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HomeBound

HomeBound

ED, ICU, Prehospital
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HomeBound has 20 years experience and specializes in ED, ICU, Prehospital.

HomeBound's Latest Activity

  1. No---you aren't being told what the actual costs are to work at any hospital in California. 1. Union dues are automatically taken out. $120/mo 2. Taxes of 13% for state and federal doesn't take into account all of the other expenses you have---so you are in a high tax bracket from the get go--so your after tax income is approximately 45-52% of what you gross. 3. Housing costs are double and sometimes triple that of other states, along with property taxes if you own. 4. Parking fees. They automatically take parking out whether you use it or not. Some places have >$150/mo for parking. 5. Commute times double and triple gas expenditures. If you want to live close in to your work--high rent and high crime if it's inner city--like UC Davis or anything downtown SF. Commute times can be anywhere from 1 hour to 3 hours one way. Time is money, remember. NoCal is not the cashcow you think it is. There are also other considerations---such as the wildfires, lack of water resources, immigration problems (free healthcare when immigrants do not have insurance), every single item is taxed at the grocery store and else where (adding yet more to your output burden), water costs are more than some people's car payments.... I could go on. There is no equal balance for "nice weather" and "I can golf and wear shorts all year long". I like eating and I like having a nice savings account. I do not want to spend all of my hard earned money getting out of the city so that I can have a little R&R. DEFEATS THE PURPOSE. The retirement system in California is $1TRILLION dollars in a hole. YOU, tax and pension contributor donkey---are paying for the present retirees. When it comes to be your turn? You ain't seeing that money again. Period. Some employers there have caught on and "auto deduct" a certain percentage of your pay to "help you" save for retirement. Read: We will take the money for our pensioners, whether you like it or not. You cannot opt out. The "ratio laws" are a joke. The Charge RNs already know how to game that--they fudge the ESI. You get 4 criticals that are supposedly now 4 lower acuity patients. You work harder, risk your license more and are abused continuously---for basically a few dollars more than you might make in a decently run non-union hospital elsewhere. The wildfires have made breathing next to impossible. The heavy metal poisoning in the entire mid valley from rice growing (such a water intensive endeavor...it's amazing that nobody notices that regular people have no water...yet the rice growers get all the water they want)---goes airborne when the fires torch the valley every year. Displacement of those people---where do you think that they go? They all just leave? No. Yet another reason rents are so high--people displaced from fires, tax hikes and job losses all flood into "more affordable" areas---driving wages down and rents up. California is a hel#hole---you couldn't pay me 5 times the amount I made there for a year---to go back.
  2. What I found absolutely hilarious is "Everglades" and the whole "Well, mommy and daddy paid for my education, and I've never had a need in my life---so I get to dispense advice to people about whom I know nothing and cannot even relate" And Everglades' assertion that "MD2U" is some sort of Godlike employer? https://homehealthcarenews.com/2016/07/agency-faces-21-million-penalty-for-extreme-medicare-fraud/ You mean this "MD2U"? Yeah. I mean....all that high standards and s#it--only the best NPs for you guys, eh? Bunch of frauds. Anybody telling me they didn't know fraud was going on---yet they're part of the "hiring team" and in the business side? Yeah. Can't wait to work with a bunch of NPs with all those high standards. OP=== If you want an online FNP or Psych NP program that is "easier" to get in and doesn't have their collective heads up their own arses thinking they're just "all that" because their tuition is ridiculous, their name is recognizable and their curriculum is just so very esoteric--- Midwestern State University. Even out of state tuition for online NP is base in state tuition cost plus $50. So it's about $150 per credit hour. Accredited. Eastern Kentucky University. Again---total tuition is about $30K. Easy to get in and not a bunch of egotistical jerks who will just take your money and spew all of this "quality education" crap---only to have you graduate making barely more than a floor nurse with craptons of debt. NOBODY CARES what school you graduated from---only that you are competent at your job. It's for these arseholes that think a lot of themselves who love to throw around "brand names" as if that means something. Worked at Duke. Bunch of egotistical and barely competent jerks. I wouldn't go there to die and I wouldn't trust someone who trained there. I know what it's like on the inside of that place---so I don't want to hear about how I don't know what I'm saying. I think those of you who believe that a big pricetag and a brand name makes you better---you need to get over yourselves. The best MD I ever knew failed general medicine at a cheap state university medical school. The best RN I ever knew got C's all through nursing school and had to take A & P 3 times to pass. Get. Over. Yourselves.
  3. HomeBound

