Nursing White Coat Ceremony?

[jl lin]

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The typical patient doesn't give a rat's fuzzy _______ about the coat size, length, doohickies and trappings of rank and status. Neither do they care particularly what letters you have after your name. They don't even care what your name is. They're going to forget it 2 minutes after you tell them, if they're even listening at all. They're sick or their kid is sick and want to be not sick, while wondering how much it's going to cost out of pocket and how they're going to pay for it. That's what's important in their lives for the time they are interacting with the vastly incongruous and indecipherable Health Care Machine where nothing is the same twice and no one seems to know what the other one is supposed to be doing.

I have been working with 10s of 1000s of patients for >20 years, and I am sorry. I must disagree w/ you. Also, as I said above, every patient and family member or staff member (regardless of role for that matter) has the right to know the full name and title/license of everyone involved w/ them and their care, period.

 

[GinnyWeasley]

Who cares? It's a clothing item.

Yes and? I was curious if the ceremony was common for BSNs. I cared because I wanted to know.

 

[jl lin]

Yes and? I was curious if the ceremony was common for BSNs. I cared because I wanted to know.

It's something new. I venture to say most professional nurses couldn't care less. They used to have capping ceremonies, but this became problematic as more men started to enter nursing...plus the caps were a pain, b/c they didn't stay on and would at times fall in some poor patient's wound as you were cleaning it. A pain and nasty. After that the focus was more on the pinning ceremony; but that usually occurred close to the time of one's actual graduation, not at the same time or when first starting the academic program. You had to earn it first--just like your college diploma. Shrug.

 

[Matthew9Thirtyfive]

It's something new. I venture to say most professional nurses could care less. They used to have capping ceremonies, but this became problematic as more men started to enter nursing...plus the caps were a pain, b/c they didn't stay on and would at times fall in some poor patient's wound as you were cleaning it. A pain and nasty. After that the focus was more on the pinning ceremony; but that usually occurred close to the time of one's actual graduation, not at the same time or when first starting the academic program. You had to earn it first--just like your college diploma. Shrug.

The only nurses I've seen wear white coats are admin nurses and the dr nurse wannabes. My wife wears Nightmare Before Christmas scrubs. Very envious.

 

[jl lin]

The only nurses I've seen wear white coats are admin nurses and the dr nurse wannabes. My wife wears Nightmare Before Christmas scrubs. Very envious.

I have worn them for year, even when working in peds, b/c I hate those jogging jacket, tight cuffs. It's kind of nasty and is harder to roll up sleeves. Lab coats are usually lighter and sleeker and have good pocket space--I don't wear long white jackets. Depends on the person I think. Most of the colorful ones are jogging jackets. The other thing is if you work in post-op surgical areas, at some places, the uniform/scrub attire can be required to be more crisp. I prefer something mid-sleeves that can be rolled up well, if necessary...not full-length jackets or jogger type scrub jackets. Regardless of where I go, I scrub my hands like an OCD person. Consequently, my hands look like a 100 year old person's hands unless I am gooping all kinds of lotion on them all the time. I also have skinny, little hands, so...

 

[jl lin]

Who cares? It's a clothing item.

Don't really care too much either. What bothers me are all the people walking around with their IDs, etc on backwards. After you've seen the 100th person wearing it that way, you think, "Hey they need to give them clips or start to crack down on this." This is just basic patients' rights and having some pride and accountability. I have heard people say they flip they badges around on purpose.

 

[Matthew9Thirtyfive]

I have worn them for year, even when working in peds, b/c I hate those jogging jacket, tight cuffs. It's kind of nasty and is harder to roll up sleeves. Lab coats are usually lighter and sleeker and have good pocket space--I don't wear long white jackets. Depends on the person I think. Most of the colorful ones are jogging jackets. The other thing is if you work in post-op surgical areas, at some places, the uniform/scrub attire can be required to be more crisp. I prefer something mid-sleeves that can be rolled up well, if necessary...not full-length jackets or jogger type scrub jackets. Regardless of where I go, I scrub my hands like an OCD person. Consequently, my hands look like a 100 year old person's hands unless I am gooping all kinds of lotion on them all the time. I also have skinny, little hands, so...

None of the PACU nurses I've ever worked with wore a white coat. If they wore anything it was the scrub jacket.

 

[RogueUnicorn]

You deny that nursing is applied science. Seriously? I won't argue with delusion. Besides, you make my arguments for me, with your bluster.

Solid backing up of your argument. I'm sure there's a lot of "applied science" in nursing diagnoses.

ETA: Read your profile. It seems you're a barely-started first year. I might as well have been explaining the rise of Donald Trump to a muskrat.

The thing I have a problem with is this attitude of "I have more training, therefore I'm better"

I have more training and I am better. At medicine. If you find that to be a problematic attitude I question your reasonableness.

 

[jl lin]

None of the PACU nurses I've ever worked with wore a white coat. If they wore anything it was the scrub jacket.

Yea. I know. Most of my post-surgical is post-open heart and such. It varies from place to place and is open to individual preference. In the OR a circulating RN may want and need the closed wristband jackets, which are usually provided. Outside of the OR, it could be the same or different. It depends.

Obviously the environment post-op is somewhat less sterile-like than in the ORs, even though it's still pretty cold in those areas coming off the OR, if that is how the particular unit is located...it varies from place to place.

I generally don't like stuff cuffing tightly around my wrists. Wrists get wet when you are washing you hands often, and I am pretty sensitive--I don't even usually wear watches.

A lot of nurses are always cold, geez, and even in those areas, I am hot, b/c I am hyper. There is always something to do if you really care; but if it slows down, or I need to put in an IV or whatever, I mostly use the coat as a temporary "stuff holder." I will take off the jacket when doing the procedure and have it near me, and then replace it when I am done. Just something I was mentored in and I find more reasonable.

I hate wearing those jogging jackets. You've got to understand though, I hate anything tight and clingy. Never had a problem not wearing my rings to work or pinning then to the inside of my scrubs--but mostly don't want to bother with that. I don't usually sleep w/ them on, so.... Can't stand my hair down on my neck when I am working. I only wear shoes b/c it's smart and safe and required--they are the first thing I take off when home. When I go to work, I go TO WORK, meaning, I am not there to parade as a doll, do bare minimal, or play on my phone. I like to travel light, so to speak. I really only use my phone to look stuff up or calculate, etc, and even then I am crazy about alcohol wiping it and washing my hands. If someone calls me while I am at work, it better be uber serious. Could care less about needless texting on company time or FBing.

