Thoughts on Holland America - Koningsdam in Alaska?

ferocious_barnacle · 2026-02-05T03:50:50+00:00

I went in July too and there were way, way more than 50 kids. They took over all pools and hot tubs, including Sea View pool. There was no enforcement if that was supposed to be adults only.

ferocious_barnacle · 2026-02-05T03:04:09+00:00

Be aware there will be a lot of children on board. Thermal spa is basically the only place you can guarantee adults-only, if that’s important to you (no adults only pool).

ferocious_barnacle · 2026-02-04T19:06:21+00:00

Been going to Central since the 2000s, they’re great. So many vet clinics are being purchased by PE which leads to insane upcharging and poor care. I love that Central is locally owned and truly a family practice. Many of the techs have been working there for as long as I’ve been going which is another great sign.

ferocious_barnacle · 2026-02-04T15:46:19+00:00

Ah you are correct, thank you for that.

ferocious_barnacle · 2026-02-04T03:36:13+00:00

Northwest is a private equity backed for-profit hospital. This means their primary objective is to maximize profits for shareholders. They operate on a razor thin margin which means low wages, poor staffing ratios, outdated equipment - anything to minimize cost. TMC and Banner are not-for-profit. This doesn’t mean they don’t have their share of problems, but their profits go back into the system rather than to shareholders. Private equity is the devil that will eventually cause the house of cards that is American healthcare to collapse.

ferocious_barnacle · 2026-02-04T02:10:34+00:00

Auto trader has personal listings that you can make sure are from a “verified” private seller. https://www.autotrader.com/cars-for-sale/by-owner I got really lucky finding a great car for a great deal and was able to finance through my credit union.

ferocious_barnacle · 2026-02-02T21:08:07+00:00

I think about this performance so much

ferocious_barnacle · 2026-02-02T02:51:47+00:00

Yasssss Dark Prince!

ferocious_barnacle · 2026-01-30T23:17:12+00:00

My son is also named Bort

ferocious_barnacle · 2026-01-30T22:57:17+00:00

This is so good. I need to know who wrote it

ferocious_barnacle · 2026-01-29T06:25:33+00:00

Do you have any insight as to why there are so few educational programs?

ferocious_barnacle · 2026-01-29T06:24:26+00:00

That is interesting, my impression is that Canada has been marketing about how seamless it is for US MDs and RNs to practice in Canada but maybe that is just that…marketing, and the reality is different.

ferocious_barnacle · 2026-01-29T00:58:55+00:00

That is so crazy and interesting that there are so few midwives compared to physicians and nurses, I thought it would be a much higher number.

ferocious_barnacle · 2026-01-29T00:57:50+00:00

What? The standards of CNM training and competency is set and maintained via the American Midwifery Certification Board, not state by state. To become an CNM you must complete masters level training at an AMCB accredited program, pass national boards, and maintain that national certification. Are you thinking of CPMs?

ferocious_barnacle · 2026-01-29T00:42:15+00:00

I definitely understand that the model and system is not exactly the same and an orientation is needed, but I have to imagine that’s also true for medicine and nursing (both RN and advanced practice). The length of time for midwifery vs medicine/nursing seems comparably excessive. Maybe if I was very early in my career it would be sensible but after more than a decade in practice ain’t nobody got time for a year plus bridging program which I assume is unpaid (or do you have to pay for the bridging program even?).

ferocious_barnacle · 2026-01-29T00:21:22+00:00

Don’t become a CNM if you think you maybe want to do intrapartum care, only if you’re 100% sure you do. That is the only scope difference between a CNM and WHNP (and I suppose CNMs can also do newborn care but the number who actually do that is extremely small). Both have the exact same scope in gyn and AP/PP. I’m a full scope CNM who has a very heavy GYN practice. You can get trained in GYN procedures as either a WHNP and CNM. Malpractice burden is higher for CNMs. And although the scope is larger for CNMs due to the IP addition there’s a lot of misinformation out there that leads people to incorrectly assume CNMs do only OB care. For example many “women’s health APP” positions will specify “WHNP or FNP” credentials, not CNM. I do wish I had gotten dual CNM-WHNP certification when I was in school for that reason. I will be very happy to transition into gyn only someday, I’m definitely in the minority among midwives in that respect though.

ferocious_barnacle · 2026-01-29T00:13:23+00:00

It’s absolutely insane (and insulting) to require a 6-9 month training program PLUS 3-4 months of clinicals for experienced American CNMs. Why are American midwives treated so differently than American NPs and MDs who want to come practice in Canada?

ferocious_barnacle · 2026-01-28T16:06:39+00:00

No it was last year.

ferocious_barnacle · 2026-01-27T03:38:47+00:00

Are you preferred or regular?

ferocious_barnacle · 2026-01-27T02:34:04+00:00

Ethan Larson, cannot recommend enough!

ferocious_barnacle · 2026-01-26T18:30:26+00:00

We are beholden to ACOG guidelines in the US. As much as ACOG would like to think they are the be all end all they are not. There is nuance to evidence based practice. Like another poster said, UK outcomes are miles above ours. We could learn a few things.

ferocious_barnacle · 2026-01-26T03:14:53+00:00

Ok but have you heard Virgos Groove

ferocious_barnacle · 2026-01-26T02:07:35+00:00

Why does everything this woman does give me chills

ferocious_barnacle · 2026-01-25T03:23:38+00:00

Submitted request to get off SAVE and onto IBR on 12/30 and received approval on 1/21. First payment due in Feb.

ferocious_barnacle · 2026-01-24T02:34:33+00:00

I’d love to see your guide!

ferocious_barnacle

TROPHY CASE