    Doctors offended by TV show about nurses

    So, they should be offended at every single medical show I've ever seen--where when the SHTF--the very first word out of the MDs mouth is..... NURSE!!!!!!!!!!!!!!! Yep. Binge watch "House" or any other decent medical drama and yeah, it's always the doctor at the bedside, consoling said patient---and when the inevitable crump comes---they yell for the NURSE. Why? I mean...if we're such dunderheads and do nothing but sling meds and take their orders, why are they calling for one of US? Do it yo damn self, if you're so good at it. I have other things to do. The show "ER" always portrayed the "smart" and "skilled" nurses as the ones that "should go to medical school". Why?? Seriously. Why would I ever, EVER, want to do that? So I can prescribe? So I can intubate (most can't do this anyway)? I can prescribe as an NP. I can intubate as a paramedic. The smart ones are nurses. We actually have a chance at a decent work-life balance. Doctors don't. At least, not for the 16 years they're battling through med school, residency, fellowship and then baby years as an attending. Nope. I think that's the dunderhead. For the most part, the ones I have known are passive aggressive and only marginally competent. I used to love rounds in the ICU when 3rd year residents needed to have me explain how to read an EKG. Or when I had to calmly and carefully lead one of my senior residents through a CF of a central line insertion (the fellow didn't know how to do it properly either, and he was "teaching" the resident. when the pt went into VF, I calmly told the resident to pull the guidewire. Neither of them did one thing right when the pt went into arrhythmia. They just stood there. Dumb as a bag of hammers.) Or the 3rd year ER resident who ordered 10 mg of morphine for an opiate naive elderly gentleman with back pain---when I stopped him---he swore that this is what he wants!!! I strode over to the attending, without a word, showed him the order. Said resident was no longer in the program the following day. They don't remember these things, and will deny them if you remind them. There are good doctors and there are bad ones. Just like there are good nurses and there are bad ones. This is the same as it is in any profession. Television tends to glamorise doctors because it's good for business--for the portfolios of the 1% to have people "trust the doctors" and go to them for every tiny teensy ache and pain. Which is precisely why we're in the mess we're in right now.
  4. HomeBound

    More Americans Dying at Home Than in Hospital

    No, I'm not surprised at all that the trend is towards being more humanistic and family oriented. Medicine as a global force scared the bejeezus out of pretty much everyone in the past 40 years--that you have to go to the hospital for everything so that you can get a pill for it or some type of "help". We've been turned into a nation of helpless and fearful victims that can't seem to do anything for ourselves. Deliberately so. A helpless population is a weak population. Fear mongering is a great control mechanism for large populations. Fear of sickness. Fear of getting old. Fear of dying. You must be young and vibrant and beautiful, or else bad things happen. I am happy to see the trend reversing. "The wise man lives as long as he ought, not as long as he can." Marcus Aurelius (Meditations - Book II, 167 A.C.E.) People may do well to begin practicing a little of the Stoicism that brought our ancestors through famine, disease and war. You can't control anything but the way that you react to things.
  5. HomeBound

    Need help with direction for dx

    We are not permitted to assist in diagnosing patients. Diagnosing is not in our scope of practice. This is your husband and that is even more inappropriate. He needs to see and speak to his physicians and if you want a second opinion you need to seek one from a qualified medical practitioner. Sorry to be so blunt but even if we had an opinion, it is out of our scope of practice to offer advice.
  6. HomeBound

    "Not sure what unit you will be hired into..."

