July 25

Well, I am moving forward on the whole MSN degree program, mostly because I want to take advantage of the financial reimbursement available to me while I'm working at a hospital. I don't see myself staying past my commitment, unless something changes for the better. I like it well enough, but birth should be better than this (and I've seen 'the better' I speak of).

Yes, I am making a difference in the lives of the women I help. I know that my care is good, and I can help them. But the system is broken and I can't fix it. I can only work within the constraints that exist. Perhaps when Kaiser docs get on board things will be different. Better? Worse? Stressful? Yes, I am expecting all of that. We are not sure the exact date, but things will change whenever it happens.

I did help a mom have a VBAC yesterday, of which I am happy to report. She really didn't want a VBAC and was scheduled for a repeat C/S next week...but her water broke and her labor was fast. And both OR's were busy with cases and her doc and backup doc were both doing other procedures. So I took care of her and URGED her to labor on and helped talk her through the contractions. She didn't even get an epidural (holding out for the spinal/epidural for the surgery). She was 7 cm when I checked her and complete not long after. I was like, um, why don't you empty your bladder and we can walk across the hall to a labor room. I knew she was complete and we could maybe get the baby to move down enough with a couple of pushes, until it was just going to happen.

She was a great pusher and we had the baby in the labor room a few minutes after the doctor came in. This doc is pretty cool with stuff, but was more than willing to do a repeat c/s if the client wanted it. She wanted it, but I was trying to tell her that she didn't need it. I was SO happy for her having the baby vaginally, without the epidural! I'm not sure she realized how much better the whole thing was going to be for her after the birth, but I hope she appreciated it.

I wasn't the best nurse, but I think I was a good labor coach. I suppose I will always be better at that than my 'nursing' skill. It took me two tried to get her IV in. And I made a mess and got blood on my hand. I was not the most skillful at those things. But I got everything done and I did get all my paperwork completed. She was really a great birther. Too bad the first was breech and she never labored with him.

Anyway, it's hard for me to work with people too afraid to believe in their body doing what it is suppose to do. She really didn't believe she could have a baby without surgery. I'm glad it worked, but I'm not sure she really wanted it to or not. It just did.

So, why don't I go on to be a CNM? Mostly because I can't afford to go to those schools. It's WAY more expensive than the school I'm currently applying for. I can get the MSN in nursing education for about $12,000 total, and most of that the hospital will pay for as I go along. It's all online and I can move at my own pace. CNM school is over $15,000 a semester. And I don't know how I would end up working in the end. Of course I'd rather do home births, but there is little support for that and I would be on call a lot. I've lived like that way too much.

A perfect practice would be home births with other midwives and working hours that would allow off time. BCWH midwives hardly ever have time off. And they don't make very much money, either. S is doing well, and trying to get her practice going. I think she has a good approach...yet she discouraged me every time I see her. She says I'm too old to begin as a CNM. That's not helpful.

P. is now taking care of over 80 clients a year. And she charges more the BC. She is grossing around $320,000. I have no idea what her work hours are like. I can't imagine she has much time off. I wonder if she has someone doing her billing? paperwork? appointment schedules? Really, it would be hard to maintain all that.

Well, enough of my random thoughts for the day. B. did ask me where I wanted to be in the end of all of this, and I can't answer. Maybe teaching college? Seems like a noble thing. Maybe not.
I just wish B. would get a job again. That would make things a bit easier to sort out. I could, then, maybe take the classes I really want to take, but until then, I am taking the next best pathway. I need to have a regular, reliable income. We need insurance. I never intended to be the primary (only) wage earner in my home. It's hard, ya know? But what other option is there?

Guess we will make it on less than $50,000 this year...and that's a family of 5. God is good, I can't explain it any other way. When I try to budget it out, it never works. We just have to keep pressing on and hope for better times. I am grateful whenever the cars don't break down and no one is sick. The thought of actually getting ahead is just laughable. Treading water is okay, though. At least as long as one's head is above the water.