I even get concerned about patients watching me use my smart phone, b/c my concern is they think I am doing unnecessary texting or other nonsense--God knows they have seen plenty of others spending inordinate amounts of time on them. Trust me, patients and others are watching. When they see healthcare professionals on their phone all the time, especially if they are sitting down, they assume the worst....and in a number of cases, it's no surprise that they are right. Personally, I think it looks better for people to use the smaller iPads and keep them in their lab coasts w/ them and only use them when needed. (Another good reason for lab coats--bigger pockets --that and a nice place for your nice Littmann Cards Stethoscope, which WILL get stolen if you lay it down. Count on it. I have had it happen twice.)

The most professional thing is to stay the hell off the phone, texting or whatever, unless there is something work-related-important or you are looking something up or calculating something. (PS. No one cares if you are checking texts or emails while on the elevator for God's sake. That's not what I am talking about.) But I see so many damn nurses on their phones texting and what not, it is incredibly annoying and unprofessional. Then what happens w/ this and nurses is hospitals decide to go all Daddy-Gov't on people, make a rule--"No cells or smart phones at work", and then you'd be damned if you can use it for work, calc's, something important. There are actually places that forbid nurses to have their phones w/ them at work. Now this is b/c people lack self-control, good sense, or a stronger work ethic. So, now if they must look something up, they have to fight for a hospital computer in order to do so--um highly desired b/c many people are vying to use them--and just use the old fashioned little calculators. This is what happens when people aren't professional and responsible.

I have had family members complain about seeing umpteen nursing sitting at stations on their mobile phones....residents too. Now, this was when the patient was being blown off and getting into to some serious stress and trouble.

OK. so that's another rant but people don't realize they undermine their own professions by not being careful w/ such things--or yes. In some cases, they could and should be more involved w/ the patients rather than on their stupid cells.

Anyway. A short to mid length lab coat works for me as a carrier, and then I put it back on w/ all my stuff until I get too hot, but even then, since it's filled w/ important stuff, you have to have it w/ you in view. I wash them after every work use, and I don't have to worry about being color-careful.

Fanny packs make sense except 1. They look entirely ridiculous, and b. You can't fit a lot of stuff in them like the lab coat pockets--certainly not an iPad mini or a good stethoscope. So that's my piece on that. And yes, as a supervisor, I have worn white coats as well. Mostly, they are nice for shoving stuff in. LOL

Besides all of that, I couldn't care less about pissing contests re: who should wear what kind of lab coat or whatever. Pissing contests are wasteful exercises, lol, no pun intended.

 

[ATPsynthase123]

I usually don't see nursing students with white coats. They tend to have fancy scrubs that I'm really jealous of...
Also, the pharmacy students at my school get LONG white coats. So jealous.
Grass is always greener. =P

Anyway, I guess I don't really care either way. I haven't heard of it before, but I don't think it changes anything. In the end, most med students end up hating their white coats, so if nursing students want it, that's cool with me.

At my university they wear the short white coats like it's glued to their shoulders.


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[ATPsynthase123]

I would think as a school administrator whose livelihood depends on those "insecure" people thinking the MD (or DO) is worthwhile, you'd want to perpetuate that sense of superiority even if you actually think 2 years of online training and shadowing (and 0 Steps of USMLE) are equivalent to a medical degree.

After all, people start thinking they can take a 6 year shortcut and save hundreds of thousands by becoming a DNP "Doctor" with all the same rights and privileges, then a lot less people will be paying the astronomical tuition/fees that keep your own profession afloat.

This is a related story posted on Reddit by a verified MD/PhD radiologist and his interactions with DNP "Doctor" graduates. It's truly terrifying that we let these people operate with full autonomy in some states. They have the knowledge to be a glorified assistant at Best. I know this because I have friends in the DNP program at my university after they dropped pre-med. it's 2 years of online courses (including exams), with a couple hundred clinical hours.

The education is a joke. Like I legit had to sit down and explain to one of them what a gene was for 30 minutes and why genes are important for physiological function.

Anyways, here is the quote:

"Thank you, I wrote a post on this a while back. However the newest bill is allowing NPs to take scans, do official reads, actually perform the procedure to get the scan. I had experienced this. At my old hospital, the hospital was testing letting NPs do official reads on CXR. There was anarchy. All of the ICU docs and ER docs were yelling at admin daily to get rads to read the CXR because and I quote "there is no point in letting someone with half my education and half my training and half my clinical experience do something that I might as well do myself. Radiologists exist because they specialize in this area, they know the physics and the medicine. What is the point of an official read if it is not from a physician?". This of course does not even delve into the fact that NPs have literally a quarter of the physics knowledge of a RT(R) who has about a quarter of the physics knowledge of a radiologist. When we were trying this program out. A CT we had a request for had huge artifacts because the patient couldn't lay still due to pain. I asked the NP to give a sedative or a small dosage of Morphine. The NP started fighting me saying something about standard of care or whatever. And that the patient hadn't been given informed consent. This is literally right after I went to the patient, I asked him if he could sit still, he said no. I then asked if he would like a sedative or pain killer. I informed him of the risks of each. I told him my recommendation was pain killer, since otherwise he was healthy(well except the possible trauma that is) and I didn't want to put him in respiratory risk. So we agreed on the pain killer. I told the rRN and she said it sounds good, but she told the NP who fought me on it. Luckily I am close with the cheif of radiology technologists(the people who actually get the scans for us radiologists). He kicked her out, did it himself, in and out done. Why train someone for 6 years for a job they are completely unqualified for. Just in terms of getting scans, RT(R)s are far cheaper to train and school."

He elaborates further:

"Reasoning was, they felt a "Midlevel" provider that was somewhat of a bridge between RT(R)s and Radiologists could be cost saving(I don't know where they got that from, I think it had something to do with having multiple people) and efficient. Guess what, scan time slowed down about 25%, # of scans performed/day was backlogged >60% of the time. Radiologists RVUs went down due to less scans to read, patients started going elsewhere for bad reports on NP reads, doctors complained due to bad reads. So ultimately the trial was shut down within a week. We even got a couple of lawsuits. Keep in mind. This was a "specialized NP" as they cal The reality is NPs are woefully prepared to act in the full capacity of a physician, especially in radiology where they receive little to no training. Hell, there is a reason radiologists and pathologists are commonly called "the doctor's doctor". We are who doctors call when they can't figure something out. So I don't see how NPs can serve this function.

