No-shows and the beginning of integration

The life of a clinician can be at once action packed, never stopping, never having time to even catch up on charting or eat lunch kind of crazy. But then there are afternoons where three patients in a row decide that it’s too beautiful outside to come to clinic. I could hardly blame them. But what happens when us midwives are left with nothing to do? 

Let me tell you, there is never nothing to do. So, we catch up on charting, count how many patients are 31 weeks and on (so that we can guess how many babies will be born while I’m still in integration), we conduct a cursory job search, talk to our consulting physicians about the births they were at this morning, look up new requirements for bone density screenings, and….catch up on charting. Again. There never seems to be a shortage of things to do, which becomes especially true when you think you’ve got nothing to do. 

Yesterday marked the beginning of my integration quarter, where I work full time with my midwife preceptor and basically play fully-grown midwife while I still have some mentoring and back up. I had really thought that I would continue doing what I had been doing and that my role would not change very much, as I’m staying with the same site and the same preceptor that I have been with since January. 

No dice. As soon as the morning started and my preceptor confirmed with me that I am, in fact, starting integration, she nodded her head, and said, “Ok then. Have a good day.” and switched chairs with me. For the past six months I have been sitting on a little stool behind her when I’m not charting, but today, I was sitting in the midwife chair. I conducted annual exams, diagnosed vaginal infections, wrote all the notes, printed orders and lab slips, and checked in with my preceptor for guidance when needed. For the most part I have been doing all of those things pretty independently, but Monday was different. Instead of offering advice before I could ask, or sitting in the room while I conduct an exam, she popped her head in, said I was her student, I was almost done, and that if I needed anything she would be back in. And I was on my own. 

I was the midwife. I knew I still had my safety net in case I saw something funky under the microscope (or just couldn’t get it focused….which is an all-too often occurrence). But it truly felt different. It suddenly hit me how vitally important the integration quarter is, and how important being given enough room to spread your wings, but still know there’s someplace safe to land is to developing a midwife. 

So, here we go, integration, bring it on! 


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