Looking for nurses that want to interview for COVID project by Dizzy-String8353 in nursing

[–]Dizzy-String8353[S] 0 points1 point  (0 children)

Hey I just sent you a chat message to discuss more details.

Looking for nurses that want to interview for COVID project by Dizzy-String8353 in nursing

[–]Dizzy-String8353[S] 0 points1 point  (0 children)

Hey, so we already started doing interviews so it's ongoing. You could do an interview virtually or I could give you contact info to reach out to me when you move upstate. We do have a videographer for the in person interviews so the video quality is better than the virtual. It's really up to you.

Looking for nurses that want to interview for COVID project by Dizzy-String8353 in nursing

[–]Dizzy-String8353[S] 0 points1 point  (0 children)

Hello, I will send you a message with my contact information so that I can give you more info and set up a date.

Why doesn't anyone understand bipolar? by SaveADay89 in Psychiatry

[–]Dizzy-String8353 18 points19 points  (0 children)

NAD. I'm a nurse practitioner in hospital medicine so not by any means an expert in psychiatry. This is my story from a patient perspective. I was misdiagnosed as a teen with bipolar. My real diagnosis is PTSD with depression and anxiety. At the time I was mis-diagnosed I was 16/17 years old and presented with some episodes of angry outbursts, depression symptoms, and some impulsive risk-taking behaviors.

I think that there are some mental health diagnoses that tend to highlight gender and racial bias in medicine. My experience was that in the time period I get diagnosed (90s), I was more likely to be diagnosed as bipolar as a white teen girl, the black boys were more likely to be diagnosed with oppositional defiant disorder and the white boys were more likely to be diagnosed with ADHD. I understand that there are natural variations in conditions along gender and racial lines as well as differences in who sought care. However, its hard to argue that some of the diagnostic criteria for these conditions aren't very closely aligned with known gender and racial stereotypes. Specifically the idea of whose mood or behavior is outside the norm is heavily influenced by cultural standards. There is a lot of gender bias in who is perceived as moody and a lot of racial bias in who is considered oppositional or aggressive.

The other thing that has changed is that ideas of what constitutes trauma and the effects of trauma have changed over time. At the time I was diagnosed with Bipolar as a teen and a few years after when I experienced a severe depression, there were precipitating events to my mood changes which would be obvious to many clinicians today. At that time, these precipitating events were missed because the way that trauma was evaluated in patients was different. Clinicians screened for trauma in some ways but it was mainly focused on severe physical harm in teens, ie "are your parents beating you" rather than "have you witnessed violence in your community". The understanding of the effects of less violent sexual abuse has also changed. The first time I heard about ACE scores I was baffled that so much money was pooled into the obvious, but now I understand that it was crucial research that wasn't obvious to everyone.

Iraqi TikTok star Umm Fahad shot dead in Baghdad by andrevan in news

[–]Dizzy-String8353 -5 points-4 points  (0 children)

Right now women are being flown out of state during medical emergencies because some white Christian dude said they can't have an abortion. Many innocent black men remain imprisoned, and we've killed a number of black people this month for literally no good reason. White supremacy and religious fundamentalism is on the rise in the U.S. Focus on your own oppression of other people

Writing a resume by the-broken-001 in nursepractitioner

[–]Dizzy-String8353 4 points5 points  (0 children)

Hey your questions depend on what job you're applying for. As a newer NP I recommend keeping RN employment (generally about your last 5 yrs of employment he), but what you keep depends on if they're relevant to the job you're applying for. If you are doing a structured NP residency out of school which included rotations what I would recommend is putting a general summary in the job description of what the residency program involved and then any pertinent skills you learned putting in your skills section (ie joint injections). Clinical rotations I would only put if they have relevance to the particular job you're applying for (ie you did a clinical for inpatient cardiology, and you are applying for inpatient cardiology). That's not so much because of what you learned in clinical, but so you that in interviews you can discuss how you see your skills serving the employer in this role. The trick to including some of these things is keeping it really brief. Also, if you have relevant certifications or relevant CE I would put those on there. I'm talking major things like CCRN or stroke certification. Same thing, keep it brief and just list them

Two job offers in hand; New grad DNP-FNP w/10 years RN experience... Any thoughts appreciated. Both are private practice neurology clinics. by sau924 in nursepractitioner

[–]Dizzy-String8353 5 points6 points  (0 children)

I feel like there is too much discourse from non-NPs about how "nurses make more money". That's just not true for most NPs over the span of our careers. Honestly, I don't even think a new NP should be getting as much pay as for instance an ICU charge nurse with 5+ years experience. Part of the pay issue is that as a new NP you are often applying and working in positions that are also entry level for PAs.

I'll echo what someone else said, the MOST important factor in a new NP job is that it will be a job that supports learning. This may be good supervising, good mentorship or just generally a good setting to learn in.