NPs unsurprisingly followed ACR criteria a little too close for comfort. She initially denied a head CT from the ED on a trauma patient saying "it wasn't in the algorithm". My problem is NPs aren't free thinking, they don't understand hypodeductive reasoning, they don't understand what the purpose of an algorithm, they don't understand that most of medicine cannot be boiled down. The NP in question who was reading CXRs barely understood the radiographic difference between free air and pneumonia, or the anatomic difference between the mediastinum and pericardium. These are basic things even the lowest intern probably knows. I mean, if you can't read scans at at least intern level, I don't see how you should practice medicine at all. Forget independently. And forget official reads.

Between myself(an engineer) and a medical physicist trying to explain everything in the physics realm for radiology. This was over the course of a week. The 10 NPs in the class at the end asked what the difference between an Xray and Ultrasound wave is. And I just wanted to shoot myself. I mean, the real problem is not even in their clinical skills. That is a completely separate problems. But their complete lack of knowledge in the basic sciences. And I understand if you don't understand how to calculate AROC and IROC of a falling object. I probably forgot too at this point evne though I could figure it out. However if you are in any kind of medicine and don't understand things like 9.81 m/s2, Force, Newtons laws, and how these things apply to medicie(I was trying to explain some basic physics to them by using a car crash in the ER as an example). I mean I feel like they are so used to following that they never do. And that is not their fault, but it is a disservice to patients to have people who only follow guidelines and algorithms. A physician is much more. A physician may use a guideline as a schematic, however you fill it in. You don't just use the skeleton and apply it to all. There is a reason why although you can extrapolate individual statistics on a population level, the reverse is not true to the same extent. A--->B, but B--//-->A

What really made no sense was replacing RT(R)s with midlevels, completely cost inefficient.

The program was kept on the DL, most of the doctors and nurses were forced to sing confidentiality agreements to prevent them of speaking of it. I refused to sign it, and threatened to sue if they wanted me to sign it. The hospital lost approximately 1.2 million in revenue and liabilities in 2 weeks. Amazing right?

I settled with the hospital for no money, but I got permission to tell this little tale to whoever I want so long as it remains anonymous for both parties and is not put in any official editorial piece. "



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[jl lin]

At my university they wear the short white coats like it's glued to their shoulders.


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"Glued?" Nah. I couldn't deal with that.

 

[darkjedi]

This is a related story posted on Reddit by a verified MD/PhD radiologist and his interactions with DNP "Doctor" graduates. It's truly terrifying that we let these people operate with full autonomy in some states. They have the knowledge to be a glorified assistant at Best. I know this because I have friends in the DNP program at my university after they dropped pre-med. it's 2 years of online courses (including exams), with a couple hundred clinical hours.

The education is a joke. Like I legit had to sit down and explain to one of them what a gene was for 30 minutes and why genes are important for physiological function.

Anyways, here is the quote:

"Thank you, I wrote a post on this a while back. However the newest bill is allowing NPs to take scans, do official reads, actually perform the procedure to get the scan. I had experienced this. At my old hospital, the hospital was testing letting NPs do official reads on CXR. There was anarchy. All of the ICU docs and ER docs were yelling at admin daily to get rads to read the CXR because and I quote "there is no point in letting someone with half my education and half my training and half my clinical experience do something that I might as well do myself. Radiologists exist because they specialize in this area, they know the physics and the medicine. What is the point of an official read if it is not from a physician?". This of course does not even delve into the fact that NPs have literally a quarter of the physics knowledge of a RT(R) who has about a quarter of the physics knowledge of a radiologist. When we were trying this program out. A CT we had a request for had huge artifacts because the patient couldn't lay still due to pain. I asked the NP to give a sedative or a small dosage of Morphine. The NP started fighting me saying something about standard of care or whatever. And that the patient hadn't been given informed consent. This is literally right after I went to the patient, I asked him if he could sit still, he said no. I then asked if he would like a sedative or pain killer. I informed him of the risks of each. I told him my recommendation was pain killer, since otherwise he was healthy(well except the possible trauma that is) and I didn't want to put him in respiratory risk. So we agreed on the pain killer. I told the rRN and she said it sounds good, but she told the NP who fought me on it. Luckily I am close with the cheif of radiology technologists(the people who actually get the scans for us radiologists). He kicked her out, did it himself, in and out done. Why train someone for 6 years for a job they are completely unqualified for. Just in terms of getting scans, RT(R)s are far cheaper to train and school."

He elaborates further:

"Reasoning was, they felt a "Midlevel" provider that was somewhat of a bridge between RT(R)s and Radiologists could be cost saving(I don't know where they got that from, I think it had something to do with having multiple people) and efficient. Guess what, scan time slowed down about 25%, # of scans performed/day was backlogged >60% of the time. Radiologists RVUs went down due to less scans to read, patients started going elsewhere for bad reports on NP reads, doctors complained due to bad reads. So ultimately the trial was shut down within a week. We even got a couple of lawsuits. Keep in mind. This was a "specialized NP" as they cal The reality is NPs are woefully prepared to act in the full capacity of a physician, especially in radiology where they receive little to no training. Hell, there is a reason radiologists and pathologists are commonly called "the doctor's doctor". We are who doctors call when they can't figure something out. So I don't see how NPs can serve this function.

NPs unsurprisingly followed ACR criteria a little too close for comfort. She initially denied a head CT from the ED on a trauma patient saying "it wasn't in the algorithm". My problem is NPs aren't free thinking, they don't understand hypodeductive reasoning, they don't understand what the purpose of an algorithm, they don't understand that most of medicine cannot be boiled down. The NP in question who was reading CXRs barely understood the radiographic difference between free air and pneumonia, or the anatomic difference between the mediastinum and pericardium. These are basic things even the lowest intern probably knows. I mean, if you can't read scans at at least intern level, I don't see how you should practice medicine at all. Forget independently. And forget official reads.

Between myself(an engineer) and a medical physicist trying to explain everything in the physics realm for radiology. This was over the course of a week. The 10 NPs in the class at the end asked what the difference between an Xray and Ultrasound wave is. And I just wanted to shoot myself. I mean, the real problem is not even in their clinical skills. That is a completely separate problems. But their complete lack of knowledge in the basic sciences. And I understand if you don't understand how to calculate AROC and IROC of a falling object. I probably forgot too at this point evne though I could figure it out. However if you are in any kind of medicine and don't understand things like 9.81 m/s2, Force, Newtons laws, and how these things apply to medicie(I was trying to explain some basic physics to them by using a car crash in the ER as an example). I mean I feel like they are so used to following that they never do. And that is not their fault, but it is a disservice to patients to have people who only follow guidelines and algorithms. A physician is much more. A physician may use a guideline as a schematic, however you fill it in. You don't just use the skeleton and apply it to all. There is a reason why although you can extrapolate individual statistics on a population level, the reverse is not true to the same extent. A--->B, but B--//-->A

What really made no sense was replacing RT(R)s with midlevels, completely cost inefficient.

