Postpartum Visit Care Record Form 24 hr, 72, hr, 7 day, 2 week, 6 week

Final grades for Winter Trimester, 2017:
Chemistry & Nutrition: 100% A+
Complications of the Prenatal Period: 98.67 A+
Postpartum Care: 99.47% A+

Last semester, I forgot to update with grades. So I’m adding those in this post as well.
Fall Trimester, 2016:
Principles of Evidence Informed Practice: 96.85% A+
Prenatal Care II: 98.09 A+
Labor, Birth, and Immediate Postpartum: 96.71 A+

Paper schedule:

Halfway Mark!

This is the halfway mark!! Today marks exactly TWO years since I began my journey with Midwives College of Utah (MCU). When I considered becoming a midwife, I was a bit unsure of which school to attend. Could I really do long distance learning? Would it be structured enough for me? Would I be able to be committed? Would I be smart enough? So many questions, and no way to figure it out unless I tried it out.

Thankfully, MCU  has a continuing education program. Students can enroll in a few classes, without any on-going obligation. Entering the continuing education program was my way of testing the waters before fully committing to distance learning. After the first semester, I was hooked! I took a second continuing education semester, and applied to become an enrolled student. In Aug of 2015, I became an official enrolled student.  However, my academic journey began earlier that year in Jan 2015 with the continuing education classes.

Today, I reflect on how frightened I was to go full force, still unsure of my calling. Unsure if I was fit for long distance learning as a student over 40 years of age. Still praying about moving forward and wondering if this was God’s will for my life. Wondering if I could hold it together while still raising five children, with six still living at home, and cooking, cleaning, grocery shopping, school runs, teaching P.E., helping my children with their homework, helping my husband with his business, continuing to be a doula, church activities, volunteering at church, yearly youth camp (week long) trips, periodic youth trips, my daughters school competition trip and then comes the preceptorship. What’s more, attending MCU is year round with a three week break between semesters to rest before the next semester begins. Their academic year is divided into trimesters: three-15 week trimesters with three week breaks. Thankfully, I have been able to continue the forward momentum.

This journey cannot be forged, though, without the support of many people. With the support of my husband, my daughters, my son and his finance who sometimes pick up the slack and will drive my school-aged children to school or pick them up after school if I’m at a birth, MCU students who have cheered me on and have been my study buddies and a listening ear, and my MCU house mother whom I can text or call anytime I need help, I am able to continue on this journey to becoming a midwife!!

Here is a small window into the support from my children:

testing-chair-watermarked
When I am taking an exam with an online proctor, there cannot be any interruptions. For this particular exam, I told all the children that they could not come in the room while I was taking the exam. When I was done with the exam, I found this chair they had put in front of the door to block entrance into the room. One of them wrote this note: Don’t go in. Mom is taking a test.

Completion of the didactic work should be somewhere at the end of Dec. 2018 (almost exactly two years from today). It does seem unreal to be two years into this work, it will be equally           unreal when it’s all completed!!

Second Year Student

The break was great! It was a much needed time of resting my mind. I had time to enjoy the last bit of summer break with my daughters. We went to the coast and beach for two separate day trips. We also got to go camping for four days in Shaver Lake with our good friends. If there’s one thing I love doing in summer, it is camping.  I was able to find two small campsites, next to each other the week before our camping trip. We loaded up a U-haul with all our gear, our friend’s gear, and we took off! We had lots of food, water fun for the children, and s’mores by the campfire. We also went to San Diego for a couple days. I took all six of my daughters, and my son and his girlfriend joined us, too. We went to Balboa Park and then the beach. We had a great time!

I tried to fit all of summer into three weeks and did a lot of activities with my children to make up for a summer vacation that was filled with school work for their mom. All six of them and I enjoyed every trip we made.

Morro Bay 8-2016 Watermarked

Morro Bay, August 10, 2016

 

Monterey Bay 8-2016 Watermark

Monterey Bay, August 12, 2016

 

Shaver Lake 8-2016 Watermarked

View from our campsite, August 16-20, 2016

 

Balboa park 8-2016 Watermarked

Balboa Park, August 23-24, 2016

And with that….

All good things must come to an end, and now, it’s time to get back to school. The 2016-2017 school year at Midwives College of Utah begins today, August 29, 2016.  It’s still so hard to believe that I am a second year student in midwifery college. This school  year will have me enrolled in 10 different classes throughout the trimesters.

