Dress code violation

The inappropriate t-shirt trend has followed newFNP to the research clinic.  The reach of the inappropriate t-shirt is, apparently, far and wide.

When newFNP saw her patient filling out forms in the waiting room, she did note that his shirt said "F.B.I." across the chest.  NewFNP naively thought that this gentleman seeking to participate in a research study about methamphetamine addiction was perhaps showcasing a touch of irony.

Not so much.  Upon closer inspection, newFNP notes that underneath the "F.B.I.", the shirt read "Female Body Inspector."  Classy.  The only female body part newFNP will let this fellow inspect is her stank eye.

But the self-appointed Female Body Inspector had nothing on the wildly inappropriate t-shirt that another research participant was wearing.  This shirt was a walking advertisement for the metal band Cloven Hoof.  This shirt featured a graphic of a mullet-man orally pleasuring a woman.  Charming.  NewFNP gets it - figuratively - and she is none too pleased.  

When newFNP gets dressed in the morning, she does the usual mirror checks: no VPL, no muffin top, no boob overflow, no totally fucking offensive t-shirt.  Check, check, check and most definitely check.

I mean really.  Cloven Hoof?  Cunnilingus?  What makes someone purchase such a shirt?  And then what possesses someone to wear that shirt to a medical clinic?  

Yuck.

On the OB front

NewFNP's practice includes routine, low-risk office obstetrics. In some ways, it's a really nice practice - moms, babies - what's not to like??

Unlike other offices, newFNP's clinic does not have on-site ultrasound. Nor does her site have a family practice MD, an OB/GYN or a certified nurse midwife. Therefore, when newFNP runs up against a concerning finding, she has a few options. She can call the family practice MD at another site, she can consult with Dr. Dual-Ivy-League-Degrees who has some ER OB experience, she can page an attending OB at a nearby hospital or she can call BostonCNM for a telephone consult.

NewFNP wasn't expecting anything unusual with her 37-week primip yesterday. Sure, she was wearing a t-shirt with the phrase "OTHER BITCHES JUST FRONT" emblazoned across her chest in red 200-point font, but other than that, nothing out of the ordinary.

(As an aside, what does that even mean? Does it mean that she is a bitch, but that she in no way fronts? And if she is 100% not fronting, to what does that even refer? NewFNP is very confused.)

As newFNP starting asking her routine prenatal care questions, it came to light that her patient had been seen in the ER for preterm labor a mere six days before. Of course, she did not go to the ER where she is registered nor did she bring paperwork detailing the visit. According to her, she did not receive medications to stop the contractions, she had a normal NST, was observed overnight and then released. She had her paperwork at home, she assured newFNP, and would bring it to her next office visit.

NewFNP proceeded with the exam and was startled when she auscultated distinctly irregular fetal heart tones.

"Why they sound like that," her patient asked. "They was like that in the hospital too."

"What did the doctor say," asked newFNP.

"I dunno. He said it's normal I think," she replied.

Great. Sure, it can be normal. It can be a totally benign finding. Her 24-week level II ultrasound was normal in every way. But a repeat ultrasound or a fetal echocardiogram would provide newFNP with the reassurance she so sorely lacked at that moment.

NewFNP filled out the referral form for a perinatology consult and a repeat ultrasound.

When it comes to prenatal care, newFNP does not front. Whatever that means.