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cayenne06 MSN, CNM

Reproductive & Public Health
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cayenne06 has 10 years experience as a MSN, CNM and specializes in Reproductive & Public Health.

I am a CNM, former LDRP RN, and long time CPM. I work for Planned Parenthood and I LOVE my job! I also have two wonderful children.

cayenne06's Latest Activity

  1. cayenne06

    Aide Documentation - Rationale?

    They need to use more professional language. Tell them next time to write “ in the rear entry position.”
  2. cayenne06

    Birth Control and 12 Hour Shifts

    I have a mirena too. LOVE IT. Just got mine replaced this year
  3. I know this is unrelated to the topic at hand but ummmmmmmmm. 25+ OTC supplements?! Why in the world. I love how alt med casts us as Big Pharma shills, pushing pills for profit and "treating the symptom, not the person". Ahem. Big Supplement is just as money-hungry and corrupt. Most supplements are laughably worthless, thank goodness. But many contain pharmacologically active compounds, and are essentially unregulated dirty drugs. Big Supplement is just as bad as Big Pharma, with the added benefit of being free from FDA oversight.
  4. cayenne06

    Birth Control and 12 Hour Shifts

    From uptodate (log on to see the citations if you are interested): "Although studies are limited, there is no evidence that any method of contraception is significantly less effective in women with obesity [5,14,15,23]. Thus, women with obesity can be offered all contraceptive methods that are compatible with their other medical conditions" If you want the patch , there is no reason you cannot use it. You can use patches or the vaginal ring to suppress your menstrual cycle too. The IUC is a great option, i highly recommend people consider long acting contraception. But not as reliable for menstrual suppression, if that is your goal. Implant is awesome too, just be aware of the potential for irregular bleeding. (of course i am assuming you dont have any contraindications to estrogen)
  5. cayenne06

    Your most bonehead moment in nursing. Or 2. Or 3.

    OMG this had me literally laughing out loud. My worst one - Admitting a labor patient as a new nurse. She was in rip roaring labor and I was feeling the pressure... And, oh god I cringe to admit this, but I went ahead and inserted her IV cath... pointing distally. I'd put in enough IVs and drawn enough blood at this point to be relatively competent, its not like it was my first one lmao. I realized my boneheaded error as soon as the needle pierced the skin, so maybe... no one noticed? And to make it worse, her husband was an EMT! OMG. I died. Just died. I still cannot fathom what came over me.
  6. cayenne06

    Integrative Medicine - is it legal?

    Which treatments are you interested in specifically? I used to practice naturopathic/alternative health care so I am intimately familiar with this topic. I really encourage you to look at this from an ethical framework, legalities aside. Because legal or not, we have an ethical obligation to provide science based care to our patients. Hopefully we all agree that ALL forms of health care should be held to the same high level of scientific scrutiny. All of us should be equally committed to evolving our practices when we have new information to guide us. Too often we blame mainstream medicine for the problems with our health care industry. This is just not accurate. Medicine is a science. The health care industry is the system we are forced to work within. Medicine is a scientific specialty just like astronomy. And science is a method for understanding the world. That's it. Its a cheat sheet to help us figure stuff out. It is fraught with human error and laughably imperfect, but the whole point of any scientific discipline is to slowly self correct. To change over time. Unfortunately we've been forced to try and practice medicine inside a profoundly flawed health care system, driven by profit. Our ability to provide care is bound up in red tape. But this is an argument against our profit driven health care system, not against science. And the alt-med industry is just as prone to criticism. Talk about profiteering and pill pushing. Teal Deer, i know. This is just My Issue. Its important to me. Like I said, i practiced alternative medicine for many years, and I did harm to patients with some of my recommendations. Learn from my mistakes! Dont be like me, bc it suuucks to publicly admit that I was wrong, and that I put my patients in danger. It still smarts a little to do it now, almost a decade hence. But I admit it openly, every chance i get, because maybe someone will take it to heart.
  7. cayenne06

    Accidental Mistake- UGH

    With these kinds of things, skip the emailing and head straight for the phone. I bet if you speak to someone they can straighten it right out for you with little hassle I am sure these things come up all the time. Not the same issue, but I was struggling for weeks to get my CT RN license-submitted all my paperwork, they verified receipt, but my application languished "in process" for weeks. Then I got a letter saying my application was closed for lack of required documentation! So I called, got on the line with a very nice lady, and it turned out all my paperwork was being dutifully placed in someone else's file, of the same name. Argh! But 10 minutes later my license popped up online! I think your snafu can be fixed just as quickly.
  8. cayenne06

    Case Study: HIPAA violation or not?

