…six months? Really?
I got here in late August, hit a speed bump with getting started, and have been trucking along since mid-September. Getting settled has been emotionally more difficult than I thought it would be. I didn’t think it would be easy, mind you, I just didn’t think it would be hard. Such is the outlook of an optimist.
I’ve had a few Facebook requests to the effect of, “PLEASE! Tell us what’s different! We want to KNOW!”
So here are a few:
MORE POSTPARTUM VISITS.
To all of my former patients: I’m feeling guilty for the years of one home visit 24-48 hours postpartum and one at six weeks. A few years back I started offering a 2 week visit just because I missed you and not because I thought it was medically indicated.
Here? Visits at day 1, 3, 5, and 7, AND at week 2, 4, and 6.
A sad point is that I don’t get to “keep” my patients after that. Here, midwives don’t do family planning, though it’s something the profession may add in years to come.
A happy point is an echo of my old life: We get to end our discharge visit with, “See you at the annual reunion party!”
MORE PAIN RELIEF OPTIONS!
In the US, the pain relief menu is short: narcotics and epidurals. Some hospitals offer water labor, and a few offer water birth.
Here, we have TENS units, nitrous, and just last month I did my first sterile water papules! (Geek alert: I’m linking to journal articles.) To be fair, sterile water papules are available in the US, I was just didn’t want to do it with no training.
(Us birthy types, of course, know that the REAL list of pain relief options is much longer: touch, massage, position changes, presence.)
So far none of my clients have availed themselves of a TENS unit, and I’ve used nitrous a few times. Wait, that came out wrong. A few of my clients have used nitrous. I had a small hand in getting it to them. Another time or two and I may be able to do it without help.
On a mundane, everyday note-like, REALLY mundane-I’ve had to get For Real about recycling. Also, all three areas of Ontario I’ve lived in for the past year have had municipally supported composting. As in, compost gets taken out on trash day just like trash and recycling, in municipally provided green bins with snap locks. I also got a cute little snap lock container for under my sink.
I’ve learned that I produce half a bag of trash per week, and I produce more compost than trash, primarily in the form of coffee grounds.
A few language things:
I haven’t picked up the “eh?” yet, though I did when I was in my clerkship. Not sure what that’s about.
Here, you don’t “call” people, you “phone” them.
A work specific language thing requires some background information. When we assess babies after birth (and the rest of the time under our care, of course), we count their respiratory rate and assess their respiratory effort. Grunting, flaring, and retracting are Not Good Things, each signaling that the baby is having to work a bit too hard to breathe. This is what retractions look like. The pertinent part starts at 0:26. Notice how the lower ribs suck in with each breath.
Here, it’s called “indrawing”. Not a biggie, but I’ve corrected myself a few times in mid sentence.
Finally, I have to pay attention to my spelling. Labour, not labor; favourite, not favorite; paediatric, not pediatric. As teeth gritting as I can be about proper grammar and spelling, this is something I need to be careful about lest I find the shoe on the other foot.
More to come!