Re: Frustrations as an NFP-only NP

July 21, 2011

I don't have any advice in regards to practicing yet, but I can relate to how

you feel. Sometimes the " right way " is a lonely path. I think it's great that

you reached out for encouragement & advice. The longer I follow this path, the

more it reminds me of driving through the deserts of the southwest. It's nice &

beautiful at first, but gets pretty lonely as we grow impatient. Our fears start

getting the best of us the longer we're on the deserted highway. It's human

nature to stop paying attention to the beautiful painted desert & think about

running out of gas or getting a flat tire. By the grace of God, eventually we

see another car driving by or we happen into a small town & everything changes.

We breathe a sigh of relief & know that we are not alone. I think of this NFP

group as one of those small towns on the way... Where people are kind and

generous and encourage us on our journey.

In Christ Through ,

ps: See you at training in October!

July 21, 2011

Hello ,Like I don't have practical advice to offer you, but I think what you are doing is giving people an opportunity to change their mind and do what is right. I don't think you are complicit in their wrong doing. One More Soul has good materials that can help you, including a pamphlet I wrote on The Harm of Hormonal Contraception (I forget the exact title). In my pamphlet I refer to medical literature. The recent information on deaths from women on Yazmin should make us renew our efforts to educate people.

Keep up the good work; we are with you in our prayers and struggle,Fr.

Hello fellow NFP providers,

I’m a relatively new family nurse practitioner (been in

practice for a few months now) and need to do a little venting.

For a little background, I work in a family practice office

and do not prescribe contraceptives. The

MD with whom I work has been supportive of my decision from the get-go (he and

his partner do prescribe contraceptives).

In discussing the office logistics with regard to my decision, we

decided that if I was seeing a patient who wanted birth control, one of the MDs

would go in after I was finished with my part and provide the contraceptive

counseling/prescription. I suggested

having our scheduling staff alert patients seeking birth control, Paps, etc

that I do not prescribe contraceptives and give them the opportunity to

schedule with one of the MDs, but my collaborating MD thought that would be too

“confusing” for our schedulers. He also

mentioned that I wouldn’t get the opportunity to introduce the option of NFP to

these patients, which I thought was a good point.

Fast forward a few months.

Being the only female provider in our practice, most women coming in for

their annual PEs w/ Paps prefer to see me.

Unfortunately, most of these women are also seeking birth control. I explain how I do not prescribe

contraceptives but promote the use of NFP.

I give a couple general statements about what NFP is, and ask if they’re

interested in learning more about that option (which is usually no). I then explain how the MD will come in and

discuss BC with them after I’ve completed the exam, addressed what I need to

address, etc. I also provide information

regarding the risks associated w/ BC and take the opportunity to encourage

abstinence, particularly, in my teenage patients. Though I feel like I’ve done a little to at

least plant some seeds regarding NFP, I exit the encounter feeling frustrated

and discouraged; not even so much about the individual encounter itself, but

about the dominating contraceptive culture in which we live. It’s such a lonely feeling.

I find myself wishing these patients seeking BC weren’t

scheduled with me. But on the other

hand, I have the great opportunity to witness to these women. Even if my message reaches just one woman,

how awesome is that? But considering the time constraints and lack of continuity of care associated with having the MD then go in and see the pt, I wonder if our current system is our best option. I also feel that I am essentially " referring " them for contraceptives, since I'm facilitaing their encoutner with the MD to get their prescription. Soon, there will be occasions where I am the only provider in the office, as well; I don't want to turn a woman away for a service she was expecting, but I don't want to write a script for BC, either. Aghh!

There is a light at the end of my tunnel, though. I plan on completing the dual Creighton FCP and Medical

Consultant programs this October and next April. I am so excited to teach couples and utilize

the concepts of NaproTechnology in my practice.

I cannot wait to actually work with patients who practice NFP. If the demand is there, I would love to

eventually focus my practice solely in women’s health/Napro.

Thank you for taking the time to read this; I know I’ve been

a little long-winded. Any words of

encouragement, practical suggestions, etc would be greatly appreciated,

especially with regard to how the issue of not prescribing contraceptives is

handled in your particular offices. I

think it’s time for me to reread my copy of “Physician’s Healed” for some extra

support, as well J

God bless,

Trumble, MSN, ARNP, FNP

Orange Park, FL

-- Fr. R. Vélez765 14th Ave, Apt 1San Francisco, CA 94118Website: www.newmanbiography.com

July 21, 2011

I believe you are heroic, and I salute and admire you. I presume you have faith and religious motives at heart for making the decisions you've made thus far, and I salute that strongly. The arrangement itself is undermining you, and there would, practically speaking, be no other way for this group practice, despite what sounds like a fairly decent or at least good-willed physician collaborator.

But I have to agree with you fully when you say "I am essentially "referring" them for contraceptives" because clearly you are engaging in at least proximate material cooperation even though the arrangement could carry on totally without you. However with you there you become at least tacitly involved in the decision to "help" patients to contracept, which means you're involved in scandal (assisting someone who is leading others to sin). The usual objection to that judgment -- that they could do all this without you by totally bypassing you in this scheme -- is not the point, given that the real issue is what they feel needs to happen to patients when you're involved, and not what might happen when you're not involved.

The only way to have full integrity and responsible freedom as a practitioner in these situations is when the other providers fully respect your position that contraceptive medical practice is bad for women, and that you won't be involved in it in any way. Unfortunately, that is almost an admission on their part that contraceptive practice is bad medicine, and the problem is that in many practices and probably in your practice the other providers would not be happy with this arrangement. For reason number one, it implicitly impudence their practice and so it is one thing to tolerate your stance when they can pigeonhole you as a "true believer" who has a "religious scruple" peculiar to yourself but not touching on what's actually beneficial or harmful to patients, but quite another to cooperate in the same clinic with someone who says contraception is bad medicine, and other members of the team fully embrace it.

I can predict that some on this list might disagree with the stance I'm taking and maybe call it a little too harsh or strict. But your own heart is telling you the truth of what I'm saying, and I don't think any moral theologian in good standing would say the situation is safe morally speaking for you. On the bright side, I would love to have someone with your credentials out here with us, offering natural family planning medical practice as we had done in the past and were successful with. Can you send a resume?

Sincerely yours,

Dominic M. Pedulla MD, FACC, CNFPMC, ABVM, ACPh

Interventional Cardiologist, Endovascular Diplomate, Varicose Vein Specialist, Noncontraceptive Family Planning Consultant, Family Planning Researcher

Medical Director, The Oklahoma Vein and Endovascular Center (www.noveinok.com, veininfo@...)

Executive Director, The Edith Stein Foundation (www.theedithsteinfoundation.com)

(office)

(cell)

(FAX)

pedullad@...

â€œOur fundamental purpose is not to go out and help the poor. For us, this has only been a means. Our purpose is to maintain the Catholic faith within us, and to allow its diffusion to others through the instrument of charity.â€ Blessed Frederic Ozanam, a 19th century founder of the Society of Saint De

Re: Frustrations as an NFP-only NP

Hello ,

Like I don't have practical advice to offer you, but I think what you are doing is giving people an opportunity to change their mind and do what is right. I don't think you are complicit in their wrong doing. One More Soul has good materials that can help you, including a pamphlet I wrote on The Harm of Hormonal Contraception (I forget the exact title). In my pamphlet I refer to medical literature. The recent information on deaths from women on Yazmin should make us renew our efforts to educate people.

Keep up the good work; we are with you in our prayers and struggle,

Fr.

Hello fellow NFP providers,

Iâ€™m a relatively new family nurse practitioner (been in

practice for a few months now) and need to do a little venting.

For a little background, I work in a family practice office

and do not prescribe contraceptives. The

MD with whom I work has been supportive of my decision from the get-go (he and

his partner do prescribe contraceptives).

