I am starting up a new blog chronicling my journey as a new nurse midwife.

New Nurse Midwife

So after almost 8 months of unemployment and serious job searching, I have accepted a full time CNM position in NV with a hospital-owned practice who serves the underserved (read: M*dicaid & uninsured) in the area.  It is a very busy practice (~ 150 del/months) almost identical to where I did all of my clinicals.  A lot of what they do is collaboratively managing their patients…which isn’t my ideal — but it will do for now.  The work week is three 8-hr clinic days & one 12-hr call overnight call shift.  I’m not sure when I will make the great trip across country.  I am a born-and-raised East Coast girl so it will be crazily different in the west.  I am working on licensing, credentialing, and prescriptive privileges.  Boring.  The end of my search seems so anticlimactic.  I interviewed for the position two weeks ago, had my offer letter on Memorial Day, then signed and sent it back on the same day.

I had two offers at the same time: one in Sleepytown, PA and the job in Exciting, NV.  NV’s salary came in $15K higher than the PA job.  They both had pretty similar benefits/compensation packets.  But overall, I liked NV better and felt the salary was pretty awesome.  Cost of living in NV is a lot cheaper than GA, PA and VA.  They cover my full relocation including temporary housing.  They also cover all my license fees, professional dues, journal subscription, CMEs, etc.  5wks vacay/year; 2.5wks sick leave/5 days CME.  $1500 for CMEs.  Then all of the health/vision/dental/malpractice (with tail coverage) insurance.  They also offer 401K w matching, FSA, STD/LTD, life insurance.  It’s a pretty sweet deal.

I won’t mind being busy — I am sure I will learn a lot.  I cannot wait to start working and getting a paycheck!  I’ve got these student loans breathing down my back.  I am still in disbelief that I have a job and expect the bottom to fall out at anytime (kinda like what happened w Delaware.)  But NV offered me $30K more than DE…which makes me smile for sticking to my guns.  I know it’s not all about money but I do need a good solid salary to live…I’m tired of being poor ;)

So the worst has happened.  B and I moved out of NC about a month ago and we both have been living back at home with the parents.  She’s at her parents and I’m at mine — (about 10 mins from each other.)  But she’s been commuting back and forth to NC to work each week.  Originally her company had said that she could work remotely and only need to travel in occasionally, but about 4 days before that was to happen they changed their requirements entirely.  They said they now want her to come in every week until at least July.  Sigh.  But they take care of her travel expenses so that’s okay.

I just got a job here locally working with a newborn twin girls.  It’s not a bad deal — totally like what I used to do before I left.  So it will work for now.  I will work a couple 3-4hr days and maybe do some overnights.

As far as my “real” job search.  I am making progress.  I talk to people almost everyday about jobs.  I had two in-person interviews this week.  One in PA — about 30 mins from where one of my classmates will be working.  The other was in NC — about an hour or so from B’s work.  I personally love the NC one.  The practice is huge and really big on technology (ie. flat screen self-check in kiosks).  It has been around for a really long time, employees have been working there for decades (longer than I’ve been on the planet).  I really like the midwife there — she’s really active in policy, ACNM, committees, loves her patients and it shows.  PA is a hospital-owned practice.  I would have residents/medical students with me.  The facilities are lower tech and less glamorous than NC.  But they have a phenomenal benefits package — relocating would be a breeze, there’s a good sign on bonus, and they cover just about everything.

So here’s the running total…I’ve been on interviews in NY, PA, NC, TN, GA, and DE.  Of those, I’ve received 3 contracts — all of which I have turned down.  I’m fairly certain PA will offer a contract soon.  NC seems like they take their time with the interviewing process so I need to figure out how I’m going to work all of this.  Other interviews that might be in the works…CA…NV?

None of the other midwives have jobs either.  Just one.  She’s the one that will be going to PA.  And as of last week all of my class passed boards.  So yay!  Now if only we could get us some jobs!

….is it the recession or what?

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After 3 (almost 4) long years in school, countless sleepless nights, many books, papers, assignments and studying.  After many clinical hours, many births, and many patients.  And finally, graduation….I am pleased to tell the blogosphere that…I AM OFFICIALLY A BOARD-CERTIFIED NURSE MIDWIFE!!!

I took my exam at the end of February after 3 long weeks of studying countless study materials.  The test was about as I had expected.  It was weird to sit in an H&R Bl*ck with my results in my hand.  But I’m happy that part is now over.

I have been searching for a job and have just about nailed one (or two) down.  I really like the Delaware prospect.  It’s on the coast with a small practice.  I’d be their first midwife which seems exciting and daunting at the same time.  I also interviewed in a very rural town in NY.  Although I mainly went on that interview for a) practice b) free trip to NY to see family c) keep my options open, they still liked me well enough to put in an offer as well.  Although both jobs say they are offering me the position NEITHER has sent in a hard copy contract.  I’m ready to negotiate, but know for certain I want DE.  I’ve already started the licensing process there — so if I don’t end up going, I’m out $400 and have a license in DE.  LOL.

