Archive for October 25th, 2007

Today I was back at work. It has been three weeks since I last worked, the first two off sick with shingles and the last week officially on annual leave. The shingles is/are much better with only the odd ‘chinese burn’, needle pricking episodes. If only I could have just got straight down to midwifery but there was a team meeting and a sorting out the chaos of my ‘to do’ box waiting for me first. As a result I awoke at 5am this morning and suceeded in getting myself really stressed out about what may await me. It didn’t help that I’m on a 24 hour on-call.

As expected there were more edicts from on high. This is being introduced, that form needs completing, where are your stats, etc. One of our team is going on a years sabbatical in January, no one to replace her, her post has not even been advertised. I asked what she is going to be doing. She doesn’t know, she just knows that she has got to get out of midwifery ‘for a while’. I am jealous, I understand where she is coming from. It’s not the job, it’s the politics and the constant changes. It’s like walking on quicksand, there is no firm basis on which to build your practice, everything is subject to the decision of some board, who know little about life on the ground, and whose sole concern is not the ‘patient’ but the budget.

My new job-share was orientating with me today, good to have company in the car. We had a few postnatal examinations to do, a booking, and then whilst she went and discharged a Mum and baby I went and did a stretch and sweep. It is the woman’s third baby and she is now 6 days post dates. She had been planning to have baby at a well-reknown birth centre, but a vaginal swab 2 weeks ago revealed that she has Group B strep, this has put her out of the criteria for ‘low-risk’ as she has been advised that intravenous antibiotics during labour will now be the best plan. Poor woman was already disappointed, and me finding that baby’s head was high and that a stretch and sweep was impossible, today, will not have lightened her mood any. Before the S&S I palpated her uterus, baby was very clearly defined, often the way with women in their third and over pregnancies. All the limbs were really easy to feel, almost like touching a baby through a blanket. As a result it was easy to tell that baby’s head was high, only a small part was sitting in the pelvis and just as easy to feel that the reason was the hand and arm it has by the side of it’s face. Every time I tried to assess just how much head was palpable it would move its arm around and at one point I felt knuckles through her abdomen! We had a chat about using positions which could allow better descent, and also raspberry leaf tea and other aids to improve uterine tone. I’m seeing her again on Monday with the hope that baby will have decided to get his arm out of the way long enough for his head to move down slightly. S&S may be easier to do then. A bigger hope will be that she has gone into labour and given birth.

Clinic today, my favourite one. Friendly, helpful staff, well organised surgery. This is the one that my new job-share will be taking over. I’m really sad to be losing it as now I am just left with the one run by a paper-free maniac, control freak, they have promised me my own room though, I shall put up lots of posters and have ‘post-its’ everywhere.

Tomorrow morning, if I havn’t been called out, my manager is coming to have a chat with me and job-share. She’ll have to make it quick as we have 30 minutes in the office, during we time we plan our workload, pick-up messages, the new visits and send of all the forms resulting from anything we did yesterday, and then it’s off to an antenatal clinic.

It’s good to be back.

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Holding things in

I spent yesterday with my daughters and all the grandchildren, a real treat, especially since it wasn’t at my house!

Jack and Amy play really well together and we really only see them when they want food or drinks. Jack is going through quite a macho phase at present, he justifies his belief that he should be allowed to have anything he wants by asserting that it’s ‘because I’m a boy’. This caused Nanny and him to have a heated exchange, the gist of which, from my side, was that it doesn’t matter whether you are a boy or girl, you can both play with the same toys. Jack was adamant that ‘cos I’m a boy, I can have anything’. I have no idea where this opinion has emanated from but he better stop being an MCP before he gets too much older.

On the way home from youngest daughter’s the Boy’s (twins) Mum started talking about Louis’ hearing test next week. This is fairly unusual, she rarely lets down her guard about things that are worrying her so I just let her talk. She is really concerned. She is fairly sure that he has some hearing, and I would agree with that, but she believes that there may be some high and low range loss. She is just dreading knowing. I said that I would rather know as then I would have a definite to deal with, she is just frightened for Louis as it would not be anything they can cure, that would be his hearing ability set for the rest of his life. Even worse because he has an identical twin, and worst of all that it had been caused by a stupid drug error. I shall just remain positive, until we know on Tuesday. I do notice though that I behave differently with Louis than with Jamie. With Jamie I am just being daft old Nanny, gratified when he smiles at me. With Louis I am constantly ‘observing’ him. My behaviour is centred upon how he responds to sounds. I talked to younger daughter about this and she agrees, we both treat Louis as a ‘case’ not just as a baby. Even after Tuesday it’s not all over with regard to hospital and Louis, he sees the paediatrician the following week about his sacral dimple/occult spina bifida. Fingers crossed that the hearing test will will reveal nothing more than a laid back baby, and that the paed will laugh off the G.P’s concerns about that dimple.

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