Phase Two Practicum, Fall 2018
COURSE PURPOSE & OVERVIEW Students assist approved preceptors with appropriate prenatal, labor and birth, postpartum and newborn care duties and describe in writing or oral presentation one case from each area (prenatal, labor and birth, postpartum and newborn care), linking knowledge or skills acquired in assistant experiences with knowledge acquired in phase two of study, including current research in the field. Students evaluate learning gained from assistant clinical experiences.
SPECIFIC LEARNING OBJECTIVES At the conclusion of this course, students will be able to:
1. Record assistant-level clinical experience obtained in the student’s own community under the supervision of one or more approved preceptors.
2. Engage in the maternity care system professionally and ethically.
3. Demonstrate fluency in appropriate clinical judgment and decision making.
4. Demonstrate proficiency in verbal, written and interpersonal communication skills.
5. Assemble an ePortfolio of professional documents and reflections to provide evidence of experience in educating others in their profession and in their communities.
6. Critique individual and social learning through reflective and critical thinking writing through ePortfolio creation.
7. Organize practice directive documents collected in ePortfolio. 8. Describe what they have learned about themselves in connection with a clarified sense of the role of education within midwifery as a profession.
SPECIFIC LEARNING OBJECTIVES At the conclusion of this course, students will be able to:
1. Record assistant-level clinical experience obtained in the student’s own community under the supervision of one or more approved preceptors.
2. Engage in the maternity care system professionally and ethically.
3. Demonstrate fluency in appropriate clinical judgment and decision making.
4. Demonstrate proficiency in verbal, written and interpersonal communication skills.
5. Assemble an ePortfolio of professional documents and reflections to provide evidence of experience in educating others in their profession and in their communities.
6. Critique individual and social learning through reflective and critical thinking writing through ePortfolio creation.
7. Organize practice directive documents collected in ePortfolio. 8. Describe what they have learned about themselves in connection with a clarified sense of the role of education within midwifery as a profession.
Phase Two Clinic
Reflection on Assistant Experiences
Mary Betsellie
CLNC 2010 MCU, Fall 2018
At the time of this writing, I have completed about half of my required clinical assists under supervision. I really enjoy the hands on and interaction with clients and I prefer the clinical aspect over sitting behind my desk. I am much more comfortable with basic clinical tasks such as taking vital signs, assessing the position of the baby using Leopold’s maneuvers, drawing blood, placing hands on for newborn examinations and administering vitamin K to the newborn. The clinical experiences have helped me to anchor some of the information that I learned in my classes. Having close to one hundred prenatal and postpartum visits with clients allowed me the opportunity to exercise my communications skills. My clinical experience up until now is with a very busy midwife practice serving the Amish and other plain communities. Being involved in a busy practice allowed me to have hands on experience just about every day. I loved working with my preceptor, she is a great communicator, teacher and an excellent midwife. I learned the importance of good organization in the office as well as when working with clients.
I feel that working with a culture that is different than my own was a valuable learning experience. While we don’t have any Amish communities here on Long Island, we do have a very diverse population. It was good practice for not projecting my own values onto clients and I appreciated seeing how the midwife works with low resource communities to get them the best care within their means. .
The most challenging part about working with this particular practice is that it is four hundred miles from my home. I had to leave my family as well as give up the part time income that we are dependent on. I could only afford to stay with his practice for six weeks. It is not possible for me to leave my home for an extended period of time, which leaves me in the position to complete the rest of my clinical requirements elsewhere.
A major obstacle in getting clinical experience is that I live in a state that does not license CPM’s. There are no practicing CPM’s on Long Island. We have only a few CNM’s who practice homebirth. Between the two counties our homebirth rate is about .03%, which means the existing practices have a low volume client load. If I can get any of the midwives to agree to work with me, I will be on a very slow track to getting my clinical work completed. It is difficult to learn clinical skills in a low volume practice because there may be weeks in between specific tasks or births. This makes it more challenging to master skills and the lack of consistency makes it harder to recognize patterns within myself.
I am undecided if I will continue with my current strategy of attempting to complete my clinical skills for phase two here on Long Island or if I will attempt to seek out a high volume birthing center who takes short term CPM students.
Musings on working with Amish communities
We spend our days visiting Amish homes and farms. Simple homes with blue kitchen cabinets and doors, wood furniture and floors, laundry flying in the wind on the porch, blue glass and blue flowered canisters all throughout the homes.
