Alright then.

It's been over a year since I went to Casa. In fact, almost a year to the date of my return I (finally) sat for my NARM exam.

I'm trying to think of how to best describe what this was like... For one thing, due to high levels of magical thinking, I did not allow myself to study until I had received confirmation that I was actually taking the exam. I should back that up by explaining that the process of sending in your PEP stuff is as stressful as waiting out the inevitable zombie apocalypse. You put, oh, say 8 years worth of work into an envelope (along with $1400) and kiss it goodbye. Then you spend the next 6 (or in my case 8 just to make it extra fun) weeks waiting to hear back about the vicious audit you're about to undergo. And when I say 8 years of work it's not just your work in there, oh no, it's the signatures of maude knows how many midwives and the notarized forms they all had to go through the hassle to acquire for you.

Suffice it to say I was not audited even though I did have to have a few things re-signed due to my inability to add single digits.

So 8 years of your life is free floating somewhere in Tennessee and you wait. When I finally got my letter informing me that the PEP portion of my certification was complete and please choose a testing date I launched into manic information consumption mode. I had completed a didactic program in 2006 so it had been a while since I had been in full-on student mode. I went nuts. I neglected my family and basically all forms of normal existence for about 6 weeks stopping only to shower every couple of days and maybe remember to retrieve my kids from school... but even then I had flash cards. Well, not in the shower but definitely in the carpool line.

I read Holistic Midwifery II cover to cover, that's over 1500 pages, people. And I highlighted. And then I went back and made notes. And then I made note cards from those notes. And I also did this for Holistic Midwifery I, Heart and Hands, and Varney's. My writing hand has, literally, not been the same since then.

So I took the exam at the MANA conference in Tennessee with about 45 other candidates. I can say, without hyperbole, it was the most stressful test taking experience of my life. The president of MANA came in and sang us a song and it made me cry. My test taking anxiety persisted throughout the entire 8 hour exam. It's 350 questions and they're loooong questions, a lot of them. And they build on each other so if you get one wrong you are probably going to get the related one wrong too.

I came out of the exam wanting to cry; I have never felt like I know less about midwifery... except for my first two weeks at Casa. I was 90% sure I failed and I was not feeling overly dramatic.

And then you just have to wait and there is no getting around it. Ida Darragh was our proctor and she told us not to even start expecting the results for three weeks. Of course I started stalking the mailbox immediately, I could not help it, it was physically impossible. So for three weeks, starting at around 2:00 (our mail usually comes at 3) I would commence a mini-nervous breakdown, check the mail, get nothing, and then spend 2 hours calming myself down.

Three weeks TO THE DAY of my exam I got my results. And what time did the mail come on this day? 5:30. I was outside keeping myself occupied by taking down the Halloween decorations and not playing the, "I know it will be today" game that I had been playing every day for two weeks.

And there it was. NARM has very distinct envelopes so I could see it as soon as I opened the box. I had planned to take it inside, sit down, take a deep breath and give myself a pep talk about how failing the NARM doesn't mean I suck. Instead I ripped it open so viciously I destroyed the envelope.

I had not really allowed myself to envision getting my results (magical thinking wins again) but I had hoped it would be something like, "Congratulations! You have passed the NARM exam..." and that is exactly what it was. And I passed by a lot which completely shocked me.

I wanted to go inside and call everyone and just savor my passed-ness but I had promised my kid I would play Uno with him and he does not take game promises lightly. While I was trying to scan and email my letter to everyone I know he was sitting behind me shuffling, shuffling, shuffling.

This all may seem crazy to anyone not on this path but if you are on the path and if you're anything like me (it was a loooooong and winding path) you will understand that never having to say the words PEP or sit that exam again is one of the best feelings in the universe.

Things I can't wait to get home to

1. My husband
2. My kids (of course)
3. Being in control of my grocery shopping trips (no car at the Casa)
4. Shopping for my kids' fall clothes
5. My dogs
6. My favorite tacos
7. Sushi
8. My own room
9. The TIVO
10. Reading Little House on the Prarie with Stella
11. My own kitchen
12. My clothes (I packed sparsely and I am hella sick of my wardrobe here)
13. Waking up at a decent hour (AKA not 5:00am)
14. Emptying one garbage can a day instead of 10
15. Target
16. Shoes that aren't sneakers

5 days left

So, I am now down to 5 days to go. Can I say it went by quickly? Yes and no. There were times when every hour was difficult and passed slowly and times that were wonderful and felt not like work at all. It's 2:00am and I am first on for a birth right now and it feels just fine.

The deal with being first on (if you get to keep the birth, but that is a whole other story) is that you have to stay with your client until 2 hours postpartum and have your paperwork as far as it can be and then you can turn it over to the person who relieves you at the end of your shift. The best possible scenario would be that your client delivers her placenta at 4:00 and you begin your PP vitals then; two hours later you have your paperwork as far as you can take it (including birth certificate and photo stickers) and then when the next first on shows up at 6:00 you can hand your client over to them to discharge. Awesome when it was your birth... sucky when you are the new first on and you have to finish vitals, discharge them, clean the room, and do the laundry.

If you are first on and you have had a client in labor but your shift ends she must be imminent in order for you to keep her as a primary... if not you must turn her over to the next first on. This can completely SUCK if you needed to count that birth, especially if you have done a lot of labor work with her. But, what goes around comes around here and soon enough someone will be turning a birth over to you when their shift ends.

