Savior, Christ the King!

This is how I spent most of the day on Saturday and Sunday...playing harp in our Christmas presentation, "Savior, Christ the King". I had more fun than I've had in a long time making beautiful music with my church orchestra! What this doesn't show is the other harpist who played with me. (She was taking the picture.)

I tried to remember to look through the strings and be sure we were together. Most of the time we were, but there were a couple of funny moments (in retrospect)...waiting for a cue from the conductor with hands poised...missed my cue, but the other harpist played the line, so it must have looked like harp ventriloquism! A couple of times, we each had mis-counted and had a solo glissando...hopefully it sounded like it belonged, even though it didn't. But the harps definitely were heard this year...both of us had good microphones and the sound techs had us turned up "hot". I promise I could hear myself tuning before the concert out in the auditorium. It feels especially good to be waiting on a cue from the conductor and playing on his cue just like he's expecting!

My fingers are just barely sore today, which is amazing since I had no callouses before I went to rehearsal last Wednesday. After almost 18 years of playing harp (yikes!), my fingers recover and re-develop callouses pretty well.

I hope I can always play harp with an orchestra...it's so much fun making music with others!

Now that we've welcomed Christ the King in music, it's time to make my heart ready again for His coming! I hope you all have a blessed Christmas season!

Over the River and Through the Woods....

...and past the cornfields, leaving the snowfall behind! One thing's for sure, I know where corn comes from...there are so many cornfields in IN and OH...it's unbelieveable! I loaded the car and drove back home to NC last Thursday and Friday. I planned to drive to the halfway point and spend a night in West Virginia, before finishing the drive on Friday. So, after saying a temporary goodbye to everyone in the office, I took off driving past scenes like this as I made my way through central Indiana and southwestern Ohio. I made it almost to the border of Ohio before needing to buy gas, and when I found a station, gas was $1.59/gallon, the lowest price in that area! I was able to fill up to the brim for only $28!!

As nightfall came, I was traveling though Portsmouth, OH. There was a suspension bridge over the Ohio River; the lighting was unbelieveably beautiful! (I just looked for a picture of it online, but I couldn't find one that was taken at night.) If you ever get a chance to see it, take the opportunity! Anyway, after I crossed the bridge, I came to a sign at the traffic light that said I was crossing into KY. Strange...I had looked at my Yahoo! directions and thought I wasn't going through KY this time. But I continued on, thinking that I was supposed to go 67 miles from the last turn I had made, and I was only at 40-something miles. It got darker and darker...except for twinkling Christmas lights, and I finally saw that I had been looking at the wrong line of directions and had gone about 20 miles past where the next directions were to take over, so I had to go back...didn't want to...but had to. Going over that bridge again almost made it worthwhile, but I was more than a little annoyed with myself, because I wasn't sure exactly where I was. I parked and dug out my PDA that I use in the clinical setting and the GPS software I bought, and after some prayer and determined effort, I ventured out again in Portsmouth going another direction. I arrived safely at my hotel in WV about 1 1/2 hours later than I had intended. I went out to get food to bring back to the hotel to eat after I unloaded and settled in (too late) after watching part of a TVLand "Cosby Show" festival. Oh well...I don't get the opportunity to do that very often.

After breakfast and a catch-up conversation with my regional clinical coordinator, I set out for the remainder of my trip and drove through WV, VA, and NC. As I drove and listened to teaching CDs, I had a front row seat to some of the most beautiful scenery imaginable! I love mountain scenery and tunnels, but I'm not so crazy about drivers that get up right behind me when I am going 70 (the speed limit) and act like they're going right into my trunk when there's no room (and I can't move over)! Anybody ever heard of BRAKES???!

I arrived in northern Mecklenburg County shortly after 4PM and met my mom and cousin for supper. I filled my tank this time for $30 ($1.70/gallon)! I had gotten just short of 500 miles on one tank of gas in my SUV...worked out to about 28.1 MPG...such a great car! After supper, I began the unloading process...it took multiple trips in and out of the apartment, but I finally got it all inside...and promptly landed in my recliner! Considering that the temperature in the previous 2 weeks in Indiana had been mostly in the 20s and low 30s with snow (and frozen roads at times), Charlotte feels like it's having a heat wave with temperatures in the 40s and 50s! Tomorrow's temperature is expected to be in the 60s!!

