My Reflections of 2009

Another year is coming to a close... in fact it is the last day of the year....it has been a very busy year....I often forget how busy the year was... until I look back at my diary and see all the entries and everything I have done and wonder how the hell I fit it all in and remain sane.... when I review my blog for the year I have 53 entries as compared with 57 last year..and my viewer rate has increased but my viewer comments have declined...I am not sure how to interpret these results..to say that I blog out of interest and to widen the scope of information for women. An objective for next year will be to blog more often and tempt more reader comments....any tips on how to do this are welcome...

Highlights this year... making Isabella's christening gown, Ian's 60th birthday in Malaysia & getting a par, Ben & Peta's wedding - Bali, presenting at the Adelaide ACM Conference, then having a Midnight snack at McDonald's with Heather...getting the house to myself (daughter moved out)....more romantic time with my husband...getting an iphone...
Low points: Ian not being well....damaging my iphone....not having enough time to myself....

Work has been challenging but exciting and next year proves to be even more so challenging with a new project a foot the 'iportfolio'. This will mean engaging the nursing & midwifery students to move to an electronic portfolio and the introduction of a new curriculum, so lots of work ahead. I am also looking at the Second Life birth unit in more depth so as to engage the midwifery students, I am hoping to get some help from Sarah Stewart who is the expert in this area.
I hope to continue working one day a week clinically, however with my teaching commitments sometimes this is difficult and I really do not want to eat into my weekends.

Big changes for our profession in 2010 with National Registration and Accreditation Scheme -National Registration due in July and also MBS & PBS changes later in the year ....it is very important for all Nurses and Midwives.... I will be keeping this blog up to date on all these issues....definitely watch this space

The biggest decision I have to make is whether or not to continue with my PhD which has been on hold this year... whilst I completed the Graduate Certificate of Tertiary Teaching which I have now done.....yeah.... I ask myself do I want to keep studying and strangely when I don't study I get withdrawals I crave more knowledge and get bored from not studying....but do I have the devotion of a three year lonely road of a PhD? I am not sure.... will have to ponder on this further..... so watch this space....

On a personal level, the three eldest grandchildren are at Kindy, pre-school and school this year where do the years go..... it will be no surprise to find that we may be expecting to be grandparents again for the 8th time. Dylan will be going to have his tonsils out in January.... so that will be traumatic....thankfully only for a short period. As for my husband I am hoping that we both win the battle of the bulge this year and work hard at losing weight and reaping the results of lowering our blood pressure and being healthier....so lots more physical exercise in 2010....

For me 2010 is already looking busy and travel plans are being made.... with in the first 6 months.... it will be Sydney, Singapore, a friends wedding in Margaret River, and Alice Springs ACM Breathing New Life into Maternity Care 2010.... and of course my major highlight is saving for the ICM 29th Triennial Congress Durban, South Africa 19 - 23 June 2011, so I am hoping not to do to much travelling in 2010 and not to spend too much money this year....

"How to weigh yourself and get the most accurate result. I can't believe I have been doing it wrong all these years".

Ref picture:http://getguid.files.wordpress.com/2007/09/diet-scales.jpg

My Key Aims: Be more healthy... walk 5 out of 7 days for 30 mins. Find some quiet time each day: laugh every day, and eat smaller portions...... the rest I will make up as I go.....Enjoy & be thankful in 2010.... Be Happy and Safe.

My Christmas 2009

Christmas is always very special for me....I just love it...as a child my experiences were mixed and really depended on what sort of report card I got as to how good my presents were. I remember clearly the year I found out the Father Christmas was not real. It was my own curiosity that got me and ever since then I always secretly wished Santa was real.


Now I go all out to enjoy Christmas and ensure that my family and especially the grandchildren enjoy Christmas..... no expense spared. I hired a Santa suit for the first year we had grandchildren and when I saw what a hit that was I bought the suit because I knew we would be using it for the years to come... this has been the third year Ian has put on the Santa suit... I must say I think he is finally resigned himself to the task... and I get my wish come true that Santa really does exist.


Dylan sent nanna to the naughty spot for kissing Santa Claus.....

I usually start by buying the grand kids toys in the July sale and lay by them for the next 6 months (easy storage) and pick them up Christmas week... and then get the wrapping done...because life is so busy the Christmas cake usually doesn't get done until a few weeks before and baked the week before... it still tastes good.



