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Turtle in scrubs 4,840 Views

Joined Mar 8, '07 - from 'Kansas'. Posts: 207 (43% Liked) Likes: 211

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  • Nov 12

    Don't forget that the reason the ACA was imperfect was because Obama was blocked at nearly every turn by the Republicans! If they had been able to implement it properly it would have been much more successful.

  • Nov 12

    Quote from smartassmommy
    I am conservative leaning, but after getting to research healthcare system around the world, I realized that systems like the NHS are really the way we need to go.

    Also, maybe we'll get lucky and Press-Gainey will no longer decide reimbursement!
    I'm originally from England and I worked in the NHS for 10 years before I came to America. While there are many good points about the NHS there are also many negatives. Going to an NHS style framework would mean much longer waits for patients...sometimes years for surgeries...much lower wages for nurses and literally zero choice for patients. Nurses wages in the UK are capped and formed into bands where you cannot earn beyond that unless you fulfill certain criteria. In England I earned 4 times less than I do here pound for dollar. There is much less ability to climb the professional ladder and less reward. There is so little money to go around that hospitals are old and groaning under the weight of patients. You cannot choose your doctor at all and you have to be referred to a specialist that takes months to get an appointment with. I am glad I don't work for the NHS anymore. However, the positives are that I never received a bill in my life for medical care there. My parents have medical care whenever they need it although they often have to wait a long time to get seen.


    The perfect system would be a hybrid. Funding from multiple areas...taxation and private insurance. Those who can afford should have the ability to buy a better insurance while those who cannot should have at least the safety net of basic, decent care free of charge. America has made things way too complicated with the whole ICD 9/10 thing. There is so much red tape and so many bureaucrats that it's out of control. ACA was a start in the right direction but it's not sustainable in the current model. Having said this, repealing it will be a huge mistake because it will leave us back where we were but now everything is more expensive. It's not like prices are going to go down!


    I too remember earning good money 10 years ago. Things weren't so tight and we could get travel reimbursement and bonuses and all that disappeared and the penny pinching started. For one side to gain the other side has to lose it seems. We need a system where everyone gains. I foresee caps on nurses wages if we're not careful. We cost too much money and they have to get that from somewhere. That's why I started accumulating degrees and certifications. Make yourself desirable.

  • Nov 12

    I don't know about you, but years before the ACA went into full effect there was a multistep transition we had to go through. It changed our entire operation a bit. The first thing I learned as a nurse was "costs, costs, costs" and how area hospitals were going out of business because people just don't pay their bills. I was told to admit Medicare patients first because they paid the most. Every place I worked freaked out about us using extra pieces of gauze and cut corners to dangerous levels.

    All of these problems were the result of decades of financial healthcare disasters. If you remember the HMO movement in the 80's, that failed and led to the need for ACA. With the ACA, we can't be denied due to pre-existing conditions.

    My employer cancels our insurance if we go below 20/h a week for two weeks in a row. With my chronic illness child, she would have lost her insurance and I'd be bankrupt soon. I rely on the ACA to have insurance that doesn't cost 4 figures for the both of us.

    I haven't had to attend the "omg, stop using so many supplies" meetings in years nor have I been asked to go home as little as an hour early to save the facility money. Financially, the ACA is helping a lot. Keep in mind premiums have been going up long before the ACA, they aren't going up because of it. Please don't get rid of ACA because certain people are on a crusade to do it. My tiny girl needs her mama to not lose the house over her hospital bills.

  • Nov 12

    I have concerns about this as well, not only for what it means for our patients, but as caregivers in the industry. I came across this article in my search to understand what might occur, but I'll need more time to digest it.

    Donald Trump's Proposed Healthcare Plan

    I do plan on writing my state representatives and voicing my concerns over many things. Mostly questions so I can clarify what to expect and how I can advocate for myself, my family, and the people we serve.

  • Nov 12

    I have no idea what to expect, and honestly I am scared.

  • Aug 20

    A&D ointment and/or hydrophor is regularly used in our clinic.

  • Aug 20

    In our clinic we use Remedy lotion (a Medline product) to intact skin on the leg. We use a moisture barrier cream to the periwound. So far good results with no maceration.

    ETA: if they have really dry, scaly skin on the ankles and heels we also use Urea 5% cream.

