Latest Comments by NRSKarenRN

Latest Comments by NRSKarenRN

NRSKarenRN, BSN, RN Moderator 111,759 Views

Joined Oct 10, '00 - from 'RN Spirit from Philly Burb'. NRSKarenRN is a PI Compliance Specialist, prior Central Intake Mgr Home Care Agency. She has '35+' year(s) of experience and specializes in 'Home Care, VentsTelemetry, Home infusion'. Posts: 27,262 (22% Liked) Likes: 13,285

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  • 0

    Found at

    Mylan 'incorrectly' classified EpiPens, shortchanging government: Regulators

    ...CMS' comments came after a trio of U.S. senators wrote the Justice Department asking if it was considering an investigation of whether Mylan violated the law "when it apparently misclassified its EpiPen product for the purposes of the Medicaid Drug Rebate Program."

    "The facts laid out ... suggest that Mylan may have knowingly missclassified EpiPens, potentially in violation of the False Claims Act and other statutes," said the letter from Sens. Amy Klobuchar, D-Minn, Richard Blumenthal, D-Conn. and Charles Grassley, R-Iowa.

    Under the Medicaid rebate program, Mylan is paying Medicaid a rebate of 13 percent for every EpiPen it sells through that health-coverage program for primarily poor people, because the company has classified the device as a generic product.

    But CMS said Wednesday that Mylan should be paying, but isn't, a rebate rate of 23.1 percent for brand-name drugs, as well as an inflation rebate that is legally required when drugmakers raise the prices of brand-name drugs above the inflation rate....

  • 0

    WOW Mylan’s EpiPen had 3.6 million outpatient prescriptions written last year per article below.

    3,600,000 RX X $55.00 profit/unit per CEO = $198,000,000 profit.

    From Institute for Safe Medication Practices

    What price must we pay for safety? Excessive cost of EPINEPHrine auto-injectors leads to error-prone use of ampuls or vials and unprepared consumers

    Recent errors

    All of the recent events reported to ISMP involved administration of 1 mg of EPINEPHrine by the IV route after switching from EpiPens to EPINEPHrine ampuls and/or vials. For example, one hospital reported three errors in the past 6 months in which the entire contents of the 1 mg/mL vial of EPINEPHrine was administered IV, when 0.3 mg IM should have been administered. In another hospital, a patient who was experiencing an anaphylactic reaction to FERRLECIT (ferric gluconate) was also given EPINEPHrine 1 mg IV when the correct dose and route was 0.3 mg IM. The patient required admission to a critical care unit for close monitoring....

    ...Available EPINEPHrine auto-injectors

    Mylan’s EpiPen is the most frequently prescribed EPINEPHrine auto-injector, generating more than 3.6 million outpatient prescriptions last year.1 Several rival products joined the market only to fall by the wayside. EpiPen’s strongest competitor, Sanofi’s AUVI-Q, was removed from the market in October 2015 due to concerns about inaccurate delivery of the dose. A generic EPINEPHrine auto-injector by Impax (labeled as Lineage Therapeutics, which Impax acquired) generated less than 200,000 prescriptions last year,2 largely because prescribers are much more familiar with EpiPen. Also, the Impax product cannot be substituted as a therapeutic equivalent for EpiPen because the US Food and Drug Administration (FDA) has determined that there is insufficient data showing that the generic auto-injector is therapeutically equivalent. (The Impax product is not AB rated in the Orange Book.) The Impax auto-injector is not covered by some insurances, and purchasing groups have had difficulty negotiating contracts with the company. Thus, EpiPen essentially has a virtual monopoly on the market, contributing to ongoing price hikes over the years.

  • 3
    BeckyESRN, MrNurse(x2), and djh123 like this.

    Quote from MrNurseXY
    May be premature, but it could be "abdominal migraines". These kids can vomit 20 times daily. It is often seen as psychosomatic. Prescribing Imitrex is a way to rule it out. Anxiety is a common symptom.
    What is CVS? | CVSA
    Thank You... always learn something new reading the school nurses forum.

  • 1
    Percephone likes this.

    i've worked primarily with Geriatric clients in home health, many with Dementia. paternal grandfather placed in SNF 30 yrs ago when Alzheimers advanced and gransmother got sick and hospitalized. Just placed my father 2 weeks ago in Memory Care unit after 2 years decline, vistiing several hours every other day o get him adjusted. Observed and heard so many similar conversations. They have such patience with "Paul" who loves to pace one end of floor to other, trying all doorknobs then flinging himself on floor in hallway for 30 min refusing to get up.

    Yesterday Dad tapping watch at 12N telling me they didn't have any food for breakfast except for small round item (donut) and no food for lunch. "They left people alone in dining room and wouldn't give us more to eat". Can see staff setting up dining room for lunch. Passing aide in hallway she mentioned Dad now allowing her to bath him, got shower yesterday...and this morning had bacon, eggs toast AND donut "He eats everything I give him".

    I'm so grateful that there are chatty, attentive LPN's, aides and activity assistants who don't mind listening to the same story for 10th time in 30 minutes, can sooth the screamers and ensure nutrition with the picky eaters.


  • 3
    sevensonnets, Loracs72, and Kitiger like this.

    Cantor Tubes still exist...

    Still remember the night I dropped 10cc glass testube filled with mercury that shattered into tiny beads size of dippin-dots ice cream all over the nurses desk, rolling over the edge onto the floor underneath desk...took me 20 minutes with piece of cardboard to corral them into plastic urine container.

    You instill mercury into smaller tube which fills and weights down balloon end

    Heard it called a Miller Abbot tube too.

