Student Health Survey

nurseprnRN, BSN, RN · Jul 20, 2015

Your insurance might not pay for a physical, but that does not mean you can't have one. You can always go to a free-standing clinic and pay cash or credit card. There's nothing the matter with an express clinic for this purpose. Tax write-off, too.

Besides, the Affordable Care Act mandates a wellness exam with no copayment. Go to your GYN for it, because you get that under the ACA too, and a GYN is qualified to do a physical.

JustBeachyNurse, LPN · Jul 20, 2015

Loss of vision means vision that cannot be corrected better than 20/200 ie legal low vision or legal blindness. Can your vision be corrected sufficiently to drive? Then you do not have vision loss. Glaucoma, retinopathy, eye trauma, cortical vision impairment are conditions that lead to low or lost vision. Myopia, astigmatism and presbyopia are correctable and not lost vision

augurey · Jul 20, 2015

Your insurance might not pay for a physical, but that does not mean you can't have one. You can always go to a free-standing clinic and pay cash or credit card. There's nothing the matter with an express clinic for this purpose. Tax write-off, too.
Besides, the Affordable Care Act mandates a wellness exam with no copayment. Go to your GYN for it, because you get that under the ACA too, and a GYN is qualified to do a physical.

Thank you! I do have an appointment with my midwife this Friday. I will look into that as I alternate between her and the OB currently. I know the express clinic I go to will not do one as it's more of an illness type of clinic and have specified they won't, but I'll see what other clinics are in my area that will.

I know my former health insurance covered a physical, but I'm not sure if my current insurance will, which I'm prepared for. I just don't think my doctor will even see me if I pay out of pocket. It was the first thing I asked the receptionist when I spoke with her, and she was hesitant. She said to call back if I'm running into any trouble and she'll see what she can do, but it's no guarantee.

Thank you very much for the information! I didn't realize that an OB would be able to do this as well. This definitely helps me figure out what my options are right now.

Loss of vision means vision that cannot be corrected better than 20/200 ie legal low vision or legal blindness. Can your vision be corrected sufficiently to drive? Then you do not have vision loss. Glaucoma, retinopathy, eye trauma, cortical vision impairment are conditions that lead to low or lost vision. Myopia, astigmatism and presbyopia are correctable and not lost vision

Thank you very much for clarifying that for me! My vision isn't terrible or anything, but I just wasn't sure what would be considered 'vision loss'.

NurseGirl525, ASN, RN · Jul 20, 2015

It's just a survey, right? Is it required? I don't think they can require your personal medical background unless it is going to directly affect your ability in the classroom and would require a special accommodation. And if that is an issue, there should be a disability person there that you go and talk to about getting that special accommodation. Our instructors say at the beginning of each semester if we have a disability that requires accommodation go see so and so. They also always say afterwards, I don't want to know what the specific disability is, just go see them. I know personally I would feel uncomfortable giving out my medical info because most of my instructors are nurses in local hospitals and you don't ever want to be blackballed from a job because someone mentioned an issue.

I am very upfront about my epilepsy. I haven't had a seizure in almost 5 years, but I feel like people around me should know on the off chance one would occur. But, I'm about to stop doing that because I have a nifty little app on my phone that can alert people should something happen, to what my issues are. It's pretty neat and it can be accessed without having to unlock my phone. It shows up on my home screen and is easily accessible with all my info and emergency contact info.

Make sure a physician or NP does your physical. I'm not sure a midwife would qualify. But yes, under ACA, annual wellness exams and yearly OB checkups are covered 100%. And most urgent care clinics will also do them along with titers and immunizations.

augurey · Jul 20, 2015

Thank you Heathermaizy!

The only thing I could check off on isn't something that would affect me in the classroom or in a clinical setting. I'm mostly worried about disclosing it, like you said, because of the possibility of being blacklisted. The fact that they are affiliated with the hospital I wish to work at eventually and where clinicals are done, it's not something I'm comfortable sharing, especially as it doesn't make me unsafe to practice in clinicals or on the job. I feel like it's an absolute need to know.

I don't think my midwife will be able to do it, but I'm currently alternating care between her and the OB/GYN, so I was thinking she could possibly let me know if it'd be possible.

I did find a minute clinic that will do the physical. I had to call and check that they would see me because some of them have age restrictions. Fortunately, they'll take me. I've called for my medical records to take with me. I had a physical last year for my former school where titers were done. I don't know if the minute clinic will be able to sign off on the titers if I just had them done less than a year ago if I provide the records, but I'm taking them just in case. I know that I have to get the Hep B started, but I don't know if I can do that while pregnant. The form does state prior to the first clinical placement, but I'm not sure how soon that is (baby is due beginning of September).

Other than that, I know I need to get the TB testing done, which they can do there. So I'm hoping they can do everything there. Otherwise I'll have to see if the OB would be willing to help me out. I've been calling all morning for doctors and so far they are all rejecting me because of my insurance. They accept my insurance and new patients, but they just aren't accepting new patients with my insurance. So I really hope between the minute clinic and the OB I can get everything I need done and in.

nurseprnRN, BSN, RN · Jul 20, 2015

I know my former health insurance covered a physical, but I'm not sure if my current insurance will, which I'm prepared for.

