Lockdown Day 7

One week down and hopefully only another three to go.

I'm back at work tonight and Jaye, a reader, asked what a typical shift is like for me here normally. So I thought I might do a bit of a 'day in the life of' post.

We work 12 hour shifts here, and there is only one midwife on per shift, except Tuesdays, when we have an obstetrician travel here for an outpatients clinic. So on Tuesdays we have another midwife here during office hours to run the antenatal obstetric clinic. We also usually have an admin staff member here during the week for five hours a day.

We are a small, rural, primary unit. We have around about 200 births a year and this number is increasing. We have two birth rooms, five postnatal rooms and an antenatal clinic room. There is only one midwife on per shift because generally we only need one. If a woman comes in to birth, she will have her community midwife with her to provide her care, and the hospital midwife is the second pair of hands if needed and we always have another hospital midwife on-call just in case.

We pride our self on being whanau (family) friendly. The woman's partner or support person can stay overnight and our visiting hours are usually pretty loose. If women need extra help they can stay for up to a week. And this is the sign on our door that usually greets visitors, I think it sums up just who we are here!

If you want to know more about our little unit and the cool midwives we have, you could watch My Maori Midwife, Season One, Episode 3. The birth is filmed here and Nicole Pihema, the midwife, is pretty awesome!

So it hurts that this is the sign that now greets people. Visitors are not permitted. One support person at the birth only, no children allowed. Women are asked to go home as soon as they are able, and they are asked to stay in their rooms until they leave.

Anyhoo. A typical shift starts with handover, when I get information from the previous midwife about what's been happening, what women are inpatients and what care they will need. This often involves a cup of tea and a chat too, but not so much anymore. It's hard to feel chatty when you are trying to maintain a two metre physical distance.

Once the previous midwife has left, I'll log on to the computer, check myself in on to the relevant computer programs that I will need and scan my emails.  And now I wipe down the keyboard and mouse first.

I have checklists to do, these involve checking that the birth rooms are stocked with all the necessary gear, checking drug expiry dates, sending equipment to the sterilising unit, checking fridge temperatures and other equally exciting tasks. The most unusual thing on the checklist is to remember to feed the fish! (We have a fish tank in our waiting area.)

At some relevant point I'll introduce myself to any women who are on the postnatal ward and we'll organise a plan for what care she'll need that day/night. If there are no inpatients, we still need a midwife here because we never know what will walk through our doors, or when they'll walk through! Patient care usually includes a general wellness check of her and baby for starters and then any or all of: breastfeeding assistance, mothercraft teaching, CPR and safe sleeping education, regular pain relief, wound care, neonatal screening and so on. We can only have normal births here, if women need surgical intervention or secondary care they need to birth in our secondary unit (an hour away), but they often come here for a postnatal stay.

I have cleaning tasks around the ward to do, such as empty the dishwasher, and if there is a birth during the night, we clean the birth room. But during the day we have a cleaner to do all the major cleaning tasks such as floors and bathrooms.

During the day, in normal times, we often have walk-ins. People will come in looking to book with a community midwife, and we provide them with information. We will do antenatal checks or fetal monitoring for the community midwives if they are tied up somewhere else. The community midwives run antenatal clinics here so there it's often busy with women coming and going and lots of midwives meeting and chatting.

Sometimes we get women turning up to birth who haven't bothered to get a midwife. Or they are on holiday. Recently I had a woman turn up out of the blue, visiting the area, about five months along and bleeding heavily. So we deal with emergency stuff too.

Tonight, I have a few extra tasks. I have personal protective equipment (PPE) packages to make up to give to the community midwives. The number of homebirths have increased in light of the covid-19 pandemic and midwives are advised to wear PPE for the second and third stage of births for even asymptomatic women (the pushing and birth bit and the placenta bit, generally the messy and heavy breathing bits) so PPE usage is increasing dramatically.

I also have about a billion extra emails to read on new protocols, covid updates and morale boosting emails from management. I feel for the frontline clinical staff in the 'red zones', it must be even more stressful for them.

And I have extra cleaning to do - lots of surface wiping to be done every shift now.

But we are here, and we are ready and waiting, and we will not turn anyone away.

Life and work

My 'real' job, the one that pays a consistent income, is midwifery.  I work a shift or two per week at the local rural hospital in the maternity ward and then sometimes I work as a rural locum, covering the community midwives.  That's what I'm doing at the moment.  And boy, can it kick my butt.

I'm in a very privileged position to not have to work much usually.  My husband often has to go away at short notice, or work long hours for his business, so we need me to be available to look after the kids.  I know not everyone has that luxury and must organise childcare as well as their working lives. I know I'm privileged, but I really know it when I work locum.

I've been involved in three helicopter transfers of sick babies in the last couple of weeks.  Today I need to drive for an hour to visit a bunch of women who live even more rurally than I do.  My children got pulled out of bed at 5.30 am the other day because my husband had to start work early and I was at the hospital with a woman.  It sucks.  But it's exciting and fulfilling and important work too.

I'm trying to remember that.  And I'm trying to catch glimpses of the good life in between the sucky bits.

Get back to work!

I guess I need to alter my 'about me'.  I took the plunge and have headed back to work.  Not on any grand scale, mind you, just one eight-hour shift at the local maternity unit per week. 

For those of you who don't know (because it's been a year and a half since I worked for money), I'm a midwife.  Sounds glorious - getting to participate in the miracle of life.  But truly, it's mostly participating in the down sides of childbirth.  Like lots of paperwork; cleaning up blood, puke and poop; trying to calm hysterical people (usually men); and helping exhausted women with ripped up nipples in the middle of the night.  The women with fantastic experiences and straightforward babies usually don't stay long in hospital, and if they do, they don't need much help.

But I tell you what - it's one job where if you do a good job you are REALLY appreciated.  I mean, nobody hugs their plumber and thanks them with tears in their eyes, do they?!

Thoughts

It's our turn for the sickies. Blech. Little boy home from school with an exhausting cough. I've got it too and lots of snot. Took the night off work on Thursday but here I am on Friday night because there is pretty much no-one else to work! Only one woman in who has just had her seventh baby and doesn't need much help from me. I'm alcoholling my hands and holding my breath whenever I go near her room, just in case.

I'm in the throws of deciding whether to give up work or not. I went back to work almost a year ago because I was going a little crazy and financially we REALLY needed it. But now it's not so tough moneywise and I'm finding I'm going crazy in a different way.

My family has no routine and it's hard for the little ones who never know if Mummy is going to tuck them in at night, be there if they wake in the night or be home with them for breakfast. Darlin' Hubby is putting in the whinge too about us never being at home together - it's either him home with the kids and me working or vice versa. I put it to him that maybe HE should quit his job, but being self-employed that's not really a goer. And besides it's me who's not really enjoying my job.

And that's the big thing. When I studied Midwifery about eight years ago, I was passionate about it in a "I'm gunna change the world" kind of way. And now I'm not. I'm still interested in it, I still enjoy it and I still think it's important. But I'm just not PASSIONATE about it.

I went down to Auckland for a one-day workshop on Wednesday. It was an amazing workshop on Childbirth Education. Inspiring, informing, energetic. But it confirmed my thoughts, I've lost my real enthusiasm for it all.

It might be that it's because of the impact it has on my family. It might be because there is not as much time left over for the other things I want to do, namely quilting and, for a want of a better word, homesteading. But whatever the reason, it's getting mighty hard to look forward to another shift.

What do you do when you have a big decision to make? What helps you sort out your thoughts?