The program was kept on the DL, most of the doctors and nurses were forced to sing confidentiality agreements to prevent them of speaking of it. I refused to sign it, and threatened to sue if they wanted me to sign it. The hospital lost approximately 1.2 million in revenue and liabilities in 2 weeks. Amazing right?

I settled with the hospital for no money, but I got permission to tell this little tale to whoever I want so long as it remains anonymous for both parties and is not put in any official editorial piece. "



Sent from my iPhone using SDN mobile

Crazy, do you have a link to that post? Curious what others said.

 

[ATPsynthase123]

Crazy, do you have a link to that post? Curious what others said.

https://www.reddit.com/r/medicalsch...ctitioners_and_their/?st=ITVPVZZG&sh=951c8027

It was /u/MRItopMD


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[ATPsynthase123]

"Glued?" Nah. I couldn't deal with that.

Like one dude had his scrubs and white coat on with the college of nursing portion conveniently covered by his name tag, while reading his pharmacology book outside in muggy 95 degree southern heat...

If a med student did that he would look like a huge f*cking tool bag. If a nursing student does it "he's proud of his accomplishments".


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[RogueBanana]

they should make it the fanny pack ceremony instead

Big fan of your work

 

[RogueBanana]

Additionally, nurses sometimes do not fully understand why physicians give certain orders or tell certain things to patients. By introducing themselves as Doctor, they are giving equal weight to their opinions on the patient's treatment.

I've seen an DNP tell a female who came into our clinic (female presented with genital herpes)

"Don't worry honey, this wont effect your life at all! Just take these pills and you'll never have to tell anyone about it! In fact, that will just make your life harder, don't tell any of the boys. Just take these pills and you'll be fine"

Now the attending doctor is desperately trying to convince this girl that she actually has a serious condition that can be spread despite the pills. The girl's response?

"But the other doctor told me it was no big deal!"

Meanwhile, I'm in the corner of the room screaming internally.

 

[jl lin]

Big fan of your work

Now that was funny...a fanny pack ceremony, but seeing that most RNs I know don't use them....

 

[jl lin]

I've seen an DNP tell a female who came into our clinic (female presented with genital herpes)

"Don't worry honey, this wont effect your life at all! Just take these pills and you'll never have to tell anyone about it! In fact, that will just make your life harder, don't tell any of the boys. Just take these pills and you'll be fine"

Now the attending doctor is desperately trying to convince this girl that she actually has a serious condition that can be spread despite the pills. The girl's response?

"But the other doctor told me it was no big deal!"

Meanwhile, I'm in the corner of the room screaming internally.

Well that is utter BS. but I have seen people w/ various titles take this approach. Like the docs and nurses that recently told a woman in active labor, "We want you to enjoy your labor experience." Now I have seen some really good labors; but having gone through it and being in a number of L&Ds that were run of the course or worse, I find that statement total BS. It's a lot having to do w/ the current nonsense in healthcare. Even under the best of conditions, um, labor and delivery is anything but "enjoyable." You may be excited, in control--if all is going well, having happy feelings of expectation, but IT'S CALLED LABOR FOR A FRIGGIN REASON. Of course none of these professionals, w/ various titles, has actually ever gone through labor, so....

I almost broke out laughing when they said that...and that particular L&D was not good at all--very bad labor experience for the mom, even w/ the epidural, which is just a bunch of crap to me; but I support a mom's choice to get it. I digress. Regardless, labor isn't an enjoyable sort of experience. You enjoy the baby afterwards, and you are still exhausted and feel some pain, so...

 

[jl lin]

Like one dude had his scrubs and white coat on with the college of nursing portion conveniently covered by his name tag, while reading his pharmacology book outside in muggy 95 degree southern heat...

If a med student did that he would look like a huge f*cking tool bag. If a nursing student does it "he's proud of his accomplishments".


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I'd ask why he was doing that, but then, nursing instructors can be ball busters re: uniform, so, if it is required... Still doesn't make clear why the dude is outside in 95 degree weather sweating. He can read that book inside in the AC, no? LOL, it takes a little time for pretty much everyone to see that regardless of the role or title, this is a not a glory-seeking kind of work. And if it is for a person, they will suck at it, b/c their stupid priorities are all wrong. I mean, that is what Hollywood and Reality TV is for. I am still waiting for a Real Househusbands of Nowhere Land to hit Bravo.

 

[trev5150]

I have been working with 10s of 1000s of patients for >20 years, and I am sorry. I must disagree w/ you. Also, as I said above, every patient and family member or staff member (regardless of role for that matter) has the right to know the full name and title/license of everyone involved w/ them and their care, period.

Ok. I didn't read your post (I didn't sign anything stating I had to read every single post), and never did I say that a pt or family member didn't have the right to know a staff member's name or title or position, esp if that individual is involved in their care. Don't read your own reactions into what I wrote and try to change what I actually said into your impression of it and then go after me with it. I wasn't in a discussion with you at all.

 

[zero0]

Like one dude had his scrubs and white coat on with the college of nursing portion conveniently covered by his name tag, while reading his pharmacology book outside in muggy 95 degree southern heat...

If a med student did that he would look like a huge f*cking tool bag. If a nursing student does it "he's proud of his accomplishments".


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Joke's on him. No one gives a **** anymore if you're a doctor, much less a medical student.

 

[Matthew9Thirtyfive]

I've seen an DNP tell a female who came into our clinic (female presented with genital herpes)

"Don't worry honey, this wont effect your life at all! Just take these pills and you'll never have to tell anyone about it! In fact, that will just make your life harder, don't tell any of the boys. Just take these pills and you'll be fine"

Now the attending doctor is desperately trying to convince this girl that she actually has a serious condition that can be spread despite the pills. The girl's response?

"But the other doctor told me it was no big deal!"

Meanwhile, I'm in the corner of the room screaming internally.

Yeah that is bull****. She is actively telling a patient to hide the fact that she had an STD from future partners. How that is not a fireable offense is beyond me, but nursing unions care more about the nurses than the patients.

Well that is utter BS. but I have seen people w/ various titles take this approach. Like the docs and nurses that recently told a woman in active labor, "We want you to enjoy your labor experience." Now I have seen some really good labors; but having gone through it and being in a number of L&Ds that were run of the course or worse, I find that statement total BS. It's a lot having to do w/ the current nonsense in healthcare. Even under the best of conditions, um, labor and delivery is anything but "enjoyable." You may be excited, in control--if all is going well, having happy feelings of expectation, but IT'S CALLED LABOR FOR A FRIGGIN REASON. Of course none of these professionals, w/ various titles, has actually ever gone through labor, so....