The menu gets sorted a week before Christmas and the turkey & ham ordered at that time.... I usually change the side dishes each year.... our Christmas is usually in the late afternoon early evening allowing the children to visit the in laws in the morning or lunch time.... This year we did discuss having Christmas somewhere else at one of the children's houses... but I really enjoy the whole ordeal and while I am young enough and able I want to continue the tradition....there will come a time when we wont be able to do it then it will go to the children to organise but not for a few years yet......God willing.


I am one to those obligatory Catholics the Easter and Christmas ones.the twice a year jobies.. that just can't give up those days... as they are so entrenched into my Psyche I cannot go without my fix of Christmas Carols. Speaking of Christmas Carols I usually like to go with my daughters and grandchildren so that they too can get a spiritual sense of Christmas by attending the Carols.



It is so much fun having all the family together... usually this is the time when somebody gets upset with somebody but no we had a brilliant time everyone had one thing in mind enjoying the moment..... and it was tremendous.... a ball was had by all.
There was presents galore... I do think the the children get too many toys... I think we will have to come up with an idea to buy the children not just toys but maybe some practical things for the year such as clothes, shoes, etc....the back garden looked like a toy shop... I am sure all the kids were delighted....

As for me my report card must of been good because I did very well with presents...books, DVDs, chocolates, jewellery, photo frames.... yes I have been spoilt... I have started reading Ian Smiths memoir - Bitter Harvest (Zimbabwe and the Aftermath of its Independence......very interesting...


We have entertained almost everyday since Christmas... having pool parties using up all the leftover food with all the kids and several of the grandchildren have had sleepovers... I think it is time for us to have a rest.... just the two of us now...before the New Year...... I need time to contemplate what my goals are for the coming year....and whether to proceed with my PhD.........

Challenging clinical shift..... a reflection

On first appearances the board looked OK...(and what is the board?...it has every ones name on in the ward so you know the occupancy & whats what at a glance)... it always seems OK when its not completely full. However we all know looks can be deceiving and the acuity of the patient load is not measured by just bed occupancy. Its always good to work with a great team.... because as we know this makes life much easier... and we were all run off our feet. There were three Cesarean sections that afternoon... one after the other... of which I had two... here's an ethical question for you? should women be able to choose to have an elective Cesarean Section (C/S) at 38 weeks? it was an uneventful pregnancy... and at birth the baby is diagnosed with Respiratory Distress Syndrome (RDS). Neonatal Respiratory Distress Syndrome is a common breathing problem in premature infants. Did you know that babies have 12 times higher chance of developing RDS from an elective C/S @ 38 weeks... I wonder if the woman knew this fact before making her decision?

After birth, newborns with mild respiratory distress syndrome may require only supplemental oxygen. Newborns with severe respiratory distress syndrome may require oxygen delivered by continuous positive airway pressure (CPAP)—a technique that allows newborns to breathe on their own while being given slightly pressurized oxygen or air given through prongs placed in both nostrils). In newborns with severe respiratory distress syndrome, a tube (endotracheal tube) may need to be passed into the windpipe (intubation), and the newborns breathing may need to be supported with mechanical ventilation. This would also mean the baby would need to be transferred to a teritary hospital that can provide the staff and care for the infant. This baby was intubated and transferred by the NETS team.... I then spent time reassuring the mother that all would be well, fortunately she was going to bottle feed which therefore meant she did not have to express her milk and send it to the baby hospital. Later in the evening she told me that the baby was doing well and may only be intubated for 24 hours.

My other challenge was looking after a profoundly deaf woman who was not well after the birth... she also had a multitude of complex social problems... I was walking past the room to the loud cries of a baby, walked in to find the mother fast asleep and the screaming baby...this really bought home to me some of the issues confronting both the mother and baby... I picked up the baby and settled it back to sleep.... later I watched dad (who is also profoundly deaf) change the babies nappy.... he was vigorously wiping the baby's bottom and the baby was screaming... not once did he look up to watch the baby... I realised how much education was required.... and spent considerable amount of time talking slowly and clearly so that he could lip read my advice... however you could only do short periods at a time... he appeared to get bored with it all.... they are a young couple whose parents provide a lot of support and help which this also creates a problem. There are baby monitors for deaf mothers... that alert the mother & father to the crying baby... and of course it is important to be constantly looking at the babies face for its expressions...

Family dynamics are always intriguing, we as midwives get to observe them and this can be fascinating. Mother - daughter, mother - son, and then there's the in-law relationship. When there is a disability this then also puts added strain on the relationships...... due to the autonomy of the client and the need to be autonomous... as a parent they have to learn to allow them to make their own decisions... this happens in all relationships.... this one was particularly difficult on all counts....

