Latest Likes For Jolie

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Jolie 21,936 Views

Joined Oct 17, '01. Posts: 9,421 (48% Liked) Likes: 13,181

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  • Apr 29

    I do not know of any situation where it is desirable to give an IV med. arterially. Even in patients with arterial lines, the primary purpose of the line is to monitor B/Ps and allow for ABG sampling, not to administer meds. Arterial lines tend to have a limited lifespan and one would not want to jeopardize the integrity of the line by giving a med, which is likely to be an irritant to the artery and cause spasm, thus risking the line. If a patient is sick enough to need an art line, s/he is sick enough to have IV access as well, which is the appropriate route for meds. In a dire emergency, with only arterial access, it occasionally happens, but to my knowledge, never if there are other alternatives.

    What is TACE?

    Edited to add: I Googled TACE and see that it is a special procedure where chemo is given via artery to treat liver cancer. This takes place in a procedure room, under highly controlled circumstances. Not the same as a nurse giving a med in the ICU.

  • Apr 22

    Quote from wooh
    Actually I support a single payer system like Canada or England or Cuba. But that's not the system we have here. Until we do, then providing healthcare for employees is an expense of running a business.

    If employee provided healthcare is a moral imperative, why should it end with single payor?



    Just like wages. Your business would probably be more profitable if your employees would work for free. Their desperation that makes them willing to work without getting health benefits is going to cost ALL of us when they end up in the hospital and can't pay their bills. Sorry I don't want to subsidize YOUR business with MY money when your uninsured employees get sick and can't pay their hospital bills, raising MY bills, raising MY insurance premiums, raising MY taxes.
    Wow! The inaccuracy of your assumptions is simply astounding. I would love to engage in an intelligent and thoughtful discussion of the ramifications of Obamacare, but you apparently are more interested in throwing out unfounded accusations than learning the reality of those whose experiences differ from your own.

    Carry on. I'll seek informed conversation elsewhere.

  • Apr 22

    Quote from BrandonLPN
    Right, because working conditions and standards of living were sooooo much better before the government and unions screwed everything up circa WWII.

    The workingman in America has done so much better since the decline of unions, haven't they? And I'm sure it'll just become a freaking worker's paradise if we eliminate that interfering government and let the free market and individual responsibility take over.
    I'm not debating unions Brandon: they are irreleant to this conversation. I won't be dragged off topic, but if you'd like to discuss them, there are plenty of other threads.

    I encourage you to research how and why employer-based health insurance became common. It has everything to do with government interference in wages and prices and very little to do with unions. It is important to the shifting of responsibility for health care payment (not in a good way) and set the stage for uncontrollable health care inflation.

    Important lessons not to be dismissed out of hand.

  • Apr 22

    Quote from BrandonLPN
    Of course having to provide healthcare as part of employee's compensation is an increased cost to employers. Obviously.

    One way or another, universal healthcare is the inevitable destiny that our country is being dragged kicking and screaming toward. Or would you rather the USA continue to have some of the worst health and well being statistics in the developed world? If extra cost to the employer is a price then so be it. If the end of PRN, "no-benefit" jobs are a price then so be it.

    And good riddance. PRN and agency jobs that don't offer benefits are a blight on our society, one of our nation's shames. I'll be glad to see them out of business.
    How does the loss of work hours (to under 30 per week) or the loss of jobs altogether when businesses close (as our competitors did) advance the well-being of workers. Now they are not just lacking insurance. They are lacking income and insurance.


    ETA:

    I'm still curious, Brandon, do you believe that your employer should also pay for your food, shelter, clothing and transportation? Why or why not?

    I'm surprised at your vitriol at prn and agency jobs. Have you never met a co-worker who didn't want or need benefits and actually preferred a higher rate of pay and flexible schedule? How does forcing every worker into an inflexible full time work schedule benefit society? It sounds suspiciously like forcing everyone into a one-size-fits-no-one healthcare plan.

  • Apr 22

    Quote from wooh
    Because employees paying for healthcare is the system we live in. Don't want to? Go to a country where that is NOT the system.
    You support continuing, and even increasing reliance on a dysfunctional system that has created massive healthcare inflation far out of proportion with inflation in other aspects of our economy that are free-market based, and has priced many out of the market altogether. Thank you for your honesty. It is not the answer I expected, and you may be surprised that it is in direct contrast with one of Obama's stated goals of his healthcare plan, which was to disassociate health care from employment.

    You also realize, I am sure, that employer-provided health insurance came about because of government interference in the employment market, via wage and price controls during WWII. So government mess up begets government mess up.

    Rather than perpetuating this foolishness, why not engage in real reform that will give individuals true control over their own healthcare purchases, decisions and spending?

    But that would require individual responsibility, which I doubt some here would embrace or support.

  • Apr 22

    Quote from BrandonLPN
    Yeah, and I'm sure that when fire safety laws and child labor laws came into being employers rent their clothes and gnashed their teeth and claimed they couldn't absorb extra cost then, too.
    Do you believe that employers should pay for employees' healthcare?