Not sure what to say to any of that, but saying you hope a patient's labor will be enjoyable and telling a patient not to disclose an STD to future partners aren't even in the same ballpark.

I almost broke out laughing when they said that...and that particular L&D was not good at all--very bad labor experience for the mom, even w/ the epidural, which is just a bunch of crap to me; but I support a mom's choice to get it. I digress. Regardless, labor isn't an enjoyable sort of experience. You enjoy the baby afterwards, and you are still exhausted and feel some pain, so...

You think epidurals are a bunch of crap? How is that?

 

[Pusheen]

Not sure what to say to any of that, but saying you hope a patient's labor will be enjoyable and telling a patient not to disclose an STD to future partners aren't even in the same ballpark.



You think epidurals are a bunch of crap? How is that?

This person needs a journal 😕

 

[Matthew9Thirtyfive]

This person needs a journal 😕

Yeah I can confidently say that after 30 hours of natural labor with our first daughter, finally getting the epidural was not a bunch of crap.

In fact, the ability to relax is what finally let her profress.

 

[Pusheen]

Yeah I can confidently say that after 30 hours of natural labor with our first daughter, finally getting the epidural was not a bunch of crap.

In fact, the ability to relax is what finally let her profress.

Yea, I have no idea what that post was even getting at. If anything, the epidural (often, not always) will make the labor experience as enjoyable as possible, and wishing that on someone is hardly inappropriate.

 

[ATPsynthase123]

Joke's on him. No one gives a **** anymore if you're a doctor, much less a medical student.

Man it's fu*king ridiculous. Like they walk around in their white coats and stethoscopes around their neck in PRE-CLINICAL classes! It's just weird and doesn't make sense.


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[jl lin]

Yeah that is bull****. She is actively telling a patient to hide the fact that she had an STD from future partners. How that is not a fireable offense is beyond me, but nursing unions care more about the nurses than the patients.



Not sure what to say to any of that, but saying you hope a patient's labor will be enjoyable and telling a patient not to disclose an STD to future partners aren't even in the same ballpark.



You think epidurals are a bunch of crap? How is that?

My point is that it's this whole PC approach that isn't totally genuine w/ patients. I am seeing it more and more. I am not saying be an alarmist, but I do believe in being real w/ patients and telling them the truth. To imply that labor should be enjoyable is misleading and total BS. I am not saying tell them how awful it can be. That can vary from patient to patient. I am talking about this nonsensical approach, wherein telling people half-truths or blowing off the significance or importance of something in order to temporarily keep the patient happy is utter BS. Sorry you missed that. You know what else is BS? OB people focusing on vaginal taring and the "need" to not do an episiotomy (now controversial but I say it depends) while NOT focusing on what's going on inside the uterus and keeping a very strict eye on moms in the immediate and longer postpartum period and having them needlessly hemorrhage. If a person hemorrhages, as a number of women can at this time, what damn difference does it matter if they have little vaginal tear or have had an episiotomy???

See I focus on the individual patients as well as others with whom he or she might have contact.

So much is total BS anymore, and priorities have gone to hell. So, back to the original example: let's tell the woman with the STD that all is well and that this won't be a future problem for her or other partners, or God forbid future children. SMH. It's BS. It's idiotic but it is part of the fairytale games that are played with patients anymore. Whatever happened to being compassionate but direct and honest?

 

[jl lin]

Yea, I have no idea what that post was even getting at. If anything, the epidural (often, not always) will make the labor experience as enjoyable as possible, and wishing that on someone is hardly inappropriate.

Dude read below. And FYI, EVERYTHING has risks. The risks of epidural are real, and I have seen them skate right over their duty to give informed consent, which is disgusting, b/c a woman is now unable to think as clearly as possible b/c of the pain of labor. You say, "Easy. Give her an epidural." Not necessarily. Regardless of what they tell the moms, the baby will get some of that medicine, a foley catheter (one more procedure which is not totally benign) must be done, they won't let her get up and walk around after that for obvious reasons, it may not work or only work partially, and you aren't getting around the intensity of having to push and push hard and still have pain. It's just BS not to give people FULLY INFORMED CONSENT and it should be done early on, well before the mother is in the extreme duress of labor. I never said someone should have one. I support a patient's decision. But it's not a panacea to the process, and the process really won't truly be "enjoyable" by the truest definition. As a matter of fact, the absolutely best labors I have seen are those that DID NOT have epidurals, and the moms were in excellent physical condition, exercised before and in good shape, and who have had a baby before and know what to expect. Sure all kinds of crap can go wrong anyway, but that's not the point.

My overarching point, as noted above, is that in many situations, we just are NOT being fully straight with patients. It's like it is part of the PC world of medicine and nursing. Crap, I feel like vets are much more inclined to shoot totally straight with you regarding your pets. So there is something rather wrong in this BS approach, and mind you, it is not just occurring with DNPs. It's some physicians, PAs and others too.

 

[jl lin]

Yeah I can confidently say that after 30 hours of natural labor with our first daughter, finally getting the epidural was not a bunch of crap.

In fact, the ability to relax is what finally let her profress.

I am not saying it wasn't. I am saying give people FULLY (complete) informed consent and be 100% honest with them--ideally with such options before that point. That's why people should have sound birth plans whenever possible. There are risks to epidurals and they are not a panacea for the handwork of labor. Might it give a person w/ protracted labor some well-needed rest for pushing/delivery? Sure, but it's not perfect. It doesn't always work. The baby can slug for 24 hours after the mother can have it, and regardless of what anyone says, it can slow down labor, b/c you can't get up and walk the hell around. I have had 30 hour labors too. The epidurals were a waste of time. Didn't work correctly, prolonged the damned process, forced me to stay in bed and have a F/C, and in my opinion were not worth the risk or annoyance. Often but not always the first one is harder, and I believe it is often b/c the laboring mom has not had the experience before and doesn't fully know what to expect. Unless there is something awry w/ a subsequent child/delivery/pregnancy, if mom is well and lean and strong (physically fit) she has more control and generally is in better shape and doesn't need it. They are too quick to push it. Women should not be forced to stay in bed while laboring unless they have something seriously wrong with them--but epidurals often force the moms to stay more recumbent...and that doesn't help the process at all.

Of course, more procedures mean more $$$, but often, they may mean more risks. Tell the patients the whole truth and not half-truths. That is my overriding point.

 

[Psai]

I have more training and I am better. At medicine. If you find that to be a problematic attitude I question your reasonableness.

100% agree. I am smarter, work harder and know more than other people in the hospital. I earned the title and the coat. If you want to put on a coat too to look like me, I can't stop you but it just looks silly.

