Tuesday, October 25, 2011

I owe you an update

For those who are interested, I know I never really explained why I was going to school to be a Midwife, and then I wasn't. To make a long story short(er), when I got admitted to the Certified Nurse Midwife program at KU, I had conflicting feelings. I chalked them up to fear and anticipation but the closer the start date got, the more I felt like I wasn't making the right choice.

You see, Midwifery is something I'm very passionate about. It's why I went to nursing school in the first place. However, the NICU has claimed me for now and I wouldn't have it any other way. I got my CNM program acceptance letter in May but as the summer went on and I prepared for the start of school, I started dreading the day I'd have to say goodbye to the NICU. Granted, that day was still 2 years down the road and I kept telling myself that I could stay and work PRN. But the fact of the matter is that between office days and the on-call hours Midwives take, I wouldn't have time for that. And every time I came home with a sweet work story to share with Ross (we had a lot of cute babies this summer), he would say that this is the perfect job for me and I'd wonder why I was leaving such a good thing.

I also grew close to a few NICU moms this summer (mothers of the aforementioned adorable babies). I love and respect 2 of these women especially and while they were happy that I got into grad school and was pursing a dream of mine, they did both question why I was leaving a job I so clearly love. And to put aside my modesty for a moment, both of these NICU moms who had been through so much made it a point to tell me that my care changed their babies' stay. That I comforted them, educated them, and so dearly loved their babies that they felt comfortable with the fact that I was there when they couldn't be. Strike 1 to the idea of Midwifery school, because that would mean a very real possibility of leaving the NICU forever.

Those comments stuck in my head and made me start questioning my choice even more. Every time I had a quiet minute to snuggle I'd wonder if I could leave this for a job in which I only form a bond with the mom and not the baby.  In late July, I finally got the opportunity to shadow a Midwife in town. I spent a typical 8-5 day with her and loved it! She was so passionate about her work and it made me realize that where your heart is, is where your job should be. Having never been a Midwife, I'm not sure if I would like it more or less than my current job, and that's quite a gamble. Then when we were talking over lunch, I learned that the Midwife I was following worked part-time, which meant 2 office days a week and six 24-hour on-calls a month. Wait. What?! Theoretically if she got called in for a labor and delivery 6 times a month, she would be working as much as I did and I'm full-time!

One reason an Advanced Practice job attracted me was the idea of office hours with weekends and holidays off. Yes, I know I'm beyond lucky to work 3 days a week for 13 hours at a time. And even though I'm at the hospital at least one additional day a week for some meeting or class or continuing education, I still have it pretty good. Except for the evenings, nights, weekends, and holidays. I miss a lot on the days I do work and when we have kids one day, part-time office hours will be very appealing. But I obviously wasn't thinking it through because Midwives aren't your typical Advanced Practitioner. They have quite the demanding on-call schedule and for good reason. But for some reason the reality of it caught me off guard. Strike 2.

Finally, the head of the Midwifery program threw a BBQ at her house the weekend before school started and Ross and I went with our friends Chris and Amanda (Amanda and I went to nursing school together and she's also pursuing the CNM path). I loved meeting all the women there and the students clearly loved being so close to graduating and "catching babies" on their own. But when I started asking them how they liked online classes, their attitude changed. Online classes had been my biggest fear from the get-go. Studying for my RNC test on my own and getting through this self-led online graduate stats class has been hard enough. I didn't know if I could continue this complete self-motivation for 3 more years! I need to sit in a classroom and see and discuss and take notes in order to actually retain what I learn. And the current CNM students just confirmed my fears. They said things like, "I thought online classes would be more flexible but I think they take up more time than just going to class would have," or "ask me again how I like it in 3 years when I'm a few years removed from it." *Gulp* Not the reassurance I wanted. Strike 3.

