As ambulatory nurses, we rarely have moments where we feel the same satisfaction or fulfillment as inpatient nurses, as we're catching patients in compartmentalized moments in their care. We'll see patients for an ultrasound visit or a blood draw here; you may see them during pre-op before their egg retrieval, and you'll communicate with them mostly over the phone or through MyChart messages.

The reality is that in fertility, we get to know the fertility patients over the years in one of their most vulnerable moments before they have the opportunity to start their family. Fertility nurses carry these patients through bad outcomes, whether it be a premature ovulation, a canceled cycle, a subpar fertilization report, a negative pregnancy test, or a pregnancy loss. Although we primarily communicate via phone and messages, we provide a level of support for patients in a time when they may feel isolated or ashamed that they are unable to naturally conceive.

One of our care team nurses, Tiffany Weng, recently had a catch that prevented an adverse outcome on one of her long-term patients. After guiding her patient through an IVF cycle and an embryo transfer, she fortunately got pregnant. After confirming the pregnancy with labs and an ultrasound, the patient reached out regarding an order for misoprostol that was placed by another physician outside of Stanford.

This patient was not under the care of that physician, and the patient questioned Tiffany if this was something that she needed to take related to her recent embryo transfer treatment plan. Many other nurses may not have caught this, but due to Tiffany's diligent care and excellent clinical knowledge, she knew that misoprostol would have a high likelihood of causing harm to this patient's pregnancy.

She took great care to listen to the patient's concerns, reassure the patient regarding the medication order so as not to cause panic, create a calm environment, and set expectations on the next steps on how to proceed. She instructed the patient to reach out to the external pharmacy that filled the order for her to ensure there was no data leak of her PHI and reconfirmed and advised the patient on her current medication instructions to not only prevent harm to the pregnancy but also to continue the success of the current pregnancy.

I truly cannot reiterate how many of Stanford's values Tiffany displayed in this situation and throughout her time as a nurse at the Sunnyvale REI clinic. She exemplifies family-centered care even before and after birth and cares for her patients wholeheartedly.

In addition to this specific clinical situation, Tiffany serves as the primary nurse for our clinic's oncofertility program. During the exodus of one of our full time NP's, Tiffany took on the task of caring for patients who have recently been diagnosed with cancer and need to cryopreserve either eggs, embryos, or ovarian tissue prior to chemotherapy treatments.

She does an amazing job of helping patients navigate:

1) complex IVF treatments, ensuring patients are comfortable, confident, and competent, as many of the patients self-administer injections at home, and
2) a heartbreaking cancer diagnosis that has essentially turned their life upside down.

As we tell all our patients, we understand that IVF treatment is not typically a choice made lightly or willingly. These patients entrust us to care for them in a highly specialized field that does not always guarantee success or a baby in their arms at the end of treatment. It can be emotionally draining for the nurses, but most especially for the patients.

Tiffany is a pure example of compassion, and her patients and our team are truly lucky to have her.