Aaaand……

…new registrant funding has been approved and released.

NOW I feel free to proceed with the next steps.

Oh, and:

SQUEEEEEEE!!!!!

 

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OK, better now

Yesterday’s post gave me the not entirely unexpected gift of silencing the brainweasels. Seriously, I sighed, moved away from the computer, and felt like my soul lost weight. I didn’t even need to wait for encouraging responses.

That being said, the encouraging responses were much appreciated. 🙂 Thanks, everyone!

One piece of information that helped is learning that delayed funding from the Ministry of Health isn’t uncommon. I was under the impression that, if this time isn’t a first, that it’s uncommon enough to warrant concern.

Well, anyway. Meltdowns such as that of a few days ago are, thankfully, uncommon. Comically distorted, mercifully brief, and uncommon. My post yesterday is the equivalent of screaming out of the window during finals week in college, and its effectiveness was startling.

Here’s to hoping for unqualified, unrestrained, enthusiastic good news soon. Heck, I may even do a random post of something birthy.

 

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Updates, such that they are

Much pathos to follow. If you want sweetness and light, please go here and here.

Yeah, I’ve been a bit quiet recently. I’ve been waiting for good news to report. I’ve gotten some-sort of. It’s good news I’m not willing to bank on just yet.

I’ve accepted an offer from an Ontario practice. They’re awesome, of course. I haven’t uprooted my life for anything less than awesome. My start date would be September 1.

Thing is, as is the case with ALL Ontario midwifery practices, this offer is “…pending new registrant funding”. From what I understand from the group, if this position ISN’T funded, it will be a first in the history of the practice.

Said funding is usually released on or around May 31. As of now, no funding has been released by the Ministry of Health.

Here’s an excerpt from recent email from the Association of Ontario Midwives to me: “AOM staff have been working daily on this issue since May, in frequent contact with all levels of the Ministry of Health, and we do believe that the Ministry understands the urgency of the need to release the funding immediately.  We are optimistic that as soon as funding flows for all Ministry programs and services, midwifery new registrant funding will receive top priority.” This is happening to ALL government funded programs, not just midwifery.

I’m having flashbacks to mid October of last year, when I found out that the bridging program in Vancouver would not be running their January course due to lack of funding.

My defense is that my contract is languishing on my dining room table, and will stay there until I know my position is funded. I can’t let myself get excited again.

On the local side I have another situation of just-beyond-my-fingertips.

Back in March, while still in Ontario, I started putting out feelers for a temporary job in Chicago. I got a whole bunch of nothing from midwifery practices. This makes sense, of course; it usually takes three months for midwives to get hospital privileges, and I was offering three to six months.

Then I applied to hospitals for labor and delivery nursing jobs. I heard back from three, and none of them wanted a temporary employee.

Then I applied for a job through a nursing staffing agency, who specialize in short term assignments. Things were clipping along smoothly until my agent realized that my nursing experience is more than five years ago. Their clients want nurses who have worked in labor and delivery in the past one to two years, she explained; so sorry.

Then I approached an administrative service specializing in midwifery and asked if they needed any help-midwife brain for hire! We went from discussing a mutually exciting and creative short term job, which slowed and stalled when she realized she could accomplish her project with her existing staff.

THEN I heard back from a nurse manager at a Chicago hospital who thought long and hard and decided she WOULD like a temporary nurse. This was a door that I thought had closed long ago, and I tripped over myself with gratitude. I was on my way out of town; she told me to call human resources when I got back to set up a time to fill out paperwork.

When I did, it didn’t occur to me until I was shaking hands with the recruiter that I should have dressed in interview clothes. I’d also been sick for a few days prior. I did the paperwork and he did a generic interview with me (What motivates you? What does teamwork mean to you?), most of which was easy but I totally tripped on one or two questions. Then I met with the nurse manager, and we half interviewed/half chatted for over an hour. By the time I left I felt like I’d known her for years. She’s amazing, her hospital is great, and I started getting excited about working there.

The next steps, she said, are an employee health physical and my reference check. If we can get those done ASAP, I could start working in a week and a half!

I skipped my way back to the train station, and the rest of my day was spent visiting friends. I loved every tree, squirrel, and person I saw.

Then, in the evening, the brainweasels got started.

My coming to human resources in Summer Casual instead of Power Suit and my answers-I-wish-I-could-take-back began to gain speed as reasons they won’t hire me. If not that, the employee health provider doing my physical will find end stage cancer or something equally horrific and equally implausible, or my references won’t call back or will give me a terrible reference. That last is especially laughable since one of them is Lynne, and I have no reason to believe that the other reference will be anything but good.

The brainweasels then gave me a mental slide show of my closed doors of the past few months: no midwife job, no nursing job; no agency work, no consulting gig. For each of them I charged forward with my usual unrestrained enthusiasm and got stopped in a Wile E. Coyote fashion.