    Agreed. I think its offensive that the nurse manager lied so blatantly to the best friend. It's really indicating that the nurse manager is the one who believes ICU nurses are better than med surg or whatever it was she was trying to fill when she put out false calls.
  7. HomeBound

    "Not sure what unit you will be hired into..."

    I didn't read it as that . I saw it as the nurse manager wants to lie about the position because nobody wants it yet the rn manager wants specialty experience . If you or anyone here believes that a med surg nurse is interchangeable with an ICU nurse or vice versa, I would love to hear then why 5 years of ICU nursing experience is required at my hospital to be hired as an ICU nurse? And, curiously, zero years is required for med surg?
  8. HomeBound

    "Not sure what unit you will be hired into..."

    I didn't see where the poster said highest. They said highly. I agree with OP. Read the actual post. Why would you say a hard no? Do you think you're better than med surg nurses? This is what those commenters are implying. I didn't see anything that implied op feels that their friend is better . I see that the OP is angry about the lying of the nurse manager.
  9. HomeBound

    On Vacation - Would You Intervene?

    No. The road to hell is paved with the best intentions.
  10. HomeBound

    Patient discharged with elevated troponin levels?

    Hmmm. This is thought provoking...so....to the library I went. https://www.ncbi.nlm.nih.gov/pubmed/19426141 Yes, yes I was thinking lactate as well. But it's also shown in this study that prolonged tourniquet use effects troponins. Pulling trops from PIVs increases hemolysis as well. Something else I came across--and I feel like such a stupid for not knowing all of this---but it's an interesting read nonetheless: https://www.austincc.edu/mlt/phb/phb_unit8LecComplicationsInSpecimenCollectionDec_31_2012.pdf
  11. HomeBound

    Women's Right to Choose

    I Muno. Please bring back that avatar of Bill Murray you used to use. I just can't with this whole thing. I'm not sure if this type of stuff is cyclical---as in---here comes campaign season and plants are paid to throw one of the God, Guns and Gays Grenades into every civil discourse? Or is this really all people have to do---try and make arguments that are so highly charged that it can cause someone to build an explosive device to murder human adults? So I guess I should ask---y'all who are just all on about rights and cells and all that---you're against the US Military going overseas and killing people, right? I mean...maybe a few of 'em are bad folks---but what about that "collateral damage"? And....since all life is precious...you're vegan too, right? How about putting dogs and cats down in the pound who don't get adopted? What about scientific vivisection for medical purposes? Rats? Mice? How about baiting a fishing hook with a worm so you can catch dinner? Want to go for the brass ring? What about capital punishment? If you're really going to live by what your book says---capital punishment is okay. That's taking a life. What if you're wrong and this person is innocent. This is a deliberate, premeditated act of ending someone's life. How does this square with the belief that all life is precious? I'm not making fun. I'm pointing out the hypocrisy of extreme statements. If you feel that all life falls under this sanctity belief---then you should not be participating in the death of any life. Which includes all of the other creatures that share our planet. That includes little brown people on the other side of the earth. Just make sure that you don't allow your kids to join the military. You can't have it both ways. It really is disturbing that it's okay with some to force the victim of incest or a rape to bear a child...but then disappear when it comes time to deal with the consequences (supporting that child for the remainder of their lives) of forcing that situation. What if I'm agnostic---and I don't believe in God until you prove it. So I get a pass---or is this "majority rules"--we get to force you to do it our way no matter your belief system---because we said so? I know I'm going to get it for this---but why is it okay to kill adult humans and child humans in "war"---war, by the way, that politicians start--and it's not okay to terminate a pregnancy that was the result of a rape?
  12. HomeBound