By the end of the BBQ I was no longer having fun. I was panicking internally and grasping at straws. I really respect the woman in charge of the program who was hosting the party. I had an admission interview with her back in April and have kept in touch ever since. During the party, she was talking to someone else about the expenses of malpractice and how unstable a job at a Birth Center actually was in comparison to being a "laborist" alongside doctors and residents at a hospital (which was suddenly shift work at the hospital again which I was trying to avoid). I realized I do love my hospital employee insurance and had banked on having it as we raise kids one day who will surely be as accident-prone as I was am. Yet I wanted to work at a Birth Center? Clearly those goals don't mesh.

So I asked the woman it it was possible to get through school, keep my credentials current but not practice as a Midwife right now, and then try to find a job in ten years or so. As gently as possible, she said I would have a hard time finding a job if I waited more than a year or so after getting out of school. When she said that, I knew Midwifery school wasn't going to happen and I dropped my classes the next morning.

After a few sleepless nights, lots of tears, and lots of prayers, I started looking into other options. A lot of people have asked, why not Neonatal Nurse Practitioner? While it is also a job I admire, and I'd love to participate in rounds like they do and learn something from Dr. P every day, I just can't see myself doing it. What I love the most about my job is the relationships with the parents and while the NNPs have more privileges and more responsibilities (I'd love to go to deliveries) they don't spend as much time with the patients and families as we do. Sure I'd be in the same field, but with a very different job. AND I'd still be working nights, weekends, and holidays. In fact, as a new NNP there's a very good chance I would be back on night shift all over again.

Pediatric NP has crossed my mind as well as Women's Health NP. But I'm so undecided and committing to a specialty like that would still mean leaving the NICU. So I am learning to be at peace with my decision to be 'just' a bedside nurse for now. I guess it's been ingrained in my head for so long that if I'm smart enough to be a nurse practitioner, I should be. But that's not the whole story. In reality, we need nurses who WANT to be bedside nurses. We need nurses who are knowledgeable about what they're doing and are willing to take the time to explain it to the parents after months of high stress and little sleep. And one perk of being at the bedside is that you learn which parents get scared by the big words and which parents are offended when things are too 'dumbed down' for them.

Yesterday I started classes at MidAmerica Nazarene University and in two years (God-willing) I will have my MSN in Nursing Education so I can teach clinicals on the side and help other students become good RNs with a passion for what they do. After all, if every intelligent RN left the floor for advanced practice, your quality of care would be in a very sorry state.

Clearly, I've been needing to get all this out for a while. If your eyes glazed over 2 paragraphs in, I'm sorry! But I'm excited to be starting the next step of this journey.


  1. Therese, this was so awesome to read the whole story! Thank you for sharing it with us. Chase & I can both say we KNOW the future babies in your care are so blessed to have you as their nurse.

    I love the direction you've found for your career. It sounds like the perfect path.

    We are so thankful that you were there for Nate, and that we got to know you. You are an amazing nurse, and will be an answer to the prayers of parents to come. That is no small thing! <3

  2. Thanks for reading the whole post! And you know you're one of the influential NICU parents I mentioned, right?

  3. Well that is quite humbling! Thank you! <3

    I forgot to mention this before, but one of the things I LOVED about your post, is that you are knowingly taking the time to care for the parents too. That is something that is often over looked - and we are one scared, confused, and leery bunch. Having a nurse care enough to make sure we understand, taking the time on the phone to answer our questions when we can't be there, making sure we're okay, and best of all, like you said, knowing which of us want our answers short and sweet, and which want details (DETAILS lol! I still have my notebook where I would record every single lab value you guys got and I would sit and look for trends, obsessive mommy I am! On a side note, Dr. P. always laughs when I whip out a chart or graph during our clinic visits haha).

    Passing all of that along to nursing students will be so valuable. I'm incredibly excited for your new journey.

  4. Haha someday Nate will roll his eyes at you for that notebook, too ;-) THANK YOU for your encouragement. It means so much to me that my passions seem to be lining up with a need in the world.