Also LOL at nps reading radiology images. I wouldn't trust a single one, I can read a scan better than any midlevel.

 

[Matthew9Thirtyfive]

My point is that it's this whole PC approach that isn't totally genuine w/ patients. I am seeing it more and more. I am not saying be an alarmist, but I do believe in being real w/ patients and telling them the truth. To imply that labor should be enjoyable is misleading and total BS. I am not saying tell them how awful it can be. That can vary from patient to patient. I am talking about this nonsensical approach, wherein telling people half-truths or blowing off the significance or importance of something in order to temporarily keep the patient happy is utter BS. Sorry you missed that.

I didn't miss you. You didn't say it. All you said was that an epidural is BS. That's what I was referring to, and you didn't really address that.

You know what else is BS? OB people focusing on vaginal taring and the "need" to not do an episiotomy (now controversial but I say it depends) while NOT focusing on what's going on inside the uterus and keeping a very strict eye on moms in the immediate and longer postpartum period and having them needlessly hemorrhage. If a person hemorrhages, as a number of women can at this time, what damn difference does it matter if they have little vaginal tear or have had an episiotomy???

What are you implying? That the majority of OBs and nurses are ignoring their patients and focusing solely on episiotomy repair? That makes no sense, since in my experience the repair is done immediately after delivery of the placenta and confirmation that the bleeding is not out of control.

I'm just not sure I get your point. Should they just not do a repair until you're absolutely sure they won't hemorrhage? That kind of defeats the purpose of doing it immediately when there might still be some anesthesia.

See I focus on the individual patients as well as others with whom he or she might have contact.

So much is total BS anymore, and priorities have gone to hell. So, back to the original example: let's tell the woman with the STD that all is well and that this won't be a future problem for her or other partners, or God forbid future children. SMH. It's BS. It's idiotic but it is part of the fairytale games that are played with patients anymore. Whatever happened to being compassionate but direct and honest?

Whom are you arguing with? No one is in support of that here.

 

[Matthew9Thirtyfive]

I am not saying it wasn't. I am saying give people FULLY (complete) informed consent and be 100% honest with them--ideally with such options before that point. That's why people should have sound birth plans whenever possible. There are risks to epidurals and they are not a panacea for the handwork of labor. Might it give a person w/ protracted labor some well-needed rest for pushing/delivery? Sure, but it's not perfect. It doesn't always work. The baby can slug for 24 hours after the mother can have it, and regardless of what anyone says, it can slow down labor, b/c you can't get up and walk the hell around. I have had 30 hour labors too. The epidurals were a waste of time. Didn't work correctly, prolonged the damned process, forced me to stay in bed and have a F/C, and in my opinion were not worth the risk or annoyance. Often but not always the first one is harder, and I believe it is often b/c the laboring mom has not had the experience before and doesn't fully know what to expect. Unless there is something awry w/ a subsequent child/delivery/pregnancy, if mom is well and lean and strong (physically fit) she has more control and generally is in better shape and doesn't need it. They are too quick to push it. Women should not be forced to stay in bed while laboring unless they have something seriously wrong with them--but epidurals often force the moms to stay more recumbent...and that doesn't help the process at all.

Of course, more procedures mean more $$$, but often, they may mean more risks. Tell the patients the whole truth and not half-truths. That is my overriding point.

The 30 hours was just prior to the epidural. Her total labor time with our first was 48 hours. The second, she started the epidural pretty soon after we went to the hospital, and the labor was about 6 hours. Epidurals can slow down labor, but if you're patient that doesn't necessarily mean section.

Or we could move to saddle blocks like they do in Europe. "Walking epidurals," they call them.

 

[jl lin]

I didn't miss you. You didn't say it. All you said was that an epidural is BS. That's what I was referring to, and you didn't really address that.



What are you implying? That the majority of OBs and nurses are ignoring their patients and focusing solely on episiotomy repair? That makes no sense, since in my experience the repair is done immediately after delivery of the placenta and confirmation that the bleeding is not out of control.

I'm just not sure I get your point. Should they just not do a repair until you're absolutely sure they won't hemorrhage? That kind of defeats the purpose of doing it immediately when there might still be some anesthesia.



Whom are you arguing with? No one is in support of that here.

I'm saying crap like this happens more than people realize. It's a shame. Well, you have to see it and discern it to be aware of it. It's about prioritizing. When you are supposed to be watching your resident, you must prioritize and do some of the work too. As an attending, You get in there and check the uterus and not simply worry about a vaginal tare, b/c poor involution and hemorrhaging can and will kill a mother. The stuff I have seen missed is just unbelievable. If you don't know how the hell to prioritize what to watch for, what the hell are you doing in the field? I get that people don't want to train residents b/c it IS a pain in the ass at times. And sorry. No. Can't get into specifics b/c of legal reasons.

Healthcare is too often swirling the bowl anymore. I don't even believe it is a particular facility anymore. I believe it often has to do w/ lowering standards of care across the board to fit into some global model.

OB seems relatively easy UNTIL things go wrong, and they do go wrong, and that's why you have to prioritize and be at the top of your game.

Again I will quote an anonymous physician: "It's like they're running a fast food joint; get in as many customers as possible, quality comes second."

 

[Matthew9Thirtyfive]

I'm saying crap like this happens more than people realize. It's a shame. Well, you have to see it and discern it to be aware of it. It's about prioritizing. When you are supposed to be watching your resident, you must prioritize and do some of the work too. As an attending, You get in there and check the uterus and not simply worry about a vaginal tare, b/c poor involution and hemorrhaging can and will kill a mother. The stuff I have seen missed is just unbelievable. If you don't know how the hell to prioritize what to watch for, what the hell are you doing in the field? I get that people don't want to train residents b/c it IS a pain in the ass at times. And sorry. No. Can't get into specifics b/c of legal reasons.

Healthcare is too often swirling the bowl anymore. I don't even believe it is a particular facility anymore. I believe it often has to do w/ lowering standards of care across the board to fit into some global model.

OB seems relatively easy UNTIL things go wrong, and they do go wrong, and that's why you have to prioritize and be at the top of your game.

Again I will quote an anonymous physician: "It's like they're running a fast food joint; get in as many customers as possible, quality comes second."

You must be a pleasure to work with.

 

[ZX10R]

Stand back everyone

Let the real professionals take over.

 

[JB50]

So many of you need to get over yourselves. Seriously it's a fricken job not a status symbol. A DNP is technically a doctor, just not of medicine. Do you correct your peers with their PhD's when they are called doctor? Cuz really I mean omg you're the real doctor and you are some how demeaned by a mere PhD being referred to as doctor I mean they should have some other name right?