    Why Nurses Are Leaving the Bedside In Droves

    I did a job at ORMC--and wow--I got an earful about Rick Scott. I'm so sorry you are stuck with him. I understand your point of view--but when the push is for "the individual"--meaning--management and administration and even nursing schools encourage the "me first" attitude--forcing nurses to compete against each other, attaching their success or failure on "clinical ladder climbing" instead of rewarding solid teamwork and patient care--nurses (and doctors. and CNAs. and technicians. it works across all levels of care)--it starts to take on the nature of a group of salesman. Competing against each other to bring in the bonus. the commission. who cares about the customer. who cares about the sales force--the company makes money off of the race to the bottom. Who will do the most for the least. When you squeeze people hard enough, as in the video from ZDogg says...if you "adapt adapt adapt adapt....then you break". This is what's happening. How many here have advised new nurses to just "adjust their expectations" when it becomes a moral issue for this new nurse who just cannot handle what's happening? How many here have told people to just "pull up roots, quit your job and move to somewhere you know no one" just so you can just have a job but continue receiving the same abuse? I read here that many state that "oh....the happy nurses just don't come here and post. that's why you don't see them". I'm not sure I understand....the absence of something is proof of it's existence? I'm not against nursing. I've worked around them, with them and as one for my whole adult life. What we're doing isn't nursing. And I simply cannot, for the life of me....figure out why nurses continue to encourage the abuse that they're suffering? I'm against exploitation. As a staffer--that's all I saw--this vicious competitiveness, encouraged by management..."daddy loves me the most!"...of nurses willing to do more and more as management stands back and says..."well then....let's take this away and see what happens!" And nurses, instead of fighting back---they adapt to the falling standards. Unions and organizing give a group power to push back. It's for protection and leveling the field somewhat. But time and again....nurses that I've met will shake their head and say...."I am only doing this for experience so I can get out." There is an answer to this national problem--but not if there are nurses who will continue to not just believe, but act on the belief---that "someone has to do the job" and that "this is how it is".
  13. HomeBound

    Why Nurses Are Leaving the Bedside In Droves

    ZDogg says it much better than I do---this isn't my opinion. This is a large problem that is far far larger than the few posters that are hanging around AN. https://www.youtube.com/watch?v=L_1PNZdHq6Q
  14. HomeBound

    Why Nurses Are Leaving the Bedside In Droves

    You're assuming that because I'm leaving nursing...that I am leaving AN. Nah.
  15. HomeBound

    Why Nurses Are Leaving the Bedside In Droves

    There's an easier answer than my old rear end becoming an NP. UNIONIZE.
  16. HomeBound

    The Nursing School to Welfare Pipeline

    Agreed. My mom worked at a crappy job for a power company her entire career...never made more than $14.00/hr and raised 3 kids on that. She had a sit down, answer the phone type job. It made her consistently insecure. About everything. About the burnout thing. I think this should enter the conversation: https://www.youtube.com/watch?v=L_1PNZdHq6Q Making up VS. Just like charting that you did q2 turns. and q2 oral care. and TC&DB qhr. and IS q hr. and tipped the bag q hr. I see it every single shift. Tipped the bag at the end of the shift and divided by 11. Sat at the nurses' station all night, yet somehow turned that vented patient every 2 hours. Tethered VS is one thing...but how did you get that temp and pain score with no temp probe foley or asking the pt how they are? How about that CMAT score or RASS. What about q4 delerium testing? I've watched nurse after nurse after nurse---and those super special smart NP students as well as the Gen Y nurses too---do this same thing. Sit and chart when they haven't done the actual work. Because they can't. They're dealing with the code down the hall that took 58 minutes--and the debriefing from that episode. They're dealing with the 18 other patients that need cups of water, ambulated TID, families sucking vortices of need asking 10K questions you've answered 10K times already but threaten to report you if you don't stand there with your attention undivided. How about if the RN is just taking their lunch break and some other poor nurse has YOUR 4 patient assignment as well as their own---and they can't chart your stuff for you....because see above. I don't report nurses that I see do this. It's not on me and if they want to take the chances that their patient is actually dying while they make up VS? Then they have to live with that. This is the problem with allowing facilities to dictate these unreasonable tasks. Unionizing in order to place hard stops in the form of nurse to patient ratio, providing break nurses who have no other duties, and mandate lunches---would change some of this. I have no idea why nurses hamstring themselves by denying that they need to organize. There are problems with unions--yes---but tell me why it's a bad thing that nurses have the time to perform patient care and still get to sit down to lunch?
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