In discussing the office logistics with regard to my decision, we

decided that if I was seeing a patient who wanted birth control, one of the MDs

would go in after I was finished with my part and provide the contraceptive

counseling/prescription. I suggested

having our scheduling staff alert patients seeking birth control, Paps, etc

that I do not prescribe contraceptives and give them the opportunity to

schedule with one of the MDs, but my collaborating MD thought that would be too

â€œconfusingâ€ for our schedulers. He also

mentioned that I wouldnâ€™t get the opportunity to introduce the option of NFP to

these patients, which I thought was a good point.

Fast forward a few months.

Being the only female provider in our practice, most women coming in for

their annual PEs w/ Paps prefer to see me.

Unfortunately, most of these women are also seeking birth control. I explain how I do not prescribe

contraceptives but promote the use of NFP.

I give a couple general statements about what NFP is, and ask if theyâ€™re

interested in learning more about that option (which is usually no). I then explain how the MD will come in and

discuss BC with them after Iâ€™ve completed the exam, addressed what I need to

address, etc. I also provide information

regarding the risks associated w/ BC and take the opportunity to encourage

abstinence, particularly, in my teenage patients. Though I feel like Iâ€™ve done a little to at

least plant some seeds regarding NFP, I exit the encounter feeling frustrated

and discouraged; not even so much about the individual encounter itself, but

about the dominating contraceptive culture in which we live. Itâ€™s such a lonely feeling.

I find myself wishing these patients seeking BC werenâ€™t

scheduled with me. But on the other

hand, I have the great opportunity to witness to these women. Even if my message reaches just one woman,

how awesome is that? But considering the time constraints and lack of continuity of care associated with having the MD then go in and see the pt, I wonder if our current system is our best option. I also feel that I am essentially "referring" them for contraceptives, since I'm facilitaing their encoutner with the MD to get their prescription. Soon, there will be occasions where I am the only provider in the office, as well; I don't want to turn a woman away for a service she was expecting, but I don't want to write a script for BC, either. Aghh!

There is a light at the end of my tunnel, though. I plan on completing the dual Creighton FCP and Medical

Consultant programs this October and next April. I am so excited to teach couples and utilize

the concepts of NaproTechnology in my practice.

I cannot wait to actually work with patients who practice NFP. If the demand is there, I would love to

eventually focus my practice solely in womenâ€™s health/Napro.

Thank you for taking the time to read this; I know Iâ€™ve been

a little long-winded. Any words of

encouragement, practical suggestions, etc would be greatly appreciated,

especially with regard to how the issue of not prescribing contraceptives is

handled in your particular offices. I

think itâ€™s time for me to reread my copy of â€œPhysicianâ€™s Healedâ€ for some extra

support, as well J

God bless,

Trumble, MSN, ARNP, FNP

Orange Park, FL

--

Fr. R. VÃ©lez

765 14th Ave, Apt 1

San Francisco, CA 94118

Website: www.newmanbiography.com

July 21, 2011

,I work in a catholic crisis pregnancy center and yesterday gave a class on fertility awareness, touching on NFP, in the Earn while you Learn program. For my population, 85% black, average age 19, the best you can do is tell them what we know. NFP requires two motivated people to work effectively. Most of these women and their partners are not that. What we do hope for is to plant a seed. In the class, there were a few mothers of girls, two young men and about 15 pregnant girls. I saw a few lights go on. (The parents were not the lights.) That is what we hope for. Those few will ask more questions, talk about it with their friends and hopefully make a radical decision... The others will hopefully remember what they heard and think about it. I cannot change their culture and won't make myself responsible for doing that. Having raised to adulthood my five children, I know that they learn best when they decide to believe, accept and understand what their parents have faithfully imparted to them. It doesn't work to try to force them. They have God given free will and must make their own choices.The reality in my work population is that when they deliver, they will be put on contraceptives of some sort in the hospital. I at least taught them some about that so that when/ if that happens, they may ask a few more questions or think critically about it. We teach them sexual integrity, but cannot police their decisions., at least you are sharing a message with them that they would not hear otherwise. Have faith that you are making more of an impression than you realize!God bless, RoskoTo: nfpprofessionals From: jrvg98@...Date: Thu, 21 Jul 2011 08:20:00 -0700Subject: Re: Frustrations as an NFP-only NP

Hello ,Like I don't have practical advice to offer you, but I think what you are doing is giving people an opportunity to change their mind and do what is right. I don't think you are complicit in their wrong doing. One More Soul has good materials that can help you, including a pamphlet I wrote on The Harm of Hormonal Contraception (I forget the exact title). In my pamphlet I refer to medical literature. The recent information on deaths from women on Yazmin should make us renew our efforts to educate people.

Keep up the good work; we are with you in our prayers and struggle,Fr.

Hello fellow NFP providers,

I’m a relatively new family nurse practitioner (been in

practice for a few months now) and need to do a little venting.

For a little background, I work in a family practice office

and do not prescribe contraceptives. The

MD with whom I work has been supportive of my decision from the get-go (he and

his partner do prescribe contraceptives).

In discussing the office logistics with regard to my decision, we

decided that if I was seeing a patient who wanted birth control, one of the MDs

would go in after I was finished with my part and provide the contraceptive

counseling/prescription. I suggested

having our scheduling staff alert patients seeking birth control, Paps, etc

that I do not prescribe contraceptives and give them the opportunity to

schedule with one of the MDs, but my collaborating MD thought that would be too

“confusing” for our schedulers. He also

mentioned that I wouldn’t get the opportunity to introduce the option of NFP to

these patients, which I thought was a good point.

Fast forward a few months.

Being the only female provider in our practice, most women coming in for

their annual PEs w/ Paps prefer to see me.

Unfortunately, most of these women are also seeking birth control. I explain how I do not prescribe

contraceptives but promote the use of NFP.

I give a couple general statements about what NFP is, and ask if they’re

interested in learning more about that option (which is usually no). I then explain how the MD will come in and

discuss BC with them after I’ve completed the exam, addressed what I need to

address, etc. I also provide information

regarding the risks associated w/ BC and take the opportunity to encourage

abstinence, particularly, in my teenage patients. Though I feel like I’ve done a little to at

least plant some seeds regarding NFP, I exit the encounter feeling frustrated

and discouraged; not even so much about the individual encounter itself, but

about the dominating contraceptive culture in which we live. It’s such a lonely feeling.

I find myself wishing these patients seeking BC weren’t

scheduled with me. But on the other

hand, I have the great opportunity to witness to these women. Even if my message reaches just one woman,

how awesome is that? But considering the time constraints and lack of continuity of care associated with having the MD then go in and see the pt, I wonder if our current system is our best option. I also feel that I am essentially "referring" them for contraceptives, since I'm facilitaing their encoutner with the MD to get their prescription. Soon, there will be occasions where I am the only provider in the office, as well; I don't want to turn a woman away for a service she was expecting, but I don't want to write a script for BC, either. Aghh!

There is a light at the end of my tunnel, though. I plan on completing the dual Creighton FCP and Medical

Consultant programs this October and next April. I am so excited to teach couples and utilize

the concepts of NaproTechnology in my practice.

I cannot wait to actually work with patients who practice NFP. If the demand is there, I would love to

eventually focus my practice solely in women’s health/Napro.