Just lol. Makes me cringe everytime.

 

[JB50]

I agree with you. I'm just saying to some small extent I understand not wanting to explain specifically exactly what your degree means since it's not going to change anything to 99% of patients and you're busy. Let NPs call themselves doctors if they want. The only thing it does is help them delude themselves. No one else cares.

I promise I'm the last person who will ever support the NP/DNP. I personally hope that some law is passed where it becomes outside the scope of practice of a physician to supervise NPs. The field would die once they lost the ability to have docs soak up all of their liability and I would dance on the grave of that profession.


Sent from my iPhone using SDN mobile

"Pre-Medical"

Get off of SDN and go work in an actual hospital or get some sort of clinical experience. The "no one else cares" portion of your quote applies to being a physician (maybe) as well.

 

[JB50]

Yass!!! This is one reason (silly reason) I am excited about my interview at Carver. Their hospital badges have huge "doctor" and "nurse" signs lol. HUGE letters 🙂 IDK why that attracted me as much as it did but hey...it did lol

I had an allergic reaction to almost all of your posts in this thread.

 

[RogueUnicorn]

Your rambling incoherence is hard to follow and harder to respond to, but let me take a crack.

Most of my post-surgical is post-open heart and such

You sure as hell talk a lot about OB for someone whose post-surgical patients are "post-open heart and such"

OB people focusing on vaginal taring and the "need" to not do an episiotomy (now controversial but I say it depends) while NOT focusing on what's going on inside the uterus and keeping a very strict eye on moms in the immediate and longer postpartum period and having them needlessly hemorrhage. If a person hemorrhages, as a number of women can at this time, what damn difference does it matter if they have little vaginal tear or have had an episiotomy???

Vaginal "taring" can cause lifelong dysfunction with a huge morbidity, including such unpleasantries as rectovaginal fistulas. Incidentally, you should read up on the lives of women in Africa (I think Uganda?) who live with these conditions, and their own reports of how their lives were saved by the physicians who fixed their "little vaginal tear".

You are not a doctor, you are not equipped to assess, understand, or diagnose "needless hemorrhage." Your laughable overreach is actually quite emblematic of the original topic at hand. Further, I am not an OB so can't comment on this, but many things require fixing immediately if any proper repair is to be done. I have the knowledge and humilty to realize that this may or may not be such a circumstance, and that I don't have the requisite expertise to say one way or the other. You on the other hand live in an ocean of unknown unknowns.

See I focus on the individual patients as well as others with whom he or she might have contact.

Or you know, you are completely distracted by irrelevant details

So much is total BS anymore, and priorities have gone to hell. So, back to the original example: let's tell the woman with the STD that all is well and that this won't be a future problem for her or other partners, or God forbid future children. SMH. It's BS. It's idiotic but it is part of the fairytale games that are played with patients anymore. Whatever happened to being compassionate but direct and honest?

That was an NP telling a patient that, let's focus, ok?

It's just BS not to give people FULLY INFORMED CONSENT and it should be done early on, well before the mother is in the extreme duress of labor.

Agreed on the latter half that discussions should happen earlier, which they usually do. But consent is revokable and also grantable at any time so you're a bit off the mark regarding the actual consent itself. Further, FULLY INFORMED CONSENT is a fantasy made up by administrators and lawyers. It's impossible to give fully informed consent without being a physician who specializes in that specific specialty. So we focus on the important/likely parts because otherwise we'd need to have a 1 year lecture series.

As a matter of fact, the absolutely best labors I have seen are those that DID NOT have epidurals, and the moms were in excellent physical condition, exercised before and in good shape, and who have had a baby before and know what to expect.

What a shocker, people who've had successful labor in the past had more successful labors. That's some straight science right there, please step up to the podium to accept your award, and appropriately sciencey white coat.

I have had 30 hour labors too. The epidurals were a waste of time. Didn't work correctly, prolonged the damned process, forced me to stay in bed and have a F/C, and in my opinion were not worth the risk or annoyance.

And finally we come to to the source of it, your own personal experience that you have decided to generalize.

Often but not always the first one is harder, and I believe it is often b/c the laboring mom has not had the experience before and doesn't fully know what to expect.

A lot of applied nursing science here. I'm sure it's not at all because their ligaments are tighter and their pelvic floors are competent from not having had a previous watermelon emerge from them. "10s of 1000s of patients for >20 years" of experience and to nobody's surprise it doesn't magically create basic science/anatomy/pathophys knowledge of a 2nd year med student.

If you don't know how the hell to prioritize what to watch for, what the hell are you doing in the field?

Neither do you.

OB seems relatively easy UNTIL things go wrong, and they do go wrong, and that's why you have to prioritize and be at the top of your game.

Nobody with half a sense thinks OB is relatively easy.

Paging @gyngyn for some actual medical specifics.

 

[RogueUnicorn]

Stand back everyone

Let the real professionals take over.

if this is real product i must have it

 

[ATPsynthase123]

Your rambling incoherence is hard to follow and harder to respond to, but let me take a crack.



You sure as hell talk a lot about OB for someone whose post-surgical patients are "post-open heart and such"


Vaginal "taring" can cause lifelong dysfunction with a huge morbidity, including such unpleasantries as rectovaginal fistulas. Incidentally, you should read up on the lives of women in Africa (I think Uganda?) who live with these conditions, and their own reports of how their lives were saved by the physicians who fixed their "little vaginal tear".

You are not a doctor, you are not equipped to assess, understand, or diagnose "needless hemorrhage." Your laughable overreach is actually quite emblematic of the original topic at hand. Further, I am not an OB so can't comment on this, but many things require fixing immediately if any proper repair is to be done. I have the knowledge and humilty to realize that this may or may not be such a circumstance, and that I don't have the requisite expertise to say one way or the other. You on the other hand live in an ocean of unknown unknowns.


Or you know, you are completely distracted by irrelevant details


That was an NP telling a patient that, let's focus, ok?


Agreed on the latter half that discussions should happen earlier, which they usually do. But consent is revokable and also grantable at any time so you're a bit off the mark regarding the actual consent itself. Further, FULLY INFORMED CONSENT is a fantasy made up by administrators and lawyers. It's impossible to give fully informed consent without being a physician who specializes in that specific specialty. So we focus on the important/likely parts because otherwise we'd need to have a 1 year lecture series.


What a shocker, people who've had successful labor in the past had more successful labors. That's some straight science right there, please step up to the podium to accept your award, and appropriately sciencey white coat.


And finally we come to to the source of it, your own personal experience that you have decided to generalize.