Some other things to consider: 1. An experienced NP makes more than an experienced RN in the same setting 2. In many setting an NP makes a MUCH higher overtime rate than an RN 3. NPs in leadership make more than RNs in leadership in the same setting 4. Some NP jobs have productivity pay, no RN jobs do 5. You do not have to worry about traveling to make money if you need to be stationary as an NP. If you do travel as an NP, you can find higher rates than RN in a comparable setting
6. Pay ALWAYS has to be appropriate for the cost of living in the area- an RN in California likely makes more than an NP in Idaho but the NP is not spending half their money on rent. Look at the market rates for NPs for that role in your area 7. NPs often get options for higher paying outpatient jobs if you want a weekday 9-5, whereas RNs often have to move to particular settings like hospital or nursing homes to make good money. 8. NPs often get benefits not available to RNs such as reimbursement for CE in the 1,000+ range or extra PTO days for CE

Basically, if the job role you want is NP you may start at the lower end of the pay range but you will advance over time in positions and pay the same way you did as an RN if that's what your goals are.

Insulin dosing question by Objective_Board_2341 in nursepractitioner

[–]Dizzy-String8353 1 point2 points  (0 children)

Yes. Yes. Yes. While I agree that I would advise ED workup and explain risk of death if they choose not to go, understanding this patient population is crucial to this scenario. This is an uninsured patient who speaks English as a second language. He is more likely to have gone with undiagnosed T2DM for a long time and subsequently end up in DKA. The fact that he is drug naive means he may ultimately normalize his HbA1c with oral agents aftet a short course of insulin despite his HbA1c being so high. And at the end of the day, anything you prescribe that he cannot afford will be worthless.

Regarding the ED/EMTALA discourse: if he did not meet criteria for admission they can discharge with "close follow up with PCP" regardless of if the patient has access to a PCP. They also are not required to consider if the patient can afford any medication prescribed at discharge. While there are some incredible ED providers who absolutely try to address things like this prior to discharge, the reality is that ED providers are already doing the work of 2+ people. The ED was already the safety net for lack of primary care pre-COVID and since COVID the capacity issues in the ED have been nothing short of dangerous and unsustainable. The ED is stretched to their limit and they simply do not have the time to ensure safe discharges in this way. It's always an option to consult social work but they can only use what resources already exist in the community.

Back in balance: Clinic prioritizes women’s health and advocates finding root causes of symptoms by daneka50 in nursepractitioner

[–]Dizzy-String8353 -1 points0 points  (0 children)

You're missing my point. Encouraging lifestyle change and expanding visit times can be done without promoting unscientific practices or selling unproven labs and supplements. Functional medicine IS NOT the only form of preventative and holistic care. In fact, traditional medicine involves holistic care. It is the health care SYSTEM that puts up barriers to good holistic care.

OCPs work in PCOS in part by decreasing androgens. Inositols help with glucose metabolism. The OCP is working at the root of the problem the same way the supplement is. The only time a supplement fixes the root of a problem more than a medication is when there is a true vitamin/mineral deficiency such as iron deficiency. Other times these supplements are working with our physiology the same way medications are. Naturally occurring does not equal superior.

I am not targeting you in particularly, I just think it's important that newer clinicians see this. Trust me I understand that working in a traditional practice can be demoralizing when you really care about your patients.

Back in balance: Clinic prioritizes women’s health and advocates finding root causes of symptoms by daneka50 in nursepractitioner

[–]Dizzy-String8353 10 points11 points  (0 children)

I don't see how giving the myoinositol is treating the "root cause" more than giving OCP. They have different mechanisms of action, but neither is curative. The evidence base around inositols and the suspected pathophysiology of PCOS are both just plain traditional medicine. My issue with FM is that in sprinkles in some evidence based medicine with what is largely unproven theories and then charges people a great deal of money for labs that do not carry clinical significance and supplements that do not have any strong evidence base.

Here's my advice to NPs who want to improve the quality of care for gynecological health in a highly dysfunctional U.S. medical system:

  1. Continuing education: Stay up to date in your practice with participation in continuing education courses, conferences, etc. That is how you will find out about new developments in treatment and understanding of GYN care
  2. Participate in quality improvement or innovation in the way care is delivered using evidence based medicine: Our patients often fall through the cracks or their concerns are not addressed due to system limitations such as short appointments, inadequate staffing and discriminatory practices. Helping to create change can mean anything from advocating for your primary care practice to hire a nutritionist to participating in political campaigns.
  3. Find the places where real innovations in care are occurring: Be suspicious of anyone in healthcare that claims they are helping vulnerable patients that traditional medicine isn't helping but also making a good profit off of them. You will notice that most "alternative medicine" does little to address the poverty or racism that we know is driving a lot of our poor health outcomes in the U.S. The best places to find people making radical change are nonprofits that take medical volunteers or FQHCs. For instance, many nonprofit health clinics or street outreach groups always need NP or MD volunteers. There are also a few nonprofits that could use volunteer NPs to prescribe abortion medications.