I moved out of my apartment in GA.  My lease ended in February and I did not renew.  Instead, B & I trekked it down there to put all of my stuff in storage.  Presently, she and I are holding the fort down in NC before we do our “for real” move soon.  We’ve been bouncing back and forth between NC and VA and DE over the past couple weeks.  It’s 3hrs to VA, then from there 3 hrs to DE.  So it works out nicely.  The town in DE is amazing.  A mid-Atlantic gay resort town.  And my practice is minutes from the beach.  We are headed back up there this weekend to look at places to live.  We struck out the last time we were in DE, but I think we should have some viable options this time.

We also got a puppy.  He’s a miniature Dachshund (of course) named Finnegan.  He’s a Black and Tan Dapple Piebald and is a sweetheart.  He’s 4 months now and just full of energy and love.  And presently asleep on my feet.

Anyway — that’s all that’s happening in a nutshell.  I’m debating on whether or not I want to change my blog since I am no longer a student nurse midwife.  And what should I change it to?  Thoughts?

Craziest day that I have ever participated in with my practice. We had ~10 labor patients, 8 antepartum patients, and 3 scheduled CS (our midwives first-assist.) Not to mention whatever came through triage. By the end of the day we had 5 vaginal deliveries and 7 CS. On a normal day, they usually will do their scheduled surgeries (usually 2 or 3) and maybe an additional one or two. So when I was leaving, they were rolling back for the last one of the day at 10pm. We were so busy that Manwife actually left me pushing with a patient to catch another pt who was crowning then came back to me.

Has a pt with an OP baby who we worked really hard to rotate. She had the classic OP dent in her stomach as well as the fontanels on exam. We pushed in sidelying, squatting, pulling the sheet — all over the place! Finally, her baby rotated and just came on down. She had a little girl, intact, and all was well. My second of the day was an induction.  When we came on she was 6-7/90/0. She was complete soon thereafter — she labored down nicely. When we started crowning, her perineum looked quite taut and blanched. Manwife wanted to cut an epis (FHTs were fine, mom was fine.) I obliged. Baby came — all was well. Unfortunately, this lady’s bottom tore every which way — she had bilateral cervical lacerations almost all the way into lower uterine segment, bilateral sulcus tears, plus the MLE which extended into a partial third. What a mess! I helped where I could, but that repair was somewhat over my head. (Personally, I might not have sewn that…MD?)

My third baby of the day was a pt without PNC.  She progressed quickly and soon we were pushing. All was well until she started to really move the baby down. Head comes out; shoulders do not. Mom was freaking out, almost kicking me, trying to close her legs with the head between them.  And the room just erupts in craziness. Everyone trying to get the mom to push and Manwife steps in to help.  Shoulders are rotated into the oblique and deliver easily.  It was less than a minute.

We only had one baby today, but we did manage a lot of triage and do some postpartum rounds on the people I delivered the day before. I had the pager and batphone, spoke with a woman who thought she was in labor. Second baby. She said she’d only been having contractions for 20 minutes, every 7 minutes…she was still talking, chatting, etc. I told her that I didn’t think it was time for her to come in yet. I told her to come on in if they got longer/stronger/closer together. So my midwife and I are hanging out at the nurse’s station.  When all of a sudden, they
fly down the hall with a woman on the stretcher. As they turn the corner, I look at my midwife and say, “I wonder whose patient that is.” She says, “Not ours. Cos they would have called” And the phone rings! It was indeed our patient. In fact, it was the very patient I talked to and told that I didn’t think she was in labor. She called around 0930, got to the hospital at 1110, and her baby was born at 1128.  Oops.

Delivery #53 was completed by an awesome RN pinch hitter.  I missed the delivery by seconds.  But I made it to my other two deliveries in time.

Well blogosphere…I’m still here :)

Life is going well. I made it through a hectic summer semester. Went to my first ACNM conference in DC. Spent a lot of time by the pool. Saw my friends and family. Hung out with my gf. Moved into a new apartment just in time to start my last and final semester before graduating to a big-girl midwife!

As far as school goes…classes this semester are okay. Health Policy, Nurse-midwifery, Lactation, and Primary Care for Women.

Clinical skills are definitely coming along. I’ve got 56 births so far (the most in my class.) Suturing is still a challenge. But I’ve caught a lot of normal healthy babies. I have also managed complications like PPH, cervical lacerations, retained placenta, pre-eclampsia, shoulder dystocia, PPROM, chorio, PTL, etc.

Up next: finding my first midwifery job!

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