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Welcome to Hello Uterverse, where perinatal peeps come for more evidence, more clarity, and fewer WTFs for Jen and Heidi. Labor nurses, educators, and research obsessives here with you in podcast form. From deep dives to surprising rabbit holes, we're here to help you think differently about the work you do every day. Let's launch.
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Unknown
Welcome back for episode number three. We're happy you're here with us here. We're going to kind of close the loop on that conversation we've been having, which really started with that first follower question about
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basically feeling intimidated with how to translate evidence into the actual conversations that we're having amongst the different members of the team.
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Unknown
Yeah, how that really translates into practice
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from paper to practice to practice and,
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wanting to make sure it's really there.
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Unknown
It's it's not about getting like the words right or sounding smart or having a whole file cabinet
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of research. It's it's how it translates to the website. But I do think that there's a couple of like persistent, I guess, myths
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that are out there with the research are how to
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implement evidence.
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Unknown
Yeah, I,
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agree there are some, some things like
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what's your like least favorite trope.
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Unknown
My least favorite, I don't know, I have a few things that I don't like. One thing that I don't like is,
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Unknown
when people, I guess my ex, one of my ex is when they say, well, this study wasn't from five years ago. It needs to be within the last five years
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for it to be applicable.
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As my 12 year old would say for right,
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like tell me you have never done research without telling me you've ever done right.
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Unknown
So this comes from nursing school right. Nursing school. They have to put a line in the sand. And when it comes to like journal editors,
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you know this but it was there some other stuff and then
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editorial fellowship and the journal editor is like, yeah, like most of your citations should be there.
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Unknown
It's not like 100% that we're looking for, you know, the current thinking on things
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Unknown
that's for like publication, which that makes sense. Right. And you're going to hearken back to your classics. But the point of research is to keep building on research.
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That's like practice is to keep building on
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all of it.
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It's not like oh 2020 didn't happen.
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Oh 2020 happened
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and it did happen. And
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and so I think when we're talking about like the whole five year thing, it's that,
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that makes sense for nursing school research papers. Right. In bedside practice.
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just a different ballgame.
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It really is. And
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what people don't understand always when they, when they're saying that is that research also costs money and
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they need grants and people that are like willing to study things.
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And once something has really been
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proven more than once,
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they're not even going to get the funding to keep redoing it. And it's like, why are you going to waste time on that? It's like, we've already solved the puzzle on this. Well, to that point. So I just, Courtney, Courtney, you know, she's like this PhD super researcher,
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all this stuff.
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And I was visiting her, and and I brought this up to her, and she was like,
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just by the time you
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start. The idea is kind of one. That clock starts ticking.
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Unknown
The grant you got to fund the research. You have to do it. Yeah. Then you have to compile all the results.
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You have to write them up.
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Unknown
Then you have to submit them for fate. Right. It's like by the time it's even hit the press it's already like 2 or 3 years old.
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Unknown
And that clock has already been ticking. So. Right. Right. The nature of the beast is just like, yeah, it's like, does it move quickly? And we also like, are we ever going to take one study and change practice?
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Unknown
I guess like, never say never because
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it's happened. But I remember learning in nursing school like that. You you don't change practice based on a single study.
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a single study can't ever tell you if this is going to make sense for your population. Right. Right. If there's going to be very few things that are that compelling.
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That you're going to totally switch practice. Yeah.
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like you said like why would we keep resetting that. We like
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we kind of move on. Yeah. We got bigger. We got, we got new fish to fry.
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Unknown
Yeah. It's like that's, that's solved. Like next on our to.
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Unknown
However there are some things that I would like to restate.
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Unknown
Oh okay.
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Unknown
here's why. So there is this, study that I came across by Kathleen Rice Simpson and Audrey Linton. At this point it's a little over 20 years old. Okay. And they ask the question. Right. Because
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Unknown
you know Kathleen Rice Simpson's been like the author of our A1 Pettersen guidelines Induction and augmentation cervical reckoning guideline through A1.
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Unknown
We're on our fifth edition. So for a very long time. Yeah. When I teach pitocin paradigm I we show
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the new one we just got in 2025. And then there's like an original like a nurse's guide to oxytocin induction from 1983. And that one stands out to me because that is the year of my birth.
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Unknown
And when you hold these two papers up side by side, it's like.
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Unknown
Nothing's really changed, right? Use the lowest dose. Titrate for effect.
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Unknown
Most people don't need a ton. To get moving.
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you gotta have a reason to use it.
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Unknown
There's very the big things. If we had to solve those we wouldn't still be talking as much as we do about that person.
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So Audrey Linden and Kathleen I.
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Simpson about 20, 25 years ago, saw
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what we see all the time, which is like
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it's in writing. We know how to safely use this medication. And yet
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every day we hear.
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Unknown
DMs, messages, calls, smoke signal. S.O.S. is from our friends. Like
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I know what's the safe thing to do. But I have so much pressure on me to titrate this or use this medication in what I perceive to be an unsafe
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way. Right. And I feel like I have no choice but to do it.
