Latest Comments by LibraSunCNM

LibraSunCNM, BSN, MSN, CNM 20,521 Views

Joined Jan 24, '08. LibraSunCNM is a CNM. She has '9' year(s) of experience and specializes in 'OB'. Posts: 861 (66% Liked) Likes: 3,336

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  • 0

    I know we've talked about the subject of DNR tattoos before, but I still found this article interesting:

    When A Tattoo Literally Means Life Or Death : Shots - Health News : NPR

    They luckily made the right call, and found that the patient did have an actual DNR on file at home when they identified him.

    I had honestly never thought about states creating online databases for POLSTs (mentioned at the very end of the article), but it seems like such a simple and useful idea I don't know why more states haven't adopted it.

    Just some food for thought, happy Monday everyone!

  • 23
    Surprised1, RA0224, cutiepie2012, and 20 others like this.

    Quote from EGspirit
    Why in our profession are we always running away from the bedside? I mean, why be in the profession?
    Because by and large, bedside nursing is backbreaking, sometimes demoralizing, and often underappreciated work. It is also work that has drastically changed over the course of a generation or so---even more physical as patients got fatter and sicker, even more complex as healthcare technology continues to evolve and patients live longer, and even more soul-crushing as patient satisfaction has started to be viewed as more important than actual patient care. Keep complaining if you like, but nursing has greatly evolved to be so much more than (but certainly still inclusive of) bedside nursing.

  • 7
    TitanGal1996, ctdfmags, psu_213, and 4 others like this.

    Quote from Emergent
    Fox seems to be the most sensationalist of the major outlets.
    Seems to be? I think that ship has officially sailed and become "is" as evidenced by the current occupant of the Oval Office.

    The CNA/RN thing annoys me too but there's nothing much we can do about it.

  • 6

    Quote from Kooky Korky
    Old fashioned here

    Hospitals could go back to the old diploma style of nurses' training. A hospital ran a school of Nursing, the
    students got lots of hands-on experience in the various specialties, and many of them hired on after graduation.
    There were 3 year programs, later shortened to 2. I think there are only a couple of diploma schools left in the
    US, if any.

    I was a diploma grad, got my BSN a couple of years later, many years later got the MSN.

    The BSN did help me learn to do physical exam but only working at the bedside helped me hone my skills, time
    management abilities, leadership, and clinical knowledge.

    My employer paid for most of my tuition and gave me a raise once I had the BSN. It was quite novel at the
    Hospitals *could* go back to that "old" style of training, but there is no financial incentive for them to do so, so I wouldn't hold your breath.

  • 3

    Quote from FSZ Student Nurse

    Thanks for catching that! I actually wrote a much longer reply, but then I made it more succinct... and less accurate.

    I believe a BSN is important for nurses in management positions and helps them develop policies that are appropriate and research-based, communicate with other departments and administrators and manage effectively. I think that "research, communication and leadership skills" are useful for all nurses, bedside or otherwise. However, these skills are covered - albeit with less detail - in ADN coursework; a BSN is not the only path to learn these skills. It's the extra coursework in the BSN related to these subjects that I don't know is necessary for all nurses; although, I'm sure it is HELPFUL.

    Slightly off topic, but I was excited to see you're a CNM! I'm only a first year student, but that's a strong consideration of mine. Feeling a little star-struck...
    Thanks for the clarification (and no need to feel starstruck haha). I hear what you're saying and can agree somewhat, I just get saddened by hearing nurses attack higher education in nursing. I feel like some people just aren't willing to accept that the profession is changing. That being said, I completely understand that the ADN serves a very useful purpose for a lot of people starting their careers, and that there are a lot of problems with nursing education in general, and many BSN programs in particular. I also agree with the general topic of this thread that the predicted "nursing shortage" is a complex topic.

  • 5
    subee, AJJKRN, ICUman, and 2 others like this.

    Quote from FSZ Student Nurse

    Most BSN level courses are focused on research, communication and leadership skills. Great for management, useless for the bedside.
    Research, communication and leadership are USELESS for the bedside? Do you really believe that?

  • 6

    Quote from Tacomaboy3
    I have several things to say:

    Firstly, you're comparing me to Trump? Seriously? Lol. Additionally, your "that's cute" and "honey" comments are passive aggressive -I don't get it. Why are those comments necessary? To passively denigrate me? It's unprofessional, but I suppose the anonymity of an online username gives you great courage. Bravo! I prefer liquor, but at least I don't turn mean.