Many of the books used in past classes are used multiple times. So for the fall trimester, I only needed to purchase two books, because I already had seven books from previous semesters! That was a huge savings.

Fall trimester classes:
Prenatal Care II
Labor, Birth and the Immediate Postpartum
Principles of Evidence Informed Practice
(It’s a relief to not have a biology class for fall semester!)

Winder trimester classes:
Postpartum Care
Complications of the Prenatal Period
Chemistry & Nutrition (BIO 404)

Summer trimester classes:
Well Woman Care
Obstetrical Pharmacology
Complications of Labor, Birth and Immediate Postpartum
Applied Microbiology (BIO 405)

I look forward to the challenges and the information I will learn. Let the second year commence!

 

End of First Year!

Has it really been a full year of being an official midwifery-student? It feels so surreal to be at the tail end of this first year. There have been lots of changes, many new things learned, new skills practiced, and even my first ever cervical exam, which went perfectly! What an amazing feeling to touch and feel a baby’s head before he/she is birthed into this world. I’ll never forget it, and I will never forget the momma who so patiently, and willing allowed me to learn on her. Thank you, C, you are the best!

At the 3-day postpartum visit, C and her husband gave my preceptor and I some flowers. Here are the ones they gave me:


My preceptor is also now giving me more opportunities to learn other skills. She has taught me how to draw medication from vials, so I can now prepare syringes for her. She taught me about the cervical exam and what to feel for and how to measure the dilation. What I love the most about my preceptor is that she never makes me feel inadequate. I know I don’t have the hands-on skills perfectly, but she never makes it seem like I’m inept. She is so patient, kind, loving, and gentle. Thank you so much, Linda!

This academic semester was a very difficult semester for me and for most of the student body. In an effort to streamline and become better equipped at serving their students, the school switched over to a different platform called Canvas. While we had a couple weeks to get familiarized with the new system, it didn’t prepare us well enough for the arduous task of navigating the new system. It took many of us weeks, if not the whole semester to finally feel comfortable using it. It took me 6 weeks to feel like I understood the system. I worked even harder than I had in past semesters, because it took me a minimum of two hours at the start of each day trying to figure out how navigate the system.

It reminded me of the time when I worked at a staffing agency a few years ago. We had been rolling along just fine with the system that was in place, when corporate decided it was time for an upgrade. Our office was one of a few offices chosen as a test pilot office. We got trained on the new system, but, again, it wasn’t enough time to prepare us for when it went live. I was in the office very late trying to manage all the payroll on the new system. It was days upon days of figuring it out, emailing with IT, and stressing. A few weeks into the change, my manager paid the massage lady next door to come to the office and give us a neck massage. That was awesome, Samantha, and I’ll never forget that you took care of us during that change! We all managed to figure out the new system, eventually, but not without a lot of headaches and stress. And this is exactly how this semester has been with the switch to the Canvas platform.

I’m positive that next semester will be easier, especially, because I finally understand the new system. I know where to find the syllabus, modules/assignments, how to upload assignments, discussion boards, and lectures. That in itself is a huge step forward!

This semester, I took three classes, Prenatal Care I, Genetics, and Herbology. Each class came with its own set of challenges. Out of the three, though, Herbology was the easiest and most fun. I blogged about Herbology, here.

Prenatal Care 1 had us creating a lot of handouts and forms. The three big assignments were the Guidelines for Universal Precautions and OSHA Compliance (6 pages of safe standards for infection prevention: hand hygiene, handling and disposing of sharps, water birth, personal protective equipment, and more, and being compliant with OSHA regulations), the Informed Disclosure for Midwifery Care (12 pages regarding how my own practice will function: philosophy of practice, transfer and transport plans, services provided, equipment carried and not carried, California laws, etc.) and the Pregnancy Discomforts Handout (13 pages). The Pre Consultation Form and the First Contact Form prepare me and the client for our first visit and our first contact. The Discussion Checklist will be perfect as a checkoff during each prenatal visit to ensure that I’ve covered all the necessary information at each visit. The Initial Prenatal Visit and Medical History Form is self-explanatory, and will be a form used for the client’s medical history. I’m thankful for these assignments, because now I have them all set and ready to go for my future practice.

