cayenne06

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

I have a mirena too. LOVE IT. Just got mine replaced this year ❤️

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.

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 lady partsl 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)

Ughhh I am so sorry. I wonder if you should reconsider taking a prep class, see if there is a way to make it work with your budget. The quicker you pass the test, they sooner your income will rise, which vastly makes up for the class fee. Not to mention the fees to keep taking the test. Plus, a refresher course will help you immensely as a new RN, since youve been out of school for a while.

You are right, in that it is a very challenging and emotionally draining field. Patients can be manipulative, demanding, difficult to engage with. Often with significant mental health needs. That work is not for the faint of heart. However- WOW. "They are kids in adult clothing." That kind of attitude is like the root of the problem. In actuality, addicts are human beings struggling with an intensely difficult problem that affects literally every aspect of their life. These patients lives are in complete shambles, and their neurochemistry is permanently altered by their addiction. It is a loong and painful process to recover. It is soo condescending to dismiss their struggles by comparing them to toddlers. You ask WHY they got addicted. Well. In large part it is OUR FAULT, handing out opiates like candy and leaving our patients dependent. Other factors are extreme poverty, untreated mental illness, abuse and neglect as a child. I guess some people might just decide to take up meth for fun, but... i think thats rare. And how do we help them? Well. We detox people in the ED then toss them back on the street because there are no rehab beds. We make them jump through hoops and follow strict rules in order to deem them worthy of medication treatment or a community residential placement. We deny them housing if they can't sober up, and throw them out if they relapse. In some states pregnant addicts can be thrown in jail. To this day it is still easier to score an opioid rx than it is to access treatment. We require providers to take special classes to provide MMT, yet anyone with an RX pad can write a big old bottle of dilaudid. We make patients come to US, instead of reaching out into the community. Listen, no one enjoys being homeless and alienated from society, covered in sores, trading sex for heroin. Like, nobody. Lets give them some grace, and some help.

This is my last hijack related to alt med- Oddly, this is a huge blindspot in the nursing profession. We are inexplicably accepting of pseudomedicine. Case in point- an entire forum on this website dedicated to the topic, misleadingly titled "Holistic Nursing." Not sure how "holistic" has become synonymous with liberally sprinkling psuedoscience into our evidence-based practices. Holistic. You keep using that word, I do not think it means what you think it means. ? We have a responsibility to our patients to understand these issues and base our practice off of the best available evidence. We can cause real harm when we don't. For real.

Happy to see this conversation. Vitamins should be used to treat medical problems as indicated. Because they have actual pharmacologic activity in our body (duh, that's their whole purpose). Same with antioxidants and electrolytes. Our body maintains a careful balance of these chemicals for good reason, and I am not sure why we think its a good idea to screw with that. Tangientially related- What kills me is that the "alternative med" community derides us as pill pushers and pharma shills. Yet they dole out "natural" pills for every possible problem (real and imagined) under the sun! Big Supplement is just as money hungry as Big Pharma (in fact they are often the same umbrella company). And worse, alt med practitioners routinely profit by selling these supplements directly to their patients. Imagine making money off every prescription you write. As a former alt med provider who is thoroughly ashamed of her past, this is a hulksmash issue for me. Lol. Supplement deficiencies and medical conditions as clinically indicated. But flintstones vitamins are delicious, so it's okay to have one or two as an occasional treat hahaha.

I always got tested for a new job as a nurse. But so far I've never been asked to test as an APRN. Not sure if that is a common experience. I've never worked at a place with random screens, but you never know when there might be a narc discrepency, or an injury/accident/error- all of these typically result in on-the-spot testing.

I wish schools better prepared their students for the red tape of health care- billing, the credentialing process, dealing with insurance. It is very daunting. Your employer should facilitate getting you on board with insurance companies and teach you how to bill. They are highly motivated to do this for obvious reasons. Mine made it as straightforward as they possibly could. I wouldn't stress about this. With prescribing. Just be cautious and meticulous about allergies and drug interactions, and the 5 rights- don't forget to ask about supplements and OTC. I strongly recommend always ordering your meds in the room with the patient. I often turn my computer towards them and review the RX together. I ALWAYS do one more verification of allergies/meds. Err on the side of asking a colleague if you aren't sure. Be mindful when taking telephone or pharmacy requests for refills- its easy to go on autopilot there. Check the chart. I've seen patients get auto refills for like 3 years without an office visit. And when you make a mistake (because you will), learn from it, and acknowedge it. Don't forget your friendly pharmacist- they they LOOOOVE getting a consult and know a crazy amount. They've saved my butt more than once.

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.

