giRNfl

I'd guess she's had a problem in the past and is not allowed access. I once had a charge nurse that was caught stealing narcotics. Being the charge nurse she had the ability to give agency nurses, traveling nurses etc. temporary codes. She was going back in after and using that nurse's temp. code to pull narcotics out. Eventually she got caught and had to do the state rehab program to keep her license. When she came back from leave of absence she was not allowed to access the machine or give others access. It was one of things that we didn't really talk about but everybody knew what was going on, KWIM?

I've worked endoscopy for 5-6 years in 3 different facilities in South Florida. First an in hospital endo suite that does both inpatient and outpatient. Later 2 different free standing outpatient endoscopy centers. In the beginning at the hospital we were using mostly moderate sedation with demerol & versed, sometimes propofol by anesthesiologist or CRNA. Demerol & versed worked ok, patients always woke up and said they didn't feel a thing, but often during the actual procedure they were moaning and writhing in pain. I felt like a few of the docs did not wait long enough for the drugs to kick in. Patients took longer to wake up so they were in recovery longer. A few of the docs started using propofol given by anesthesia and quickly realized the patients did better and the procedure was easier & quicker. The patients who had both liked the propofol much better. They were amazed how quickly they were awake. In the year I worked in the hospital endo suite we went from maybe 20% of cases with propofol to about 90%. In the 2 outpatient centers I have worked in it's almost 100% propofol. Occasionally we would do a case with demerol/versed if the patient was self pay and didn't want to pay for anesthesia. I don't know much about insurance/medicare billing or reimbursement, but it must be covered or we would be getting a lof of complaints. This is in FL, not the Northeast. Rarely we have a patient that says they don't want any sedation of any kind. When that happens I try to assess the reason they don't want it. Have they had a colonoscopy without sedation before? If so no problem, they know what they're getting into. If they've never had a colonoscopy and insist they don't want sedation then we try to get them to sign the consent anyway and tell them we will only give it if they ask for it during the procedure. Usually a few minutes into the procedure they wind up wanting the sedation. Only one time did I have a patient that absoulutely refused sedation and had never had a colonoscopy. The reason she didn't want it was because she had to be able to drive to pick up her kids from school, there was no one who could pick up the kids for her. She was extremely anxious about the procedure and I had a bad feeling it wasn't going to go well. Well the doc attempted the prodcedure anyway and she cried the whole time. Of course he couldn't get to the cecum because she was too tense and and in too much pain to continue. I tried to comfort her and let her hold my hand, I thought she was going to break it. It was afwful for her and awful to witness. So don't tell me a colonoscopy is not painful. Certianly some people can tolerate the procedure with out any meds, but I feel that is the exception not the rule. When it is my turn it will be propofol all the way.

Hi, I am also a FL RN applying for endorsement in IL. I emailed IL BON to ask if they participate in NURSYS, I never got a reply. On the NURSYS website IL is not listed so i figured that's a no. I just mailed the CT-NUR form to FL DOH with a $25 check and got the form back in a sealed envelope a couple of weeks later. The instructions and address to mail the form are on this page: http://www.doh.state.fl.us/mqa/clientserv/cert_mail.htm I don't know why FL BON told you they won't fill out the CT-NUR form because they they will and they did for me. The instructions are right there on the site I posted. Good Luck. I've finally gotten all of my paperwork done and am about to mail in my application.

Thanks Path77 for your reply, but hopefully I would not still be trying for that job 10 months after my post! Actually I did manage to get ahold of someone back then, and she explained that the rejection had nothing to do with the personality test, but between the time I saw the job posting and submitted my application the job was filled. Life took an interesting turn though and we wound up moving to Chicago instead of Dallas, and that was AFTER I got my TX RN license and was all mentally geared up for TX. I mean DH was already working and living in Dallas for several months while I was still in FL, then he gets this GREAT job offer in Chicago. So here we are!

It's open ended and multiple choice at the same time, if that makes any sense. They gave you statements and they you had to choose from strongly disagree, disagree, neutral, agree, and strongly agree. A lot of the questions were like, I am more efficient than everyone else I know, or I am the most cheerful Super Nurse on the planet (ok exaggerating a bit here) and on most of those I answered neutral because I thought I'd come off as a conceited B*** If I put agree. They only give you 20 seconds on each question (but there's no count down to let you know how long you have left) so I felt pressured to answer them fast. Oh well, I'll let you all know what happens when I call today.

Yeah hospital HR departments are like that here too, which is why it's usually easier if you know someone on the inside. As far as making you do everything online I'm not sure if the hospitals here are doing that, it's been a few years since I've done the hospital thing. The outpatient surgery center I work at now is behind the times, it doesn't even have a website (or an HR dept. for that matter, too small). I'll call the HR dept. tomorrow and see if I get anywhere.

thanks for your reply suzanne. i'm pretty sure i was rejected due to "nurseinsight" questionnaire they had me do. it was one of those personality tests with a lot of vague answers to choose from. i hate those tests & i think i gave too many "neutral" answers. the response i got back seemed very automated like nobody reviewed my application & it was generated due to the "nurseinsight" test. below is the reply i got this morning. it does not give me the impression the job was filled. if the posting of names and contact numbers is not permitted, perhaps someone that works there might know the manager of the department and might mention my interest to them. i know sometimes you have to get around the hr "gatekeepers" and have a contact within a facility to get noticed. in the area i currently live i know a lot of people at various facilities that could help me get my foot in the door for various jobs. it's a bit harder moving to a new state where i don't know anyone. it's a long shot i know, but if anyone out there can help i'd very much appreciate it. perhaps i don't want to work for a place that screens out qualified, hard working nurses with such "personality tests", but holy cow i haven't been rejected for a job in 10 years! anyway, thanks for reading. dear virginia, thank you for your interest in the outpatient surgery rn (prn 6a-6p or 8a-8p) position at medical center of plano. we appreciate the time you invested in the interview process. while we were impressed with your background and experience, we have decided to pursue other candidates for the position. best wishes and continued success in your career endeavors. cordially, hca medical center of plano human resources