It was interesting for me... usually when you are in a room there is the noise from the telly or people talking... however this room was silent especially when the baby was sleeping... I was kneeling to empty the catheter bag... it was quiet in the room...the IVAC started to alarm... but my hands were full so I couldn't turn off the alarm.... it was a piecing noise nobody in the room heard it...it must have been going for a few minutes when another midwife entered the room to see what the problem was... she was surprised to see me there and said "can you not hear that alarm?" I laughed and said my hands are full.. couldn't turn it off and I was amazed that the sound was so annoying could not be heard by anyone in the room but me....this experience gave me a small insight into what there life might be like... one I would not want. Fortunately for this young woman she was breastfeeding like a dream.. she had a good milk supply and enjoyed feeding.....I was confident that the baby would not go hungry and at least its crying would be for other reasons... other than being hungry, a small consolation. As you can imagine I could spend my whole shift just with this couple providing them with care and education but alas I have four other clients to share my time with.

On entering another room, I was amazed to see the woman, baby and partner all huddled in the bed together...the partner was almost lying on top of the baby... I said good afternoon and suggested that it was not a good idea for them all to be lying in this small bed and almost covering the newborn baby.....the partner was upset and said "I'm not sure its my baby..." to which I responded... well whoever baby it is, it is not good to all be sleeping almost on top of the baby... the mother responded by saying... he's joking... it is his baby" at this point I wondered why did I come to work today..... as my shift was turning into a shambles.... a baby with RDS, two day 1 cesarean sections, a deaf couple and a man who didn't know if this was his baby... and I wondered how the rest of the shift would go as I had only met half my patients.....

A bell was ringing..... then a man shouted in pain.... I thought what the hell is that? a few people gathered in the corridor... we are used to women yelling but not a man.... I entered the room to find a man doubled over in pain.... now I really wondered what am I doing here....after making a quick assessment and asking a few questions, it turns out he had injured himself a few days ago and had not been to the doctors and the pain just got worse...his wife had just had a baby yesterday... so as we are a maternity hospital we packed him off in an ambulance.....lesson to men... if you have injured yourself and have pain go to the doctors, it will only get worse if not treated... and if you don't want to go to the doctors, don't visit your wife in hospital.....and complain of the pain you have....

My other cesarean mother had so many visitors I could not get into provide the care required with all the visitors who did not want to go and the mother did not want them to go..... this baby was not ready to breastfeed and they both needed lots of time and education........

could my shift get worse.....with breastfeeding issues...IV antibiotics, complex family issues.....pain relief requests...resiting IV cannula....just the normal run of the mill... everyone running around busy.... it must be the first time I have been late off finishing because I have to write up my client reports..... I must be slipping or I was so busy I just never got on top of things.....it was a matter of doing what was most important first.....but the bells kept on ringing.... could of done with another pair of hands.....

Its funny I always tell my students.... you must make sure you document contemporaneously...which I did at the bedside but not in the progress notes... for me this was the shift from hell...everyone was of late.... it goes to show you that if your client acuity is high you will fall behind in managing your load. It will just take one client to have breastfeeding issues or a complex social problem and you are out of whack....

What would I do differently next time.... probably keep more up to date with my client progress notes.... I could have made time to update each one as I dealt with their issues rather than at the end of the shift... ask the visitors to leave after an hour....and not engage with the complex social issues....easier said than done... profoundly deaf people need a lot of one on one time for communication purposes... I would re-organise the work loads... however there just was not enough staff... so much for the governments 3% cuts.... it comes off at ground level.... just not good enough....

Yes I had a double scotch when I got home........

Besotted with Grief

Today I attended the funeral of a 27 year old colleague who was a former graduate of mine with whom I had developed a professional relationship with over a period of time. I feel extremely saddened and completely perplexed by the whole ordeal. There were family, friends, acquaintances and work mates present and there was not a dry eye in the place.....everyone enmeshed within their own feelings of grief & saddness.

Her father gave his eulogy starting with "No parent should see there children die first" How true is this? as a mother & step mother of 6 children and 7 grandchildren I pray to see them grow up healthy, independent, happy and able to contribute to society in a meaningful way.... I certainly want to die before them and God forbid I should have to do what this man had to do today...