    The problem here is not the photo per se. It is how the photo was obtained- by a student, on a personal cell phone. This is just wrong, HIPAA or not. As a student, you don't take pictures of people who are vulnerable and reliant on you for care. 100% never okay. Even if it is interesting and you want to show your classmates. Just asking the patient if you can take a photo is crossing the line. You have no right to make that request, and the patient could easily feel pressured to consent. If her providers deemed a picture was necessary (for medical or learning purposes) and the patient was appropriately consented, It would be reasonable for a student to request a copy for their own education. And, you especially do not take that pic on your UNSECURED PERSONAL PHONE! I mean whaaat. i just cant even. I just can't even. Serious lack of judgment here.
  9. cayenne06

    CNM and WHNP dual program

    hahahahahaha omg so true.
  10. cayenne06

    CNM and WHNP dual program

    A CNM can do everything a WHNP can do, plus catch babies. I can't think of anything to gain by having both. Is there a specific reason you want both? I would think a better dual cert would be CNM and FNP if you want a broader knowledge base. I've also thought that CNM/WHNP and psych NP would be a useful combo, at least for the pt population i take care of. Women often struggle to find psychiatric/addiction care during pregnancy, which is a time when many need it most.
  11. cayenne06

    Nurse Practitioner working without a MA

    That is just mind boggling to me- I can't bill insurance for transcribing blood pressures or filling out prior auths! Admin wants me to have a solid support team so I can spend my time seeing patients- i.e, generating revenue (Providing higher quality care is just a side benefit, as far as they are concerned ). I love my job to an almost embarrassing degree. I want to work for this organization forever. But I would quit if I didn't have a support staff. No way, just no way. My patients deserve better, and *I* deserve better.
  12. cayenne06

    Supervised smoking in LTC

    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 through withdrawal if they don't want to? Of course, employees deserve to be protected from workplace hazards including secondhand smoke. As others have mentioned, there are many ways to do this that do not involve curtailing the rights of residents. Give them their smokes. Give them access to whatever vices we can, they deserve it. Wear a mask if you have to go out with them, and stop with the hyperbole. Supervising a ten minute smoke break is not the same as working in a smoke-filled bar for 8 hours. Stay upwind, and enjoy the social time.
  13. cayenne06

    Not sure how to handle this situation with recent interview

    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 manager personally and was hired through her, new application etc. I imagine that once I filled the position, they sent out courtesy letters to all the other applications languishing in the system. lmao
  14. cayenne06

    RNs Told They are Equal to MAs

    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 want to spend as much face time with my patients as possible. That is my job, you know that. I think were are using a different definition of "equal" here. I lead my care team and I make the decisions. Their job is to help me do my job. No way are we equal in terms of responsibility and expertise. But we ARE equal within the team. I could not provide the same quality of care, or see as many patients as I do, without them. Thats what I mean by equal.
  15. cayenne06

    RNs Told They are Equal to MAs

    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 nurse. I have no clue what the right tube is to run an A1C, I don't know how to work the autoclave, I don't want to be in charge of managing our inventory or taking BPs or turning over exam rooms or managing a full waiting room or triaging the gazillion phone calls we get each day. I just want to do my work, and do it well. My MAs have critical insight regarding our work flow, and their feedback is invaluable. It's all about working together; we are more than the sum of our parts. It takes a culture shift in the office.
  16. cayenne06

    RNs Told They are Equal to MAs

    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 team.

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