Since returning home, I've been to a reunion of a church group celebrating its 30th anniversary in ministry; some of those folks I hadn't seen in over 20 years, so that was pretty neat! I played harp in the church orchestra twice on Sunday morning; I've missed that terribly since I've been away in Indiana. I got lots of hugs and friendly greetings from those I've missed! I went to a Christmas dinner with Mom at her church on Sunday (and ate too much...sigh).

Yesterday, I went to practice with another harpist the harp parts for the Christmas musical that we will be playing this weekend on Saturday evening and Sunday afternoon and evening. We had to play "divide and conquer" on one of the parts because the arranger must have forgotten that harpists only use three fingers and a thumb on each hand to play any given chord. Some of the chords had at least 10 notes to play, and I threatened to play with both hands and my left foot! (If only I were really that coordinated....sigh!) Although it wouldn't be ladylike at all, it would get the notes covered! Oh well, after a nice long sectional rehearsal, the other harpist and I have a plan of attack at least. We'll have dress rehearsal Wednesday night to further cement things. I love to play in church orchestra!

Today, I'm just getting ready to do more schoolwork, thinking with great joy that next Christmas, I should be able to just go to work, decorate, and enjoy the season just as it's meant to be...boy, oh boy, am I ever looking forward to that!!

White Rain

I try really hard not to pay too much attention to the weather reports, because I've seen them be wrong so many times. Take, for instance, last night's report. Yahoo! had predicted snow or a wintry mix for Sunday, but the TV report before bedtime was that this would be a "rain event".

When I woke at the usual time this morning, I noticed it was darker than usual, so I got up and looked out the window. Yep, you guessed it...the "rain event" looked just like the picture above. White rain?? Sorry for all of you who love snow, but the first thing out of my mouth was, "Oh, no!" Now, truthfully, I love snow, too, but only when I don't need to travel in it. I had planned to go to church today.

Now, my friends in places that really get snow would laugh at what we got here in Indiana...probably only about an inch. But, it's always a test of my faith when I have to drive in it, because in my area of the country, we don't get very much snow, but we do get ice and sleet. That's why until I moved to Oklahoma in the early 90s, my dad, who was a truck driver, was always called upon to take me to school or work when it snowed (or did whatever it was going to do in NC). Boy, oh boy, the first time I had to drive to school at ORU when it snowed (because they wouldn't cancel school), I had this white-knuckle grip on the steering wheel all of my 5-10 minute drive there.

I went upstairs where I could see the road, and watched the cars as they moved along the road without a bit of difficulty. I thought about it, and decided the following things:

• If it were a work day, I'd go to work no matter what it was doing outside, so why would going to church be any different?
• I squinted, and as far as I could tell, there was no "mix"...just snow.
• Cars were moving along the (secondary) roads without one bit of difficulty. Now, I know this is Indiana, but it didn't look threatening.

So, off I went...and you know what? The roads were only wet where the snow had been, but had already melted. I drove safely to church, where I worshiped and heard this great sermon on "Faith in Development"...about how the things we go through in life are meant to develop and strengthen our faith in God! I'd already had my object lesson on the way to church!

The snow is melting quickly, it seems, though it's still very cold. The snow is still at this pretty stage on the roadside and in the trees. It's so amazing that God proves Himself and His love to me over and over again!

A Different Sort of Thanksgiving...

While most of the country was bustling with holiday celebrations with food, family, and friends, my holiday was a quiet one in Indiana. I was struck with how different this day was from most of my other Thanksgivings in the past.

As a child, Thanksgiving was a time to gather at my grandparents' house next door with my parents and usually an aunt and her daughters. Since I was an only child, I was accustomed to things being a good deal quieter than they were on those special days. I would play with my cousins, then we would eat a fabulous lunch, and we cousins would continue to play after lunch while the grownups were cleaning up. But after a little while, I'd slip away to our house (when I'd had enough "loud") and take a nap until time for the city's Thanksgiving parade. I'd sleepily watch the parade, then drag myself to the kitchen to get some favorite leftovers.

For many years, I attended a church that had a wonderful Thanksgiving service that started without fail at 10AM with praise and worship songs, reading of Scriptures, and testimonies from people who were especially thankful for things that had happened in the past year. I can still remember how whole families lined up in the sanctuary to give their praises to God. We always closed with communion and the Aaronic blessing (the Lord bless you and keep you...). Most of the time, we were doing good to finish the service by 12:30PM, and I'd rush to get to my family lunch, which had usually already started.