    Secondly, you said nurses don't see returns on their educational investments. I kind of get what you're saying, but your statement isn't the most accurate. Wages/salaries for bedside RNs, regardless of degree, are fairly similar within institutions, but a BSN or higher greatly increases your income potential - whether it's leaving the bedside or transferring to a higher-paying hospital while still at the bedside.

    Thirdly, I'm unsure why you brought up the history of nursing and telling me to brush up. Hm okay, I will? But, registered nursing is still a profession.

    Fourthly, I never said in my post that BSN-opposers should shut up and drink the poison...nor all that other rambling you did. I think you misinterpreted my post. If RNs are content with their jobs and plan on retiring in the same role, all power to them - a BSN certainly won't help their pay or clinical competency. But, I also feel that the culture of nursing is changing, with fewer RNs retiring at the bedside and fewer RNs staying within the same department or employer - a BSN gives them flexibility to move around and augments their competitiveness for higher-paying jobs. It's not imaginary employment. That's like calling Warren Buffet a fool for investing his money in the stock market, all for the sake of future imaginary payoffs.

    Perhaps my original post was lacking in brevity. This is what I meant - a bachelor's degree in nursing has NEVER been about increasing one's clinical competence, which is why it seems a bridge program is filled with useless classes. But, if you want future career flexibility and better income potential, then pull up those panties and take those seemingly useless classes. Whether it is personally worth it is up to the individual's circumstances.

    Additionally, you ABSOLUTELY DO NOT have to accrue massive debt for a BSN, so I don't get your martyrdom analogy. And if you do, then it's your fault, and no one else's. Personal finance and awareness is a great skill.

    I'm not yet for a mandated BSN. And until it is, I likely will never get one.

    Now, go change out of your soiled big girl panties, please.
    Thank you for your sane, rational reply! Couldn't agree more. If you don't want to get a BSN, don't get one. If you've got an ADN, found an area of nursing where you're comfortable and a BSN truly won't be of any benefit to you, then more power to you. But to deny that that is where the profession is headed, and to claim that furthering one's education in nursing by involving loosely-related topics or courses, rather than sticking strictly to hands-on tasks only, is "fluff" or a waste of time, is just stubbornly keeping one's head in the sand, IMO. The nursing profession is rapidly adjusting to meet the growing needs of an ever-changing healthcare system. This includes a push towards more education for nurses. Adapt or die.

  • 0

    Quote from Allison T
    I too was the pioneering CNM at a hospital. I was on call virtually 24/7. My plan was to gradually persuade management to hire another CNM. I did ultimately succeed with that. However, our service got shut down by the CEO a short time after we hired the 2nd CNM.
    I am an experienced midwife (and state affiliate leader) who has heard many, many sad and abusive stories from midwives who started midwifery services at hospitals. One thing to do is really thoroughly research the hospital, the CEO, and the OBs. For example, I have seen hospitals hire a CNM to start a service, then fire the CNM when the local OBs get threatened. Then a few years later, with the OBs complaining about the workload, the same hospital again hires a CNM (who is unaware of the history). You may learn some helpful things from the state ACNM affiliate members and/or other APRNs such as NPs. If I had done my research, and seen how the hospital treated NPs (like they were disposable), I wouldn't have gone there.
    It is essential that the office staff understands you and midwifery. If the person answering the phone says "Do you want to see the doctor or just a midwife?" it is not good.
    Another tricky thing is that you are not really a midwifery service if you aren't 24/7. How will your patients feel if they come to a midwife for prenatal care and get a non-midwife at their birth? When you are the sole midwife at a hospital, it is inevitable that this will happen.
    Many, many hospital administrations do not understand that midwives labor sit. I would get phone calls asking, "Can't the nurse or the monitor watch the patient?" In fact, I was trying to get to the place that the nurses would be at the bedside (or birth ball side, LOL) with the patients so that I could stay in office a bit longer, but I lacked the support of administration with this. There was no nurse training unless I provided it, uncompensated, and with no one stepping in to help with my other other duties. And this in a state that provided nurse training in Lamaze childbirth techniques, lactation, and other relevant topics at a huge discount for nurses.
    So make sure that admin understands this about you (if indeed you do plan to practice "real midwifery" and be with your patients in labor). You have to be willing to either reschedule people's prenatal or GYN visits, or have your office colleague (MD/DO or whoever else you are working with) see the pts if you are at a labor/birth.
    I do recommend monthly team meetings (CNMs/CMs, head L & D nurses, OBs, CEO or maternity service leader) to ensure everyone is on the same page. We had these, but because the CEO was essentially off his rocker, they didn't work well. However, in general they seem a helpful concept.
    Good luck, and I hope you do your research.
    Thank you so much for sharing your valuable experience. I haven't been that pioneering midwife before, but I suspected that a lot of the issues you described are what the OP might come up against, I just didn't know how to reply that! I hope you are in a better situation now, and my hat is off to all of you who fight the fight to get midwifery care into places where it's never been.

