jeffsher

jeffsher

Peds, Psych, Medical Home Case Manager

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About jeffsher

jeffsher has 22 years experience and specializes in Peds, Psych, Medical Home Case Manager.


Former Peds nurse, now doing Case Management (Medical Home)

Latest Activity

  1. Yes, your ambulatory care experience will be invaluable. I worked 5 years in-patient (Peds), and then 17 years Primary Care (Peds, Family Practice, and Internal Med). I currently case management elderly and some younger adults, although we will soo...
  2. I work as a PCMH Case Manager (embedded in a clinic, employed by an insurance company), and our primary duty is disease management of patients with COPD and Heart Failure, although with all of the co-morbid conditions, deal with many other diseases a...
  3. Does anyone....

    Absolutely. I rarely get out "on time" these days. In fact, this was the week from hell. But I still love my job.
  4. Does anyone....

    Absolutely! I've only been doing it for 7 months now, and it is a lot of work. But work isn't "work" when you love what you do.
  5. Becoming a CM with no experience in CM

    Many times companies will post that they want experience, but that doesn't mean that they ONLY hire those with experience. Ignore the experience requirement and apply anyway. What do you have to lose?
  6. Cm is a thankless job!

    It's called "entitlement attitude", and it's becoming more and more pervasive.
  7. Any nurses who used to be teachers?

    Baubo516, I've been out of commission for a while (surgery and a med problem that landed me in the hospital 3 weeks after the surgery) and missed your April post up until now. Glad everything is going well. Being a CNA will be an incredibly positi...
  8. Telephonic case manager

    I just started as a Telephonic CM back in January. I work for an HMO, and the position was newly created to cover the Medical Home and Community Case Managers in our system (over 100 CMs; there is also 1 other nurse hired as a coverage nurse). In th...
  9. Has Anyone Here Worked in a Coumadin Clinic?

    Just had an inservice on Pradaxa this week. It's not good for those with risk of GI bleed, but it carries lower risk of intracranial hemorrhage. Coumadin has a narrow therapeutic index, which is a definite disadvantage, but it's proven therapy. As...
  10. Has Anyone Here Worked in a Coumadin Clinic?

    Pradaxa is a direct thrombin inhibitor, while Coumadin/Wafarin prevents the activation of*4 clotting factors that depend on*Vitamin K. No need for monthly labs and frequent dose adjustments as with Coumadin. Of course, time will tell whether Pradax...
  11. Has Anyone Here Worked in a Coumadin Clinic?

    One consideration: how long will coumarin clinics be needed, as the new drug Pradaxa doesn't require lab work?
  12. I was giving multiple chemotherapy meds to a 2 year old for her ALL, mixed syringes up, and mistakenly gave a hep flush IM (was supposed to give L-Asparaginase). I was fortunate that I had already given the Vincristine IVP and not mixed up THAT syri...
  13. outpatient mrsa protocol

    MRSA is widespread in the community. In our clinic, we wipe down exam rooms where there has been drainage from a MRSA wound; otherwise, standard precautions.
  14. What grosses YOU out?

    72 hour stool collection for fecal fat on a patient with cystic fibrosis. Also, I caught a gastroenteritis about 6 months after I finished nursing school. I had been vomiting all night, was dehydrated, and went to the ED. It turned out that I had ...
  15. Doing real CPR as a student.

    As an aside, the "success" rate (meaning the patient eventually left the hospital alive) for CPR is 17% when performed in the hospital, 5% for those with chronic illness(es), and less than 3% in nursing homes.