Hi Texas nurses! I'm a FL RN moving to the Dallas area in about 6 weeks or so. I've gotten my TX nursing license and I've started looking into jobs. I applied online for a position at the Medical Center of Plano in Outpatient Surgery. I filled I completed the online application process last night after hours. This morning at 8 am I received a rejection email. It seemed like an auto response as it was not signed and seems like it was way too fast for anyone to have actually read my application. I am definitely qualified for the job as I've been working in outpatient surgery for the last 5 or so years. Anyway, my question is does anyone work at Medical Center of Plano and know who the contact in the Outpatient Surgery department would be? I would like to try to get a real person see my resume rather than an auto response via email. THANKS! Virginia

A hospital I used to work for had the tracking system. We called it the nurse lojack. Our only worked on our particular unit, but it did know when we were in the bathroom or such. Most of us did not like wearing them & would "forget" to put them on or leave them at the desk. The tracking device would also cancel the call light when one of us entered the room. They could track how long it took to respond to a call bell & who was in the room & how long. It did save one nurse's butt when a patient claimed that she hadn't been in the room all shift. The hospital backed her up after checking the logs. But I have no doubt they would've just as happily used the info against the nurse. We also had to carry around a phone at all times. THe phone could be very convenient but also a nuisance because invariably you would get calls when you were starting an IV, bathing a patient, were in the bathroom or otherwise had your hands full. One particularly crabby unit secretary would yell at us if we didn't answer the phone when she called. The hospital also tried to get us to sign something saying we were responsible for paying $800 for the phones if they became damaged or lost. We all refused. You're going to require us to carry the phones but if we accidentally break one we have to pay for it? I think not. There are many reasons I don't work for that hospital anymore. Can you tell how much I miss it? LOL Virginia

Well this is probably a little late. I'm sorry you weren't listened to when you tried to tell them your prep wasn't adequate. We usually tell people to call their doc if they call & say the prep isn't working so if the doc want's to have them take additional prep they can. Around here I don't see many golytely preps anymore. You might ask about another prep next time. As for getting a ride, does the center not offer transportation? Every center I've worked for offers transportation for people who can't get a ride, where I'm working now it's $15 round trip. I don't blame you for refusing the IV. If we have any question regarding cx a procedure we don't even make the pt change until we've checked with the doc. We will skip the person & keep admitting other patients for that doctor so there will be someone else will be ready for them until things are clarified. We don't like to stick people needlessly if we can help it. Hope your 2nd try worked out better.

We've got the newer Olympus system, the Docs do their dictation on the computer right in the procedure room & it spits out a 2 copies of the procedure report/MD orders (1 for the doc), a letter to the reffering doc, 2 copies of the patient report (1 for pt, 1 for the chart) which includes the procedure results, patient instructions & pics. It's really nice.

I have worked in 3 different endo depts. and have never had the equipment to record. We give the pictures to the patient though. It's funny the reaction, some people really want to see the pictures and some are completely grossed out. Virginia

It had nothing to do with the doctor, everything to do with the hospital & our manager. Yes money was a factor, I'm sure. Not from the GI Doc's perspective, my pay doesn't come from his pocket, but from the hospital (for profit hospital, Tenet) which is NOT run by doctors but by corprorate types. First of all we didn't have enough staff to have a 2nd RN in the room. The turnover was so high, we just couldn't keep nurses... including myself! I left after only 1 year, & only stayed that long so I could tell myself I'd given it a fair shot. For a while we tried having a tech in the room to assist the endoscopist, but our techs weren't very good so that didn't work out. FWIW some of the docs WERE asking to have a second RN in the room but they were told no. We were supposed to have 2 nurses for Bronchs & ERCPs, but that didn't always happen either. By the time I left most of the docs were using anesthesia (diprivan) so that helped a lot. Now we RN's could focus on assisting. Now I'm in an outpatient center & let me tell you it's a endo nurse's dream. The attitude there is so different. We are supported by our manager. The place is owned by the docs. The stress level is not even on the same chart as it was at the hospital. Yes we're very busy, but at least you know it's going to end & you won't get called back in the middle of the night! And on the rare occasion that we do moderate sedation, yes we get 2 nurses! Virginia ETA: as far as billing goes, anesthesia bills seperately & it is covered.

Hi, I'm in South Florida. I've worked endo for about 3 years, first in a hospital & now in the outpatient setting. When I first started we were using demerol/versed but some of the docs had started using Diprivan given by anes. Now all of our GI guys use Diprivan nearly 100% of the time. The very rare exception is when the patient doesn't have insurance & doesn't want to pay for anesthesia, or if a patient doesn't want sedation at all. I feel so much safer doing procedures this way. Before, we had to sedate & monitor the pt, & assist with the procedure, not to mention charting everything. It could get a little hairy if there was a lot of polyps or a bleed or something. Now we have a CRNA or anesthesiologist to give diprivan & monitor the pt. I can focus on assisting. Not to mention the pts tolerate the procedure better & wake up quicker. As for reimbursment, medicare does pay for anesthesia for endo procedures. Most if not all of our patients are medicare. Oh btw I LOVE LOVE LOVE the outpatient setting. (The hospital endo dept. I worked in had little support from our manager & the highest staff turnover of anyplace I've ever worked)