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Unknown
So they set up the study of just like
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Why do nurses, despite knowing, continue to follow orders that they believe are unsafe when it comes to oxytocin?
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Unknown
so what they found was, you know, pretty interesting.
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Unknown
But what I think's more interesting is the demographics of the population or stuff. Okay. And what and what were those demographics, the mean age of these nurses. Late 40s.
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Unknown
All A1 members, they were like past mid-career and they had very high on average very high levels of education like a lot of them had master's degree. Right. But because that was the pool that they were recruiting from because you're recruiting by male primarily.
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Unknown
Right. Many years ago we were not. It's stuck right. We weren't being like anybody want to be part of my study. Click my link in bio. That wasn't. Yeah.
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Unknown
oh, and
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Unknown
like their average amount of experience was like 20 years, 20 plus years. If we looked at our average nurse now,
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Unknown
I think just the demographics are just so different enough.
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While to repeat the study.
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Unknown
I think so too,
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Unknown
because I think, man, if it was hard, then
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Unknown
20 years ago
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pre pre-arrival trial. And our induction rate 20 years ago was half or more I can't think exactly but about half of what it is today.
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Unknown
Right now we just had like 41% of ups are induced. Yeah that's a lot.
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Unknown
It's at least double.
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Unknown
Yeah. And we use so much more to
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Unknown
we use so much more pit. Yeah. Use it more often. More patients with different patients than we did before. And the demographics of the nurses are so different to me.
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Unknown
That would be a reason to repeat the study. Yeah. So many variables are now different. We can't hold this to be true any longer.
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Unknown
So that is a reason
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to repeat. And so that study would be a situation like that. Like wow. So many variables have changed.
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Unknown
We need to rethink this because what was driving it before might not
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be driving it now.
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Unknown
Yeah. So that's the five year thing
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Unknown
to be answer. I think so I don't know I mean we always kind of go through some rabbit holes.
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Unknown
But I think the thing is, is like looking at
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Unknown
why are we saying the five years for this and really looking at it like, does it make sense for something like what you just described with the Kathleen Rice Simpson,
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Unknown
and Audrey Linden study that makes sense
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Unknown
to to redo something like that, because demographics are different. The age group is kind of different.
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Unknown
They're we're dealing with
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Unknown
different things in life than than we were previously.
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Unknown
And just seeing where that falls. But other things, you know, it may not
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Unknown
really benefit to repeat because what what has been proven is maybe more on a scientific level, that that type of thing has not changed. Yes, yes.
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Unknown
So being able to ask those questions of like, does it make sense that this
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Unknown
has to be within five years because it's moving so quickly. Technology is so different that yes, it really benefits from like currency. Or is this
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Unknown
basic physiology. And I think that goes also to like I guess one of my big ex is like, show me a study.
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Unknown
But it's not really something. That's one either we can study. Yeah. Or they need to study. Like we don't have to do research on everything. Like like you said, if it's settled science or just like a biologic fact, or there's going to be some things that are just like, unethical to do, like, show me the study, that putting a pillow on someone's face and sitting on it is bad for them, right?
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Unknown
We can't we can't do that. But I think one thing that, oh my goodness, one thing that we hear a lot is,
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Unknown
show me like, where's the research saying that a uterine resting tone of 30 is is bad and is going to cause injury to the baby? That's like, well, that's something we can't
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Unknown
study in real time because no one's gonna consent to us petting them to the point where their resting tone is 30, 45, 50.
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Unknown
Right, right. Yeah. And see what happens. How those types of things are studied is after the fact, looking back, you know.
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Unknown
Yeah. So there's retrospective ways of looking at things. But also we already know that,
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Unknown
you know, blood flow is reduced by about half. Right. We can do the math. And
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Unknown
I guess I would kind of get into, like, study size going back to, gosh, this is like the caffeine resurfacing episode.
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Unknown
Her and James, like 2005 article. I know we just last episode said you don't need to be able to sight stuff, but when you have a handful of favorites, these are just kind of cult favorite classic articles.
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Unknown
But I think that this is a little bit adjacent to just being like, oh, I have a study for that, because
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Unknown
the article that you're referring to,
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Unknown
really explains the why
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of what we do every day in our job.
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Unknown
Yes. Yeah. Man, so many gold nuggets to that article.
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Unknown
We'll put it in the show notes. I read
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Unknown
one thing this week, and that's not within the last five years.
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Unknown
But like,
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Unknown
the science stands. Yeah, that that doesn't change. Fight you on it. We will. We'll meet you in the streets and fight you on it. You've just published that article. Talk about another show.
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Unknown
so now I guess I would say so. There was just this article that was, like, basically laid out that Acog guidelines and A1 guidelines, some are line up and some diverge.
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Unknown
And instead of in my perception taking ownership over it that yeah guidelines tend to be loose looser or I guess more often they tend to be more just more blanket statement statements. They're going to leave a lot. And that speaks to the scope of practice of a physician. Much different than a nurse. There's a lot more individual autonomy to decision making.
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Unknown
Yeah. So they tend to not be. Whereas for the one in for nurses, they, they're, they're a lot more pointed I guess we'll say.