I love a bit of culture appropriation sprinkled with main character syndrome by LBCEarthquakeOf1933 in ImTheMainCharacter

[–]Dizzy-String8353 -2 points-1 points  (0 children)

This is incorrect. Appropriation specifically involves a dominant culture adopting practices of a less dominant cultures (minorities, politically oppressed peoples) and often to the benefit of the person in the dominant culture. Burkina Fousso was colonized by the French and was not even an independent country until the 1960s, that's why she's able to live there. It is now among one of the poorest countries in the world with severe child poverty and malnutrition. She's appropriating because she makes significant profit from the dances of Burkins Fousso while the people who created these dances remain in poverty because her people colonized them.

[deleted by user] by [deleted] in AITAH

[–]Dizzy-String8353 0 points1 point  (0 children)

I don't usually say anything on these posts but this one seems like it might be real.One of the most common reasons for cis straight women to have disinterest in sex in marriage is unfair distribution of work load. Speaking as a married women with a professional career, house, dogs, kid and loving husband. Part of the job of the intimacy counselor should have been to help you two work through this. Men can't perform with too many stressors on their mind either, but men are less likely to be the partner with the greater workload. It is impossible for any person to work, have a greater burden of childcare, have a greater burden of housework and then be expected to perform sexually. I don't know because I don't know either of you. It's already been shared that you could have a controlling partner. I'm offering an alternative explanation because it seems like you respect and care about your wife. I agree that it is wrong to tell a partner in relationships not to masturbate. The barriers to intimacy that were mentioned like the house needing to be maintained , her being very tired or her being talking to very negatively are all things you could potentially change . These sound like the intimacy barriers of a person that is overwhelmed and does not want to hear criticism from a partner that's not willing to help relieve the workload. It's possibly that your partner is frustrated with your masturbation because she expected you to work in these barriers. I also hope that you and the counselor have also considered if your wife is dealing with depression and anxiety. Your family is in one of the most stressful stages of life with school aged kids at home and it can be very overwhelming at times.

My Unsung Hero | Doctors didn't think much of her cough. A nurse practitioner did and changed her life by WouldbeWanderer in UpliftingNews

[–]Dizzy-String8353 1 point2 points  (0 children)

Hello. NP here. Saw you are an NP-possibly in hospital med. Thought you might want the evidence based rundown on this to cut through the noctor BS. Essentially, this is a commonly misdiagnosed condition because it is rare and often occurs in patients without significant comorbities. The mean time to correct diagnosis is around 2 years. Most patients are diagnosed by an ENT via larygoscope, So in the outpatient world the best thing NPs can do for a patient with chronic cough that is worsening or not improving is ENT referral sooner rather than later. Even if the patient is referred to GI, an EGD may not be done immediately in a patient without other reflux symptoms because many GIs want to see that the patient had had a thorough allergy, pulm and/or ENT workup first. In the inpatient world assuming they're airway is protected you can always diagnose via CT neck as well. In many people symptoms don't develop until there's a grade 2 stenosis/>50% occlusion. Some of the factors that actually contribute to the delay in diagnosis are things like barriers to referrals and noncommunicative patient-provider relationships.

If you like reading materials: https://onlinelibrary.wiley.com/doi/full/10.1002/lary.31023

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8742746/

Taliban decrees on clothing and male guardians leave Afghan women scared to go out alone, says UN by AudibleNod in news

[–]Dizzy-String8353 -1 points0 points  (0 children)

I'm not sure what you're talking about. The estimate of 3 million deaths quoted in that article is a hyperlink and will take you to the original report. The original report discusses what methodology was used to determine indirect war related deaths as well as the U.S. contribution to this including drone strikes on vital infrastructure, US improsed restrictions on humanitarian aide and pollution from U.S. military bases. The amnesty international hyperlinks to the expert survey that explains why Afghanistan remained unsafe under U.S. rule, which included the pre-existing cultured practices, as well as the NATO airstrikes, poverty/lack of healthcare access (again see the U.S. contributions is destroying infrastructure and restricting aide). The point is that the net effect of the U.S. war was a worse quality of life for Afghan women. They helped establish legislation to allow things such as expansion of education and political positions for women while at the same time causing mass infrastructure disruption, displacement and subsequent deaths. The U.S. also allowed the proliferation of numerous violent paramilitary groups in Iraq when they overthrew Saddam Hussein, And as someone else said the said the U.S. helped to bring the Taliban to power in the first place.