Thank you for taking the time to read this; I know I’ve been

a little long-winded. Any words of

encouragement, practical suggestions, etc would be greatly appreciated,

especially with regard to how the issue of not prescribing contraceptives is

handled in your particular offices. I

think it’s time for me to reread my copy of “Physician’s Healed” for some extra

support, as well J

God bless,

Trumble, MSN, ARNP, FNP

Orange Park, FL

-- Fr. R. Vélez765 14th Ave, Apt 1San Francisco, CA 94118Website: www.newmanbiography.com

July 21, 2011

Sorry folks, meant to say "impugns their practice". Voice activated dictation is nice but it does have to be proofread carefully!

impudence their practice

Sincerely yours,

Dominic M. Pedulla MD, FACC, CNFPMC, ABVM, ACPh

Interventional Cardiologist, Endovascular Diplomate, Varicose Vein Specialist, Noncontraceptive Family Planning Consultant, Family Planning Researcher

Medical Director, The Oklahoma Vein and Endovascular Center (www.noveinok.com, veininfo@...)

Executive Director, The Edith Stein Foundation (www.theedithsteinfoundation.com)

(office)

(cell)

(FAX)

pedullad@...

â€œOur fundamental purpose is not to go out and help the poor. For us, this has only been a means. Our purpose is to maintain the Catholic faith within us, and to allow its diffusion to others through the instrument of charity.â€ Blessed Frederic Ozanam, a 19th century founder of the Society of Saint De

Re: Frustrations as an NFP-only NP

Hello ,

Like I don't have practical advice to offer you, but I think what you are doing is giving people an opportunity to change their mind and do what is right. I don't think you are complicit in their wrong doing. One More Soul has good materials that can help you, including a pamphlet I wrote on The Harm of Hormonal Contraception (I forget the exact title). In my pamphlet I refer to medical literature. The recent information on deaths from women on Yazmin should make us renew our efforts to educate people.

Keep up the good work; we are with you in our prayers and struggle,

Fr.

Hello fellow NFP providers,

Iâ€™m a relatively new family nurse practitioner (been in

practice for a few months now) and need to do a little venting.

For a little background, I work in a family practice office

and do not prescribe contraceptives. The

MD with whom I work has been supportive of my decision from the get-go (he and

his partner do prescribe contraceptives).

In discussing the office logistics with regard to my decision, we

decided that if I was seeing a patient who wanted birth control, one of the MDs

would go in after I was finished with my part and provide the contraceptive

counseling/prescription. I suggested

having our scheduling staff alert patients seeking birth control, Paps, etc

that I do not prescribe contraceptives and give them the opportunity to

schedule with one of the MDs, but my collaborating MD thought that would be too

â€œconfusingâ€ for our schedulers. He also

mentioned that I wouldnâ€™t get the opportunity to introduce the option of NFP to

these patients, which I thought was a good point.

Fast forward a few months.

Being the only female provider in our practice, most women coming in for

their annual PEs w/ Paps prefer to see me.

Unfortunately, most of these women are also seeking birth control. I explain how I do not prescribe

contraceptives but promote the use of NFP.

I give a couple general statements about what NFP is, and ask if theyâ€™re

interested in learning more about that option (which is usually no). I then explain how the MD will come in and

discuss BC with them after Iâ€™ve completed the exam, addressed what I need to

address, etc. I also provide information

regarding the risks associated w/ BC and take the opportunity to encourage

abstinence, particularly, in my teenage patients. Though I feel like Iâ€™ve done a little to at

least plant some seeds regarding NFP, I exit the encounter feeling frustrated

and discouraged; not even so much about the individual encounter itself, but

about the dominating contraceptive culture in which we live. Itâ€™s such a lonely feeling.

I find myself wishing these patients seeking BC werenâ€™t

scheduled with me. But on the other

hand, I have the great opportunity to witness to these women. Even if my message reaches just one woman,

how awesome is that? But considering the time constraints and lack of continuity of care associated with having the MD then go in and see the pt, I wonder if our current system is our best option. I also feel that I am essentially "referring" them for contraceptives, since I'm facilitaing their encoutner with the MD to get their prescription. Soon, there will be occasions where I am the only provider in the office, as well; I don't want to turn a woman away for a service she was expecting, but I don't want to write a script for BC, either. Aghh!

There is a light at the end of my tunnel, though. I plan on completing the dual Creighton FCP and Medical

Consultant programs this October and next April. I am so excited to teach couples and utilize

the concepts of NaproTechnology in my practice.

I cannot wait to actually work with patients who practice NFP. If the demand is there, I would love to

eventually focus my practice solely in womenâ€™s health/Napro.

Thank you for taking the time to read this; I know Iâ€™ve been

a little long-winded. Any words of

encouragement, practical suggestions, etc would be greatly appreciated,

especially with regard to how the issue of not prescribing contraceptives is

handled in your particular offices. I

think itâ€™s time for me to reread my copy of â€œPhysicianâ€™s Healedâ€ for some extra

support, as well J

God bless,

Trumble, MSN, ARNP, FNP

Orange Park, FL

--

Fr. R. VÃ©lez

765 14th Ave, Apt 1

San Francisco, CA 94118

Website: www.newmanbiography.com

July 21, 2011

Hi Congratulations on being a new NP! Thank you for being NFP only. I totally and completely understand your dilema. Been there, done that. Still deal with it all the time. I hate to tell you, unless you work in an NFP only practice, it won't get better. I don't say that to discourage you, but so you can deal with the realities of the world we work in. I am also going to disagree with my friend Dominic on this one. This is not your private practice. These patients are not coming to see a solo provider or someone who does not Rx contraception. This practice and these patients already belong to a contracepting practice, and physicians who are providing

contraception. You are really just helping the physicians with the part of the exam, diagnosing, and treatment that you are able to do, then relinquishing care back to the physician for the piece that you do not provide. The fact that the patients are requesting you is nice, because you do get a chance to bring up the points that you know the physicians probably will not. *WE* know that what the patient is asking and what the physicians are providing is wrong, but it is not in our ability, or YOUR ability to control that. You are planting seeds where there were previously none, and raising awareness. You are the beacon of light in a sea of darkness, especially for those young women. Don't give up on them yet. I am not sure what your approach has been thus far, but in addition to talking about the abortificacient effects of all hormonal

contraceptives, and IUD's, try to bring up the GREEN, Natural, aspects of NFP. The ability to monitor for health problems, the need to be off hormones to decrease the risk for miscarriage when a woman might decide to try and achieve a pregnancy. In my experience, *ANY* talking and teaching you do, is far more that the other providers will do or have ever done. Soon, you will be getting appointments from people who want to see you BECAUSE you do not contracept, and because you can help them with their NFP or female problems.When you are alone in the office, make sure to be clear with the front office staff as well as being clear with the physicians, that you will not be providing the Rx the pt wants. They need to determine that at the beginning, when they check in. Perhaps having them fill out an update form upon check-in that includes the questions "Are you here for any refill on birth control

today? Do you need the doctor to give you a refill for birth control? Do you need a refill or new prescription for any other medications"In my experience, what will normally happen is the patient will tell you or the other staff what she wants (ie OrthoNovum, Seasonale, etc) and they will pass it on to the physician to write the script, or they will call it in to the pharmacy. If you are using electronic Scripts, it might become a little stickier, depending on who has access to that portion of the EMR. The pt may have to wait. Again, when you are passing on the information, I know it might feel as if you are "helping" in some way, but you are not. You are relaying the information about the pt. The pt is using xyz and wants a refill. If you were in private practice, it might be a different story. I usually tell my patients from

the outset that I do not Rx. Around here, many women get OCP's or shots from Mexico, so they are not really concerned. When they are surprised, and ask what they should do. I direct them to the phone book. Every Ob/GYN does Rx. Am I referring them because I say that? No. I am just stating a fact. What state do you live in? Do you have independent Rx authority?About the CrM training, it is awesome! Do you have access to a diocese or physicians that will refer clients to you? My problem with the Creighton program was never getting the number of clients they wanted for us to get certified. At the time, (2005), even if we, as non-physicians complete the Medical Consultant training and pass the tests, we can not use the designation as a Medical Consultant, unless we

also get certified as a Practitioner. I don't think that has changed. Don't let that stop you from getting the training, but just a heads up that it might be difficult to get the 18 clients, depending on the dynamics of your practice and where you live. You can email me privately if you need to vent! Sandrock, RNC-OB, APRN, CNM, MSN ....blah blah blah....To: nfpprofessionals Sent: Thursday, July 21, 2011 12:57 AMSubject: Frustrations as an NFP-only NP

Hello fellow NFP providers,

Iâ€™m a relatively new family nurse practitioner (been in

practice for a few months now) and need to do a little venting.