  • 5

    Quote from klone
    I recently had a woman call our unit to ask if she could bring her Chihuahua in when she goes into labor, as it's her emotional support animal and would help her with breathing during labor.
    Lol! "Yes, yes you can have your dog your home birth."

  • 3

    Also, the quote feature is your friend Go to the specific post you want to reply to and hit the quote button on the bottom right-hand corner.

  • 5

    Quote from pixierose
    You sound very kind, VM.

    I had that type of shift last night.

    Except it was with an ice cream sandwich.

    And the patient kept ringing that call bell ...

    And I couldn't get that sandwich fast enough for him ...

    So he started hollering every 2 minutes, "I wannnnnnnnnnttttttttt thatttttttttt sanndddddddwichhhhhhhhhhhhhhhh!!!!!"

    And I practically sent that sandwich sailing in the air toward his versacare ....

    VM: kind and compassionate

    Pixierose: ready to bolt out the door have ICE CREAM SANDWICHES for patients at your hospital?! I would be obese within weeks!

  • 4

    Working, hands down, particularly if you're working the night shift (unless you're one of those lucky people who thrive on nights).

  • 2
    JanineKelbach and rn1965 like this.

    Oh my goodness! I'm so glad the patient and her baby were OK in the end. You're so right, AFE is one of those ultra-rare, terrifying events you know you may see once or twice in a career but just pray that you don't. Strong work!

  • 0

    Quote from novice7
    Hi biggolp1,

    Not to burst your bubble, but I am dealing right now with the very concern you have. I graduated in 2001 from Frontier University (which at the time was not a University yet, so only offered a CNM certificate) and chose to do my Masters at Philadelphia U. for a Masters in Midwifery. At the time I never considered moving on for a DNP or EdD which is what I want now.

    I practiced as a nurse (BSN) from 1991-2001, then as a MS CNM from 2002-2013, then did some L&D nursing again, and most recently took a job as a Nursing Instructor in an ADN program. They did ask if I had a MSN and I said no, because it is not. They accepted the MS because many places matriculate a Masters in Nursing as just a MS. (also, I clearly had the credentials, etc. needed). I have looked into pursuing first a DNP, and now a EdD, and I can tell you, it has been extremely difficult to get accepted anywhere. They all want that MSN, and they do not consider my MS in Midwifery to be equal. I am not interested in going back for a second masters degree, so for now, I am stuck. When I send emails and inquiries, I either get short, "We cannot accommodate you" type answers, or none at all. Since I was in Class 2 of the MS in Midwifery program at Phila U. I would love to know if any other grads have completed a terminal degree, and how/where they did it.

    Be sure you have all the facts before you get into something you can't get out of. Back when I went through the program, they were sure the Masters in Midwifery would be huge and everyone would be offering it within a few years. Not so.

    Interesting, thanks for sharing your experience!

  • 11
    llg, higginsdoggrn, nursel56, and 8 others like this.

    I'm not an NP, but a CNM who lurks on this board from time to time. All I can say is yikes! A hospital that large should have an entire nursing education department, not one overworked educator. I agree with previous posters that if you jump into this mess, particularly for free, I'm sad to say you're helping them continue in this unsafe and toxic manner. My best advice would be to band together as many doctors and advanced practice providers (i.e., people who can bill for their services and therefore have leverage) as possible to demand a change in the nursing education department and be persistent about it. "Helping" in this manner isn't really helping in the long term, as much as I COMPLETELY understand your desire to help the nurses themselves.