    [IMG] B3VwzVZ96Ul0idJy-PGlw[/IMG]

  • 3

    Augh, the good old days...

    Gomco Portable Gastric Drainage Aspirator
    Fiddled with these many times on night shift to get suction to work AND responsible for emptying them --no eyeshields to prevent splashing in the 1970's.


    Buretrol IV set is still used today, seen in pediatric units. See Buretrol Youtube video


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  • 2
    sevensonnets and traumaRUs like this.

    I'd taken the day off from work to complete masters class paper, typing away from my dining room computer. Taking an eyebreak, checked email and saw news scroll on Comcast of 1st plane hitting tower. My husband was home so we quickly turned on Wpvi/abc TV and with disbelief saw the second plane hit the towers, saw people dangling or jumping from upper windows due to fireball and then slow motion building crumble. We were glued to the TV rest of the day.

    My cousin's wedding was scheduled for that weekend in Newport Beach RI. With the airports closed, several family/friends unable to attend. Leaving Philadelphia, PA we drove up I-95 on Friday amazed to see the black dusty skies from building collapse + still smoldering items remaining, Traffic was so light on NJ turnpike around NY and eerily quiet. As we drove home Sunday evening, still 2 spirals of smoke seen over NY city.

    Many prayer offered that week, and yearly thereafter.

  • 4
    BabyFood26, sirI, Garden,RN, and 1 other like this.

    Turns out the reported "Nurse" in this famous LIFE WWII V-J picture was actually a dental assistant at the time! Karen


    Greta Friedman, the woman kissed by a sailor in the iconic picture taken in Times Square on V-J Day in 1945, has died, according to her son Joshua Friedman.Friedman told CNN that his mother died at an assisted living home in Richmond, Virginia. She was 92.

    The black-and-white photograph of Friedman, dressed in a white uniform, being embraced and kissed by a sailor to celebrate the end of World War II became an enduring image....

  • 3

    Kaci Hickox 's lawsuit will be allowed to proceed re false imprisonment and violation of privacy--- highly think she will win invasion of privacy portion of suit as media circus developed with public outside tent setup she was subjected to. Karen

    From Philadelphia Inquirer :
    September 8, 2016
    by The Associated Press

    Some of Ebola-quarantined nurse's lawsuit claims are tossed

    ...U.S. District Judge Kevin McNulty agreed with state lawyers that the Republican governor and state health officials are immune from the federal civil rights charges brought by nurse Kaci Hickox. But he ruled in a decision published last week that Hickox can proceed with parts of her lawsuit alleging false imprisonment and invasion of privacy....
    ... Hickox said one thing is certain: "This decision vindicates my rights by giving me the opportunity to find out from Governor Christie directly whether the decision to detain me was motivated by science or by politics," she said in a statement. "Christie was ultimately responsible for my detention, and he should have to answer for it and show it was made in good faith."...
    ...The judge wrote in his decision that "bad science and irrational fear often amplify the public's reaction to reports of infectious disease." He wrote that Ebola is a virus and not a "malevolent magic spell" but that the state should have some latitude in its efforts to contain it..

  • 1
    TheCommuter likes this.

    Philadelphia Inquirer report


    TT Technical Institute of Carmel, Ind., and its locations including Center City, Marlton, Levittown, and Plymouth Meeting in the Philadelphia area, have closed, idling most of its 8,000 staff and sending more than 30,000 students home, after [URL=""]the U.S. Department of Education stopped giving its new students financial aid....

    ....In its statement, the Department of Education says it might decide to forgive ("discharge") loans for students still attending ITT when it closed.

  • 0

    Just found this event. Karen

    Philadelphia Networking Luncheon

    The Philadelphia Young Nurse Professionals invite RNs, new-to-practice RNs, and students to a complimentary networking luncheon co-hosted by Bryn Mawr Hospital. This event will be held on August 19 from 11:30 AM – 1 PM. Presenters – Marianne Harkin, MS, RN, NEA-BC; Patricia Ann Blaney, RN-BC; and Barbara Daulerio, BSN, RN, OCN – will discuss "Empowering Nurses to Provide Integrative Therapies to Hospitalized Patients and Conduct Research on Their Benefits." Attendees will (1) learn about the applications and benefits of aromatherapy and reiki for hospitalized patients, and (2) discuss the implementation of an RN-driven aromatherapy and reiki program in a community hospital. Bryn Mawr VP of Patient Care Services Marianne Harkin and Main Line Health Senior VP & CNO Barbara Wadsworth will also be present for a Q&A session during the event. Guests can meet at 11:15 in the Warden Lobby (Bryn Mawr Hospital Conference Room F, 130 South Bryn Mawr Avenue, Bryn Mawr, PA 19010). Click here to reserve your seat.

  • 1
    herring_RN likes this.

    New report finds 1 in 3 nursing assistants relies on public assistance, “care gap” worsening: “Raise the Floor: Quality Nursing Home Care Depends on Quality Jobs has organized CNA's and ancillary nursing home staff in several states. They are behind "Fight for $15" wage and quality of care campaign in several states where organized.

  • 4
    HarleyGrandma, NYbabyRN, AJJKRN, and 1 other like this.

    Found at CNN

    Aleppo's angel:
    A nurse's devotion to Syria's children

    This is a touching story about Malaika, a 29-year-old head nurse, caring for fragile infants in the neonatal unit at Aleppo Children's Hospital. Because of the Syrian war, she lost her home, her husband divorced her and took her children away from the area. She won't leave her patients and her hospital. Karen

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