For a little background, I work in a family practice office

and do not prescribe contraceptives. The

MD with whom I work has been supportive of my decision from the get-go (he and

his partner do prescribe contraceptives).

In discussing the office logistics with regard to my decision, we

decided that if I was seeing a patient who wanted birth control, one of the MDs

would go in after I was finished with my part and provide the contraceptive

counseling/prescription. I suggested

having our scheduling staff alert patients seeking birth control, Paps, etc

that I do not prescribe contraceptives and give them the opportunity to

schedule with one of the MDs, but my collaborating MD thought that would be too

â€œconfusingâ€ for our schedulers. He also

mentioned that I wouldnâ€™t get the opportunity to introduce the option of NFP to

these patients, which I thought was a good point.

Fast forward a few months.

Being the only female provider in our practice, most women coming in for

their annual PEs w/ Paps prefer to see me.

Unfortunately, most of these women are also seeking birth control. I explain how I do not prescribe

contraceptives but promote the use of NFP.

I give a couple general statements about what NFP is, and ask if theyâ€™re

interested in learning more about that option (which is usually no). I then explain how the MD will come in and

discuss BC with them after Iâ€™ve completed the exam, addressed what I need to

address, etc. I also provide information

regarding the risks associated w/ BC and take the opportunity to encourage

abstinence, particularly, in my teenage patients. Though I feel like Iâ€™ve done a little to at

least plant some seeds regarding NFP, I exit the encounter feeling frustrated

and discouraged; not even so much about the individual encounter itself, but

about the dominating contraceptive culture in which we live. Itâ€™s such a lonely feeling.

I find myself wishing these patients seeking BC werenâ€™t

scheduled with me. But on the other

hand, I have the great opportunity to witness to these women. Even if my message reaches just one woman,

how awesome is that? But considering the time constraints and lack of continuity of care associated with having the MD then go in and see the pt, I wonder if our current system is our best option. I also feel that I am essentially "referring" them for contraceptives, since I'm facilitaing their encoutner with the MD to get their prescription. Soon, there will be occasions where I am the only provider in the office, as well; I don't want to turn a woman away for a service she was expecting, but I don't want to write a script for BC, either. Aghh!

There is a light at the end of my tunnel, though. I plan on completing the dual Creighton FCP and Medical

Consultant programs this October and next April. I am so excited to teach couples and utilize

the concepts of NaproTechnology in my practice.

I cannot wait to actually work with patients who practice NFP. If the demand is there, I would love to

eventually focus my practice solely in womenâ€™s health/Napro.

Thank you for taking the time to read this; I know Iâ€™ve been

a little long-winded. Any words of

encouragement, practical suggestions, etc would be greatly appreciated,

especially with regard to how the issue of not prescribing contraceptives is

handled in your particular offices. I

think itâ€™s time for me to reread my copy of â€œPhysicianâ€™s Healedâ€ for some extra

support, as well J

God bless,

Trumble, MSN, ARNP, FNP

Orange Park, FL

July 21, 2011

I don't see how a Catholic doctor could in good conscience be involved with this. It would be tantamount to admitting a "need" for prescription contraception for contraceptive purposes. And already knows this. Now, what might be different is if they conmpletley respected her care of her patients and let her take care of them as she sees fit. What nerve they have to get her to agree to have people come in after her to offer hemlock, when her only desire was ever to help people!

Do you need the doctor to give you a refill for birth control?

Sincerely yours,

Dominic M. Pedulla MD, FACC, CNFPMC, ABVM, ACPh

Interventional Cardiologist, Endovascular Diplomate, Varicose Vein Specialist, Noncontraceptive Family Planning Consultant, Family Planning Researcher

Medical Director, The Oklahoma Vein and Endovascular Center (www.noveinok.com, veininfo@...)

Executive Director, The Edith Stein Foundation (www.theedithsteinfoundation.com)

(office)

(cell)

(FAX)

pedullad@...

â€œOur fundamental purpose is not to go out and help the poor. For us, this has only been a means. Our purpose is to maintain the Catholic faith within us, and to allow its diffusion to others through the instrument of charity.â€ Blessed Frederic Ozanam, a 19th century founder of the Society of Saint De

Frustrations as an NFP-only NP

Hello fellow NFP providers,

Iâ€™m a relatively new family nurse practitioner (been in

practice for a few months now) and need to do a little venting.

For a little background, I work in a family practice office

and do not prescribe contraceptives. The

MD with whom I work has been supportive of my decision from the get-go (he and

his partner do prescribe contraceptives).

In discussing the office logistics with regard to my decision, we

decided that if I was seeing a patient who wanted birth control, one of the MDs

would go in after I was finished with my part and provide the contraceptive

counseling/prescription. I suggested

having our scheduling staff alert patients seeking birth control, Paps, etc

that I do not prescribe contraceptives and give them the opportunity to

schedule with one of the MDs, but my collaborating MD thought that would be too

â€œconfusingâ€ for our schedulers. He also

mentioned that I wouldnâ€™t get the opportunity to introduce the option of NFP to

these patients, which I thought was a good point.

Fast forward a few months.

Being the only female provider in our practice, most women coming in for

their annual PEs w/ Paps prefer to see me.

Unfortunately, most of these women are also seeking birth control. I explain how I do not prescribe

contraceptives but promote the use of NFP.

I give a couple general statements about what NFP is, and ask if theyâ€™re

interested in learning more about that option (which is usually no). I then explain how the MD will come in and

discuss BC with them after Iâ€™ve completed the exam, addressed what I need to

address, etc. I also provide information

regarding the risks associated w/ BC and take the opportunity to encourage

abstinence, particularly, in my teenage patients. Though I feel like Iâ€™ve done a little to at

least plant some seeds regarding NFP, I exit the encounter feeling frustrated

and discouraged; not even so much about the individual encounter itself, but

about the dominating contraceptive culture in which we live. Itâ€™s such a lonely feeling.

I find myself wishing these patients seeking BC werenâ€™t

scheduled with me. But on the other

hand, I have the great opportunity to witness to these women. Even if my message reaches just one woman,

how awesome is that? But considering the time constraints and lack of continuity of care associated with having the MD then go in and see the pt, I wonder if our current system is our best option. I also feel that I am essentially "referring" them for contraceptives, since I'm facilitaing their encoutner with the MD to get their prescription. Soon, there will be occasions where I am the only provider in the office, as well; I don't want to turn a woman away for a service she was expecting, but I don't want to write a script for BC, either. Aghh!

There is a light at the end of my tunnel, though. I plan on completing the dual Creighton FCP and Medical

Consultant programs this October and next April. I am so excited to teach couples and utilize

the concepts of NaproTechnology in my practice.

I cannot wait to actually work with patients who practice NFP. If the demand is there, I would love to

eventually focus my practice solely in womenâ€™s health/Napro.