When I moved several states away, there was never enough time allotted for me to go home for Thanksgiving, especially since I was going home for Christmas and New Year's Day each year. Those Thanksgivings were celebrated with other families -- the first couple of years with the family of my handbell teacher and other kids from the university who had no family in town, then after that, it was usually spent with my dear friends who were a second family to me. These friends usually had Thanksgiving dinner in the late afternoon, so most Thanksgivings found me at the hospital working day shift (usually for double pay...needed that!), then going to their house for the evening.

When I moved back to my hometown, I hosted my parents at my apartment for my first Thanksgiving back in town and felt so "grown up", decorating and having everything "just so". We shared the food preparation and cleanup, visited a little while, and they went home. I am so thankful that I hosted Thanksgiving at my house that year, because the next year, Daddy was in an assisted living facility and couldn't have made the trip. Since he's been gone for almost 3 years, Mom and I have usually been together for a meal and a visit.

But this year found us separated -- she in the family home in North Carolina, and I in Indiana. Thankfully, her cousin came over to have lunch with Mom, and they spent a musical afternoon together, playing the piano and singing. I, on the other hand, spent some quiet time in Scriptures, and did a variety of activities, from watching the parade and other old sitcom favorites, to studying for the next exam that I hope to finish next Monday. Oh, and yesterday, I went to see the baby who was my first "catch" and his parents; they're all doing well and the baby's already gained over a pound in the past month! I had taken some pictures, and I made them into a Smilebox to send them...that's always fun.

I decided to "take myself out on a date" this evening...really hard to find a restaurant open. I finally found a Cracker Barrel restaurant open, and I enjoyed their Thanksgiving meal, which gave me the tastes of the day, without the opportunity to get seconds (and thirds, etc.). I had to laugh when on the way there and back again I saw this huge blow-up of Tom Turkey sitting on someone's nicely manicured lawn.

And, no-o-o, tomorrow I won't be out at 4AM shopping...that's when you'll know I've lost my mind, because 4AM is for SLEEPING...unless I would be babycatching, and I don't think that's liable to happen.

Whatever the season of life, whether boisterously loud, quiet, or somewhere in between, this fact remains -- the LORD is good, and His mercy endures forever! Happy Thanksgiving!

Oh, what a relief it is!

As of 3:45PM on November 12, I finished my Advanced Antepartum course! I scored 90 (A) on the test, and my final grade was 88.8% (high B). I've been studying so long for that second test and I feel so-o-o-o good that it's finally over! I'm almost floating...shoot, by the time I finish my last two exams for this year, I may well be flying!

Help! I'm studying and I can't wake up!!

No...this isn't me, but if you had seen me the last few days while I've been studying, this is what you would have seen! I've started to study for next week's test each day this week (except Tuesday) in the late morning, and it isn't long before I'm nodding. So much material...all of it to be condensed into 50 questions. (Can you say overwhelming?) The next test on my dashboard is on Advanced Antepartum (Pregnancy, for non-nurses) Care. Here's an overview of what I'm trying to get organized in my head:

• Depression in Pregnancy
• Organic Diseases in Pregnancy (cardiac, respiratory, dermatologic, thyroid) -- management and treatment
• Rh and blood group incompatibilities
• Substance Abuse in Pregnancy (tobacco, alcohol, marijuana, cocaine, and meth) -- cessation strategies, effects on babies
• Domestic Violence
• Genetic Testing (types available & reliability, counseling, genetic diseases)
• Teen Pregnancy
• Older Women (age 35 and above...sigh) and Pregnancy

I do make progress daily, but there's so much information to absorb. But absorb it I will...and then another course will be finished and off the radar!

Tuesday in Indy

On Tuesday, it was time to go back to Indy for a day in the office. When I walked in, I smelled strong bleach throughout the house. I found out that the one I had half-expected to go into labor all weekend while my preceptor and I were on call, went into labor on Monday (while we were off call) and had her baby girl early on Tuesday morning before I went back on call. They left the birth center (together) at about 7AM that morning. So...the smell was coming from the thorough cleaning they do after each family goes home.