Yes! I was just going to say that you need to make sure you have the best cover letter ever. Explain yourself, make sure it is readable and engaging and highlights you as an individual. And equally important, keep it short and sweet. Half a page. Otherwise no one is likely to do more than skim it. Also, ill reiterate the previous posters because it is worth repeating- network. I admit that is easier said than done, of course. But you want to be a known entity, not a faceless online applicant among thousands. Otherwise there is a high likelihood your application will be automatically dismissed based on a computer algorithm, without anyone ever laying eyes on it.

Related question- are you credentialed with the insurance companies? Are you billing on your own at all? If not, well... thats not a good sign.

What do you mean by "see them with the doc"? Like, you both are physically with the patient at the same time? What is your role when you guys are in the exam room together? I mean the whole idea behind "saving money" with an APRN is paying you less than an MD but still making loads of money off your billable services. You aren't generating revenue if you are seeing patients with your doc. I am the first to jump up and help my MAs or LPN if I magically happen to be done with my own work. But I would feel very unsatisfied and undervalued, if that was a defined part of my role. I don't enjoy working as a nurse or an MA. It is not the career I chose. You should meet with your office manager. Express your confusion over your role, and ask them what they had in mind when they hired you. If they TRULY want an NP then get your responsibilities outlined on paper, in specifics. If it becomes clear they dont plan to utilize you as a provider, definitely time to seek greener pastures.

I honestly wonder if at this point it is better just to leave it in place. If she has had it for 30+ years without infection or obvious complications, seems safer to leave well enough alone than put her through the risks of removal, esp if it is an old-school device. ETA- oops. I missed the update. Glad the removal went well!

I have learned to make a point of telling this to patients when they come in for insertion. Grasp the strings, and 1-2-3 done! (assuming its not embedded lol)

I agree that it should be a mandated report, just like any other dependent abuse ? ugh. How awful. I'd want to make an anonymous report as well, but it doesn't sit quite right with me, HIPAA-wise. You'd still be making the report based on info you obtained within a confidential nurse-patient relationship. Even de-identified patient info should only be used for medical/educational/research purposes. But morally speaking, how could you NOT report, you know?!? Really interested to hear what others have to say about this. Gosh, I don't think my conscience would be able to let it go unreported. I couldn't bear it ?

Monthly appointments for chronic medications?!?! That is setting the patient up for serious health risks.

I usually just say "Are you interested in quitting or cutting down? No? Well, we are always here to help if/when you are" No judgment, no lecture, no pressure. I am especially conscious of this with smokers who are recovering addicts and people with poorly controlled mental health problems. Cigarettes can be a lifeline for them, and thats OK. I have strong feelings about allowing these types of patients to smoke while in residential/inpatient treatment- LET THEM SMOOOKKKKE! I am however upfront about the importance of never smoking inside or around children, and provide harm reduction strategies based on the patients situation (if they have a newborn, medical issues, etc).

Come work with us at Planned Parenthood ❤️

Yikes. That’s a bit harsh.

My school had one lecture about abortion techniques. No option to rotate clinically ? I take students all the time, I love it. You can always reach out to local abortion clinics to see if you can initiate a relationship with your school- i bet you will get a lot of positive responses. Abortion is basic women's health care. Midwives have a responsibility to understand the techniques, and students deserve the opportunity to have clinical practice if desired. Even though most states bar non-MDs from performing MVA abortion, it is *well* within entry level CNM scope, as is med AB. The same techniques are commonly used by midwives for miscarriage management , so even if you don't want to provide abortion services, these skills are important. Certainly no one should be required to participate in actual abortions if they don't want to. But at the very least, we need to understand the process so we can help counsel our patients. *Interesting to note that appropriately trained midwives can use MVA to manage a nonviable pregnancy. Yet are legally barred from using the exact same skills to manage a termination. Hmmmmmmm.

How come? Because we provide abortions?

Are we talking AIDs patients, or patients with HIV? HUGE difference. If you are caring for AIDs patients they are severely immunocompromised, and you are a much greater risk to them, then they are to you. HIV pos patients are just like every one else. Treat them the same. And if their viral load is zero, then you cannot get HIV from them.

I work full time for Planned Parenthood. Hands down the best job i've had. Pay is lower than my other job offers, but i am soooo glad i took this position. Of course, every affiliate is different (and every clinic is different), so I can only speak for myself. Plus, the work you do is so meaningful. It feels realllllly good to go home each day knowing that you are making a direct and measurable difference in someone's life, and in the health of the community as a whole. And yes, there is a lot of primary care. In fact many of the clinics in our affiliate offer full scope primary care. I focus on sexual/reproductive health because that's my true love.