Month four as a new CNM

Oh...hi there!  It's been a while since I have blogged, hasn't it?  Life as a new CNM is certainly busy.  I tend to do a lot of resting at home when I am off (not in the office, not on call).

I guess it's time for a bit of an update.

I am now four months into my new career as a CNM.  I feel that I have grown and learned so much in just those four months!  I have gone from very, very green, to just a lovely color of sage.  Yep, still a newbie.  Still learning things, every single day!

I am getting much more comfortable in the office setting.  So much so, that I rather enjoy office days!  They are getting to be busier as I start seeing more and more of the prenatal clients, as well as tons of annual exams/GYN issues.  I think I've said this before - I was really lacking in GYN experience as a student midwife.  I honestly didn't think I would need much in that area, due to my (now defunct) laborist midwife position I was supposed to be starting last summer.  Well, well, well.  Look what we have here......I am a full scope CNM.  Sure wish I had more GYN experience under my belt now!

It's a good thing that I see a good 50/50 mix of pregnant vs GYN clients in the office.  I am learning tons about well woman care, as well as GYN problems.  Talk about a crash course in gynecology.  I've treated more STDs than I care to imagine (all different types, thank-you-very-much), and have seen and felt several different GYN abnormalities.  Not enough to be anywhere near "experienced", because I tend to do a lot of testing and referring of my GYN complications to my surgeon/MD consults.  Oh, and breast issues?  Wow, have I learned a bunch about those.  Breast cancer - such a scary thought.  By the way, still have lots and lots to learn about breast issues/gyn problems.

When in doubt?  Get a good history and physical exam, order labs/imaging, and refer to a surgeon/MD.

I would like to learn how to place IUDs and learn how to place Nexplanon.  For now, I just refer my IUD insertion patients to the providers in the office who can place them.  One of these days, I will get my tush in there while they are placing one, so I can get some hands on experience to learn how to place them as well.  It's one thing to learn on a plastic model, and quite another to do it on an actual person/uterus.

Still learning about birth control methods.......thank goodness for my cheatsheets and pocket guidebooks.  I still have questions, and ask my fellow CNMs about how to best manage different problems related to birth control (pills, depo provera, etc).  So, so, so much to know!

I also seem to have the tocolytic effect when I am on call.  Very few births :-(  Boo hoo.  I miss being able to catch those slippery little chubalubs!