Thank you for taking the time to read this; I know Iâ€™ve been

a little long-winded. Any words of

encouragement, practical suggestions, etc would be greatly appreciated,

especially with regard to how the issue of not prescribing contraceptives is

handled in your particular offices. I

think itâ€™s time for me to reread my copy of â€œPhysicianâ€™s Healedâ€ for some extra

support, as well J

God bless,

Trumble, MSN, ARNP, FNP

Orange Park, FL

July 21, 2011

,

Congrats on your new job and new degree! That's awesome that you're NFP-only. It's definitely not an easy moral position to explain or act on! I'm a resident and have asked several mentors, spiritual directors, and even ethicists about specific situations I've been in the past 3 years and I can tell you what I know.

It sounds like you're in a position where you are a " material participant " in their sin.. as opposed to the other participation which is more serious. My SD told me that by counselling a woman and telling the resident what birth control they wanted (I was a medical student at the time).. taht it was material participation. He seemed okay with this option as a necessary evil for me getting the medical training and being a practicing Catholic doctor.. but I asked if it was a level of sin that I would then have to confess. He said I should confess it every time... and that didn't sit right with me. Pretty much against the act of contrition that promises to avoid sin. (I don't know if you're Catholic.. but that's my Catholic answer, I guess, if it applies).

On my OB rotation as an MD this past year, I was in a position more similar to yours. I spoke with an ethicist about it (which you can call! there's a bioethics hotline - ).. I decided with him that I was referring for contraceptives if I left a room and told someone else " this woman wants Depo/Implanon/micronor/____ " . It might seem like semantics, but it helped my conscience to be more careful abotu my wording both with the patient and with my co-workers... by telling the patient " I don't prescribe birth control, but would love to talk to you about natural fertility monitoring if you're interested. If you're not, there are many other doctors that will be willing to prescribe it. " And then left it to them to decide if they were asking someone else. I would also provide my colleagues with a list of people that I " did not discuss contraception with " ... as opposed to saying the list was people requesting contraception. It worked for me for a month... it could help you a little. Or, I really wonder if you can just tell he physician that it's put you in a difficult situation.. and you're just going to need to tell the women that you won't prescribe it, but they are welcome to see someone else, even within the practice. It might so happen that they come to you for PAPs, and then call and ask one of your partners for refills.. or make a second appointment. Or, if it's a real pain.. they'll decide to go to the male doctors. I ended up electing out of my student health rotation because it would be mostly contraceptive counselling, and I felt that would put me in a position where I would be really uncomfortable and butting up against my values on a daily basis. If it's coming to that for you ( I don't know how much gyn you get daily)... I'd very seriously consider talking to the physician again about having the schedulers alert patients. That's how one of the OBs I know handles it.. and that's what my practice is planning to do for me. It is a special request, but it is done. As a style point, I've heard practices that make sure not to bill a patient if they come in for contraception only and slip through to your schedule, but don't end up getting it from anyone at that visit.

None of the suggestions I can think of make any of it easy... but your struggle is carrying the cross alongside God's own heart for your patient's sexuality. You're never in it alone.. He started it all in the first place! Glad you're part of the group!!

~Kirsten

,

I work in a catholic crisis pregnancy center and yesterday gave a class on fertility awareness, touching on NFP, in the Earn while you Learn program. For my population, 85% black, average age 19, the best you can do is tell them what we know. NFP requires two motivated people to work effectively. Most of these women and their partners are not that. What we do hope for is to plant a seed. In the class, there were a few mothers of girls, two young men and about 15 pregnant girls. I saw a few lights go on. (The parents were not the lights.) That is what we hope for. Those few will ask more questions, talk about it with their friends and hopefully make a radical decision... The others will hopefully remember what they heard and think about it. I cannot change their culture and won't make myself responsible for doing that. Having raised to adulthood my five children, I know that they learn best when they decide to believe, accept and understand what their parents have faithfully imparted to them. It doesn't work to try to force them. They have God given free will and must make their own choices.

The reality in my work population is that when they deliver, they will be put on contraceptives of some sort in the hospital. I at least taught them some about that so that when/ if that happens, they may ask a few more questions or think critically about it. We teach them sexual integrity, but cannot police their decisions.

, at least you are sharing a message with them that they would not hear otherwise. Have faith that you are making more of an impression than you realize!God bless,

Rosko

To: nfpprofessionals From: jrvg98@...Date: Thu, 21 Jul 2011 08:20:00 -0700 Subject: Re: Frustrations as an NFP-only NP

Hello ,

Like I don't have practical advice to offer you, but I think what you are doing is giving people an opportunity to change their mind and do what is right. I don't think you are complicit in their wrong doing. One More Soul has good materials that can help you, including a pamphlet I wrote on The Harm of Hormonal Contraception (I forget the exact title). In my pamphlet I refer to medical literature. The recent information on deaths from women on Yazmin should make us renew our efforts to educate people.

Keep up the good work; we are with you in our prayers and struggle,

Fr.

Hello fellow NFP providers,

I’m a relatively new family nurse practitioner (been in practice for a few months now) and need to do a little venting.

For a little background, I work in a family practice office and do not prescribe contraceptives. The MD with whom I work has been supportive of my decision from the get-go (he and his partner do prescribe contraceptives). In discussing the office logistics with regard to my decision, we decided that if I was seeing a patient who wanted birth control, one of the MDs would go in after I was finished with my part and provide the contraceptive counseling/prescription. I suggested having our scheduling staff alert patients seeking birth control, Paps, etc that I do not prescribe contraceptives and give them the opportunity to schedule with one of the MDs, but my collaborating MD thought that would be too “confusing” for our schedulers. He also mentioned that I wouldn’t get the opportunity to introduce the option of NFP to these patients, which I thought was a good point.

Fast forward a few months. Being the only female provider in our practice, most women coming in for their annual PEs w/ Paps prefer to see me. Unfortunately, most of these women are also seeking birth control. I explain how I do not prescribe contraceptives but promote the use of NFP. I give a couple general statements about what NFP is, and ask if they’re interested in learning more about that option (which is usually no). I then explain how the MD will come in and discuss BC with them after I’ve completed the exam, addressed what I need to address, etc. I also provide information regarding the risks associated w/ BC and take the opportunity to encourage abstinence, particularly, in my teenage patients. Though I feel like I’ve done a little to at least plant some seeds regarding NFP, I exit the encounter feeling frustrated and discouraged; not even so much about the individual encounter itself, but about the dominating contraceptive culture in which we live. It’s such a lonely feeling.

I find myself wishing these patients seeking BC weren’t scheduled with me. But on the other hand, I have the great opportunity to witness to these women. Even if my message reaches just one woman, how awesome is that? But considering the time constraints and lack of continuity of care associated with having the MD then go in and see the pt, I wonder if our current system is our best option. I also feel that I am essentially " referring " them for contraceptives, since I'm facilitaing their encoutner with the MD to get their prescription. Soon, there will be occasions where I am the only provider in the office, as well; I don't want to turn a woman away for a service she was expecting, but I don't want to write a script for BC, either. Aghh!

There is a light at the end of my tunnel, though. I plan on completing the dual Creighton FCP and Medical Consultant programs this October and next April. I am so excited to teach couples and utilize the concepts of NaproTechnology in my practice. I cannot wait to actually work with patients who practice NFP. If the demand is there, I would love to eventually focus my practice solely in women’s health/Napro.

Thank you for taking the time to read this; I know I’ve been a little long-winded. Any words of encouragement, practical suggestions, etc would be greatly appreciated, especially with regard to how the issue of not prescribing contraceptives is handled in your particular offices. I think it’s time for me to reread my copy of “Physician’s Healed” for some extra support, as well J

God bless,

Trumble, MSN, ARNP, FNP

Orange Park, FL

-- Fr. R. Vélez765 14th Ave, Apt 1San Francisco, CA 94118Website: www.newmanbiography.com

July 21, 2011

Kirsten is 100% right I believe, and it's good and trustworthy advice.

