Ongoing Consent
Consent is checked at every step of the exam. The patient can withdraw it at any point, and that choice is honored right away.
Certified Nurse-Midwife · Trauma-Informed Care
Every exam can be one where the patient feels safe.
I'm Dr. Ashley Tuttle, a certified nurse-midwife (CNM), midwifery educator, and forensic nurse. I bring a midwife's approach to every exam and give clinicians practical, ready-to-use tools for trauma-informed care, so patients keep their voice, their choices, and their dignity in every encounter.
Dr. Ashley Tuttle
Certified Nurse-Midwife
DNP, APRN, CNM, FNE
The Mission
Trauma-informed care, reimagined.
“Trauma-informed care isn't an extra step. It is evidence-based care, done well.”
- Consent is ongoing, not a single checkbox
- Narrate every step before it happens
- The patient can stop at any time
Framework
The Four Pillars of Clinical Safety & Patient Agency
Every tool on this site is built on these four principles. They make the patient a partner in the exam from start to finish.
Narrated Transparency
Say what you will do before you do it: what the patient will feel, how long it will take, and why. Nothing should come as a surprise.
Patient Control
The patient chooses an agreed stop signal before the exam begins. When it is used, all contact stops immediately, with no questions and no pressure.
Environmental Safety
Privacy, warmth, draping, lighting, and where people stand in the room all help a patient feel safe.
Clinical Resources
Pelvic Exam Tool & Protocol
A 5-phase protocol, bedside preference builder, language guide, and stop-signal algorithm.
OpenRoom Setup Recommendations
Ways to adjust lighting, layout, draping, and sensory details that tell patients they are safe.
OpenDNP Project
The research behind the protocol, with an interactive walkthrough and the full paper to download.
OpenTrauma-Informed Care Facts
The Four Rs and practical actions for every stage of a clinical visit.
OpenReferences & Resources
The research, professional guidance, and websites behind these tools.
OpenSpeaking & Institutional Advisory
Training, grand rounds, and policy consulting for clinics and health systems.
Open