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Tuesday, March 22, 2011

Exploration Ambivalence

             Week 5 of my clinical rotation and I'm finally more confident in my clinical abilities.  So far I've scaled the computer charting wall, collected many passwords and am spending more time talking to my patients rather then trying to figure out the computer.  I am amazed at how much of what I've learned in school is coming together for me.  Suddenly, I can make sense of the labs, order appropriate testing, and consult with my physician colleges without the feeling of dread that they will scowl at me for asking so many questions.  I guess that is what "integration" is for?..Graduation is quickly approaching and I still can't seem to bring myself to think that far ahead.  Invitations?...reception dinner?...Thankfully, I have a couple weeks after I return home to worry about those details.

             Aside from my random thoughts and wishful thinking, I am in awe of the women I care for.  Some of them traveling 6 hrs for 1 prenatal visit, some may or may not have transportation, others dealing with family members with multiple issues, trying to get a college education and trying to maintain some sense of "healthy" for themselves.  These women are doing the best they can for themselves and their families all the time!  I find myself to be not only a healthcare provider, but a counselor, advocate, friend, and many other things.  My only limiting factor is TIME!  I'm having a hard time limiting my visit to just 10-30minutes a visit.  I've heard this complaint again and again, how do they "preverbal bean counters" expect to me to see 20 women daily with varies issues?  As my wonderful preceptor has told me recently, she has had to leave pieces of her heart behind to accommodate the increasing number of clients she "has" to see daily.  Visiting with women is one of the things I love about becoming a midwife.  I will have to think outside the box to give women the kind of care I think they should have and do it in 30 min or less.

            On a separate note, I am still working on solving the pharmacy issue.  That is..why does it take so long for medications to get filled at this particular Indian Health Services unit?  Let me remind you, apparently it takes an average of 2-3 hrs for 1 prescription to be filled. I'm not saying the service units pharmacy is lazy or taking long lunch breaks, but I would really like to know the big secret as to how many prescriptions they fill daily vs. a Wall-greens and why Wall-Greens is faster?  I know I'm not the only one who would like to know this answer.

           One of my goals for being here was to educate women in their options for care and so far I've had the luxury of time to do that.  Some women have been very forth coming in their questions about "all things female" while others have taking a quieter approach, but I fear with the lack of time we as providers have to discuss all matters of heart and health, we may be missing the meat of each visit.  I know I've learned more about a woman in 1 good visit then I would have in 10 short visits!  Each woman I encounter I learn a little more about her unique needs and I pray that I do not loose that closeness with them by trying to meet the needs of the practice I am with.

          
              

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