Then I remembered that the Ontario job is no guarantee, either. I’m not kidding about the flashbacks. My hope sinks a little more with each passing day, though I’m coping by doing what’s in front of me and going “LALALALA!!!!!”

I’m close to the end of my coping, and I’m close to the end of my money.

For the past three months I’ve put on my Big Girl face. I got up and tried again, admonishing myself to not be upset over not getting something that only happened in my imagination anyway. I’ve had flickers of resentment against the concept that As A Nurse, I’ll Always Have A Job. For the most part, though, I don’t feel entitled to anything, so that’s not something I entertain very much or for very long.

It wasn’t until yesterday evening that I said out loud, “I’m so tired of getting my hopes up.” That was the crack in the dam. For most of the rest of the night I surrendered to the brain weasels and cried.

I know myself well enough that in The Big Picture, I’m fine. I’ve said elsewhere that I have no real fear of being homeless and starving. Next year, next month, hell, maybe next week I’ll look back on last night and see how unnecessary it was.

Until I get more information, though, all of my fears have at least a seedling of rationality to them. For a variety of culminating reasons, last night they got distorted by mental funhouse mirrors into an insurmountable, undefeatable monster.

It’s my hope that getting this out will get it out of my head.

In the meantime, all I have to do, all I can do, is wait. I trust, because it’s my default setting, but in this moment, I can’t tell the difference between rational and irrational fear.

 

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Ah, validation….

….you bring such mixed feelings.

I’ve been loud and clear about my reasons for moving, and now it’s happened somewhere else: North Carolina.

I’m sad for my midwife sisters and for their clients, but I’m not surprised and horrified.

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Rewind/play…..

May 21, 2012: Edited to protect the privacy of those involved in my story.

I worked at this small community hospital in Chicago for just over a year.  The midwife group was three full time equivalents in the form of four midwives. In business lingo, that means two of the midwives were full time (me and the practice director) and the other two were part time (Karen and the fourth midwife).

About three months after we started, we learned that we would be losing our contract with the Chicago Board of Health, which was our major source of patients. I heard there were a few angry meetings, but given the speed with which most government organizations run-which would be the speed of a glacier-it’s reasonable to speculate that the decision had been made before I started there.

For the next several months, the practice director and I tried mightily to increase our volume. She made a lot of phone calls to nearby community organizations and nurtured relationships with them. I spoke with the manager of a nearby feminist women’s health center that once offered OB services but stopped when their affiliated hospital was purchased by a faith based organization. I introduced her to the department chairman and business manager of my hospital to negotiate bringing us into their clinic space.

Our efforts brought more hope than results. After another few months of negotiations going nowhere and watching our numbers dwindle I decided to kick back and wait to be laid off. On a hunch I started to compile names and addresses of clients, starting with ones whose babies I had caught and eventually just writing down the names of women coming in for gyne visits that I thought were cool, thinking I would invite them to join me wherever I ended up.

Shortly after Labor Day, The Day came. I was in my office preparing for my clinic day to start and two women from human resources came in with severance letters for all of us. They were apologetic but professional.

“What took you so long?” I asked.

I cheerfully gave back my pager and asked if I could bail on my clinic day, and they said yes. I was getting severance in lieu of notice, and I was quite ok with that. I like the amputation version of being let go as opposed to the death by a thousand paper cuts of having to show up for another month.

While everything at the hospital was happening, Karen had decreased her hours and was taking steps towards opening her private practice. As I left the hospital the day I was laid off, the first thing I did was call her. “So, uh, I just got let go. Mind if I come over? I don’t want to go home and stare at my walls.”

She didn’t mind, and when I got there she gave me coffee and cheesecake.

I mentioned to her that I had a list of about 25 patients that I was reasonably sure would follow me, and how about if I join her in her new venture? I thought I was being all slick and business like.

When she tells the story, she always planned on having me as a partner.

Even though I knew the layoff was coming, I was more depressed than I thought I should be. At the same time I going through a breakup of a not very serious relationship, and felt that my grief was out of proportion to the seriousness of the relationship.

I had an energy work session not long after that, and through some guided imagery I realized I was grieving every job I’d ever lost, including the ones I’d voluntarily left that had a heavy emotional charge to them.

My fogginess continued for about a month. I felt like a chess piece being played in a cosmic chess game, not fully understanding what was happening but trusting the source that was moving me.

I can’t pinpoint a particular time when I Was Better. I just took the next step, and before long I became excited at this possibility we were creating.

In the years following the opening of A Woman’s Place, more than a few people, midwives and others, commented on how brave I am. I’m not exactly sure what “bravery” is. Midwifery practice models in the US include midwives who are hospital employees, physician employees, or health care organization employees. I had done all three in four years and was laid off from each of them. Being involved in a private practice is just a different kind of risk.