Again, they have to cover it. You do NOT have to pay a copay for this. In most states, physicals can be done by any licensed professional as specified in the regs regarding health licensure. I would bet that your midwife, if she does well-woman exams, would qualify for this...and your insurance WOULD pay for it.

JustBeachyNurse, LPN · Jul 20, 2015

What kind of condition do you not wish to disclose? History of one? Something not really relevant say childhood broken bones or anything that is not relevant to your current state of health and ability to safely practice.

Even with mental health issues most BoN ask to disclose only if not stable. So a bipolar 1 patient with no recent hospitalizations currently stable on a treatment regime generally not mandated to disclose.

You may need specific clearance from your OB/midwife to attend classes & clinical while pregnant. Check school policy.

Also usually you need the first two HepB (at least a month apart) before start of clinical rotations (policy may vary). If you are in your 20's you may have received the vaccine as a child and only need a titer or booster.

If pregnant most obstetrics practices draw MMR & varicella titers since you cannot receive these vaccines while pregnant and if exposed the fetus may be at risk.

augurey · Jul 26, 2015

Sorry it took so long to get back in here.

GrnTea: I asked about this at my appointment Friday. My midwife said that she was able to fill it out. She also got me started on my Two Step Mantoux test.

I also met with the Student Coordinator at the school Thursday who said that those just recently admitted will have an extension on all of the health forms, fortunately. Even with starting as quickly as I did, it would be a miracle to get them in by the deadline because of the time needed to get the TB testing done.

JustBeachyNurse: It's a past history that has no relevance to now and certainly wouldn't have an impact on patient safety or my own.

I did end up getting a letter from my midwife stating that am able to attend classes/clinical while pregnant. I was informed by the school that clinicals start in the 5th/6th week which would be the week after I'm due or the following week. Since I'm allowed to go up to 41 weeks, that would be the following week. I don't doubt that I will need clearance after birth.

Thank you for pointing out on checking policy on needing clearance while pregnant. It's not something I had considered.

I had some titers done last summer for my former school which had shown that I was immune to MMR and varicella. I had my medical records pulled and took them with me Friday as I wasn't sure what they would have on file at my midwife's office and wanted to make it as easy as possible for her to fill out. I do need the Hep B series.

The school is only wanting the the first of the series to be done before clinicals. I discussed this with the Student Coordinator and if I was unable to get the vaccine while pregnant, I would sign a waiver and would just get it ASAP after the birth. My midwife said based on where I'm at in my pregnancy, I can start the series; however, they do not do Hep B there.

So this is my next thing to work on as I have no idea where to get it at. The health department won't do them for adults; only children. I'm not sure if I could try a different county; if they would 1) do them for adults and 2) if they'd allow me to go there from a different county.

I looked more into the Minute Clinic, but you have to be under age 20 and they refuse if you're pregnant.

I'm going to try one of the local drug stores and see if they will. I asked them about it before and they did them, but they didn't the vaccine in stock, and I'm not sure if pregnancy will be an issue. I don't know of any other clinics that I could try. Although, once the new PCP processes my paperwork, I can get in within about 3-4 weeks and possibly have it done there.

I truly appreciate everyone's responses! They've been very helpful and have made this an easier process to get through.

JustBeachyNurse, LPN · Jul 26, 2015

Many free standing providers (pharmacies, minute clinic, etc) won't accept the risk of vaccinating a pregnant woman even if they have clearance from their OB or midwife. You may have to waiver until you can get the vaccine. You can also ask the school, if a larger college/university that has health services on site you may be able to get the vaccine there.

nurseprnRN, BSN, RN · Jul 26, 2015

I was nursing my second when the Hep B vaccine first came out, and asked my very excellent pediatrician if it was OK to take it. He smiled benignly and said, "It'll be much better for the baby if his mother doesn't get hepatitis."

Too late I realized that it might have been a good study to see if newborns got any level of protection, either permanent or (more likely) temporary from breastfeeding.

Get the clearance from your midwife and good work on getting this all put together! I see case management at some time in your future. :)

augurey · Jul 31, 2015

JustBeachyNurse: I honestly figured that most places outside of a provider's office wouldn't be willing to do it. Before I asked the school, I figured I'd give the local pharmacy a call just to see since it's right around the corner. To my surprise, they are willing. They actually put me on with the pharmacist. I explained that my midwife advised me it was safe for me to get now and the reason behind why I'm asking to get it while pregnant. After that, he was fine with it and said I shouldn't have a problem being refused when I go in.

I'm going in Monday to do it, but if I encounter any issues, I'll probably just ask the school for any resources they may know of. If not, then I'll just have to do the waiver. If the pharmacy decides to refuse the day I walk in, I'm not going to fight it as I understand their reasons and am grateful they are even willing right now.

GrnTea: I think that would be interesting to see about protection in newborns if received while pregnant (or through breast milk). I know some vaccines are recommended while pregnant for that reason. I got the Tdap with my daughter two years ago, and I just got it again last week for this one.

I'm probably going to go Monday morning for the Hep B. If they refuse, I'll find another resource or do the waiver, but if they want anything in writing from my midwife, I'll be in for my second Mantoux reading so I can probably get it then.

Everything is falling into place, though. All late admits are given until the 17th to get everything done. Aside from the second Mantoux and the Hep B, I have all other medical forms filled out and ready to submit. Then just the drug test and finger printing and I'm ready to go.