Sincerely yours,

Dominic M. Pedulla MD, FACC, CNFPMC, ABVM, ACPh

Interventional Cardiologist, Endovascular Diplomate, Varicose Vein Specialist, Noncontraceptive Family Planning Consultant, Family Planning Researcher

Medical Director, The Oklahoma Vein and Endovascular Center (www.noveinok.com, veininfo@...)

Executive Director, The Edith Stein Foundation (www.theedithsteinfoundation.com)

(office)

(cell)

(FAX)

pedullad@...

â€œOur fundamental purpose is not to go out and help the poor. For us, this has only been a means. Our purpose is to maintain the Catholic faith within us, and to allow its diffusion to others through the instrument of charity.â€ Blessed Frederic Ozanam, a 19th century founder of the Society of Saint De

Re: Frustrations as an NFP-only NP

Hello ,

Like I don't have practical advice to offer you, but I think what you are doing is giving people an opportunity to change their mind and do what is right. I don't think you are complicit in their wrong doing. One More Soul has good materials that can help you, including a pamphlet I wrote on The Harm of Hormonal Contraception (I forget the exact title). In my pamphlet I refer to medical literature. The recent information on deaths from women on Yazmin should make us renew our efforts to educate people.

Keep up the good work; we are with you in our prayers and struggle,

Fr.

Hello fellow NFP providers,

Iâ€™m a relatively new family nurse practitioner (been in practice for a few months now) and need to do a little venting.

For a little background, I work in a family practice office and do not prescribe contraceptives. The MD with whom I work has been supportive of my decision from the get-go (he and his partner do prescribe contraceptives). In discussing the office logistics with regard to my decision, we decided that if I was seeing a patient who wanted birth control, one of the MDs would go in after I was finished with my part and provide the contraceptive counseling/prescription. I suggested having our scheduling staff alert patients seeking birth control, Paps, etc that I do not prescribe contraceptives and give them the opportunity to schedule with one of the MDs, but my collaborating MD thought that would be too â€œconfusingâ€ for our schedulers. He also mentioned that I wouldnâ€™t get the opportunity to introduce the option of NFP to these patients, which I thought was a good point.

Fast forward a few months. Being the only female provider in our practice, most women coming in for their annual PEs w/ Paps prefer to see me. Unfortunately, most of these women are also seeking birth control. I explain how I do not prescribe contraceptives but promote the use of NFP. I give a couple general statements about what NFP is, and ask if theyâ€™re interested in learning more about that option (which is usually no). I then explain how the MD will come in and discuss BC with them after Iâ€™ve completed the exam, addressed what I need to address, etc. I also provide information regarding the risks associated w/ BC and take the opportunity to encourage abstinence, particularly, in my teenage patients. Though I feel like Iâ€™ve done a little to at least plant some seeds regarding NFP, I exit the encounter feeling frustrated and discouraged; not even so much about the individual encounter itself, but about the dominating contraceptive culture in which we live. Itâ€™s such a lonely feeling.

I find myself wishing these patients seeking BC werenâ€™t scheduled with me. But on the other hand, I have the great opportunity to witness to these women. Even if my message reaches just one woman, how awesome is that? But considering the time constraints and lack of continuity of care associated with having the MD then go in and see the pt, I wonder if our current system is our best option. I also feel that I am essentially "referring" them for contraceptives, since I'm facilitaing their encoutner with the MD to get their prescription. Soon, there will be occasions where I am the only provider in the office, as well; I don't want to turn a woman away for a service she was expecting, but I don't want to write a script for BC, either. Aghh!

There is a light at the end of my tunnel, though. I plan on completing the dual Creighton FCP and Medical Consultant programs this October and next April. I am so excited to teach couples and utilize the concepts of NaproTechnology in my practice. I cannot wait to actually work with patients who practice NFP. If the demand is there, I would love to eventually focus my practice solely in womenâ€™s health/Napro.

Thank you for taking the time to read this; I know Iâ€™ve been a little long-winded. Any words of encouragement, practical suggestions, etc would be greatly appreciated, especially with regard to how the issue of not prescribing contraceptives is handled in your particular offices. I think itâ€™s time for me to reread my copy of â€œPhysicianâ€™s Healedâ€ for some extra support, as well J

God bless,

Trumble, MSN, ARNP, FNP

Orange Park, FL

--

Fr. R. VÃ©lez

765 14th Ave, Apt 1

San Francisco, CA 94118

Website: www.newmanbiography.com

July 21, 2011

Yes I agree, but as 's collaborator did say, correctly I think, opportunities may be lost to convince someone because they may cancel the appointment as soon as they learn they can't get contraceptives there. That has always bothered me. Nevertheless, while the evangelist in me wants to ask why we're expected to announce beforehand that we're not offering hemlock today, the pragmatist in me is constrained to acknowledge, much against my preference, that yes, in some situations the conditions are so bad that the most useful approach is to post some such warnings, just to keep peace and sanity in what might otherwise become a hopelessly adversarial situation.

Somehow we must in the future do far better than merely to avoid becoming conscripts in the contraceptive revolution, and instead become the sirens, architects, and foot soldiers of the counter-revolution!

More on that later perhaps.....what about not-for-profit national medical practices specializing in NFP and in handlilng the numerous and diverse complications of contraception? Wouldn't this be a genuine healthcare way of having a "preferential option for the poor"? (meaning here not just those materially impoverished but especially the contraceptively-spiritually impoverished)

Sincerely yours,

Dominic M. Pedulla MD, FACC, CNFPMC, ABVM, ACPh

Interventional Cardiologist, Endovascular Diplomate, Varicose Vein Specialist, Noncontraceptive Family Planning Consultant, Family Planning Researcher

Medical Director, The Oklahoma Vein and Endovascular Center (www.noveinok.com, veininfo@...)

Executive Director, The Edith Stein Foundation (www.theedithsteinfoundation.com)

(office)

(cell)

(FAX)

pedullad@...

â€œOur fundamental purpose is not to go out and help the poor. For us, this has only been a means. Our purpose is to maintain the Catholic faith within us, and to allow its diffusion to others through the instrument of charity.â€ Blessed Frederic Ozanam, a 19th century founder of the Society of Saint De

Re: Frustrations as an NFP-only NP

Hello - I have been a lurker and read with interest all the communication here and this is my first posting.

Possibly this has already been said or tried, but....Would it help to print out the reasons you do not prescribe BC, post them in a prominent place, and have a handout available to give to the clients when they make an appointment? - In this way many clinets are educated - and have something to reflect upon.Then, if they still choose to come to you, you do not need to hint at anything and have started educating them before even seeing them.

You have been educated and trained specifically in this area and these are your professional and personal convictions. If I, as a patient, am doing something that is harming my health - I would like my provider to educate me (gently, but thoroughly) So I can consider all my options.

Budke, LPN

Billings instructor

Re: Frustrations as an NFP-only NP

,

Congrats on your new job and new degree! That's awesome that you're NFP-only. It's definitely not an easy moral position to explain or act on! I'm a resident and have asked several mentors, spiritual directors, and even ethicists about specific situations I've been in the past 3 years and I can tell you what I know.

It sounds like you're in a position where you are a "material participant" in their sin.. as opposed to the other participation which is more serious. My SD told me that by counselling a woman and telling the resident what birth control they wanted (I was a medical student at the time).. taht it was material participation. He seemed okay with this option as a necessary evil for me getting the medical training and being a practicing Catholic doctor.. but I asked if it was a level of sin that I would then have to confess. He said I should confess it every time... and that didn't sit right with me. Pretty much against the act of contrition that promises to avoid sin. (I don't know if you're Catholic.. but that's my Catholic answer, I guess, if it applies).