    Who should pay for their food, shelter, clothing and transportation?

    If your answers differ, why do they differ?

  • Apr 22

    Quote from IrishIzRN
    And sometimes it isn't about the profession but about the individual first. The ACA has protected my child. I'll take that. The rest...stuff I think can be dealt with. My profession isn't my main priority in life.

    I understand your concern for your child's health coverage. My point is that it is not necessary to make blanket accusations about conservatives and employers evading taxes and laws in order to voice support for aspects of Obamacare that are positive, especially when doing so reveals ignorance of the actual legislation.

    The ACA comes with amazing benefits. Sure there are negatives but not everything is always perfect. People need to learn to find a way to work with the new system and accept it. My husband is a small business owner. The company doesn't believe their employees should ever be without insurance and has always provided high quality health insurance. So the ACA...is something they pretty much agreed with from early on when it comes to the idea of providing insurance for employees.
    I am happy that your husband's business is one that provides insurance to its employees. I don't know the nature of his work or his competitive environment. I can tell you that we have researched every way possible to fund healthcare for FT employees, and can't do it without spending every dime of income the business makes. Our industry is one that operates on an extremely thin margin. We don't have profits of 10-20% or more to pay additional expenses. To be forced to do so would put us out of business, because it is something that we can't, in this market, pass along to customers. Obamacare limits the amount of cost sharing with employees. The amount that we could ask employees to contribute is only a small fraction of the actual cost.

    To the poster who asked who should pay for our employees healthcare: This answer is not politically correct, but it is the truth: the employee. We are currently a small enough business that we are not legally required to provide health insurance. We make this clear in our interview process. Anyone who takes a job with us does so knowing full well that they are on their own for healthcare. (Which, for the record, so is my family. Our individual insurance plan is paid fully out of our own pockets, not by the business. And I am a cancer survivor, so I know full well the difficulties and cost associated with purchasing private insurance with pre-existing conditions. Even so, our premiums went up by 33% when Obamacare went into effect.)

    My point in my initial post was that the policies of this administration have solidified our decision that it is not feasible for us to expand our business, due to the overwhelming healthcare costs associated with doing so. We have proven that other costs associated with business are recoverable, by becoming profitable and repaying our start-up. In our area, there were essentially 4 well-known businesses providing the type of products and services that we do. 3 small businesses and 1 corporate conglomerate. One of the small businesses closed at the end of the year rather than attempt to compete in the Obamacare era. The 2 of us that remain are small enough to be exempted, and so continue to be competitive. Obamacare would sink us, and as much as you may judge me for not paying my employees' healthcare, they tell me they would rather have a job without employer paid insurance than no job at all, which is where our former rival's employees are right now.

  • Apr 22

    Thank you, Esme, for a well written, fact based discussion. It is disheartening to find fellow healthcare professionals so ill informed of the requirements of this law that they fail (or refuse) to recognize its implications, and resort to throwing out emotion-laden accusations that have little basis in fact.

    No where in my post did I say that the law was 100% bad. It does have some positives. Nor did I claim that it will irreparably harm all businesses. I clearly indicated that I was posting about the experiences of one small business about which I am thoroughly knowledgable. And despite naysayers arguments to the contrary, I can assure you that our decision to let our letter of intent expire stemmed from a thorough review of the financial implications of an expanded staff (to the extent possible, given the constant changes in the implementation of Obamacare.) Costs involved in building, equipping, stocking, hiring and training staff can be recovered, as we have proven with our original business. Insurance costs associated with Obamacare can only be minimally offset, leaving us with approximately $100K in losses in the first year of expansion. We can't justify taking that risk. If unsuccessful, we would not only lose our business, home, retirement and kids' college funds, we would put our current 30-some employees out of work. So, although some posters here won't believe me, our decision, in large part, stems from a sense of responsibility to the employees we already have. Kind of like not having more kids when you're unsure of your ability to feed and clothe the ones you already have.

    Reasonable people can and do disagree about the risks and benefits of this legislation, but unsubstianted arguments like those posted above do nothing to further the discussion and, in my opinion, diminish the stature of our profession by demonstrating the failure of some members to inform themselves (even to the most elementary level) about legislation and current events that are intimately tied to our profession. I would liken it to a geographer emotionally shouting at the top of his/her lungs that the earth is indeed flat. Such ignorance is an embarrassment to fellow professionals.

    I hope that the information provided is helpful to the original poster.

  • Apr 22

    AYes, I am experiencing this as an employer.

    Obamacare requires employers with 50 or more FTEs (full time equivalent employees) to provide employer based insurance to employees who work 30 or more hours per week. The law mandates comprehensive coverage but limits the amount of money the employee can be charged to help pay for this coverage, placing an onerous financial burden on the employer to pay for insurance to employees who did not previously receive it.