Back to leaving soon... I'm really really going to miss the people here. A'Maya is awesome, I have learned so much from her without even really realizing that she's teaching me. And the resident I would completely stalk into being my best friend if we lived anywhere near each other... I'm probably going to miss her the most. The other interns too, we have (what I firmly believe to be) the best group possible; everyone is hilarious and hard working and we're all genuinely happy for each other when things go well and worried when things seem off... I love these women.

I have a BRUTAL week of shifts ahead of me thanks to the awesome A'Maya trying to make sure I get what I need. It's going to be hellacious though; on Monday I work 24 hours straight, then a couple of first on days and a first on at night that goes directly into a first on day so that means I will work from 6pm-6am and then directly into 6am-6pm again that night... it's going to be hallucination levels of exhaustion.

I just made really bad coffee. If you are in any way a coffee aficionado bring your own coffee and press.

Oops

I fell behind there for a bit!

I had a long dry spell where I did not catch a baby for an entire week; it sucked. Watching other interns catch 2 or 3 in one day and so now I have been here for 5 weeks and have only caught 8 babies. 8 is a good number but I think I had caught 6 of those 8 in two weeks. Then I had two days off in a row which kind of sucks because you're here and you paid for it and I was just hanging around doing nothing.

Anyway, I'm leaving in 9 days... I will be back home in just 9 days. I can't wait; I miss my kids an immense amount. Today I felt pretty sad about having missed 6 weeks of their lives that I'll never be able to get back. I just cannot wait to see them and hear everything they have to say.

Right now I have a cold and it SUCKS. My shift yesterday was 6am to 6pm and I pretty much wanted to die the entire time. I did catch a baby but I was so zonked from this cold that it wasn't all that enjoyable.

But then E drove me to Pei Wei and everything was all better.... kind of. I pigged out and went to bed at 9:30 although because I was second on (so I was on call until 6am) I didn't go deeply to sleep until I knew I was off call completely. And now today I still feel pretty crappy but I'm first on tonight so hopefully I will either feel better by then or there will be no babies tonight.

two weeks left

Somehow all of the sudden it got down to two weeks to go. I can't say that I'm sad although I truly love our intern group; I feel like I got very lucky with the group of women I have with me. We got a new intern a few days ago and we all fell instantly in love with her.

In the past three shifts I have managed to miss about 9 births and it sucks. I really only need a handful of stuff before I leave and for the first time I'm starting to fret about it. Wednesday morning I had to give a birth to the next on because I had been up (literally) all night with random labor checks and by the time this labor started going I was so tired I couldn't count heart tones or do simple math. It sucked. I could have made it through the birth but the 2-3 hours of vitals afterward would have killed me. I've probably already said this but when you catch a baby you are responsible for a minimum of two hours of postpartum vitals and all of the paperwork through the birth certificate... it's an immense amount of work.

We kind of have an influx of interns so I'm a wee bit worried about getting the very last of my numbers but, you know, whatever... can't stress the numbers too much or you will miss the forest for the trees.

Tonight I'm second on so I have to sleep with one ear open for the intercom. You get paged and it can be incredibly jarring if you are deeply asleep to have to jump up and run across to the clinic. If you are at all able to sleep in your bra and scrubs I highly recommend it... I once had to do a birth without my bra on and it sucked.

Time warp

This place has the strangest effect on my sense of time; I never know what day it is, only the date and the time... could be Monday, could be Thursday: Who knows?

It's been interesting. I have been here for almost a month, I think... there goes that sense of time thing again. I can say that it took me about 3 weeks to really find my feet here and feel like I know what the hell I'm doing. And now that it has been 32 days (but who's counting?) I feel like my skills have the bump I was hoping they would be for me to be a more confident midwife back at home.

Yeah, I came here for some numbers, I won't lie but I also came here for some confidence.

That being said, I freaking WANT TO GO HOME. I have 15 days not counting today which is technically just getting started. I was second on last night and I got called to the birth center at 3:30 for a birth that didn't take place until 7:30 so I was up for several hours and now I am first on tonight. Already there have been 3 births (all of which I missed due to the timing of shifts) but two of which I had to do postpartum vitals and discharge and then clean the rooms, do all of the trash, and handle the laundry. I'm not going to lie and say it doesn't suck to have to do hours and hours of work after someone else gets the catch but the general feeling around here is what goes around comes around.... I have yet to be able to hand over one of my postpartum clients though I am looking forward to that happening someday!

Anyway, back to wanting to go home; I have all of my numbers that I needed except for 1 newborn exam. Yay! I will still stay until October 15th unless they seriously don't need me in which case I would so love to go home a few days early. I know it will be over soon but I cannot wait to get back to my kids and husband. I am one of those people who doesn't enjoy being out of her comfort zone and this has been about 90% out of my comfort zone.

My advice to anyone coming here is to just put one foot in front of the other and try not to look at the big picture... keep it small. One day at a time, etc. If I sit here and look at the schedule of the next two weeks I will feel overwhelmed so instead I just look at it one shift (sometimes one hour) at a time and that makes it seem more manageable.

Waiting

You would think after 3 weeks here I would stop believing that Sundays at the (closed) clinic are going to be boring. Far from it... one transport this morning, two 36 hour postpartums (including PKU, ouch) and now I am waiting on a mom with suspected SROM.

My nerves are kind of frazzled, working with the new midwife and still trying to gather what it is she wants from me and how she likes things done. Ah well... I hope if this client is in labor she goes before my shift is over!