A lot of applied nursing science here. I'm sure it's not at all because their ligaments are tighter and their pelvic floors are competent from not having had a previous watermelon emerge from them. "10s of 1000s of patients for >20 years" of experience and to nobody's surprise it doesn't magically create basic science/anatomy/pathophys knowledge of a 2nd year med student.


Neither do you.


Nobody with half a sense thinks OB is relatively easy.

Paging @gyngyn for some actual medical specifics.

Savage


Sent from my iPhone using SDN mobile

 

[JB50]

Like one dude had his scrubs and white coat on with the college of nursing portion conveniently covered by his name tag, while reading his pharmacology book outside in muggy 95 degree southern heat...

If a med student did that he would look like a huge f*cking tool bag. If a nursing student does it "he's proud of his accomplishments".


Sent from my iPhone using SDN mobile

lol ded

 

[darkjedi]

OB people focusing on vaginal taring and the "need" to not do an episiotomy (now controversial but I say it depends) while NOT focusing on what's going on inside the uterus and keeping a very strict eye on moms in the immediate and longer postpartum period and having them needlessly hemorrhage. If a person hemorrhages, as a number of women can at this time, what damn difference does it matter if they have little vaginal tear or have had an episiotomy???

See I focus on the individual patients as well as others with whom he or she might have contact.

Dude read below. And FYI, EVERYTHING has risks. The risks of epidural are real, and I have seen them skate right over their duty to give informed consent, which is disgusting, b/c a woman is now unable to think as clearly as possible b/c of the pain of labor. You say, "Easy. Give her an epidural." Not necessarily. Regardless of what they tell the moms, the baby will get some of that medicine, a foley catheter (one more procedure which is not totally benign) must be done, they won't let her get up and walk around after that for obvious reasons, it may not work or only work partially, and you aren't getting around the intensity of having to push and push hard and still have pain. It's just BS not to give people FULLY INFORMED CONSENT and it should be done early on, well before the mother is in the extreme duress of labor. I never said someone should have one. I support a patient's decision. But it's not a panacea to the process, and the process really won't truly be "enjoyable" by the truest definition. As a matter of fact, the absolutely best labors I have seen are those that DID NOT have epidurals, and the moms were in excellent physical condition, exercised before and in good shape, and who have had a baby before and know what to expect. Sure all kinds of crap can go wrong anyway, but that's not the point.

My overarching point, as noted above, is that in many situations, we just are NOT being fully straight with patients. It's like it is part of the PC world of medicine and nursing. Crap, I feel like vets are much more inclined to shoot totally straight with you regarding your pets. So there is something rather wrong in this BS approach, and mind you, it is not just occurring with DNPs. It's some physicians, PAs and others too.

Alright, you really need to calm down because it's abundantly clear you don't have a fantastic grasp of what you are trying to talk about. How many babies have you delivered? Your personal experience does not equal medical science.

 

[JustAPhD]

So many of you need to get over yourselves. Seriously it's a fricken job not a status symbol. A DNP is technically a doctor, just not of medicine. Do you correct your peers with their PhD's when they are called doctor? Cuz really I mean omg you're the real doctor and you are some how demeaned by a mere PhD being referred to as doctor I mean they should have some other name right?

Just lol. Makes me cringe everytime.

To be fair, us PhDs aren't in the wards seeing patients.

 

[Psai]

I'm saying crap like this happens more than people realize. It's a shame. Well, you have to see it and discern it to be aware of it. It's about prioritizing. When you are supposed to be watching your resident, you must prioritize and do some of the work too. As an attending, You get in there and check the uterus and not simply worry about a vaginal tare, b/c poor involution and hemorrhaging can and will kill a mother. The stuff I have seen missed is just unbelievable. If you don't know how the hell to prioritize what to watch for, what the hell are you doing in the field? I get that people don't want to train residents b/c it IS a pain in the ass at times. And sorry. No. Can't get into specifics b/c of legal reasons.

Healthcare is too often swirling the bowl anymore. I don't even believe it is a particular facility anymore. I believe it often has to do w/ lowering standards of care across the board to fit into some global model.

OB seems relatively easy UNTIL things go wrong, and they do go wrong, and that's why you have to prioritize and be at the top of your game.

Again I will quote an anonymous physician: "It's like they're running a fast food joint; get in as many customers as possible, quality comes second."

Sorry but you don't practice ob and from reading your posts, it's very clear that you don't know what you're talking about. This is exactly why nurses shouldn't wear white coats; they just haven't earned them. Go do medical school, finish ob residency and then come back so you can tell us how arrogant and naive you were back in the day.

 

[jl lin]

You must be a pleasure to work with.

The people that care about quality and high standards love me. Those that don't, well who cares?

 

[jl lin]

Sorry but you don't practice ob and from reading your posts, it's very clear that you don't know what you're talking about. This is exactly why nurses shouldn't wear white coats; they just haven't earned them. Go do medical school, finish ob residency and then come back so you can tell us how arrogant and naive you were back in the day.

I would say "How so?" but I know you are trying to bait me about specifics. You think that uterine hemorrhaging is a laughing matter? I hope not. How unreasonable is it to put first things first? It's not. Even a vaginal tear is not to the level of deadliness as someone bleeding out that needs some or more of the following in PPH:
Treat the Cause:

• 1. If antepartum, deliver the fetus and placenta.
  2. If postpartum, use oxytocin, prostaglandin, or ergonovine.
  3. -->Explore and empty the uterine cavity, and consider uterine packing.
  4. -->Examine the cervix and vagina, ligate any bleeding vessels, and repair trauma.
  5. -->Ligate the uterine blood supply (ie, uterine, ovarian, and/or internal iliac arteries).
  6. -->Consider arterial embolization.
  7. -->Consider hysterectomy. Number 7 is particularly great, especially in a young woman or one that still wants children.

 

[JB50]

To be fair, us PhDs aren't in the wards seeing patients.

I understand that haha I didn't say you were in my post. People with PhD's (department chairs, etc) are stilled called Doctor _____. But I see what you're saying in terms of the hospital and the use of "doctor" in that setting. Who's to say a DNP hasn't earned the right to introduce themselves as "Doctor ____" considering PhD's do the same outside of the hospital setting. <<< that was the comparison I was making.

 

[JB50]

Sorry but you don't practice ob and from reading your posts, it's very clear that you don't know what you're talking about. This is exactly why nurses shouldn't wear white coats; they just haven't earned them. Go do medical school, finish ob residency and then come back so you can tell us how arrogant and naive you were back in the day.

At what point has someone earned the right for a white coat? Lab technicians? Research assistants? PhD's? Please.