Latest Comments by Jolie

Jolie 26,822 Views

Joined Oct 17, '01. Posts: 9,478 (48% Liked) Likes: 13,459

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  • 0

    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.

  • 10

    I for one am desperate for an alternative to the high cost and poor coverage issues realized under the Affordable Care Act. We are a self-employed family of 4. We purchased our first individual family health insurance policy in 2010 when we opened our business, crafting a plan with our local BC/BS affiliate that covered all care in our primary provider's office without regard to deductible and minimal co-pay. Other care was subject to a $5K family deductible, which seemed high at the time, but quaint now. We had no maternity care, which we did not want or need, but did have vision coverage and behavioral health coverage. We were on our own for dental. Our premiums were approximately $500/month.

    Fast forward 7 years. We now pay $1500/month for a plan with a $15K family deductible, so those numbers have tripled. That means we pay $18K/year and then the first $15K out of pocket, totaling $33K for anything other than the mandatory preventive services, many of which we have no use for. If we paid full price out of pocket for the preventive services we use, it would probably amount to about $500 per family member. So for our $18K premium, we can expect to receive about $2K per year in actual services. I understand that's how insurance works, spreading costs out over pools of participants. But keep in mind that $18K isn't the starting point for our actual insurance coverage. $33K is. That is unsustainable. We pay a larger % of our income for healthcare than anything else. It out-paces the cost of our home, cars, utilities, food, and even college education for 2 children. We earn a relatively high income and can barely afford this. I can't imagine how families with more modest incomes do it.

    Besides cost, the other issue that impacts us is that so many insurers have pulled out of the individual market in our state. When we purchased our first policy in 2010, there were a number of companies from which to choose, and several different plans offered by each company. We had a wide range of choices for cost and benefits. We are now down to 2 companies offering individual plans here, and none include out of area care, other than life-threatening emergencies. Both our children are in college. One attends about 2-1/2 hours from the city where we live, and must travel home for any healthcare service to be covered. Her college is very small, does not have a student health center, so if she has a minor illness such as strep, she either has to drive 150 miles home to have her visit counted toward our deductible, or pay fully out of pocket to go to a local urgent care or doctor in her college town. Our younger child attends college 1/2 way across the country, so we had no choice but to purchase a separate college-based policy for her, with additional premiums of about $200/month. But at least she doesn't have to fly home to get her strep throat checked.

    I firmly believe that unless/until the primary responsibility for payment rests with the individual consumer, costs will never be reigned in. A plan to reduce costs must include personal responsibility for payment, coupled with the ability to purchase insurance across state lines, the ability to purchase coverage that meets ones needs and budget, not a pre-determined set of benefits, transparent pricing and reporting of outcomes, negotiation between consumer and provider, and the establishment of pre-tax/tax free personal healthcare savings accounts.

    I understand that low-income individuals will require subsidies, and welcome that approach, but EVERYONE must pay his/her own bills from his/her own (potentially subsidized) account, removing the perception that healthcare doesn't cost much because other people are paying for it.

  • 0

    I can't comment on the professional standard of care, but having recently taken care of my daughter and mother following orthopedic surgeries, I definitely used their gait belts in the shower. I had to have a way of keeping ahold of them in the slippery confines of the shower, and had no other options to use.

    Unless your client has unusually delicate skin, I can't see any harm in doing this to prevent (or at least safely manage) a fall.

  • 2
    poppycat and Davey Do like this.

    Please contact your nursing school and insist that they advise you on how to specify IL for your NCLEX, and how to apply for an IL license. It is their responsibility to ensure that their graduates are properly prepared to undertake these basic tasks necessary for licensure. Don't take "No" for an answer. You paid tuition and fees for 4 years for this.

    Best wishes to you!

  • 10

    Their current interest means nothing unless it translates into a job offer prior to your start date at the new hospital.

    If they come thru with an offer that interests you, consider it within the scope of your knowledge of the facility. Have you been satisfied, other than the lack of responsiveness to your previous applications? Is the pay acceptable? Are your benefits adequate? What is the hospital-wide work environment? Is staffing appropriate? Are you comfortable with the professional atmosphere? Are your educational needs met? Do you believe that you will enjoy working on the new unit?

    If so, I would consider staying. It seems that they are making a reasonable effort to correct their past neglect of your job interests, and most of the other intangibles that contribute to job satisfaction (or lack there-of) are known to you. If you move to another employer, those factors will all be unknown. You might end up unhappy in the specialty of your choice, because the practical details of the job are not to your liking.

    Good luck.

  • 0

    Can anyone direct me to information discussing the use of IVIG for a patient who has experienced a transfusion reaction resulting in severe hemolysis?

    I'm not seeking medical advice. My friend has asked me to help her formulate questions for her physician (heme- onc specialist) who is proposing 1 or more infusions of IVIG to "counter-act" a presumed transfusion reaction believed to be the cause of severe anemia. I have Googled everything I can think of, and can't come up with any articles or websites that describe this use of IVIG. What I've read leads me to believe this is not a conventional treatment. I'd like to assist her to become informed about the risks/benefits so that she can make a thoughtful decision, but I'm at a loss.

    I'd appreciate any reputable information. Thanks in advance!

  • 3
    Kitiger, Here.I.Stand, and morte like this.

    It sounds like administration is turning a blind eye, not wanting to address an unpleasant issue with this patient/family. In the event of an emergency, you can bet they will hold throw the staff and unit manager under the bus for any harm that might result.

