Need to interview a nurse - simple questions! Please help

Pmddcook · Oct 5, 2011

RN

Associate Degree in Nursing from Moorpark Community College, CA

Daily assessment of patient, medication administration, and monitoring/implementation of new MD orders

Interact daily with MD's and PA's, RT, PT

poopprincess · Oct 5, 2011

RN

ADN

Assessment of pt., medication administration, implementing MD orders, maintaining safety (ex. confused pt. trying to climb out of bed, or doing regular checks on pt. in restraints)

Interact daily with MDs, PTs, RTs, chaplains, dietitions, pharmacy, pet therapist, and other nurses concerned with my pt. (ex. Dialysis), pts. families

Positive Interactions: Reporting off to other nurses, or discussing issues about the pt. where something is getting solved. Calling MD and telling them the problem, they listen and give new orders to help the pt. OR listening to a pt. who in distress and having them feel better once they got it off their chest or they are provided with options that offer them a quality of life despite their health problems.

Negative Interactions: Calling a MD at 3 a.m. (these aren't always negative, depends on the MD)

green217 · Oct 5, 2011

your title (lpn, rn...) rn

your degree/school attended bsn, unm

three major responsibilities on a daily basis review medical records to assess overpayments or underpayment of reimbursement. if the providers' coding/billing is not supported by appropriate documentation, then the provider might have to pay back medicare, medicaid, and other health insurance companies. vice versa, if medicare underpaid the doctor, then medicare will have to send additional reimbursement to the doctor.

which other health professionals are your interacting most frequently? i do not interact with other health professionals. i don't interact with anybody at all. i work from home.

what contributions do you think your profession could make to other professions in the business side of healthcare, revenues are the backbone! healthcare facilities derive their revenues from patient copays, reimbursement from health insurance, medicare, etc. however, medicare and health plans want to combat fraud and abuse, so they check if the providers' billing claims are legitimate claims. so they ask reviewers and auditors to look into the medical records. if the physician is billing for a complex procedure, but his documentation is scarce (didn't take the patient's history, one set of vs, didn't assess the heart, lungs, abd, etc.)... then the physician may be denied of the claims or he maybe asked to pay back the reimbursement if he already received the money. in short, we are here to prevent fraud and abuse and encourage health providers to improve their documentation.

give example of positive and effective interaction among health professionals?

give an example of negative and ineffective interaction among health professionals.

nerdtonurse?, BSN, RN · Oct 5, 2011

Your title (LPN, RN...) RN

Your degree/school attended ADN (BA and MS in other disciplines) from a community college

Three major responsibilities on a daily basis: Medication administration, pain management, symptom management. I monitor for critical labs, vital sign changes, neuro changes, etc.

which other health professionals are your interacting most frequently? MDs, Respiratory therapists, and other nurses (on the floor, I'd add CNAs, but we don't have those).

What contributions do you think your profession could make to other professions: other health care providers could adopt the holistic attitude of nursing -- a person's not just a diagnosis; how is that diagnosis affecting their ability to complete ADLs, earn a living, maintain a household, look after dependent members of the family? I don't just push pills and go away, I'm constantly monitoring a person's cardiac, respiratory, GU, GI, neuro and psychological status for changes.

Give example of positive and effective interaction among health professionals? When I have a patient that's taken a sudden turn for the worse -- deteriorating mental status, dropping O2 saturation, increased difficulty breathing, I and several other nurses along with RT will be in the room, tossing ideas around -- new onset CVA? sudden pulmonary edema? fluid overload? We try to get the best idea of what's going on before we wake up a doc. They don't respond well to, "my patient looks funny." Which leads me to...

Give an example of negative and ineffective interaction among health professionals....people who call the doc in the middle of the night for "my patient looks funny." When I call the doc, I have my information -- pt's O2 saturation has been steady at 98% on 2 liters, suddenly it's 80%, lungs that were clear are now full of rhonchi and crackles. Or, called to pt's room, pt complaining of nausea and substernal CP, however, pt has GERD and just ate chips and salsa brought in by family, no EKG changes , BP changes, or HR changes noted, can I have some zofran and I've already given Mylanta off of the PRN orders, you want to start them on Nexium or Protonix?

The worst, however, is when I have a patient going down the tubes -- sudden respiratory failure, s/s of a MI, sudden frank bleeding from the GI tract or bladder -- and the doc either a) doesn't call me back, or b) blows me off with a "oh, they'll be fine, I'll see them in the morning" (when it's 11pm at night). The sad truth is, a patient's outcome can depend on 1) how willing their nurse is to pitch a fit if necessary to get the patient some help, and 2) how willing the on call MD is to answer/respond appropriately to a nurse's concerns. I've sent the police out to a doc's house to wake him up and get him on the phone for a bleeding post-op patient with a crashing hemoglobin. I don't give a rip, I'll wake you up, you can act like a child all you want to as long as my patient lives to go home. I've been screamed at, cussed out, and I've told the docs the same thing, "When you're done screaming, can you go keep my patient from dying?" That usually cuts them off at the pass....

Romarina · Oct 5, 2011

Thank you for your time and promptness writing these replies. I am reading your responses and learn so much about the profession I am entering... Thank you again and I look forward for more nursing experiences.