Genetics class was extremely challenging. Here is a post I made about it earlier in the semester. Several past students had to extend this class, and I purposed in my mind that I would not extend it! I did learn a ton about chromosomes, mutations, diseases, disorders, and how to create a family health pedigree. I’m planning on including a family health pedigree for my clients who have markers for possible genetic diseases. I’m thankful that I had to create a pedigree key, because I now have the key to use with future clients. I also created a Prenatal Genetic Testing Table which list all the genetic testing available so clients know their choices. Thankfully, I will be completing this class on time and I do NOT have to extend it!!!

In all, even with the switch to Canvas, the challenging Genetics class, I thank the Lord that He gave me the knowledge, strength, and health to complete this semester, and close out my first year of college!! I was even able to take a week off to go to teen camp with the teens from our church! That was a wonderful break, and I had loads of fun. Those teens make me feel young!

I look forward to becoming a second year student-midwife at the end of August with the commencement of the fall semester.

Here is a list of all the forms and handouts created this semester that will be a tremendous asset to my future practice:

MDWF 338 – Prenatal Care 1
Warning Signs in Pregnancy
Breast Changes
Discussion Checklist
Fetal Movement Record
First Contact Form
Guidelines for Universal Precautions and OSHA Compliance –  6 pages
Pre-Consultation Form
Pregnancy Discomforts – 13 pages
Prenatal Examination Form
Initial Prenatal Visit and Medical History Form
Informed Disclosure for Midwifery Care – 12 pages
(Here is a section about the legality of midwifery in the state of California which I
included in my informed disclosure:

Legal Status of Midwifery in the State of California
California Association of Midwives states the following (Licensed Midwife Practice Act)
“The licensed midwife may assist a woman in childbirth as long as progress meets
criteria accepted as normal. Normal pregnancy and childbirth is defined as meeting all
of the following conditions:

  1. There is an absence of any preexisting maternal disease or condition likely to affect the pregnancy.
  2. There is an absence of significant disease arising from the pregnancy.
  3. There is a singleton fetus.
  4. There is a cephalic presentation.
  5. The gestational age of the fetus is greater than 37 0⁄7 weeks and less than 42 0⁄7 completed weeks of pregnancy.
  6. Labor is spontaneous or induced in an outpatient setting” (CAM)

BOTNY 150 – Herbology
Six Herbal Reports (5 herbs each report, for a total of 30 herbs)
Red Raspberry Leaf Handout
Safe Herbs and Herbs to Avoid
Pregnancy Tea
Herbs for Midwives Form

BIOLOGY 306 – Genetics
Pedigree Key
Prenatal Genetic Testing Table

FINAL GRADES:
MDWF 338 – Prenatal Care I:    98.61%
BOTNY 150 – Herbology:         98.92%
BIO 306 – Genetics:                   98.88%

That’s another straight A semester!

Winter 2016 Update

There is so much to update, and not enough time to update!

First, before there is more written, I didn’t realize how little time I would have to keep this blog updated. I thought I would at least have a couple hours a week to write about my experiences throughout the trimester, but that did not happen. Instead, my days were full of school work (6-8 hours per day), house work (unending), cooking, church, and other student midwife related duties. So, this post comes between trimesters. I finished two weeks before the trimester ends which gives me about a four week break! Next trimester begins May 2, 2016.

A quick, condensed (not so quick/not so condensed) version of this winter trimester goes as follows:

I was able to complete all the observation births needed, and I qualified to move to the assist phase. This means I can now log all home birth/birth centers prenatal and births I attend with an approved Midwives College of Utah (MCU) preceptor.  I can also log things like doing vaginal exams, heart tones, catches, placenta exams, postpartum, newborn exams and well-woman care. Of course, there are many more things I will have to learn as I have different skills signed off.

I was certified in neonatal resuscitation (NRP) and basic lifesaving (BLS) using an AED (automated external defibrillator). These certifications were needed as part of the requirements to enter the clinical program at (MCU).

I reached out to three local midwives by sending them an email seeking a clinical placement. One of them let me know they would like to meet with me. Long story short, this midwife agreed to be my preceptor, and we spent a couple hours one mid-morning filling out the appropriate MCU forms. I sent them off, and waited for them to be approved. At the same time, I also applied to the clinical program. About 10 days later, my preceptor was approved by the Clinical Dean, and I was accepted into the clinical program! I have already logged a birth and some prenatals!

A benefit to being a midwifery student is that I can attend births and/or prenatals with other licensed midwives. They do not need to be my approved preceptor for me to assist them. However, because they aren’t an approved preceptor, the births and/or prenatals I attend with other licensed midwives will not count towards my numbers needed (more about in another post). But, I am eager to learn so I will assist at births with other licensed midwives so I can gain more experience!