I had a full day in the office on Tuesday. My preceptor is letting me see most of the patients now and I check in with her to confirm my treatment plan. Most of the time, she will step in anyway, if only to say hello to the client. If I get behind because of the needs of the patient that I'm with, she will step in and take over or go see the next patient. It's a challenge because even though I know that any given visit is going to involve some aspect of women's health, sometimes I never really know which direction the visit is going to go until I get in there. I have to be ready to address the physical and educational needs of someone still pregnant (with or without complications), someone who delivered very recently or a few weeks ago, someone who is there for her annual check-up, someone who plans to start a family or who wants to delay that event for now (or permanently), someone who is past childbearing age, or baby needs up to 6-8 weeks of age. That's only office work, too! That doesn't include when someone calls in and thinks she's in labor or when someone calls with a problem that needs medication or a trip to the hospital! I'm finding out that this type of work is going to keep my mind thinking and constantly working. I'm thankful for the wide variety of reference materials available to help me make good decisions about how to help my clients, many of them on my PDA. I'm also thankful for our consulting physicians who are available when needed (and kind, too).

Today's charting was done by a little after 6PM, so I determined to go to the hospital to see if I could find the parents of the two little boys I caught last week. From my time as a NICU nurse, I know that being a NICU parent is a roller-coaster ride like no other. I checked on my second little guy first, and he was rooming in. I thought I might get to see him and his parents, but I couldn't get them to answer the door. (I knock on doors very softly, so it's possible they were all asleep and didn't hear me.) I haven't seen it in writing, but I was told that this one was diagnosed with pneumonia; it's possible he will go home on the 10th. I slid a note under their door and went on to the next part of the adventure.

It was already dark outside, so I couldn't see as well as I might have if I'd gone earlier. In Indy, there are 3 large hospitals connected by a "People Mover" -- monorail system. That in itself is pretty impressive to me. So I got on the People Mover at one end, where the first baby is, and rode to the last stop, a children's hospital where the other baby is. I met a pharmacist on the train who told me exactly where I needed to go. I hadn't called ahead...was simply taking a chance that the parents would be there and I could at least see them, if not the baby. They had gone to dinner, but after a few minutes, they came into the waiting area, and we visited a short time. Their little boy had surgery last Wednesday, and on Tuesday, he had been moved to the Infant Unit from NICU. Joy, oh joy...his parents asked me to come back and see him! He was asleep, but he looked so-o-o good. They told me that if his tests turned out normally on Wednesday, they would probably send him home on Thursday (today)! His mom is scheduled to come back to the office and see me in a couple of weeks; I think I'll get to see the whole family that day, so that will be exciting...maybe I'll get to hold him then, too!

I had an opportunity to chat with these parents and found out that the baby's mom had wanted to be a midwife, but dating, marriage, and now parenthood had all happened so quickly that she hadn't been able to do that. That's when I was able to share my story with her and tell her that I'd wanted to be a nurse-midwife for 20+ years. I assured her that if she is supposed to be a midwife, her time will come. After that little visit, I left with a song in my heart, rode the People Mover back to my car and made the 1+ hour drive back to Muncie. I love this work!

It's a boy...um-m-m, make that two!

Well, I didn't have to wait much longer for the blessed event! After seeing a few patients in the Indianapolis office last Monday morning, picking up my primary preceptor from the airport, and having an absolutely scrumptious Italian lunch, I went to my home away from home in Muncie. Just as I was falling into a pasta coma...I got a phone call from my preceptor, saying that we needed to meet a couple at 5:30 PM back in Indianapolis. So after gathering everything I might need if we had to stay overnight, I took off for the Indy birth center, a little over an hour away.

I met this really sweet couple there just before 6PM and found out she had really progressed to the latter phase of first stage of labor, yet she didn't even look like she was in labor. She was so calm and peaceful, and they worked so beautifully together. I thoroughly enjoyed watching them. I just did what I needed to do and stayed out of their way as much as possible. They had mentioned that it would be really neat if their first baby came on the 27th, because both of them had birthdays on the 27th (in January and February). Just before midnight, they got into the tub (since they wanted a waterbirth), and my preceptor and I followed them into the tub room. Just three pushes later, a precious baby boy was born in the water. I quickly picked him up out of the water and laid him gently in his parents' arms. He was so precious and there was so much joy in that room! And yes, he was born on the 27th, at 11:59PM!

This precious little one had complications and had to be transferred to the NICU, though, and he was found to have several abnormalities that will require surgery. None of these were evident upon newborn exam, but were found with testing once he arrived in the NICU.