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Unknown
but instead of just, you know, acknowledging that there's a difference or we could do better of maybe trying to line up between the two specialties. They kind of went after the Iwan guidelines saying like and that they were like came on like all basically old or,
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Unknown
not super robust science.
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Unknown
And it's like, was it statistically significant or not like. Yeah. The end size was small but
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Unknown
it met statistical significance. And if you have a small n which is like the number of people, if you don't know what an n number and n is the number of people in the study, you know, you have 100 patients.
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Unknown
Statistical significance. It's probably because it's just a biologic truth right.
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Unknown
It probably means it's going to be very replicable. It means it's probably very generalizable to lots of populations. If you are able to achieve statistical significance with such a small number of patients, and instead of understanding that they were basically like, well, must not have been that kind of stuff in here, like,
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Unknown
oh boy, oh boy.
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Unknown
anyways, well, we've really diverted, so we covered our research in five years. Can you study everything?
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Unknown
do you have any other ethics. Those are kind of our big ones. Yeah. Those are kind of the, the main to that. We see a lot I think about a lot. No. You have a, we have a, I know we have others, but we have four.
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Unknown
Yeah. Okay.
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Unknown
speaking of statistical significance, there we go. There it is. There it is. Versus clinical significance. Yeah.
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Unknown
Give me the. So what? It's the. So what of it all?
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Unknown
Yeah, it is, because there are going to be things that are statistically significant. But then is it going to translate to the
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Unknown
clinically significant.
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Unknown
No it's not. Not always and sometimes sometimes it is. And so I think it's good to be able to delve through that. And
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Unknown
what we said before is not every thing that mean something matters, and not everything that matters mean something. And so you got to kind of like work through the source a little bit on that.
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Unknown
Yeah. Like you said, I think a lot of things can be studied that we can't study everything that matters. Right? And not everything that's studied
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Unknown
is meaningful or or kind of like the so what up at all, right. A lot of it comes back to, like you said, that funding piece of like, what do people have money for?
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Unknown
Or maybe what you know, grad students are hot for. People are tend to be doing a lot of research.
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Unknown
And then the last one is you know, not just that status of old versus clinical significance, but that causation versus correlation. Oh yeah. Those two get so intertwined and people try to use them synonymously and they're they're not.
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Unknown
And I think that's somewhere that nurses kind of really like dive in because it's something that we deal with maybe interpersonal professionally. When we're dealing with like
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Unknown
patients, people at the public, who don't have a strong science background and being able to, to, to talk about that. My favorite statistic, which is coming up on Mother's Day, is that crime goes down on Mother's Day.
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Unknown
And is that just because moms are all like these like criminal kingpins that we're going to take a break off from our like
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Unknown
or our dastardly dealings?
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Unknown
Or is it just like, is it a correlation of like, you know, families tend to be together, it lands on a Sunday. Are people more reflective or like, you know, we don't really know, right.
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Unknown
It's like it's a correlation. Not causation, I don't think. I mean, moms probably could be.
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Unknown
Yeah. All the big crime lords aren't, aren't doing anything on Mother's Day because they're
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Unknown
there with their moms. Yeah, it is the moms or it is the moms are organized crime rings. I mean, that probably makes more sense. Doesn't like vandalism.
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Unknown
So yeah, that's our episode for today. Are those are our X? We'd love to hear what your X are or like the things that you struggle with or get challenged with. You can always drop us a line on our website.
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Unknown
Uterverse.com. We have a contact form. If you have a topic you want us to cover a question.
00:17:03:40 - 00:17:15:36
Unknown
You have a rabbit hole, anything a red flag a green flag. Yet we want to hear it. We want to hear it and then make it into an episode for you. All right. We'll see you next time.
00:17:15:36 - 00:17:18:14
Unknown
Thanks for listening to Hello Uterverse!
00:17:18:18 - 00:17:21:45
Unknown
For more evidence, clarity and community. Head to Uterverse.com
00:17:22:07 - 00:17:25:23
Unknown
and follow us on TikTok and Instagram at hello Dot Uterverse.
00:17:25:35 - 01:34:41:14
Unknown
Nursing is wild. Practice with confidence.
01:34:41:18 - 01:34:41:46
Unknown
Murphy.
01:34:42:03 - 01:34:43:37
Unknown
Today we're going to talk about your birth.
01:34:43:45 - 01:34:49:33
Unknown
How do you feel about evidence based practice, Murphy? Do you feel like it's a stool or a funnel
01:34:49:41 - 01:34:54:29
Unknown
when you have to challenge a provider? How do you feel comfortable.
01:34:54:36 - 01:50:38:47
Unknown
No comment. Okay. You just laid back and chill. He. He doesn't have a question. The attitude he pushes with attitude. Yeah. It was right now. Like how relaxed is nervous system is. He's ready to go.
01:50:39:01 - 01:50:51:25
Unknown
Thanks for listening to Hello Uterverse! For more evidence, clarity and community. Head to universe.com and follow us on TikTok and Instagram at hello Dot Uterverse. Nursing is wild. Practice with confidence.