cayenne06 MSN, CNM

Paragraphs and spacing are *critical* whether it is a message board, an email, whatever. I also re-read before I submit and try to pare it down as much as possible; I tend to be a bit logorrheic if I am not careful haha. Less is more when it comes t...

THIS. Pain is hard to quantify. A stated pain score needs to be placed in context. Some people under-report for various reasons, others over-report either because they've never really experienced severe pain so don't have a context, or because a high...

I dutifully ask my patients to quantify from 0-10 (when i remember), but if you asked me to rate *my* pain, i'd be one of those annoying patients saying "it's not really pain, its just achy and sore," and "well i've had much worse pain in my life, bu...

And here's the problem. We as health care providers might have the know-how to research a potential CPM and determine if she is qualified and experienced. The lay public may not know how to vet a potential provider, nor should it be their responsibil...

I once inserted an IV cath facing distally :/ And the patient's husband was a medic, watching me do this. I cannot even believe it, to this day. My very first error as a nurse was while I was working at a boarding school for teenagers with mental he...

I nicely tell them that my front desk staff handles those issues, and I also remind them that I am seeing patients all day and they will probably get a quicker response if they tell us what they are calling about, even vaguely. Then i transfer them t...

Are you serious? We all know cigarettes are terrible for us. But it is an enjoyable, relaxing, and social activity. And it is addicting as heck, which means stopping is physically and emotionally painful. WHY would you want a resident to suffer thro...

I once received a rejection letter after I had already started at the job! It was kind of terrifying at the time but hilarious in retrospect. I had applied through their career portal originally, but not too long after I happened to meet the unit m...

Of *course* I can do these things. And I often do, if they are busy and I am not. You know that is true, so I am not sure why you made the comment. I said that I don't *want* to do these things. I want to provide consistently excellent care, and I ...

Just because people have different skill sets and levels of responsibility does NOT mean they aren't equal. My clinic cannot run without skilled medical assistants, a well oiled front desk, and effective management. I would be *lost* without my nur...

I actively seek out feedback from my MAs, and wish we had a formal process for 360 reviews here. Constructive advice from my team has helped me become a more effective leader AND team player. We are 100% equal in terms of the value we add to the tea...

I love women's health and I LOVE being a CNM. I didn't really like working as an RN in any capacity. The sheer volume of tasks that need to be completed and charted on, ugh it makes me tired just thinking about it. I used to have to manually transcr...

I have two MAs assigned to me personally. I cannot imagine seeing my patient load with ONE MA, let alone none. No way.

Functional medicine: The ultimate misnomer in the world of integrative medicine – Science-Based Medicine

My favorite is when a patient calls with a question and insists they can only talk about it with me- and then when I get them on the phone they want to reschedule their appointment or find out how much an IUD costs. AHHHHHHHHHHHHH.

Most places just buy a big bottle from Costco and keep it in the break room, problem solved. More convenient for everyone involved. I have zero qualms about sharing my personal OTC meds with coworkers. However, hospital stock can only be dispensed wi...

Ah, the wisdom of experience. Don't work off the clock, accept help and offer it freely in return, USE YOUR PTO, own your role in the caregiver-patient relationship. Never fool yourself into thinking you've finally learned it all. That will never ev...

I've never had a dirty needle stick, but i've poked myself a few times and it does hurt, plus you will almost invariable see some blood at the site. And overall the risk of contracting a blood born pathogen from a SQ needle stick is very low, plus th...

Sooo... you are saying that if a pregnant woman came to you to discuss options, you wouldnt volunteer information about abortion? What would you do if your patient came to you specifically for help accessing abortion services? Your personal beliefs ...

The first step with an unclear or dubious order, is always to ask the provider for clarification on the exact wording. If you don't understand why it was ordered for your patienty, politely ask them to explain the rationale. If you have concerns abo...

The first step when doing dose calculations for liquid meds is to figure out how much drug is in each mL of solution. It should make a lot more sense once you do that. If you already did that and are still stuck let me know!

Doing away with the nursery in the name of being Baby Friendly really gets my britches in a bunch. The default should be that baby stays in the room with their parent. We should absolutely tailor obstetric care to promote a healthy physiologic trans...

Don't forget that newborns naturally have a variable RR, so you really need to do a full minute. I agree that a hand on the chest can be easier than trying to watch for a rise. I will use my steth to count too sometimes, but that can be difficult unl...

Agree with everyone above. You don't need special care in early labor and it tends to progress faster when you are at home, where you can eat and drink and rest and go outside. It can be hard to figure out when you are actually in a solid labor patte...

I've only ever done women's health for my entire career, and my only RN experience was in LDRP. It's a learning curve, very different than other types of nursing. My biggest advice is to take as much orientation as they will give you, and learn from ...