Latest Comments by Jolie

Jolie 27,262 Views

Joined Oct 17, '01. Posts: 9,493 (48% Liked) Likes: 13,516

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  • 0

    Quote from SmilingBluEyes
    There are flat-rate "boutique" primary care practices popping up in varying states. The flat rate buys you a system free of the insurance industry meddling and gets you in quicker and for preventive care before things become a big problem....that is forward thinking and I believe, a model for ushering in single-payer systems. No it won't fix everything but it increases access for relatively low flat rates. It makes sense. The suits hate it, of course, as it cuts into their status-quo profits which naturally, they cannot abide. But the barn door is open and the horses are out, so to speak. It's coming and it's gonna change a lot.

    There are a few of these practices in my town. One is a large, multi-service practice with multiple specialists, lab, pharmacy, therapists, etc. Others are more typical family practice providers. They are meant to be combined with a no-frills, high deductible catastrophic plan, which we are not allowed to have under Obamacare because we are "too old."

    So we're forced to carry an Obamacare compliant plan that is much more expensive and covers a multitude of services we'll never use.

    We receive most of our healthcare from a specialty practice due to a condition that affects more than one family member. I would love to see their practice offer a subscription service, and would even be willing to help fund and/or staff a start up. But for that to be practical, the individual mandate requiring fully Obamacare compliant insurance coverage must go away.

  • 3
    chare, Swellz, and amoLucia like this.

    If you have any questions after reviewing the IDPFR website, please contact your school of nursing. At the risk of sounding like a COB, it bewilders me that colleges and universities apparently fail to prepare their graduates for basic professional tasks such as job searches, applying for NCLEX and initial licensure, meeting continuing education requirements, endorsing licenses and maintaining licenses. If this was covered, and you didn't realize that it would one day apply to you, an advisor at your school should be able and willing to guide you. If this was never covered, then shame on them!

  • 2
    h00tyh00t and SopranoKris like this.

    Quote from teachable
    ...At least then there's an explanation even if their assumption about what is going on is inaccurate.

    I don't blame anyone but myself. I do think that the surgeon was a bit of a jerk insisting over and over that I handle and touch the organ just for the experience when it's clear I was trying to learn not to be woozy from the sight of surgery for the very first time ever. We hadn't even covered this material, so I didn't know what to expect.
    You state that you don't blame anyone but yourself, and in the very next sentence, you blame the surgeon for insisting that you touch a surgical specimen and for not knowing that you were woozy, even though you had not informed anyone that you felt ill, and you tried to conceal your queasiness.

    Please take responsibility for your actions, mistakes, misjudgments, etc., or you can expect next semester to follow a similar path.

    Good luck to you.

  • 8

    Having precepted students in the OR, I can assure you that no one expected you to be involved in patient care, but they DID expect you to be aware of safety issues. When you felt ill and woozy, it was your immediate responsibility to alert someone and/or remove yourself from the room. Remaining in the room, closing your eyes and trying to compose yourself may have resulted in you falling, fainting, vomiting or who-knows-what else, compromising safety and infection control. The last thing the OR staff needs is to be forced to attend to an observing student who failed to take responsibility for him/herself.

    Feeling ill may have been unavoidable. Remaining in the room was your choice, and it was one you should not have made. You were correctly criticized for that.

  • 5
    TriciaJ, BeckyESRN, MrNurse(x2), and 2 others like this.

    In our district, the nurse's decision to call 911 is respected. A call to parents follows immediately. If the parents arrive before the child is transported by EMS, they can interveve and decline the transport, assuming responsibility themselves. Unless documentation is in place in advance, grandparents can't do that. Granny's job should have been to comfort & calm the child. If she wasn't doing that, I would have sent her out of the office so I could focus my attention on the child.

  • 6
    RNqueens, scuba nurse, GdBSN, and 3 others like this.

    I agree. It is not the nurse's job to make or enforce attendance policy as it relates to excused or unexcused absences. Your job is to promote health and wellness and enable students to attend school by managing health needs that might otherwise impact attendance.

