Oh my. You’re a midwifery student and clinicals/apprenticeships are finally in sight! I’ve been precepting nurse midwife students for five years now and have noticed some trends along the way amongst the midwifery students. In that vein, I’ve decided to write a list of the things I keep saying over and over to my students in the hopes that others can benefit and better prepare for clinicals. Additionally, I have found that not all preceptors are strong preceptors – so, if you have had a preceptor that is less than outstanding – take this advice to heart, and know that there are many preceptors out there that absolutely love precepting and teaching. I know every one of these tips benefited me in learning the art of midwifery – hopefully you’ll feel the same.

Show up prepared

This is my number one recommendation. To me, how a student shows up to clinicals speaks volumes. Are you 5 minutes late? Did you prep for the patient schedule? Did you schedule a doctor’s appointment in the middle of your clinic day? Did you bring your resources (both on paper and on the internet or apps you use)? Did you bring your stethoscope and a pen? And lastly, did you bring a good attitude? Show up early, be prepared, plan to stay late, and bring good snacks (and coffee).

Set goals (both by yourself and with your preceptor)

Goal setting is my number two recommendation. You have to know where it is that you want to go. Sometimes your midwifery programs are helpful with this…and sometimes they intentionally are a little vague. Your preceptors are good at guiding you towards your goals as well, but at the end of the day, your success falls on your shoulders. Your goals can be simple (i.e. I want to repair a second degree laceration independently; I want to place 5 Nexplanons…). If you adopt this goal mindset early in your learning, you’ll go farther than you could ever imagine.

Expect hard work

I tell people all time – midwifery is an amazing career, but the job itself is often lonely and hard. People tend to think that all midwives do is catch babies. That would be lovely to catch babies all the time, but I think it would also dampen the excitement of when we do get to go to a delivery! Midwifery school is long and hard, but it is so worthwhile. Expect the difficult days and enjoy the easier days. Don’t let one hard day bring you down. You are learning a new craft; recognize this takes time, patience, perseverance and hard work.

Suture, suture, suture…then repeat

Learn to suture; then practice, practice, practice. Remember the first Grey’s Anatomy episode where Cristina is sewing a banana peel for something to do? That’s the idea we’re going for. Use a Nexplanon insertion arm, a chicken breast, a foam pad. Something! Just start sewing. Do not wait until your first day of clinicals to hold a needle driver and a suture. Order a set, borrow a set. Better yet, work with a colleague – a doctor, physician’s assistant, midwife – that sutures and have them show you a few tricks.

Master knots

Schools will teach you how to tie a surgical knot. Practice will teach you how to tie knots one handed. This is one of the most valuable thing a you can teach yourself before or during school. There are countless times that my hands are tying knots by muscle memory and my eyes are looking at the patient or the nurse to tell them something important about the plan of care. Do a simple YouTube search for single handed knots…watch the same video 25 times in a row, then keep practicing.

Give grace

Give yourself grace. Midwifery is a hard trade to learn and it takes years to become an expert at the trade. Some days you will feel like you don’t know anything and that you did everything wrong (this feeling still occurs long after passing your boards). Give yourself extra grace on these days. Remember all of those people (family, preceptors, faculty, friends) that helped you get to where you are; remember that we are to walk with women through their births, pregnancies and life. Don’t forget to give these people grace too.

Learn to ask for feedback

Giving and receiving feedback is difficult for most people. One of the most difficult aspects of receiving feedback is to keep your mouth shut and actively listen. The second most difficult thing is to apply the feedback that you were given. Feedback should always include your assessment of your strengths, weaknesses and areas to improve. Sometimes strengths and weaknesses are equal within a clinical day; often times they are not. In addition to asking for and applying feedback, learn how to give feedback yourself. Precepting is a learning and teaching opportunity. Each preceptor should strive to improve how they precept with each student interaction, and often times, each student needs different things from their preceptor. Approach these times for feedback with respect, patience and gratitude.

Journal

Learning to be a midwife is awesome. It’s like someone gave you a new pair of glasses and you can see the world more differently and clearly than ever before. Capture these moments to read for decades to come. Go buy a pretty new journal and pens, and try to write your stories down each week. Better yet, keep journaling long after you graduate. You won’t regret it.

Expect homework from your preceptor

A mark of a good preceptor is an individual that doesn’t give you every single answer. In clinical practice, the provider looks up information – ALL THE TIME. And sometimes, even after looking at the guidelines, evidence, case study, and the textbooks, you still have to phone a colleague. That is the nature of medicine! If you or your preceptor stumble across something that you don’t know well; don’t know the most recent literature or guideline on; or you just want to engage in a good case study about one of your patients – take the initiative to say you’;; look it up and report back!

Give thanks

Students, I hope by this point in your careers you’ve had the chance to precept another nursing student or colleague. If you haven’t ever precepted a student, I highly encourage you to seek out an opportunity to do so – precepting will only make you a better student. I mention this important facet of your experience prior to coming to clinicals because your preceptors are working very hard to teach, support and mold you. We often stay late and show up early to accomplish extra teaching or capture an additional learning opportunity for you. Don’t overlook this hard work. Thank you preceptors often and do not overlook the time, care and encouragement they are giving you.

Show up and smile

Yep. The last one is that simple. You can do everything recommended on this list but you still have to show up! The smile is extra – but it’ll make you and everyone around you feel better.

What tips do you think helped you through nursing school or midwifery school? Do you think you were prepared to start clinicals – why or why not?

Jamie