As a parent you raise your children and hopefully give them the tools and skills to deal with the issues of life, you get them through the teenage years with all the trials and tribulations , the tears, tantrums, laughter & joys and then they are deemed adults..... now they make their own life decisions with maybe your guidance or not.... then you step back and watch... this at times can be very painful.... because you cannot stop the mistakes they make..... just as my mother could not stop me... it was my lessons to learn. You can only be there as the shoulder of support. However this does not stop it from hurting or being painful.... because you love them so dearly you want their life to be perfect or less painful.

Such a young life gone....for what.... for making the wrong choice at the time....her father went on to say " as you lay on the foot of my bed sharing your day talking to me... then kissing me on the forehead as you left for work....I had no idea that I would never see you again". His pain was palpable.... it broke my heart... I tried to put myself in his shoes just for a moment and the pain was too much.....How tragic... as a parent you do your best... but sometimes it is hard to see the forest for the trees.... her mother had passed away a year ago and.........Grief can be so debilitating and depression can be so desperate & bleak that you are unable to make the right choices....it is so hard to know why things happen and we may never know the answers.... but hopefully some lessons will be learned.

For me as a parent I pray never to have to bury my children or grandchildren and that when it is my time to die that my children will accept my passing and celebrate the life I lived and move on with their own lives finding comfort in their strenghs and resilience, knowing that i will always be in their hearts.
Elisabeth Kubler-Ross wrote that "you will not grow if everything is perfect. But pain is a gift with its own purpose".

Life is a responsibility...hopefully we make choices based on what is in our hearts as the right thing to do....life is full of choices we just have to know which one to make.........


I am thankful for the lovely companionship of a dear friend after the service.... sitting in the coffee shop.....dissecting the funeral, chewing the fat.... solving the worlds problems... laughing, crying...laughing.... and finally I don't feel so bad that my office is complete chaos and I have not managed to clean it up....after she described her sewing room...I was laughing so much I felt better...I think my office is not too bad..... thank you my friend.....friendships are so important...

Depression is a serious illness, it is not just about low moods, or just feeling sad or stressed....that happens to us some of the time... it is about not being able to function as you used to....not being able to sleep at night....increased drugs or alcohol.. a complete list can be found on the Beyondblue site...if you know someone who may need some help guide them to seek some help even if it is taking the first step of looking at the site and doing the Interactive Depression checklist... its simple and they can do it themselves... then guide them to seek help. Depression is no different to having a serious heart condition, diabetes or hypertension.... it needs treatment... so that people are enabled to make the right choices.....

The blogfrog..... looks good

Hi All,

thought I might try the blogfrog..to increase my readers / traffic... all you have to do is sign up: all you have to do as readers is to link your blog to mine, or sign up for TheBlogFrog. Just follow the instructions on the widget.... it is fun...

The other resource I have just discovered is Diigo.... can't believe I have not seen this before... for me who is always surfing the net and finding interesting articles and storing them on my hard drive...now I have a resource library, you can highlight, make notes.....and save them all in your library. I can build and then share with my friends and students... just brilliant..
Have fun.....

A woman.......

A friend sent me this email.... I thought I would share it.... it rings so true...remember the old saying "many a true thing is said in jest" well this is it...

"Whatever you give a woman, she will make greater.
If you give her sperm, she'll give you a baby.
If you give her a house, she'll give you a home.
If you give her groceries, she'll give you a meal.
If you give her a smile,she'll give you her heart.
If you tickle her fancy she will give you an orgasm.
She multiplies and enlarges what is given to her.
So, if you give her a bit of crap, be ready to receive a ton of sh*t."

I just love it...... enjoy life it is too short....

Sudden Death...... unexpected death.... when it happens to someone you know...

Death is final... yes we all know this, but when it happens suddenly and unexpectedly it rocks you to your core.... I am shocked, saddened, devastated that a young soul is lost in such tragic circumstances... a former graduate midwife of mine passed away yesterday....I just can't believe it, taken in the prime of her life.. the first I heard was on 'Facebook'..... this raises the question for me, is this appropriate?

I have to say all the comments were dignified and professional.... however not 24hrs had passed.... for me this was to short a period of time... it is not a criticism but an observation... that with this new medium of communication that is instantaneous...and very public.... sometimes we do not have time to contemplate... its there in your 'face'. I wondered if all her family and friends knew before seeing it on Facebook? I am sure her direct family would know but as for all your friends that's a different story....