    We own a small family business. 5 years ago, we risked everything we own to open it. For about 3 years, we had almost no income as the business slowly grew, stopped losing money, them finally became profitable. Even now, we can't afford to purchase insurance for our employees. To do so would exhaust the money that we need to pay our household expenses, and also re-invest in maintenance, updates, education, and improvements. We currently employ about 35 people, some FT, some PT, some inexperienced 16 year-olds, some highly educated professionals. We would like to invest in an expansion that would nearly double our capacity, but to do do would require a staff of over 50 FTEs, putting us in the position of having to absorb health insurance costs of roughly $100,000/year, which we can't afford to do. Those are costs that we can't recoup or share with employees. So because of Obamacare, we won't build a new building, purchase new durable equipment, hire additional legal or accounting consultants, purchase additional advertising or hire 30 new people.

    That is the effect that Obamacare is having on one small business. Imagine the collective effect nationwide on jobs and the economy.

  • Apr 21

    I love NICU nursing, and you will probably enjoy many aspects of it as well. But having come from a more comprehensive peds and PICU background, you may find it somewhat limited. The scope of patients you will encounter in the NICU is just a tiny fraction of what you are used to seeing in the 1 month - 18 year age range.

  • Apr 19

    Ive never met a school nurse, but if I ever do, I dont know whether I will just tell her off about how little I think of her or just roll around on the floor laughing at her.[/quote]


    Oh please! Some idiot parent brings a child into the ER because scabies is going around, and it's the school nurse's fault!

  • Apr 14

    First of all, practice normal newborn assessments on your well-baby patients.

    Then, prepare a cheat sheet to bring with you containing the following information: normal vital signs for neonates, norms for common lab values such as CBC, electrolytes, and glucose.

    Prepare drug cards for a few common meds such as Ampicillin, Gentamycin, Surfactant, and Caffeine.

    Read up on the pathophysiology of the most common admitting diagnoses: Prematurity, Respiratory Distress Syndrome, Possible Sepsis, and Glucose Instability.

    Prepare a brief (1 or 2 nursing diagnoses) careplan for each of the above.

    No one can (or will) expect you to have any experience with NICU infants. But as a preceptor, I can tell you that nothing is more frustrating than trying to guide a student who lacks even the most basic foundation needed for further learning. Students who have not prepared for their NICU observation will learn nothing, frustrate the staff, and probably find themselves sitting in the breakroom. The only thing worse than an unprepared student is a "know-it-all" who oversteps his/her bounds and does things without asking.

    In 11 years of OB and NICU nursing, I was fortunate to encounter only one such student. I informed her instructor that she was not welcome back in my unit. Turns out, I was not the first one to complain, and I believe she was dropped from the program.

    Thank you for asking. Given your conscientiousness, I am sure you will do fine! Please post and let us know how it goes!

  • Apr 12

    Quote from tbanurse
    It seems to me that it would be more important to know the NCLEX pass rate rather than the attrition rate. If a school bragged that they had 100% graduation rate but only a 60% NCLEX pass, I would not consider that a good program. If, on the other hand, they had a 60% attrition rate but a 100% NCLEX pass, that would tell me that at least they are not "dummying down" the curriculum to get students to graduate. Sure, it may be a very difficult program to complete, but isn't that what we want from our future nurses? The ability to critically think through a problem and have the knowledge base to carry out into the real world? My bridge program started with 30 but only 19 graduated. Still waiting on everyone to take the boards, but so far we have had only one person fail (I believe 11-12 have tested so far). I would put more weight on the NCLEX, but that's just me!
    NCLEX pass rates are important, but only part of the story. Most state Boards of Nursing will put education programs on probation if their pass rates fall below 80%, but unless schools provide the information, prospective students may have no way to know the graduation rate of their program. What about schools that accept students who are not qualified, take their tuition money for a few semesters, then flunk them out? Or worse yet, award passing grades, but with-hold degrees and NCLEX eligibility of students based upon an irrelevant exit exam intended to inflate their NCLEX pass rates?

    IMO, the most valuable bit of information would be the NCLEX pass rate based upon the number of students who initially enrolled in the program. For example, 100 students start, 40 drop or flunk out, then 20 of the remaining students fail NCLEX. That would make a pass rate of 66% among the students who took NCLEX, but only 40% of the initial classmates actually became RNs. That's a big difference in school performance.

  • Mar 4

    Referring to ANY human being as "it" is completely inappropriate, regardless of the particulars of a patient's personal life.

  • Feb 12

    Sick leave is intended to allow an employee time to heal from an injury or illness and then return to work without a significant disruption in income.

    In most instances, an employee must return to work for a designated period of time after sick leave. If the OP's timeframe did not allow for a sufficiently long return to work following her surgery, then it is unlikely that she is eligible to be compensated for the sick time off.

    Taking sick time at the end of a period of employment without returning to a committed position is typically not covered. If it was, we would all be sick for the last 2 weeks of our jobs.


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