    If your risk manager is unwilling or unsuccessful in intervening, I suggest a call to your fire department. In most municipalities, they have the right to free access to facilities for unannounced inspections to address safety/compliance issues. And they won't take "no" for an answer. Ditto your local health department.

    An upcoming JCAHO inspection would undoubtedly prompt action as well.

  • 5
    supermom44, Devon Rex, cleback, and 2 others like this.

    Please take my post in the spirit intended: to help you find a better fit in your next job, not to be critical of you personally.

    You mention having worked in a number of specialties, and I presume that those jobs involved different employers. Yet you ultimately burned out of all of them. The one constant has been you.

    I believe you would benefit from taking some time to evaluate your strengths, weaknesses, interests, tolerance for stress, chaos, unpredictability, desired hours, willingness to do OT or on-call, salary requirements, family needs, desire for further education, benefit expectations, etc. Take time to write your "dream job" description and set out to find something as close as possible to it. Decide what terms and conditions of employment are non-negotiable to you (such as a particular shift or salary level) and what you are willing to be flexible on (amount of PTO or insurance choices). Don't limit your thoughts to clinical specialty, since much of what makes our jobs satisfying or pure hell has to do with other variables, such as rotating shifts, staffing, length of commute.

    In short, I would say that the least stressful clinical area is the one that fascinates you the most. Not because it will be stress-free, but because your tolerance for the negatives will be higher when you are engaged in something that is meaningful and important to you. But even that needs to be balanced out by acceptable working conditions, which includes so much more than money.

    Good luck to you!

  • 0

    Did you utilize FMLA when you went on maternity leave?

    FMLA allows employers to recoup the cost of benefits paid on behalf of an employee on FMLA if she does not return to work in a benefits-eligible position for a specified length of time following FMLA.

    This is to protect employers from shelling out substantial amounts of money towards benefits for employees who really have no intention of returning to work following a leave. Not all employers pursue this, but the law allows them to do so. Human Resources can let you know the likelihood of your employer requesting a pay back.

    If your leave was not FMLA, but rather based on a maternity leave policy then you will have to check with your employer to learn their policy.

  • 7

    Quote from medsurg4ever
    Hello all,

    I am not a nicu nurse, I work with the elderly mainly on med surg. I have so much respect for what you nicu nurse do on a daily basis. i am posting here because I would like to know your opinions on this matter. Some background, my niece was born at 25 weeks, weighed under two pounds at birth. Had 2 bouts of NEC, was resolved with antibiotics never needed surgery.

    My niece at two months of life was given three vaccines one day apart, dtap, hib and ipv last week on mon, tues and wednesday. on the overnight shift Saturday sometime after 1 am she went in distress, 02 desats, bradycardia and low bp's, she had previously been stable, on what looked like nasal canula, i'm not sure what you would call it but she definetely wasn't on cpap or vent. She needed to be intubated and they were never able to stabilize her, she passed saturday late afternoon.

    I had no idea that vaccines would even be offered so early as she wasn't even at her due date. Is this common practice? The doctors deny this could be related to vaccines as it was several days after the fact. the autopsy isn't complete but didn't show anything wrong with her gross anatomy. Your opinions, could this be vaccine related? And on a personal level, would you consent to these vaccines if it were your own child, a 25 weeker at day 60 of life?

    Please tell me I'm wrong
    My heart breaks with yours. As a NICU nurse and mom of 2 former preemies, I know that there is nothing more agonizing than the deterioration of a baby believed to be stable.

    We are unable to provide answers to medical questions, but I can tell you that the vaccine schedule you describe is fairly standard, and in my experience, not linked to complications. Please accept my prayers that your family finds understanding and comfort.

  • 1
    AliNajaCat likes this.

    Quote from KarenMS
    What makes you think troll? Probably just made an account to post because he/she was stressing and then forgot about it.
    I wasn't referring to the OP, but to the post from brpeifer, directly above me. Sorry for the confusion.

  • 2
    Guest12/13/16 and brownbook like this.

    I value patients being able to rest, but would manipulate pillows & blankets enough to be able to visualize an IV site, even if it meant disturbing the patient. I believe an hourly check is standard.

  • 2
    AliNajaCat and KindaBack like this.

    New member, joined today, first & only post. Troll alert?

  • 0

    Quote from mindywright3
    I'm not a nurse yet, but I just wondered, how do you differentiate between menstrual cramps and cyst pain? because the treatment would differ. I can't imagine prescribing exercise for cyst pain and I remember not only missing school for it but even as an adult, having to leave work because of it. ironically I have minimal menstrual cramping...But I'd think elementary and middle school aged girls would have a hard time telling the difference. I'd be leery of recommending exercise without a history. but again! I'm not a school nurse. Just learning!

    Having had both, it is my experience that there is no similarity between the 2 kinds of pain. I am also not familiar with ovarian cysts being common in school-aged girls, but I may be wrong about that.

    I don't recommend extreme exercise, but encouraging a young lady with moderate to severe period pain to do normal gym class & athletic practice is difficult, although usually quite helpful.

  • 1
    sergel02 likes this.

    Few nursing tasks are as challenging than giving shots to frightened, uncooperative children. Gather your supplies, get as much help as possible distracting & holding the child, and get it done as swiftly as possible. Your technique may not always be picture perfect, but it is unlikely that any harm will come from forgetting to z track or injecting into pinched tissue. The child received the intended vaccine. Consider that a win.


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