The Midwife Assistant Orientation class I took this trimester with MCU prepared me for much of what my responsibilities as an apprentice will be. I was also required to prepare a midwife’s assistant bag, and this is what it looks like:

MidwifeInProgress Assist Bag

I collected several pieces of equipment, and I slowly plan on adding to this bag.

Watermarked MidwifeInProgress

The bag I purchased is here. I know I will eventually need a bigger bag, but this will do for now for prenatal appointments with my preceptor.

I also purchased and received my Practical Skills Guide for Midwifery from MorningStar Publishing Company. This is a skills book in which it has all the midwifery skills I need to learn. As I master each skill, my preceptor signs off the skill. There are skills from basic general skills like proper hand washing technique, using a stethoscope, and reading a blood pressure to more advanced skills like drawing medications, administering IV fluid, and suturing. These are only a few of the skills listed in the guide.

Oh, and I was honored with being called for jury duty where I spent 7 hours doing my school work before being called to a courtroom. I had to return for a second day to see about getting picked for the jury. Thankfully, they selected 12 jurors, and I wasn’t one of them!

School while on Jury Duty Water Marked

I created my clinical binder, which is a beauty!

 

I went to an IV class in Ventura, Ca, and I started my first ever IV. I still need a lot of practice, though! Hopefully, I can get some people to agree to being my practice models. But, I feel as if I might be able to start on IV in an emergency situation (doesn’t sound very confident, I know, but it’s a start!)

I am well supported by so many people, including my church family. My pastor knows that I have school so when he asked me if I would be able to be a driver and hotel chaperon for the fine arts competition for our school students, he said, that I would still be able to do my school work. So that’s exactly what I did. I drove the students there, dropped them off, and did my school work in my vehicle. I stayed at the hotel after I dropped them off the next two days, and I did my school work. I was able to complete ALL of my assignments for the semester! It means so much to me that people in my life understand this season in my life, and understand that I have to make adjustments to get through it.

School is demanding, to say the least, and this is my life for the next four years until become licensed as a midwife. I am thankful for the people in my life that understand this: my husband, my children, my family, my friends, my church family. It won’t be forever. In 3-4 years, I’ll be done with the first phase of this academic pressure/demand. I plan on continuing to the Bachelors of Science in Midwifery, and eventually to the Masters of Science in Midwifery, so that will add more academics. Hopefully, I still continue to have the same support as I do now. Lots of people dedicate their entire lives to their academic success, and I am trying to only dedicate the next few years. The next 5-7 years compared to the next 30 years or so of being a midwife is well worth the short-lived sacrifice.

Currently, I have allowed my life to revolve around my college career. I want to finish this season, and finish strong. I do need to find a balance, though. For now, that balance manifests itself in a break for a few weeks between trimesters.

I will update when I get my final grade for my last class, but currently this is how all my classes ended for Winter Semester, 2016:

COMM 114:  A+

MDWF 146 (Midwife Assistant Orientation): A+

MATH 212: A+ (this was a very hard class for me and many other students. I’m quite surprised that I was able to be successful and pass this class with an A. It took a lot of work and determination!! This class had 11 tests!)

BIO 202: A+

Winter Semester Opens

With huge anticipation, I was still awake at 12:20 a.m., Monday morning (January 4, 2016) when classes opened. The start  of a fresh semester was exciting because of all the possibilities.

This semester’s classes are
MATH 212 – Math for Midwives, BIOL 202 – Anatomy and Physiology of Obstetric, COMM 114 – Communication Skills,  and MDWF 146 – Midwife’s Assistant Orientation. A typical full time class load is three classes. However, I decided I wanted to speed up my academic portion, so I added another class to this semester. I wasn’t sure what I was getting myself into! It has been challenging, to say the least. I’m not sure I will do this again for any other semester.

I created my schedule spreadsheet to help me stay on course. This took me three days of getting all my classes organized, reading the syllabi for all four classes, figuring out Live Sessions, and trying not to be too stressed out.

WEEK 3 UPDATE: Things are going, well. I’ve settled into a routine of school all morning, afternoon, and evening! As long as I continue this way, I should be done by about week 12 (instead of week 15). This will give me approximately a 5 week semester break! I’m looking forward to that. I would much rather work extremely hard in the beginning of the semester, and take a nice long break at the end of the semester, than the other way around. As of right now, I’m one week ahead in two classes, and on schedule for the other two classes.