Dogs come up to greet us but never try to follow us inside. Sometimes we do our work by the light kerosene lamps. Blood pressure and heart beat sounds are mixed in with cow moos and horses clopping.
New mamas are found relaxing or nursing while a young maiden is found cooking, ironing or cleaning for her. It is the same in almost every Amish home. All midwifery is done behind closed doors so children don’t see, mothers magically control the time of birth so as to be done before the children wake and so papa can milk the cows on time or get the other chores done.
The midwife helps bring the babies but she also spends time, making connections and networking for these families when more is needed. Sometimes spending countless hours on the phone looking for resources or referring out to other professionals when necessary. All while keeping in mind, this is a low resource community with no health insurance, no phones and no vehicles of their own. She knows her families well and even when new families come into care, she knows some of their extended family by now and what genetic history they are bringing in with them.
She is showing me what community midwifery looks like, though my community is worlds apart from this one, all humans can benefit from the individualized, humanized, culturally responsible care that I am witnessing.
Reflection on Assistant Experiences
Mary Betsellie
CLNC 2010 MCU, Fall 2018
At the time of this writing, I have completed about half of my required clinical assists under supervision. I really enjoy the hands on and interaction with clients and I prefer the clinical aspect over sitting behind my desk. I am much more comfortable with basic clinical tasks such as taking vital signs, assessing the position of the baby using Leopold’s maneuvers, drawing blood, placing hands on for newborn examinations and administering vitamin K to the newborn. The clinical experiences have helped me to anchor some of the information that I learned in my classes. Having close to one hundred prenatal and postpartum visits with clients allowed me the opportunity to exercise my communications skills. My clinical experience up until now is with a very busy midwife practice serving the Amish and other plain communities. Being involved in a busy practice allowed me to have hands on experience just about every day. I loved working with my preceptor, she is a great communicator, teacher and an excellent midwife. I learned the importance of good organization in the office as well as when working with clients.
I feel that working with a culture that is different than my own was a valuable learning experience. While we don’t have any Amish communities here on Long Island, we do have a very diverse population. It was good practice for not projecting my own values onto clients and I appreciated seeing how the midwife works with low resource communities to get them the best care within their means. .
The most challenging part about working with this particular practice is that it is four hundred miles from my home. I had to leave my family as well as give up the part time income that we are dependent on. I could only afford to stay with his practice for six weeks. It is not possible for me to leave my home for an extended period of time, which leaves me in the position to complete the rest of my clinical requirements elsewhere.
A major obstacle in getting clinical experience is that I live in a state that does not license CPM’s. There are no practicing CPM’s on Long Island. We have only a few CNM’s who practice homebirth. Between the two counties our homebirth rate is about .03%, which means the existing practices have a low volume client load. If I can get any of the midwives to agree to work with me, I will be on a very slow track to getting my clinical work completed. It is difficult to learn clinical skills in a low volume practice because there may be weeks in between specific tasks or births. This makes it more challenging to master skills and the lack of consistency makes it harder to recognize patterns within myself.
I am undecided if I will continue with my current strategy of attempting to complete my clinical skills for phase two here on Long Island or if I will attempt to seek out a high volume birthing center who takes short term CPM students.
Musings on working with Amish communities
We spend our days visiting Amish homes and farms. Simple homes with blue kitchen cabinets and doors, wood furniture and floors, laundry flying in the wind on the porch, blue glass and blue flowered canisters all throughout the homes.
Dogs come up to greet us but never try to follow us inside. Sometimes we do our work by the light kerosene lamps. Blood pressure and heart beat sounds are mixed in with cow moos and horses clopping.
New mamas are found relaxing or nursing while a young maiden is found cooking, ironing or cleaning for her. It is the same in almost every Amish home. All midwifery is done behind closed doors so children don’t see, mothers magically control the time of birth so as to be done before the children wake and so papa can milk the cows on time or get the other chores done.
The midwife helps bring the babies but she also spends time, making connections and networking for these families when more is needed. Sometimes spending countless hours on the phone looking for resources or referring out to other professionals when necessary. All while keeping in mind, this is a low resource community with no health insurance, no phones and no vehicles of their own. She knows her families well and even when new families come into care, she knows some of their extended family by now and what genetic history they are bringing in with them.
She is showing me what community midwifery looks like, though my community is worlds apart from this one, all humans can benefit from the individualized, humanized, culturally responsible care that I am witnessing.