By the time all the care and paperwork was taken care of, I went to sleep at about 5AM Tuesday and slept about 4 hours until it was time to wake up and get ready to see patients in the office again. I can't say I actually felt very well, but I think I managed to disguise it until after I was able to see 3 patients...my preceptor saw the other three patients scheduled. Just about to the home stretch...and then it happened. We got another phone call from a patient who was in labor; I called and asked her to come over for a labor check.

You guessed it...active labor...so I knew I wasn't going anywhere! So, Tuesday night brought more watching and waiting, but it was exciting! At least for me, it's quite freeing to see these women and their partners be so in tune with themselves and their labors. They are central to their own labor process, and I, though I am carrying out the procedures I need to do, try to remain on the periphery... ever observant, though, because I have a responsibility to recognize potential problems and intervene when necessary. That's where I'm finding out that 29 years of experience as a nurse is helping me; it has trained my senses to know that something needs attention, even if I can't pinpoint what the exact problem is.

Anyway... back to the story. Tuesday's laboring mom worked hard for many hours, and finally, at 4:43AM on Wednesday, her little boy was born (this one on dry land)! Before he was born, between pushes, the mom and the other four of us in attendance tooks turns yawning. It was a long night, but such a wonderful experience!

About 3 hours later, once things had settled down a bit, I was sitting at the kitchen table near the birthing suite trying to stay awake and chart while the family held and cuddled the baby, when I heard the unmistakable sounds of a baby having respiratory distress. Everything had been fine when I examined him at about 2 hours of age. And, as I've heard from other family members over the years, the comment was made that those sounds were "cute baby noises". In my mind I was thinking, "No, not cute baby noises...sick baby noises!" I re-examined him, and many of the distress signs disappeared when the baby got warmed up again. However, there was just a faint hint of bluish-gray color on the baby's face and an oxygen level in the mid-80s (for non-nurses, normal is mid-to-high 90s). With oxygen, the level would come up to the mid-90s, but when the extra oxygen was taken away, back into the 80s he went. After talking to my preceptor, I ended up calling the hospital NICU and talking to the neonatologist on call; the baby ended up being transported to NICU for further evaluation about 5 hours after birth.

Two sweet little boys...both transported to NICU. My inner NICU nurse wouldn't shut up and sit down, but I hope both babies will be the better for it. Gotta shake that black cloud from over my head! So...next on my list of hopes and prayers (besides complete health for these two babies) is a great normal birth and healthy baby that goes home with his/her parents, and not to the NICU!

My preceptor insisted I stay at the birth center for a nap before making the drive back to Muncie, because she didn't want me to be in a wreck. I'd had 10 hours of sleep in about 3 days and used muscles I didn't know I had, but what wonderful experiences I had along the way! Once I got back to Muncie, I had a late supper and fell into the bed, where I don't remember anything that happened for the next 11 hours! This, my friends, is going to be a very rewarding way to invest my days on this earth, and I am thankful!

Step by Step...

At long last, it's time to tell what's been going on the past six months as I've been traveling the road toward my dream! Here's just a sampling of what's been going on the last six months....

May 2008:

• I attended the final required on campus session (Clinical Bound) at my school, Frontier School of Midwifery and Family Nursing in Hyden, Kentucky, for a week. And what a week it was! We (student nurse-midwives and student family nurse practitioners) practiced all kinds of skills we would need in our clinical settings on mannikins and on each other. (Eek!!) I made new friends of people I had only seen on our student forums and we still keep in touch by e-mail and phone...Ah, bonding in the trenches! School tradition has each student ring the bell at the chapel when we pass a milestone. Below, in the foreground, I'm ringing the bell for the second time (Initially, I rang it at the first session in May, 2005, at the end of Frontier Bound.)

• Since I had lost my preceptor in Greensboro, NC, just weeks before I was to go to clinicals, I had found one preceptor in the NC mountains who had been a family nurse practitioner for 15 years, but who had become a nurse-midwife only this year. She said she could offer me lots of primary care, family planning, and gynecology visits, but she could not supervise my baby-catching yet (until she had been a nurse-midwife for at least a year). I made arrangements to start with her; the catch was that I had to finish a huge community assessment paper before I could start clinicals. I started working on that course, and she graciously consented to wait for me.