On my OB rotation as an MD this past year, I was in a position more similar to yours. I spoke with an ethicist about it (which you can call! there's a bioethics hotline - ).. I decided with him that I was referring for contraceptives if I left a room and told someone else "this woman wants Depo/Implanon/micronor/____". It might seem like semantics, but it helped my conscience to be more careful abotu my wording both with the patient and with my co-workers... by telling the patient "I don't prescribe birth control, but would love to talk to you about natural fertility monitoring if you're interested. If you're not, there are many other doctors that will be willing to prescribe it." And then left it to them to decide if they were asking someone else. I would also provide my colleagues with a list of people that I "did not discuss contraception with"... as opposed to saying the list was people requesting contraception. It worked for me for a month... it could help you a little. Or, I really wonder if you can just tell he physician that it's put you in a difficult situation.. and you're just going to need to tell the women that you won't prescribe it, but they are welcome to see someone else, even within the practice. It might so happen that they come to you for PAPs, and then call and ask one of your partners for refills.. or make a second appointment. Or, if it's a real pain.. they'll decide to go to the male doctors. I ended up electing out of my student health rotation because it would be mostly contraceptive counselling, and I felt that would put me in a position where I would be really uncomfortable and butting up against my values on a daily basis. If it's coming to that for you ( I don't know how much gyn you get daily)... I'd very seriously consider talking to the physician again about having the schedulers alert patients. That's how one of the OBs I know handles it.. and that's what my practice is planning to do for me. It is a special request, but it is done. As a style point, I've heard practices that make sure not to bill a patient if they come in for contraception only and slip through to your schedule, but don't end up getting it from anyone at that visit.

None of the suggestions I can think of make any of it easy... but your struggle is carrying the cross alongside God's own heart for your patient's sexuality. You're never in it alone.. He started it all in the first place! Glad you're part of the group!!

~Kirsten

July 21, 2011

You guys are splitting hairs. Having that same visit, right after the NP sees the patient, is just the same.To: nfpprofessionals Sent: Thursday, July 21, 2011 3:27 PMSubject: Re: Frustrations as an NFP-only NP

I agree.

Sincerely yours,

Dominic M. Pedulla MD, FACC, CNFPMC, ABVM, ACPh

Interventional Cardiologist, Endovascular Diplomate, Varicose Vein Specialist, Noncontraceptive Family Planning Consultant, Family Planning Researcher

Medical Director, The Oklahoma Vein and Endovascular Center (www.noveinok.com, veininfo@...)

Executive Director, The Edith Stein Foundation (www.theedithsteinfoundation.com)

(office)

(cell)

(FAX)

pedullad@...

â€œOur fundamental purpose is not to go out and help the poor. For us, this has only been a means. Our purpose is to maintain the Catholic faith within us, and to allow its diffusion to others through the instrument of charity.â€ Blessed Frederic Ozanam, a 19th century founder of the Society of Saint De

Re: Frustrations as an NFP-only NP

,

Congrats on your new job and new degree! That's awesome that you're NFP-only. It's definitely not an easy moral position to explain or act on! I'm a resident and have asked several mentors, spiritual directors, and even ethicists about specific situations I've been in the past 3 years and I can tell you what I know.

It sounds like you're in a position where you are a "material participant" in their sin.. as opposed to the other participation which is more serious. My SD told me that by counselling a woman and telling the resident what birth control they wanted (I was a medical student at the time).. taht it was material participation. He seemed okay with this option as a necessary evil for me getting the medical training and being a practicing Catholic doctor.. but I asked if it was a level of sin that I would then have to confess. He said I should confess it every time... and that didn't sit right with me. Pretty much against the act of contrition that promises to avoid sin. (I don't know if you're Catholic.. but that's my Catholic answer, I guess, if it applies).

On my OB rotation as an MD this past year, I was in a position more similar to yours. I spoke with an ethicist about it (which you can call! there's a bioethics hotline - ).. I decided with him that I was referring for contraceptives if I left a room and told someone else "this woman wants Depo/Implanon/micronor/____". It might seem like semantics, but it helped my conscience to be more careful abotu my wording both with the patient and with my co-workers... by telling the patient "I don't prescribe birth control, but would love to talk to you about natural fertility monitoring if you're interested. If you're not, there are many other doctors that will be willing to prescribe it." And then left it to them to decide if they were asking someone else. I would also provide my colleagues with a list of people that I "did not discuss contraception with"... as opposed to saying the list

was people requesting contraception. It worked for me for a month... it could help you a little. Or, I really wonder if you can just tell he physician that it's put you in a difficult situation.. and you're just going to need to tell the women that you won't prescribe it, but they are welcome to see someone else, even within the practice. It might so happen that they come to you for PAPs, and then call and ask one of your partners for refills.. or make a second appointment. Or, if it's a real pain.. they'll decide to go to the male doctors. I ended up electing out of my student health rotation because it would be mostly contraceptive counselling, and I felt that would put me in a position where I would be really uncomfortable and butting up against my values on a daily basis. If it's coming to that for you ( I don't know how much gyn you get daily)... I'd very seriously consider talking to the physician again about

having the schedulers alert patients. That's how one of the OBs I know handles it.. and that's what my practice is planning to do for me. It is a special request, but it is done. As a style point, I've heard practices that make sure not to bill a patient if they come in for contraception only and slip through to your schedule, but don't end up getting it from anyone at that visit.

None of the suggestions I can think of make any of it easy... but your struggle is carrying the cross alongside God's own heart for your patient's sexuality. You're never in it alone.. He started it all in the first place! Glad you're part of the group!!

~Kirsten

July 21, 2011

,

There has been so much back and forth on your situation that I more or less lost track of it. I have two suggestions. First, be aware that the Hilgers' programs are very light on the value of the temperature sign and ecological breastfeeding. Fehring has shown the value of crosschecking the mucus sign.

Second, if you stay at that office, perhaps you could write up a release to be signed or at least reviewed by your patients. It would include the data about the links between OCs and breast cancer and other effects. Getting it by your docs would be almost impossible, but it might serve to raise the question about what they really do think about writing prescriptions for a known carcinogen.

Kippley

www.nfpandmore.org

Frustrations as an NFP-only NP

Hello fellow NFP providers,

I’m a relatively new family nurse practitioner (been in practice for a few months now) and need to do a little venting.

For a little background, I work in a family practice office and do not prescribe contraceptives. The MD with whom I work has been supportive of my decision from the get-go (he and his partner do prescribe contraceptives). In discussing the office logistics with regard to my decision, we decided that if I was seeing a patient who wanted birth control, one of the MDs would go in after I was finished with my part and provide the contraceptive counseling/prescription. I suggested having our scheduling staff alert patients seeking birth control, Paps, etc that I do not prescribe contraceptives and give them the opportunity to schedule with one of the MDs, but my collaborating MD thought that would be too “confusing” for our schedulers. He also mentioned that I wouldn’t get the opportunity to introduce the option of NFP to these patients, which I thought was a good point.

Fast forward a few months. Being the only female provider in our practice, most women coming in for their annual PEs w/ Paps prefer to see me. Unfortunately, most of these women are also seeking birth control. I explain how I do not prescribe contraceptives but promote the use of NFP. I give a couple general statements about what NFP is, and ask if they’re interested in learning more about that option (which is usually no). I then explain how the MD will come in and discuss BC with them after I’ve completed the exam, addressed what I need to address, etc. I also provide information regarding the risks associated w/ BC and take the opportunity to encourage abstinence, particularly, in my teenage patients. Though I feel like I’ve done a little to at least plant some seeds regarding NFP, I exit the encounter feeling frustrated and discouraged; not even so much about the individual encounter itself, but about the dominating contraceptive culture in which we live. It’s such a lonely feeling.

