Running header: CLNC 2020 REFLECTION OF ASSISTANT EXPERIENCES 1

Reflection of Assistant Experiences

May-August 2018
CLNC 2020
Katlyn Carter
August 7, 2018
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Reflection of Assistant Experiences

I feel I have grown a lot as a birth assistant and student midwife in my clinical placement

this term. While my preceptor has a low-volume practice and my birth numbers with my

preceptor are low (1 to be exact plus additional doula birth experience), I feel I have really

excelled in other areas.

I believe I have (mostly) mastered vitals and abdominal assessment. Granted, there are

times that confirmation is necessary which I feel is healthy. I spent my first trimester as a Phase

2 student feeling like I didn’t know anything, having to ask for help constantly, and most

important to note, I would make fun of myself and make the “new student” comments to clients.

As time has gone on and I have spent more time in clinic with clients, I have come to realize that

it’s okay to ask my preceptor to confirm a FHT that sounds faint with the fetoscope instead of

cracking a joke. I think more experience and confidence has helped, but also talking about taking

on a bigger role in clinic and at births in the future. Clients won’t trust me perform a vaginal

exam, draw their blood, or anything else if they think I’m incompetent.... because I’ve been

telling them how incompetent I am. I’m learning to trust what experience I have, ask for help

from my preceptor in a professional way, and trust myself to apply my knowledge in the clinical

setting.

I have received great feedback from clients regarding my skill and participation in their

care. That helps build my confidence and encourages me to continue. I appreciate feedback and

will seek out a way to ask for constructive criticism from clients. I ask doula clients for feedback

and have a specific form for that. I would love something like that from midwifery clients. It’s

easy to say the nice things, but not as easy to give the feedback that can help me grow.
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I really appreciate the feedback that I receive from my preceptor. Most feedback has

come from clinical experiences and postpartum care. I have had the opportunity to walk beside a

client battling postpartum anxiety and depression this term. I have had some experience in this

area, but not from a care provider’s perspective-actual in-home support of a mama sobbing,

covered in spit-up, not showered in a week experience. This experience, not one I would wish on

anyone, was very good for me. It’s not easy to have hard conversations in a gentle, supportive

way. We supported this client through this time that she now reflects on as “the best postpartum

yet” after suffering horrible periods of darkness with her two previous children.

My skills have definitely improved over this trimester. I have improved in accuracy of

vitals. I am now doing most blood draws in clinic (mostly successfully!). My preceptor offered a

4-hour workshop on exams and how to chart your findings. That was super helpful! It’s nice to

get together with other students and really review things and talk about why they are applicable

to the midwife’s scope of practice.

The biggest challenge this term has been the lack of actual births. I’m perfectly happy in

my placement and am looking forward to our future numbers going up. We have 2 births planned

in August (one is a hospital birth with co-managed care), 2 in September, 2 in December, and a

couple early winter EDDs. To date (Aug 8th), I have 22 prenatals, 13 postpartums, and 2 well-

woman exams including PAPs.

I have met a lot of the goals I set at the beginning of the trimester including the

following:

 Perform a complete abdominal assessment including fundal height, lie, position, and
presentation (3.42)
 Assess fetal growth using manual measurements (3.43)
 Better monitor progress and chart progress of labor (4.29)
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 Inspect the placenta and membranes for completeness (4.47)

 Assess immediate condition of the newborn (6.17)
 Promote and maintain normal newborn body temp (6.18)
(Skill numbers from Skills Competency Form for Phase 2)

I have loved learning abdominal assessment and belly mapping. I have received good

feedback from clients in my skill and including them in the process. Assessing fetal growth with

a measuring tape is challenging because some of it is subjective, but I am getting better each

week. I feel I learn more and more about assessing the progress of labor with each birth I attend

(both as a doula and as an assistant). I have loved learning more about placentas and enjoy giving

clients a “tour” of the organ that grew their baby after birth. I am learning to assess the

immediate condition of the newborn. I have really focused on this (as situations have allowed),

as I find it as fine line between the-baby-is-quietly-coming and the-baby-isn’t-quite-with-us.

Watching babies make the transition is truly amazing, and I am honored each time I get to

witness it. I have much respect for this process while also acknowledging when our help is

required.

Overall, I am pleased with my progress as a student in clinic and student/assistant at

births. I feel I have grown a lot in feeling more comfortable with myself and my knowledge. I

have found areas to improve on. I recognize I have many, many things left to learn, and

recognize my personal growth and improvement.