  • Apr 23

    Due to random drug tests and my children wanting to eat every single day, I can not smoke the reefer. But, I am counting down the years until I can retire.

  • Apr 2

    I went to Indeed.com to find my new job. I found that it was easy to navigate and filter and I used some basic search words to find the types of jobs I was interested in and also by location. I started by looking for wound care jobs but ended up looking outside of wound care. I ended up leaving the world of wound and ostomy care because I decided to try something entirely different. I did wound and ostomy care for 12 years but I think it was time for a change. I will never say I wasn't challenged though.

  • Feb 19

    Try Indeed. That is where I found my new job. Also, if you have a good relationship with vendors, they often have the some tip about jobs that are open or will open.

  • Aug 30 '15

    How was I anti-catholic? I just quoted what several of the staff had said to me when I asked if they would mind praying with the patient while I did their dressings or something. In small towns where everyone works together and goes to the same churches with the people they work with you would be surprised at the discrimination. And actually it's not illegal. The U.S. Government has granted churches, religious schools and religious hospitals the right to discriminate based on religion. The hospital could fire me because I am atheist and the only reason they don't is I went to catholic school with the chief of staff

  • Aug 27 '15

    Quote from DorothyMargaret
    When a patient asks you to pray, it's not about you at all, it's about the PATIENT and his needs. He may be terrified and he needs that support. Just think of it as a placebo that will help your patient feel better. If you can't think of any appropriate words, ask a colleague or go online and find a little prayer. It WON'T hurt you. Kindness won't cost you a single thing.
    No, it won't kill anyone, but I wouldn't ask a Christian to pretend to pray to Zeus because it would make ME feel better. That's just self-indulgent and rude to think I have the right to step on someone's beliefs (or lack thereof) for MY comfort.

  • Aug 27 '15

    I clicked because of the allusion to "A Connecticut Yankee in King Arthur's Court." I stayed because I've had this problem.

    I live in a secular region, but work at an extremely religious organization. Charge nurses are required to ask if anyone would like to pray at the beginning of each shift (no one has to pray, they just have to ask). The hospital shares a campus with a church, and a lot of our patients and staff are part of that congregation. So, I get asked to pray a lot, and other nurses do pray over people a lot. I wouldn't mind standing silently while someone prays (what I do at shift change), but I don't know how to pray. I tell them I need to spend time with other patients but I'd be happy to have a chaplain come pray with them.

    "Hi God. Please, umm, keep an eye on Bob in this time of recovery. He presented to the ED with rales bilaterally, sating in the 80s, complaining of shortness of breath. He was started on Lasix and admitted for observation overnight. He put out about 1,300ml of urine since 5pm last night. Lung sounds are improving and O2 is now in the low 90s. So, uhh... amen?"

  • May 17 '14

    Emory is an AWESOME program. When you go to Bridge week you'll get some practice there as well. Just remember the guidelines and review before going to mark a patient. If you work with another WOCN it doesn't hurt to go together and eyeball the patient together. You will get a cool little pocket guide that is a good reference as well. As far as suggestions you may want to mark more than one site and mark one w/ a number one and a 2. Additionally, during your assessment if you notice a fold or indentation that appears flat when the patient is supine clean the site with alcohol, mark "NO", and cover with tegaderm. That helps the surgeon out when they are in the OR. You won't always get to have your patient stand, twist, or lift their knees because sometimes the surgeons will call as they are ready to roll in so get a good look at them in a sitting position and look for a pannus. You don't want to have to go through extra adipose tissue which could cause stomal retraction. Good luck to you!

  • May 17 '14

    Hello ~ I've been a nurse for many years, but within the last year I've become a WOCN; I don't have a lot resources where I work as a WOCN, who can help guide me with some more complex/advanced recommendations. I understand that every hospital and patient is unique, but generally speaking I'd love to have an online mentor, who has a lot of WOC experience, that won't mind helping me, occasionally, to work through some questions that come up. For example, what criteria do you use (generally) for consulting surgery for an operative or more advanced bedside debridement of a pressure ulcer or how do you treat an ostomy with mucocutaneous separation leaving an area of mucosal tissue around the stoma instead of peristomal skin.

    Please send me a message/email if you'd be interested in sharing your knowledge and mentoring an old nurse but new WOCN

    Thanks,
    Dee


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