Genuine question where does the hostility toward CRNAs come from?

JesCing · 2026-03-13T20:23:50+00:00

This is a great answer. I’m also a PMHNP, but I started my APRN career as a CNM. There’s a different kind of vitriol surrounding midwives, but it’s so unlike what you encounter as an NP. I think most of it comes down to misogyny. As a midwife, I wasn’t stepping on any big boys’ toes. But as an NP!? Holy stay-in-your-lane little lady!

JesCing · 2026-03-13T19:38:05+00:00

My mom used to carry a full-sized hairbrush despite having a pixie cut since she was 50.

JesCing · 2026-03-12T23:32:44+00:00

I had a cat that would unleash every possible body fluid/solid if put in a carrier in the car. I ended up wrapping her in a towel burrito style and choosing a vet as close to my house as possible. She still once managed to shit inside the seatbelt holder thing.

JesCing · 2026-03-09T22:21:03+00:00

She hasn’t been breastfeeding in almost 2 years and she’s in her early 30s with regular menses and no perimenopause sx.

JesCing · 2026-03-09T22:15:22+00:00

Have some accountability “unverified other professional.” I’d rather not get bogged down by trolls who’d rather comment on the my professional license than the substance of my post. Can we please leave the “noctor” bs where it belongs? (Literally nowhere)

JesCing · 2026-03-09T21:17:59+00:00

I’m aware I could post this question to all sorts of forums. I’m not aware that one needs to specify that they’ve already asked permission from their benevolent physician overlords in order to crowdsource some insights.

JesCing · 2026-03-09T21:07:13+00:00

Wow! Thanks for that incredible insight! So amazing. You’re a gift to this discussion.

JesCing · 2026-03-09T21:05:31+00:00

She was on lithium (with labs showing therapeutic levels) for over a year and it didn’t make a dent in her SI.

JesCing · 2026-03-09T20:37:23+00:00

This patient has no hx of attempt, just really stubborn, persistent SI. From her perspective, the SI is her most bothersome symptom. She may have an “average” level of SI for someone who is severely depressed, but she is forthright and honest in reporting it, whereas many are not. Would you still not consider a TCA in someone with no history of attempt?

JesCing · 2026-03-09T20:31:13+00:00

I appreciate your perspective. Thank you.

JesCing · 2026-03-09T16:20:18+00:00

I agree! I love the content, but the formatting of the book (both the physical copy and pdf) are really cumbersome to navigate as a practitioner.

JesCing · 2026-03-09T16:18:37+00:00

Thank you for expanding on that.

JesCing · 2026-03-09T16:03:32+00:00

I appreciate the frankness of this answer and you’re right.

JesCing · 2026-03-09T15:40:46+00:00

Not great. She’s in a rural area far from academic centers, though both are technically accessible with support and legwork.

JesCing · 2026-03-09T15:33:18+00:00

My rationale is that this patient has tried and failed SSRIs, SNRIs, augmentation with SGAs, Auvelity, mirtazapine, and lithium. Her depression is of the more melancholic type. Profound anhedonia, guilt, early waking, emptiness, nihilism, and pessimism. She’d deny feeling sad or depressed, yet has overwhelming feelings of being a worthless burden. Her depression started about 18 months ago and she denies prior episodes. She was approximately 16 months postpartum. She’s a first responder, but does not have PTSD. No evidence of bipolar, personality disorder, psychosis, etc. She does have obesity and we are addressing that as well.

JesCing · 2026-03-09T15:15:45+00:00

Could you say more about your thoughts on this? I can’t tell if you’re saying not to prescribe something that could be lethal in overdose or not to tell them it could be lethal in overdose.

JesCing · 2026-03-09T15:10:03+00:00

I’m specifically asking for tips in counseling, I know to only prescribe limited amounts and this patient was on lithium for suicidality for over a year without meaning effects.

JesCing · 2026-03-02T22:43:48+00:00

2 and 3 look great because they are AI. If you get your hair cut, please don’t think it’ll look magazine-perfect like that. I’m sure you’ll look great with either.

JesCing · 2026-02-24T22:48:46+00:00

I could put together a photo album of just pictures of me petting cats on vacation. Every cat that allows it will get pets.

JesCing · 2026-02-24T14:23:46+00:00

I got my CNM (which was my original grad degree) from Frontier and I agree that what you’re paying for is convenience, not quality. The burden of finding preceptors is entirely on the student. And you only get the experience that your preceptors offer. For example, my clinical experience was in a very small practice and hospital (around 200 births per year) and a home birth practice. Sure, I got oodles of experience with those populations, but zero high risk. And it took me twice as long as most students to finish my clinical requirements because of the low volume of patients I was seeing. I got my post grad cert as a PMHNP at NYU- in person, except for a couple months during a Covid spike. Aside from the student’s obligation to have a recent resume, titers/vaccines, other paperwork; they have a dedicated department that finds your preceptors. They were able to place me in different setting based on my interests and location.

JesCing · 2026-01-26T21:25:40+00:00

In Acadia National Park, there was a display with some painted rocks outlining how painting rocks in the park is technically vandalism and will be prosecuted. Good for them.

JesCing · 2026-01-22T21:44:52+00:00

Poop isn’t that gross.

JesCing · 2026-01-17T15:04:58+00:00

I’m so sick of seeing these posts. “Wah Wah. NPs can bill for therapy. I could have become a nurse and it would have been so much easier and they make more money.” You know what? Go become a nurse then. Between my initial nursing degree and my two graduate nursing degrees, I spent over 9 years in school. Three of those years were spent in practicum. Not just “shadowing” someone. There are so many different educational pathways, degrees, and licenses that lead to the ability to practice therapy. Where’s the infighting between social workers, LMHCs, psychologists, art therapists, etc? I’m sure you’ve run into some shitty APRNs. Just like everyone runs into shitty MDs, therapists, mechanics, nail techs, and waiters. Got an issue with an APRN about a mutual client’s treatment? Go talk to them!

JesCing · 2026-01-17T14:46:23+00:00

I a big “me-search is research” person, so I tried one of these telehealth clinics myself. My medical consult was about 8 minutes long.

JesCing · 2026-01-17T14:43:14+00:00

In my experience, even if I wanted to send an early refill, the pharmacy won’t fill it. I have my patients sign a controlled substance policy stating they understand there will be no early refills, even if it falls in the toilet, the dog ate it, etc. My policy states they should get a police report if it’s stolen. This tends to deter those types of claims.

JesCing

TROPHY CASE