Latest Comments by rearviewmirror

rearviewmirror, BSN, RN 5,309 Views

Joined: Mar 2, '15; Posts: 199 (57% Liked) ; Likes: 431
Specialty: ER

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  • 1
    brownbook likes this.

    Quote from brownbook
    I'm just guessing. It seems like it is more of a "chart check". Making sure all the labs, EKG's, echo, x-ray, etc., results are in the chart? If that's it, it seems like something a clerk or MA could do? But I may be wrong.

    I'd still check it out if I were you. But don't quit your other job.
    It's not a clinical job, and pretty much hands off, so not exactly like a pre-op nursing...Yeah, actually someone I know was kind of surprised because most of these can and are done by MAs or receptionists. I guess I can find out and update y'al here. And nope, not quitting until new job's secure.

  • 1
    KelRN215 likes this.

    well, the description looks more like running down the list of what needs to be cleared prior to having elective surgery as opposed to doing precerts. For example, if pt wants to have bariatric or knee surgery, the surgeon has protocol or list that he wants cleared prior to the OR date: labs, echo if you have heart problem, medical hx and med recs, etc. Sounds like a simple job, but for someone who wants to grow into administration/management type throughout the career, not sure if it holds lots of potentials.

    Maybe it's not a very common thing for RNs to do.

  • 0

    Hello nurses, I tried searching this on forum but did not find any post, so here we go. I am in a transition period between staying at current job to finding a new path. I came across a surgical clearance nurse, and wanted to see if anyone does it or has an experience and obtain your input.

    It definitely sounds more interesting than sitting on a desk and punching keyboard (which is what I do), but I would like to see myself grow in leadership and do risk, safety or quality in the future, and I am not sure if this position has lots of potentials for growth.

    What does the day to day look like? Do you like it or hated it? Is there potential for growth? What are your thoughts? Thank you!

  • 0

    Quote from Been there,done that
    It's up to you to interpret and apply the criteria. The difference is... on the commercial side, you don't want the criteria to meet, so payment can be denied.
    In the hospital setting, you want the criteria to meet so the hospital gets paid.
    It's all a game, I liked the commercial side, so I could work from home.

    Best wishes.
    haha I thought you would be one of those who would reply, saw your id around the ur/cm posts so appreciate your input very much.

    I have been on the receiving and reviewing end as well at commercial instead of being on the side trying to get LOS approved, so really curious how the work stress and load will look. I sometimes think hospital UR staff will just shove all the clinical in scanner and just send them and move on, but know that's not it either... wonder if reviews at hospital take longer.

  • 3
    ChrisJ6991, brownbook, and cleback like this.

    It's hard to explain with words but here it is: as JKL33 explained, you probably went through the veins at that point. I worked in ER and on sonosites so I am pretty confident of my IV skills.... but I am a paperpusher now so take it or leave it....

    when you hit the flash of blood, you do have to insert it in little more to make sure tip is in the vessel instead of "on the vessel." I would slightly push the needle upward (you can see it bend very little sometimes even) as I advance mine just little bit once I saw the flash. That's how I advanced my needles and never missed an IV most of the times. Sometimes you get people who have absolutely no veins since they came to hospital so often, then knowing how to use sonosite helps tremendously.

  • 0

    Hello my trusty old nurses. No place like here to ask a question!

    I am working at commercial side doing utilization review and since I got an opportunity to move over to hospital side, I was wondering if you have experience working at the hospital side doing UR, and what is different between them two: which one you liked, and which one you didn't and what suited you the best.

    I will be doing mostly inpatient reviews.

    Thank you for sharing your wealth of knowledge!

  • 1
    BlinkyPinky likes this.

    New attitude would be good, but new job would be better, yet new career would be best. I would have done engineering if I could back; now I have a family so that's not an option. I did change my miserable situation by getting a non-bedside job at insurance; it isn't for everyone. I never found any fulfillment at the bedside since I thought I was enabling the screwed up system in the ER and people who flock to it. The bad (drug addicts, narcotic seekers, the entitled, the never-payers, administration injustice) outweighed the good (true traumas, the grateful, people who really needed help). I changed my misery by switching over to non-bedside position at insurance company, and I get better pay, all weekends and holidays, and no one acting nonsense. I highly recommend you getting off the bedside.

  • 1
    mso819 likes this.

    I don't work from home (have been offered but I prefer not being stuck home every single day) but I am doing UR in an insurance company (third party admin to be more exact).

    Yes you need your RN license and active status to be able to work in CM or UM, and they look for RNs as you are still using clinical judgments and skills learned from bedside to make decisions after reading clinical. I highly doubt any companies allow their nurses w/o any CM or UM experience to allow them to work at home immediately upon hire; more plausible scenario is you would be working up to 6 months after showing consistent outcome and productivity, then let you work at home.

    I would highly encourage you to apply EVERYWHERE. I literally applied to any job post that had "CM" or "UM" for insurance companies. It is realistic to expect to be offered at smaller companies or TPAs than the big-box companies, though not saying you won't be offered there, as they look more for experienced candidates. I did phone first and then face-to-face, was called by director who interviewed me and got an offer via phone. Sell yourself; good luck!