Let’s keep this momentum going!

First Semester Summary

This is a summary of my first semester as an enrolled student at Midwives College of Utah. Because I’m beginning this writing as I’m nearing the second semester (it starts this Monday, Jan 4, 2016)!), I’m only providing a summary. From here on in, weekly updates will be posted recording my midwifery progress.

Fall semester began Aug. 31, 2015.

The courses I took for the Fall semester were: BIOL 100: Anatomy for Health Professionals, HIST 184: History of Midwifery, HLTH 130: Holistic Health. I enjoyed all the classes, but BIO 100 was difficult. I was afraid, many times, that I would fail that class. There was a whole ton of memorizing. Electrons, protons, DNA, RNA, neurons, chromosomes, and a whole bunch more, including the skeletal, respiratory, digestive and other body systems. I studied, studied, and studied some more. I was shocked both times with the grade for the midterm and final exams: 200/200! All the hard work paid off.

This semester is when I hit “the wall.” “The wall” is a time when a student has a difficult time moving forward in their school work. It causes lots of discouragement, because the student falls behind in their school work. It can nearly break a student and make them believe they made the worst decision ever. I hit this wall mid-Oct.

I fell behind, and I didn’t think I’d be able to finish on time. Thankfully, MCU has protocols in place to assist students who are having a difficult time. First, my teachers reached out to me asking  me what was going on. That was the first little shake. Secondly, my house mother reached out to me, and offered to mentor me. Thirdly, I joined a Facebook student support group. Lastly, I joined a sister circle. (I’ll blog about these resources later.) It was hard knocking this wall down. My mentor called me once a week, and I gave her an update and a goal. She encouraged me, and she was my accountability person…. Using all these resources, I was able to knock “the wall” down, and push forward.

This semester is, also, when I met some amazing fellow student midwives. We’ve encouraged each other, kept each other accountable, and became internet friends. I was able to find the Facebook student support group which was a tremendous encouragement! It’s so good to see that others are also struggling through the same issues I am struggling! I hope to meet these fellow classmates some day at student conference.

I completed all my courses on time. I created a movie for the History of Midwifery class. I made a whole lot of awesome and some not so awesome foods for Holistic Health. I got straight A’s for my first semester enrolled as a full time student. I worked super hard for those A’s!

I learned that I MUST reach out sooner when I begin to reach “the wall.” I also learned that I cannot allow myself to fall behind.

I purchased a few midwifery items: student stethoscope, regular stethoscope, pulse oximeter. I also purchased a bigger and better planner to keep all my school work and doula appointments in better order. A friend, who used to be a midwife years ago, gifted me a baby weighing scale and the sling that goes with it.

My goal for winter semester, 2016, is to hit the studying hard the first six weeks, and get far ahead in all my classes. It’s better to work hard at the beginning of the semester, as opposed to working hard at the end and stressing about the deadline.

Come on, winter semester, 2016, I’m ready for you!

 

 

Student-Midwife, Fall 2015

August, 2015, I became a full-time student enrolled at Midwives College of Utah. My life and the life of my family has been turned into a life of college with a mom of eight children (3 adults, 3 teens, 1 pre-teen, and a 7 year old) and wife who does school work 6-8 hours a day, six days a week.

I’ll tell the story of a Midwife in Progress for several reasons. It will be a way to document and show me how far I’ve come from the moment I decided to follow this path. You, the audience, will see the progress it takes to become a certified professional midwife (CPM). You’ll see the difficulties, tears, joys, setbacks, accomplishments, disappointments, and anything else that comes in the path of a student-midwife. There will be plenty of opportunities to feature other student-midwives and midwives, giving them a platform to tell their own stories in their own words. Finally, I’ll also upload my school work papers, client-handouts, and write about anything I find pertinent.

Once licensing and certification is accomplished in approximately 3-4 years, a midwife continues to learn and grow through continued education, research, and with every birth she witnesses. A midwife never ceases to progress. Thus, she is forever a Midwife in Progress.

Some posts will be long and meaningful, and some will be short and quick, depending on how busy I am with school and family life. So, follow along in this long journey towards midwifery certification and eventually the full midwifery role.

Watermarked

This was the first day of midwifery college. I had to do the whole “first day of school picture.”