• I had already planned to attend the annual convention of the American College of Nurse-Midwives in Boston at the end of May, hoping to make contact with someone who could supervise my intrapartum (labor and birth) clinicals. I wasn't beyond posting a notice on the bulletin board that said, "Desperate student needs preceptor!" But it didn't have to go that far. My plane was (hours) late leaving Charlotte for Boston due to "mechanical difficulties" (turned out to be a malfunctioning air conditioner... important, yes, but don't scare me like that!). Anyway, on the shuttle ride from the Boston airport to our hotel, I met a nurse-midwife from Indiana who owns two of that state's birth centers. She had come looking for someone to hire for one of them. When I told her I wasn't that far along yet, that I just needed to find someone to supervise my intrapartum clinicals, she said, "Come on over!" I've had a love for birth centers since the early 80's when I worked as an outreach follow-up nurse for a birth center in High Point, NC, so after several chats during the course of the conference, she agreed to be my second preceptor and said she would start with me when I finished at the site in the NC mountains! To me, that just shows how God knows what I really like and arranges things to fit...even if it takes a late departure on an airplane to make it happen!

June 2008

• Milestone birthday on the 5th...the big 5-0! Other than being bogged down with studies, I'm feeling younger by the day!
• Despite lots of frustrations and hard work, I finished the required community assessment paper at the end of the month...92 pages later!! (May I hear another Eeeeek??) This is the middle chapter of my thesis...one more chapter left to go...early next year! I made a 97 on it and learned so-o-o-o much about the city I grew up in and thought I knew all about.
• At the end of the month, I played harp (along with another harpist) for the patriotic musical, Celebrate America, at Hickory Grove Baptist Church in Charlotte. I LOVE playing with a church orchestra!

July-September, 2008

• I started clinicals at one of the health departments in the NC High Country on July 8th. I didn't quite know what to expect...the answer to that is...the unexpected, of course! My preceptor didn't know this about me, but most of the time I do better if I am told what I'm going to do with little or no warning. (That way, I don't have time to figure out a reason that I can't!) I learned that when I was taught how to swim in my 20's -- my instructor took us to the deep end of the pool and told us we were going to jump in...and I believed her! On my first day, my preceptor was explaining to me how we were going to do a speculum exam on our patient and I thought she was going to do it and let me watch...somewhere along the way, it became obvious she meant I was going to do the exam and she was going to watch! (For those of you who aren't OB/GYN nurses, but are women, you know this as the friendly (?!) little instrument that you encounter when you have an annual Pap smear done...'nuff said.) Of course, I knew how to do it...we had practiced back in May...but I was hoping for a longer time before I had to do that. Survived it, though...both the patient and I, and the preceptor was pleased with my first "real" exam. After about 2-3 weeks of doing the exams several times a day with my preceptor, I told her I would go in alone and if I needed her, I'd call her. It was quite a confidence-builder when I didn't need to call her in to help.


• I liked working with the health department clients far more than I ever dreamed. Some of them had so many problems of various kinds, and since the daily pace wasn't very fast most of the time, I had time to offer them and listened to them. For some, I got the feeling that it was the first time that a medical person had ever seemed interested in hearing their stories. They seemed so appreciative, and they were so patient with me while I learned. In fact, I think the only impatient one was me. It's quite humbling on one hand to be a student of any sort, but to be in an area that isn't necessarily your forte (primary care, family planning, and gynecology) is downright scary after 29 years of being in areas related to labor and birth. I felt more than once a heavy weight of responsibility like never before, because I thought, "If I miss something, I could really mess up someone's life". I daily had to "get over myself".


• You've probably seen the sticker in cars, "No fear"... on some cars, it reads, "Ain't skeered"! Not on your life, buckaroos!! I noticed something...until I got fairly comfortable with seeing the patients, I was quieter than a church mouse...focusing so intently on what to examine for which problem...oh, and don't forget this...or that....sometimes I gathered as much information as I could think of about someone my preceptor sent me in to see, only to come to her office and she would ask me something I hadn't thought about. On one patient, I did that 3 times before I finally got all the data I needed. (It was something neurological, in case you wonder...not my forte.) Also, we had a fairly large Latina population (thank God for a wonderful trilingual interpreter), and I wanted to try my Spanish, but it took all the courage I could muster to make an attempt. For some reason, it was easier to try my Spanish with the patients' children then with the patients themselves. (Maybe that's the level I was ready to communicate on.) I learned so much about Latin culture, and even did a couple of assignments that had my Latina clients as the subjects. I was awestruck with the knowledge base my preceptor had about almost anything she was seeing in her patients...and yet, she was so very patient with me. I'll never forget her for that.