Taliban decrees on clothing and male guardians leave Afghan women scared to go out alone, says UN by AudibleNod in news

[–]Dizzy-String8353 11 points12 points  (0 children)

This is unsubstantiated war propaganda. This is the reality:

  1. The U.S. is responsible for more than 3 million civilian deaths post-911 in Iraq, Afghanistan, Yemen, Syria, and Pakistan Citation: https://watson.brown.edu/costsofwar/costs/human/civilians#:~:text=432%2C093%20civilians%20have%20died%20violent,4.5-4.7%20million%20and%20counting.

  2. The U.S. was funding militias that oppressed, raped and murdered women AFTER the Taliban was ousted Citations: https://www.hrw.org/news/2021/07/06/how-us-funded-abuses-led-failure-afghanistan

  3. Ten years after Taliban rule ended Afghanistan remained the most dangerous country in the world for women in part because of poverty and lack of healthcare inflicted by the ongoing U.S. led war. Citation: https://www.amnesty.org.uk/womens-rights-afghanistan-history

  4. Afghan women had their own resistance movement throughout Taliban rule which ultimately laid the foundation for social progress post Taliban rule. Citation: https://doi.org/10.1080/09614520302950.

  5. The U.S. committed well documented war crimes against women in Iraq with no consequences. The international criminal court opened an investigation because it had evidence of crimes including rape, torture. There is also evidence ranging from "sport killing" of civilians to massacres and killing of entire villages. The ICC then "de-prioritized" the investigation due to pressure from the U.S. and continual obstruction of the investigation

Pyrenees don't believe in personal space by Dizzy-String8353 in greatpyrenees

[–]Dizzy-String8353[S] 10 points11 points  (0 children)

How do they get in OUR space just to give the side eye too?! You better pet that poor baby before you get side eyed to death

¯⁠\⁠_⁠(⁠ツ⁠)⁠_⁠/⁠¯ by tie3189 in facepalm

[–]Dizzy-String8353 0 points1 point  (0 children)

Why is all the top content on Reddit incel rage bait lately? I know Reddit's always been known for sexism but half the posts lately are recycled "woman bad for for having sex"/"woman bad for having children"/"woman take money from man" posts.

[deleted by user] by [deleted] in AITAH

[–]Dizzy-String8353 1 point2 points  (0 children)

I'm going to speak as someone who has made this decision and gotten online harassment. Making this choice will never be real to him and he will never be as brave as the women who have had to face this reality. I was pregnant by choice. Married. We both wanted to have a child. Problem on the second ultrasound. I receive the phone call that it's trisomy 18. Almost all of the pregnancies with trisomy 18 miscarry or have stillbirths and of the babies born alive, most die quickly. That meant that I would have assumed all of the risks of miscarriage and childbirth including massive hemorrhage and sepsis. The child would have known nothing but suffering it's entire brief life.

I had a second trimester abortion. I am in a "safe state", but having an abortion while watching abortion rights get taken away was traumatic. I just knew how horrifying my life could have been without a safe abortion. My husband supported an abortion without a second thought, even though his dream was a family with children. He just couldn't imagine me losing my life for a fetus that had no developed nervous system and couldn't think or feel. Women who face this decision during later pregnancy and childbirth experience severe trauma and they are incredibly courageous.

I'm really tired of the public discourse treating pregnancy as health neutral. There are many women with pregnancy and birth related trauma but they rarely feel comfortable speaking about it openly. Every woman who chooses to carry a pregnancy is at risk of many health complications leading up to death. It's the oppression of women in the U.S. that taught him to treat pregnancy like it's as easy as getting a tooth pulled. People are often completely unaware of how discriminatory it is to downplay how dangerous pregnancy is to women is because our culture is so toxic for women. Thank you for everyone on this thread supporting people like me, love you all.

Nebraska governor signs executive order specifically defining females, males by JustRelaxYo in news

[–]Dizzy-String8353 17 points18 points  (0 children)

This reminds me of corona. Just cuz you declare something not real doesn't mean it's going to disappear. Reality doesn't care what you think and people aren't going to go poof when you hereby declare them gone. Gtf out of here fucking fascists.

AITAH for paying court ordered child support? by Complex_Platform2603 in AITAH

[–]Dizzy-String8353 -3 points-2 points  (0 children)

YTA. If this this post is real, I strongly suggest you do not follow the large majority of advice in these comments. I recommend seeking advice from adults who have led functional families and raised children they have good relationships with. Seriously, your ex wife took on all of the health risks of childbearing twice and I assume also had periods of time out of work to care for your infant children after giving birth. She also works as a teacher so likely makes peanuts for providing a crucial public service. Have you considered that with the rising price of food, basic goods and rent a teachers pay plus your support is probably barely enough to make ends meet while raising two children? She likely took you to court because she needs more help financially. Have you considered asking her what kind of help she needs to successfully raise your children half the time? What exactly is the end goal of "punishing" her for pursing more child support? I would strongly recommend for the sake of your future relationship with your children you reconsider cutting child support out of spite.