    The policies you set would be those that indicate health conditions for which a student should be excluded from school, such as vomiting, diarrhea, fever, etc. & the conditions that must be met for the student to safely return to school (such as being symptom free for 24 hours without medication.) If those conditions are met, it makes no sense for you to continue to exclude the student.

    I suspect that the administration has set the 3 day limit as a means of enforcing attendance, believing that parents won't keep a student out for non-health reasons if a doctor's note is needed. It won't work. If parents are going to pull their kids out of school for a vacation or other elective reason, needing a doctor's note won't change their minds. It will only create issues of excused versus un-excused absences, which are not your problem.

    If you are convinced that a child is returning to school safely, without a health condition that poses a risk to himself or his classmates, turf the enforcement of this policy back to the school administrators, where it belongs. You are the nurse, not the truant officer.

  • 3

    Quote from Meghan2323
    Hi there,
    I am an RN who is finishing up my BSN and need some help with an assignment on a topic that I feel is important to carefully address as it is a very sensitive and emotional issue. The topic of childhood obesity is what I have chosen to research. For this project, I must interview different health care providers and get their opinion/input on the following questions:

    1. Why and to whom to do think childhood obesity occurs?
    2. What are the symptoms of childhood obesity?
    3. What should those involved with childhood obesity do to get help?
    4. How much of a problem do you feel childhood obesity is and do you think that our society is doing enough to help?

    If any of you great nurses out there wouldn't mind helping me out and giving me some of your feedback, I would greatly appreciate it! (I need to interview at least 10 people). Also - if you do address the questions, would you mind putting whether or not I could use your name in my references page as "interviewed" - otherwise, I can just put "anonymus." Anyone who works with children/obesity would also be hugely appreciated! Thanks SO much and happy Saturday!
    -Meghan

    I don't understand the nature of your assignment. Are you attempting to research health care providers' impressions of childhood obesity and how those impressions influence care given to children? Or are you gathering factual data to write a paper describing childhood obesity?

    If you are writing a paper intended to describe health care providers' impressions of childhood obesity and how those impressions impact the care they deliver, you won't get that information from the questions you have posed.

    If you are gathering factual data, I don't understand the purpose of your questions. There is plenty of scientific, research-based information on incidence of childhood obesity, causative factors, morbidity and mortality, effective treatment methods, etc. available on-line and published in textbooks and journals, so I don't understand why interviews with unknown individuals are necessary for such a paper. And if I may climb on my soapbox for just a moment, nursing is an evidence-based discipline. We owe our patients care backed by scientific rationale, which is obtained via research, not personal opinion.

    My first med/surg instructor clarified this issue 30+ years ago by stating that our pathophysiology paper was to describe the science behind management of type I diabetes, not our experience with Danny the Diabetic. Timely advice today. Thanks, Ms. Bohan
    Please list me as "anonymus."

  • 2
    SobreRN and AliNajaCat like this.

    Quote from jaycam
    We can already do that. That's why I have insurance from Tennesse while living in WA.

    jaycam,

    Are you covered by a group plan? Many employers and groups cover out of state employees on a plan based somewhere other than the employees' residence. That is not the same thing as an individual being able to purchase a plan from any insurer in any location.

    Employers can only purchase insurance in states where they have established business, and individuals can only purchase insurance in the state where they live. This significantly limits choices & raises costs.

  • 0

    Quote from Not_A_Hat_Person
    When I was covered by my ex-employer's plan, I paid $800/month for 2 adults, with a $5,000 deductable. If I had to sign up for Obamacare, I probably would have come out ahead.

    I wouldn't be so sure about that. Our current family of four premium is $1500/month, with a $15,000 deductible. Because our plan won't pay for care outside our immediate area, we had to purchase a second, college-based policy for our daughter who attends school out of state, to the tune of another $200/month. I'd trade you places in an instant.

  • 3

    Quote from smartnurse1982
    If Obamacare did not force people to have health insurance,then who would treat these people if they had an emergency?

    The ER?
    No,they do not treat people for free.
    Someone has to eat the cost even if you didn't want to.