• I learned a huge lesson about health care economics there...couldn't just assume that because I said some test needed to be done or whatever, that the patient could afford to have it done. For lab tests, I went around to the inhouse lab and found out the prices of the tests, told the patient what I thought she needed and had to give her the option of how many of the tests (if any) she could have done. I got very familiar with the health department formulary, a list of medications that the health department stocked at CVS Pharmacy (next door) that wouldn't cost the patient anything, and the $4 list at Walmart. Many of my patients weren't even eligible for Medicaid (never mind health insurance) and would have to work out a payment plan with us. It made me very aware of the fact that we have to gauge what we order on what won't make the patient have to decide between our treatments and tests and their rent or their next meal. Hard lesson...but a good one for someone starting into practice.


• I've always loved the NC mountains...and this summer was no exception! I drove up on Mondays and back home on Fridays. At first, I stayed with my preceptor's sister-in-law who allowed me to stay at her house at no charge (3 weeks!); I almost snagged a beautiful kitty to have as a pet, but with all my traveling, there was no way. The whole area was covered in Christmas tree farms...amazingly beautiful! I know I had the most lovely ride to my clinical site. I also got to be a tourist a couple of times: I toured Linville Caverns and hiked on Grandfather Mountain and crossed the swinging bridge, too!

• In August and early September, I stayed at a church retreat center and lived next door to the church's youth pastor and his family. It was something special to come home in the evening to hear the kids wanting to tell "Miss Kathy" what they did at school that day! The retreat center was a converted school building with bunk style quarters. I had one 6-bunk room all to myself. One bunk was the closet, one was the pantry, one was a study place, and of course, one was for sleeping! They only charged me $10/night, and I had full kitchen and bath facilities. I loved getting to know that family...they're really special!

September/October, 2008 --

• Since leaving the mountains, I've traveled many miles. I stayed home about a week packing for who knows how long in Indiana. Then I started off on yet another adventure. I took parts of two days to drive to Indianapolis and stayed in the birth center there while I attended a training session and conference on Centering Pregnancy. It's group prenatal care and it's catching on all over the country. After learning about this type of care, I think it's a great model. It allows women at a similar point in pregnancy to build relationships and learn to care about each other, while giving providers a chance to share pertinent information within the group setting and facilitate group discussion about pregnancy-related topics that the group is interested in. It's like a childbirth education series and the education part of office visits all in one!
• After that, I traveled on to Muncie, IN and started clinicals here about 3 weeks ago. There's a catch, though. I thought I had until I reached 500 clinical hours to finish all my coursework...oh no...not true...the real number is 400 hours, and I already have about 315 hours in with 2 full classes and 1 more test in another class to go. So...I'm only in the office 1 or 2 days a week, trying not to go over the limit. I'm using the other days of the week to study, do assignments, read, etc. The patients here have seemed very accepting of me and my preceptor says she hasn't gotten any complaints about having a student take care of them, and she says that's amazing. She asks every now and then when I'm graduating; she has two open positions at the birth centers. So we shall see....
• I did lots of traveling in October. Sadly, I lost a dear friend (86 years old) who was like a second dad to me since the time I lived in Tulsa, OK. He fell down his basement stairs, hit his head, and went into a coma, from which he never awakened (on this earth, anyway). I took off driving from Muncie to Tulsa October 7-8 to be with my second family, and was astonished to see how I really missed Tulsa and its people. It was my first time back there since moving back to Charlotte 4 years ago. I was able to take my harp and play for the memorial service and for church the next day, then left the following Monday afternoon to return to Muncie. Though tired, I repacked on Wednesday and flew home to Charlotte on Thursday to celebrate my mom's 80th birthday and get winter clothes. I flew back to Indy on the following Monday...and my body proceeded to let me know that was "quite enough, young lady"... had a raging case of hay fever last week...should have bought stock in the Kleenex company! I've rested a lot this week, and in a few hours, it will be time to start my clinical sessions again.
• I've watched the births of two babies so far one in the hospital and one in the birth center, but haven't yet "caught" any myself...my preceptor thinks that could possibly happen this week! Stay tuned....