  • 0

    THR is one of the few hospital systems I have not worked at, so I can't offer clear judgement, but collected from interacting with peers and other coworkers, ex-coworkers, THR seems to have decent reputation. I know for sure that Parkland offered to pay about $2 more than other systems (that was 3-4 years ago) but it's crazy there so I personally didn't want to work there. Methodist pay is decent as well, Baylor is not as good. Both of their benefits didn't seem that great either. I had a coworker who moved to L&D in THR Fort Worth and she didn't have much to complain about so probably was decent enough. I don't think any hospital systems will blow you away since all people care about are cutting cost and saving money and paying as little as they can afford.

  • 0

    I am in care management but trying to transition into more leadership/management and nursing admin role at a hospital. I have about 5 to 6 years of exp and wondering what the salary range is for someone like me breaking into the hospital admin job in Dallas, for example at infection control, quality improvement or clinical doc integrity.

    Thank you for your input!

  • 2
    nursel56 and wannabeny like this.

    Your question is difficult because the term Luxury is very subjective. If you live within the realm of reality, and expect nice life, personally if I were you, I would not live in NY or CA.

  • 0

    Thanks for inputs everyone. While I realize the importance of needing to think through it well before getting into, I also am encouraged by NPs who enjoy what they do now, though he/she did not like bedside RN job necessarily.

    It is true of what many of you said. NP and RN is clearly, VERY VERY different role. One is a provider, and the other is not. I think in that alone, the whole ball game changes. I won't be spending time drawing up dilaudid and priming 50cc bag of NS with phenergan or 50 mg benadryl because patient says "Oh, I have to have that with my dilaudid because of _____," or running around to bring somebody warm blanket or a sandwich (nothing wrong with that innately, just not what I want to do in my 40s) @Armanix asked if I won't find demanding patients and RNs paging, etc stressful. No, because I will be calling shots, and I have right to say "NO" if I find it consistent with my practice principals and clinical expertise. From my experience, patients tend to act in whatsoever manner they please with RNs and ancillary practitioners (LVN, CNA, RT, radiology tech, phlebotomist, etc) but in general, they respect providers, including NPs and PAs, because they are seen as "oh, this guy/gal can diagnose and prescribe, and can order stuff." I do not want to work in the hospital anyway (aka Cronies. INC), so if I can afford it, I would work in clinic or under specialist to learn the ropes, so hospital administration is hopefully not something I encounter. Yes, clinics or urgent cares, and wherever else can have corrupt people, but that's comparing hundreds of them to a couple. I don't think there's anything wrong with RNs calling me to ask what to do. That's what providers are for, and if position of leadership, challenges and decision-making is merely annoying, I don't see why someone would want to be a provider in the first place.

    Like many said, being RN and NP is very different thing. In my notion, one works and works and works, while the other gets to think, use the brain, diagnose, prescribe, order, etc and perform in similar role as a doctor, though not in completely the same role of course. I am not saying that RNs can't use their brains, but the minute and de-humaning works (like realizing that you graduated Bachelors and is literally spreading cheeks to wipe a rectum), delivery-boying, errand-running, hotel-resorting and restaurant-servicing, are far different than working as provider. Those are just my thoughts.

  • 0

    I titled this cautious ask: since basically I am addressing multitude of providers, so I wanted to be respectful. I hope this question does not meet you with hostility since I wanted your honest input.

    I left the bedside because I hated it. I just could not see myself doing hard labor all day and being treated like crap by administrators and patients alike, to see my education turned into sandwich delivery boy and narcotic pusher for HCAPS. So I left bedside for insurance job.

    Now being bored out of my mind and doing mindless computer work for few years, I reignited my previous desire to continue my education for APRN, which would provide diagnostic and prescriptive authority that would expand my ability as clinician very widely. I had wanted to work as NP under a specialist to learn and use my skills in useful manner at work and outside work and grow in expertise. If there are any providers here who had similar distaste for bedside, yet decided to continue the path of NP, what has been your experience?

  • 0

    Utilization management or case management (sometimes these two are separate or synonymous. Depends on the company).
    You can also try informatics, but likely not since those require MSN.
    More realistic transition is UR/CM since you can at least interview for those if you have hospital experience. Make sure you prioritize working for commercial or non-hospital organizations (i.e insurance companies such as Aetna, Cigna, BCBS) if you hate hospital cronies and bureaucrats.

  • 4
    broughden, Sammie7, LovingLife123, and 1 other like this.

    What is wrong with wanting to wear gloves? When I was in the ED, there were lots of people from the hood, so there would be lots of scabies, lice, etc issues and that include their belongings. It appears that most here disagree with the preceptor because by wearing gloves, one way or another, you are "discriminating," which is a big no no now days, and hurting someone's feelings or what have you. Just narrowing down someone's desire to wear gloves whatever the situation be into either ignorance and fear seems pretty narrow-minded to me too.

    I didn't study infectious disease or science of contagion or disease but at the end of the day, it's my safety and well-being and my family that is at stake. I am not denying the humanity of HIV patients, or any patients as I would treat them the same as someone with different disease, as I would wear gloves into all rooms. And if THAT offends yal...... oh well, I shrug and go on my day.


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