Death is always hard to understand... but a sudden death is very painful, it seems inexplicable....you are constantly questioning, wondering, thinking, reliving and speculating is there anything that could of been done to prevent it... but alas there are no answers.. it is time to unite and support each other and be thankful for the life you have...Communication is very important in these situtations to stop speculation and rummors... but that also needs time... time for investigating and reflecting.... This time of year makes it worse... Christmas, a time for celebration and families...

The loss of this beautiful talented young women's life has made me think how grateful I am for the life I have and my wonderful family, friends and work colleagues... it is a time to reflect......

"Rest in Peace Hayley"

ref picture www.mythinglinks.org/ct~ritual~death.html

Teaching Nursing Ethics & Law – Singapore

It is great when you are passionate about your job/work because you give it 110% and it is so satisfying. I consider myself so fortunate to be able to go to Singapore every year to teach post-graduate nursing students an ethical and law unit. However in doing so I appreciate the enormous cultural diversity that Singapore has to offer and learn something new about myself, each trip. This year I was particularly tired and needed some time to recharge my battery. I know that seems a contradiction of terms, 12 hours of intensive teaching and time to recharge.... well it is about spending time doing what you love and doing what you want to do.... without fear or recrimination...... not having to please anyone except yourself.....it’s about finding a balance.


Strangely as a mother, you are always a mother you are never considered ‘anything else’ as you have roles and responsibilities within society. I find when I go away...... I can be ‘whoever I want’ time for ‘me’ without having to be anyone else. Don’t get me wrong.... I am enormously proud of being a wife, mother, nanna, and miss my family immensely when I am away, but miss being able to express me as ‘me’. I think that men get the better deal..... Because even if they are a father, it does not change how they are viewed within society.....they seem to be considered the superior sex and why because they are a man.....They seem to be able to do whatever, and it does not matter if they are a father or not.... they are just ‘men’. I am sure as hell going to come back as a ‘man’ in my next life.


I love the life style of Singapore.... it’s a vibrant clean city, with a low crime rate, taxis are like getting into a freezer and the people are polite. The choice of shopping is enormous and the shopping hours are extended late into the night.... as opposed to Perth’s draconian shopping hours & choices.


Singapore is a mix of an old colonial world (The Raffles Hotel for a Singapore Sling at extortionate prices but it has to be done, of course not a Singapore fling) and a modern city with a great MRT (underground rail system)...... the contrast is staggering at times and it’s such a romantic city, I can imagine a clandestine liaison happening, something straight out of a Barbara Cartland book... Singapore at Christmas time is beautiful..... Ian and I spent a pre Christmas here a few years ago... and this time it was even more beautiful... the city is lit up like a Christmas tree.


There are many, many temples, of which this trip I only visited one the ‘Buddha Tooth Relic’ Temple...... it has to be one of my favourite temples....spending time quietly sitting, watching, reflecting and admiring the exquisite beauty.
China Town is another favourite, with its bargains, massages and outdoor eating....


The Intercontinental Hotel is sheer indulgence..the staff are excellent... one more mix of old and new world Singapore...... having room service, is just sheer luxury..... And I love it.... Breakfast in the Olive Tree Restaurant with Mr Wong cooking your eggs just how you want them..... Watching business people wheeling and dealing over meals.... it really is a different world. I have to say the only thing I really dislike is the Humidity...... I don’t know why I put make up and blow dry my hair in the mornings because as soon as I step outside it’s like my internal body temperature turns on a tap and I am dripping wet...... not a good look.


My favourite shopping centre has to be Takashimaya and the Kinokuniya bookshop.... I also found the Harrods store in basement 2 of the Takashimaya Fantastic..... Ian will be disappointed..... Major purchases this trip....... pearls magnificent pearls...... couple of books both work and pleasure....kids silk dressing gowns. and a couple of electronic gadgets..... Not much really.


I get great satisfaction from teaching.... however the proof will be in the pudding when the assignments are ready for marking. Most of the students are enthusiastic, try very hard, and they work hard, I do admire the fact that they work full time and then come in for their classes after work or on the weekend for the lectures. I had a good uptake of students considering it is not compulsory for them to attend. It is challenging teaching professional issues, (ethics) in Singapore; there are several issues to be mindful of... namely different values and morals. Also fundamentally the attitude is ‘doctor knows best’ and nursing is viewed as a subservient role..... My aim is to empower the nurses to be evidenced based and not to be afraid to stand up for what they believe is right, to advocate for the patient together with empowering patients and not be paternalistic in their care. I managed to also visit a couple of hospitals this trip.... watch for the next blog....