I find myself wishing these patients seeking BC weren’t scheduled with me. But on the other hand, I have the great opportunity to witness to these women. Even if my message reaches just one woman, how awesome is that? But considering the time constraints and lack of continuity of care associated with having the MD then go in and see the pt, I wonder if our current system is our best option. I also feel that I am essentially "referring" them for contraceptives, since I'm facilitaing their encoutner with the MD to get their prescription. Soon, there will be occasions where I am the only provider in the office, as well; I don't want to turn a woman away for a service she was expecting, but I don't want to write a script for BC, either. Aghh!

There is a light at the end of my tunnel, though. I plan on completing the dual Creighton FCP and Medical Consultant programs this October and next April. I am so excited to teach couples and utilize the concepts of NaproTechnology in my practice. I cannot wait to actually work with patients who practice NFP. If the demand is there, I would love to eventually focus my practice solely in women’s health/Napro.

Thank you for taking the time to read this; I know I’ve been a little long-winded. Any words of encouragement, practical suggestions, etc would be greatly appreciated, especially with regard to how the issue of not prescribing contraceptives is handled in your particular offices. I think it’s time for me to reread my copy of “Physician’s Healed” for some extra support, as well J

God bless,

Trumble, MSN, ARNP, FNP

Orange Park, FL

July 21, 2011

If I could get the Catholic hospital here in her town to get another NFP only provider--preferrably an OB-Gyn who does infertility, we could hire . So far, we've not been successful in getting an OB here--please provide prayers (we have identified an individual who wants to come but no takers on the hospital side).

bob

Subject: Re: Frustrations as an NFP-only NPTo: "nfpprofessionals " <nfpprofessionals >Date: Thursday, July 21, 2011, 3:20 PM

First of all, she didn't say they were Catholic. I am guessing they are probably *not* Catholic, because usually the Catholic docs who prescribe contraception (and the VAST MAJORITY do) would not tolerate another provider in the office who does not. It would be "in their face" so to speak. Been there too. EVERY Catholic OB/GYN where I am 'does it all'- from birth control to tubals- and they advertise it in the Church Bullitans.

The screening questions at the desk at check-in, is merely one solution to her dilema, and prevents her from being put into a potentially uncomfortable and compromising position.

Second of all- yeah- I would agree with you. Ideally we would practice in an environment of collegiallity, collaboration, and consultation,but many physicians do not treat NP's/CNM's/ as if they have a brain and have been trained to use it. Some states legally require 'physician supervision, delegation, and/or oversight" of Advanced Practice Nurses, (NP's/CNM's)- so there are a lot of variables

Thirdly- she is an employee. She is working in THEIR PRACTICE. She can only do her piece, and then what happens is up to the physicians in the practice, because she is not the boss. She would in no way compromise herself or her values by doing this. She is providing the care they need, giving them the information they may not have heard otherwise, and hopefully planting seeds. There is no referral involved. The patients are already there, expecting a service that has been offered by the practice.

There are very very few NFP only practices and providers in this country. In your strict estimation of what is wrong and right, NONE of us would be practicing. It is not any better that the OTHER SIDE who think those of us who do not give out contraception should not be practicing either. We shouldn't be there if *the others* provide, and we shouldn't be there if *we* don't provide.

Other that quitting and then being unemployed, what solutions do you have to offer this new Nurse Practitioner?

To: nfpprofessionals Sent: Thursday, July 21, 2011 1:17 PMSubject: Re: Frustrations as an NFP-only NP

I don't see how a Catholic doctor could in good conscience be involved with this. It would be tantamount to admitting a "need" for prescription contraception for contraceptive purposes. And already knows this. Now, what might be different is if they conmpletley respected her care of her patients and let her take care of them as she sees fit. What nerve they have to get her to agree to have people come in after her to offer hemlock, when her only desire was ever to help people!

Do you need the doctor to give you a refill for birth control?

Sincerely yours, Dominic M. Pedulla MD, FACC, CNFPMC, ABVM, ACPhInterventional Cardiologist, Endovascular Diplomate, Varicose Vein Specialist, Noncontraceptive Family Planning Consultant, Family Planning ResearcherMedical Director, The Oklahoma Vein and Endovascular Center (www.noveinok.com, veininfo@...)Executive Director, The Edith Stein Foundation (www.theedithsteinfoundation.com) (office) (cell)

(FAX)pedullad@...

â€œOur fundamental purpose is not to go out and help the poor. For us, this has only been a means. Our purpose is to maintain the Catholic faith within us, and to allow its diffusion to others through the instrument of charity.â€ Blessed Frederic Ozanam, a 19th century founder of the Society of Saint De

Frustrations as an NFP-only NP

Hello fellow NFP providers,

Iâ€™m a relatively new family nurse practitioner (been in practice for a few months now) and need to do a little venting.

For a little background, I work in a family practice office and do not prescribe contraceptives. The MD with whom I work has been supportive of my decision from the get-go (he and his partner do prescribe contraceptives). In discussing the office logistics with regard to my decision, we decided that if I was seeing a patient who wanted birth control, one of the MDs would go in after I was finished with my part and provide the contraceptive counseling/prescription. I suggested having our scheduling staff alert patients seeking birth control, Paps, etc that I do not prescribe contraceptives and give them the opportunity to schedule with one of the MDs, but my collaborating MD thought that would be too â€œconfusingâ€ for our schedulers. He also mentioned that I wouldnâ€™t get the opportunity to introduce the

option of NFP to these patients, which I thought was a good point.

Fast forward a few months. Being the only female provider in our practice, most women coming in for their annual PEs w/ Paps prefer to see me. Unfortunately, most of these women are also seeking birth control. I explain how I do not prescribe contraceptives but promote the use of NFP. I give a couple general statements about what NFP is, and ask if theyâ€™re interested in learning more about that option (which is usually no). I then explain how the MD will come in and discuss BC with them after Iâ€™ve completed the exam, addressed what I need to address, etc. I also provide information regarding the risks associated w/ BC and take the opportunity to encourage abstinence, particularly, in my teenage patients. Though I feel like Iâ€™ve done a little to at least

plant some seeds regarding NFP, I exit the encounter feeling frustrated and discouraged; not even so much about the individual encounter itself, but about the dominating contraceptive culture in which we live. Itâ€™s such a lonely feeling.

I find myself wishing these patients seeking BC werenâ€™t scheduled with me. But on the other hand, I have the great opportunity to witness to these women. Even if my message reaches just one woman, how awesome is that? But considering the time constraints and lack of continuity of care associated with having the MD then go in and see the pt, I wonder if our current system is our best option. I also feel that I am essentially "referring" them for contraceptives, since I'm facilitaing their encoutner with the MD to get their prescription. Soon, there will be occasions where I am the only provider in the office, as well; I don't want to turn a woman away for a service she was expecting, but I don't want to write a script for BC, either. Aghh!

There is a light at the end of my tunnel, though. I plan on completing the dual Creighton FCP and Medical Consultant programs this October and next April. I am so excited to teach couples and utilize the concepts of NaproTechnology in my practice. I cannot wait to actually work with patients who practice NFP. If the demand is there, I would love to eventually focus my practice solely in womenâ€™s health/Napro.

Thank you for taking the time to read this; I know Iâ€™ve been a little long-winded. Any words of encouragement, practical suggestions, etc would be greatly appreciated, especially with regard to how the issue of not prescribing contraceptives is handled in your particular offices. I think itâ€™s time for me to reread my copy of â€œPhysicianâ€™s Healedâ€ for some extra support, as well J

God bless,

Trumble, MSN, ARNP, FNP

Orange Park, FL

July 21, 2011

Where are you? You could get O'Dea to talk to your CEO and possibly get donors to set up something like the JPII Center in Austin. Easier said than done, bur some motivated groups - and you may need a group- have succeeded.Sent from my iPhone