And thus we proceeded, not seeing what we were accomplishing because we were building it.

Posted in Career moves, Deep thoughts, Feminism, Home birth, Hospital birth, How did I get here? | Tagged , , , , , , | Leave a comment

Rewinding….

May 21, 2012: Edited to protect the privacy of those involved in my story.

Once upon a few years ago, I started this blog thinking I’d be chronicling my journey. I’ve done some of that, but more of the “my journey” has been my current path. I’ve decided to give myself permission to skip around in my history and piece together the chronology later.

The warp speed version:

Started grad school in the fall of 1998.

Graduated in the spring of 2000.

Moved to Chicago and worked for Homefirst, a large, physician run home birth service for nine months. (There’s something symbolic about that. Nine months. J)

Worked in a suburban private physician practice doing hospital birth for two and a half years.

And here’s where warp speed slows down and storytelling resumes.

In May of 2003 my then boss sat me down and told me he needed to let me go because malpractice rates had doubled for the third year in a row. (You do the math.) I had already registered for my professional convention, which was a few weeks later, and he was kind enough to send me on their dime.

In the days following, I signed up on a room share list serv and started communicating with a midwife in Chicago that I’ll call Karen. Huh, I thought, maybe there are jobs where SHE works. The room share coordination ended up being me, her, and a midwife from Utah named Kathy.

Kathy was already there when I arrived, and Karen got there the next day. Turns out that Karen was very part time, only working a few days a month on labor and delivery, and Spanish was a requirement at that hospital. Le sigh.

Otherwise, that year’s convention was the most fun I remember having at any since then. The three of us got along FAMOUSLY. My most cherished memory was the three of us being in the hot tub at 10 pm and discussing what we would say to a woman wanting an elective c section and comparing notes on our more challenging cases.

I was prepared to relocate if I had to, and I had a few impromptu interviews, none of which went anywhere.

Upon arrival back home, I continued searching for a job, and also began to consider: if I stay in Chicago, where would I want to live? I looked at neighborhoods whose condo prices were ones I could afford.

A week or so after convention I got an email from Karen. Turns out she had been recruited for a half time position when she was in the pool (notice a theme here?) with an old midwife friend of hers. The same practice had a full time position, did I want to apply?

You betcha. I applied, interviewed, and had the job within a few weeks, with the luxury of starting a few months later, after an already scheduled vacation. Severance pay is a good thing.

In an interesting point of synchronicity, the Chicago neighborhood I had chosen was a less than ten minute drive from this practice’s affiliated hospital.

To be continued…

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OMG, REALLY!?!

During the years of my private practice, all kinds of women came through my doors. Plenty of women knew from the start that they wanted a midwife. But I congratulated the women who transferred care mid pregnancy or later when they realized they weren’t going to get the birth they wanted. They overcame the fear of offending their doctor and brought their pregnancy elsewhere. That they overcame anything is of course an assumption I’m making. Some women didn’t give a thought to what their doctor might think. Most, though, had some degree of discomfort that they may be hurting their doctor’s feelings.

Some were surprised, perhaps with mixed feelings, that their provider didn’t even notice or care. For some of them, though, their fear was justified-like one woman getting an angry phone call and the Dead Baby speech from an obstetrician who refused to accept that she had actually left his care.

Today I came across this headline: “Fear of Being Labeled “Difficult” May Keep Patients from Participating in Shared Decision Making”. It’s from the website of the Informed Medical Decision Foundation, who states, “We believe that the only way to ensure high quality medical decisions are being made is for a fully informed patient to participate in a shared decision making process with their health care provider.”

I read the article with increasing incredulity, and something in my head broke in the last paragraph: “Most physicians are probably not aware that patients are concerned about asserting their preferences in a medical consultation,” says Dominick (Frosch, lead author of the study). “Our study suggests that health care providers need to be explicit with patients that their opinion matters and that it’s okay to disagree, otherwise the treatment that is prescribed may not be one the patient is willing to adhere to.”

What dream world does this guy live in?

Take this fear and add female social conditioning to it. You know, the female conditioning of not making a fuss and being a good girl.

Add to THAT the natural conservatism we have towards our babies. A health care provider can make a pregnant woman do anything by saying her baby may be in danger.

“Our study suggests that health care providers need to be explicit with patients that their opinion matters and that it’s okay to disagree.”

What if it isn’t?

Dr. Dominick Frosch, I’d like you to meet the physicians of Aspen Women’s Health Center in Provo, Utah:

 

My way or the highway

These health care providers explicitly state that their client’s opinion DOESN’T matter and it’s SO not ok to disagree that they can go to another provider if they do.

I commend them for their honesty.

Fear doesn’t come from nowhere.  This particular fear is a solidly rational one for pregnant women.

 

 

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