    Too many people think the care provided in the ER is free.
    I don't support the government forcing citizens to purchase a product against their will. But nor do I support enabling irresponsible behavior on the part of competent, able-citizens who refuse to take responsibility for their own needs.

    Obamacare's mandatory coverage makes insurance unaffordable for far too many people. We've already read examples of this from professionals working full time, so we can imagine how it applies even more so to young people with modest incomes. In order to gain their participation, changes must take place that lower the cost of coverage, including allowing individuals to choose plans tailored to their needs and budget.

    If young women want to save money by choosing a plan without maternity coverage, LET them do so. And let them take the responsibility of preventing pregnancy, or arranging payment in advance for the services they will need if they become pregnant.

    If families don't wish to pay for a policy with preventive care, let them purchase one without, and pay out of pocket for their kids' sports physicals.

    If mentally competent, able-bodied adults choose to go without coverage at all, LET them! But when they show up at the ER with a back-ache or ear ache, require them to make payment arrangements before they are seen. If they show up with a life or limb-threatening emergency, stabilize them using the minimum resources possible, and discharge them with a down payment and payment agreement in hand.

    Unless and until we demand responsibility from (some) people, we will never get it. We need to lose the nanny mentality that we know better than they do what they need, and we need to quit bailing out their stupid decisions. Most of us who have raised teenagers have learned this lesson with our own children, yet some refuse to apply it to others in society at large. That puzzles me.

  • 0

    Quote from MunoRN
    Bronze plans are required to cover generic meds with just a copay prior to the deductible being met, so you might consider generics.

    Source please? Effective date please?

  • 6

    A HIPAA violation occurs when someone accesses, discloses or uses protected health information in a way that compromises the privacy or security of a patient and is not protected as an "acceptable" or "unavoidable" incident.

    Allowing or enabling a patient to contact a trusted friend or family member from a healthcare institution is not a HIPAA violation. Nor, for the life of me, can I see how accidentally dialing a wrong number provided to you by the patient himself would be a violation.

    Please stop finding ways to torture yourself about HIPAA. There are enough real pitfalls in our profession. We don't need to go looking for imaginary ones

  • 7

    Is this a grant (which does not require re-payment) or a loan that you will have to pay back? If it is a loan, what are the interest rate and terms?

    Please consider these factors in deciding whether to accept the money at all, and if you do accept it, in determining how and when you will repay it, and what the ultimate cost will be.

    For example, if you receive $1500 in loan money this summer, but eventually have to pay back $3000, you might be better off declining the money and finding a less expensive source of cash for car repairs. Many students and new graduates post here looking for advice on how to manage tens of thousands of dollars of debt. Please don't join their ranks if at all possible.

    Good luck to you.

  • 0

    I believe the only way to get to the bottom of this is to request a meeting with the CNO. If you do so, please have a witness present who supports you, such as your manager, and/or the physician who assisted you in resolving the issue.

    If you don't wish to do this, I completely understand, but then recommend that you put it behind you, which of course is easier said than done.

    Best wishes to you.

  • 5
    canoehead, Supernrse01, OldDude, and 2 others like this.

    Quote from it'snotatumor
    Jen-Elizabeth,...Your rationale for why OTC's should not be allowed in schools are completely valid, bottom line. Potential for harm DOES exist in allowing students to self-medicate, my argument is that making policies prohibiting OTC's in schools in the name of providing a safer environment is akin to making everyone remove their shoes at airport security to protect us from terrorists-they are both illusions of safety.

    I think that we can all agree that drug abuse is a complicated issue that is not easily remedied, and one with potentially significant and devastating consequences. I greatly appreciate this forum and I felt comfortable voicing a contrary opinion because of the level of respect and knowledge that I have seen here. Thanks for making this day go by quickly!

    I can't help but wonder if the reason for the policy is a legal one. How many times have we been warned that it is bad (from a legal perspective) to have a policy in place and NOT follow it. That raises a red flag that may as well be blood in the water to the sharks that are plaintiffs' attorneys. Perhaps the school district attorney feels that it is more of a liability to have a policy against self-medicating that everyone knows is being ignored and regularly violated, versus having no rules at all.

    Just a thought.


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