Running header: CLNC 2030 REFLECTION OF ASSISTANT EXPERIENCES 1

Reflection of Assistant Experiences

September-December 2018
CLNC 2030
Katlyn Carter
December 5, 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, 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. This term we have had a few

experiences that are new to me that I have/am learning from. We have an obese client (not new

in and of itself) that I have had to modify some things for and think of things a little differently. I

had never experienced a client that was hard to really get a good picture of what is happening

with her body. We needed to find a BP cuff that would take an accurate reading and even now, I

have to really focus to ensure I’m accurate. I usually only use a fetoscope after 20 weeks or so

for prenatal appointments but am needing to use Doppler to ensure I’m getting good FHT’s.

This has been a really good experience thus far. This client discovered the MMOC with her last

birth after several very medical births, and I am happy to be a part of her birth team.

This trimester I am taking Ante/Intrapartum FHR Surveillance which has helped me

learn, understand, and appreciate FHR surveillance during labor, especially. I haven’t been the

best at remembering to stay on top of regular FHT’s during labor. I’m realizing that I now view

it differently after taking the course and feel I will be more conscious of it at future births. I’m

learning to trust what experience I have 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 until this trimester. I, officially, had a client ask that I not attend her birth. She said I was too
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happy and outgoing and she and her husband didn’t want that at their birth. My preceptor

ensured them that my etiquette at births is totally different, but it didn’t change their mind. I’ve

definitely had to sit with this for a bit. I understand that they hired their midwife and not her

student. I understand that I’m not for everyone... and I’m good with that. It really is unfortunate

because I need the numbers! I find that this experience has made me pay attention to my

presence in the room even more than I have been in the past. It’s kind of a weird place to be. I’m

not there because the client chose me. I’m there because my preceptor has allowed me to be. I

think this may be growing pains of a student.... being in a “middle” place. I feel much more

comfortable with doula clients because I can be my own person (without worrying about being

wrong) and know that I’m there because they want me there. I’m grateful for all the experiences

I have had and look forward to being the person that the client hired!

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

placement and am looking forward to our future numbers going up. To date (12/5/18), I have 8

assist births, 9 newborn exams, 95 prenatals, 40 postpartums, and 8 well-woman exams. I have

arranged to be joining a higher-volume practice June 2019 and looking forward to that, as well.

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)
 Support physiological management of the third stage of labor (4.45)
 Inspect the placenta and membranes for completeness (4.47)
 Assess immediate condition of the newborn (6.17)
 Insert intravenous line and administer fluids, draw blood for lab testing (4.60)
(Skill numbers from Skills Competency Form for Phase 2)
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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.