Jolie

Please clarify with your current employer whether you will be responsible for any of the cost of benefits you received during your leave. The Family & Medical Leave Act allows employer (in some circumstances) to bill employees for a portion of the cost of benefits they received during their leave, if they do not return to work in a benefits-eligible position. This doesn't apply to every situation, and some employers choose to waive it even if it does apply, but I would make sure you know the answer to this question and get it in writing to protect yourself. Best wishes to you!

I'm sorry for your circumstances. I seriously doubt you were dismissed for a performance problem. Even in right to work states, employees have some protections against malicious firing. Employers typically have Human Resources policies and procedures regarding hiring and firing employees, and if they fire someone in a manner contrary to their own written policy, they can be held accountable by the legal system. It is true that during your probationary period, an employer may be able to dismiss you for any- or no reason at all. But if they give a reason for the dismissal, it must be handled in keeping with their written policy. You state you were dismissed for performance issues. I would suggest you contact Human Resources and ask for a copy of their written policy regarding dismissing an employee for performance problems. If that policy outlines corrective actions to be taken by the preceptor, unit manager or Human Resources prior to firing, and those steps weren't applied to you, you might have a case for wrongful termination. You might also quietly ask around about other pregnant employees terminated for questionable reasons. If you can establish a pattern, it may support your argument of wrongful termination. That said, this does sound like a potentially bad place to work. Please weigh your options and consider seeking employment at another reputable healthcare facility where you will be valued and treated professionally. My very best to you.

https://wnep.com/2019/11/08/donor-breast-milk-processing-source-of-geisinger-nicu-infection/ This article describes the pharmacy's procedure (or lack thereof) for cleaning equipment used to measure donor breastmilk as hand washing with a brush and air drying. This is blamed for equipment contamination with pseudomonas that led to the deaths of 3 infants and infections of 5 more who survived. I have not worked in a NICU in over 20 years, but even by the standards of the 1990's dark ages, I can't fathom anyone believing this to be an acceptable practice. Every health department in the country has food service standards requiring dishes be sanitized by heat or chemical processes. And anyone who has passed Microbiology 101 understands the need for infection control precautions for immunocompromised individuals. Yet the "dishwashing" process in Geisinger's pharmacy wouldn't hold up to the standards in most of our homes. Some of these babies were undoubtedly receiving only a few cc's of donor milk per day. Why were their rations not simply drawn up into disposable syringes or poured into single-use Volufeeders? My prayers to the families and innocent staff members. Such an easily preventable tragedy.

Thanks, Kyrshamarks for opening a realistic conversation about the topic of government controlled healthcare. Alfie's case (nor the other little boy earlier this year, whose name I can't recall) was NOT about preventing a slow painful death, or even about allocating money to patients most likely to benefit from treatment (at the expense of those not likely to benefit). If it had been about either of these things, there would have been no objection to the parents taking Alfie out of the country at their own expense for evaluation and possible treatment elsewhere. But that was not allowed. They weren't even allowed to take him home. This. was. all. about. control. And if we allow our government to fully fund and dictate healthcare, it will happen here. This next statement is not meant as a slam to the British. It is meant as a warning to us: I find it utterly inexplicable the extent to which people will willingly relinquish control of decisions pertaining to their own health, safety and well-being in exchange for the mistaken notion that they are not responsible for payment for the goods and services they receive. I am also dumbstruck by the number and seeming intelligence of people who think that because a bill does not arrive in their mailbox, they are receiving something for free. God rest that precious soul. And the next. And the next after him.........

Beth, might you be confusing TMS with ECT? What you are describing is typical of out-patient ECT, where an efficient, well-run clinic can admit, treat, recover, and discharge an experienced patient about 1-1/2 or 2 hours. TMS does not require a patient to be npo, there is no IV or sedation, and no recovery time. Most patients drive themselves to and from treatment, often before or after work, or even possibly on a lunch hour. Max time in the chair is about 40 minutes. I have become familiar with this procedure recently, accompanying a family member. The clinic is part of a multi-specialty psychiatric practice, with MDs, NPs, therapists, RNs and psych. techs. The initial mapping of each patient is conducted in 2 steps, first by the RN and tech working in tandem. Once they determine the ideal coordinates, the procedure is repeated by the physician, and then results are compared to those generated by the machine itself. The first treatment is conducted by the physician. Mapping is repeated approximately 1/2 way thru the course of treatment. Each session is conducted by either the RN or psych tech, with a second professional present in the office. The person conducting the treatment uses the time to converse with the patient, present educational information, etc. This isn't a therapy session, but is useful in assessing the client's mood, activity level, motivation, behavioral plan, side effects, etc. It is not acceptable in this practice to plug in earphones and "chill" during the treatment. To Curious MD, As a business owner myself, I understand the challenge of starting up a new business and realize that personnel represent the biggest expense, by far. Though it may be tempting to cut corners to save on this expense, I implore you NOT to do so. Give up your own salary first. (Like many entrepreneurs, we went for a few years without paying ourselves.) It is necessary, and will pay dividends down the line when your business thrives because of the quality and commitment of the front-line people interacting with your patients. Best of luck to you.

It's state law here: Rule 59 – Regulations for School Health and Safety – Nebraska Dept of Education

Are hospital acquired surgical site infections reportable (by mandate) to any government or regulatory agency? Is there a means for a patient to self-report a hospital acquired surgical site infection, like a website or hotline, similar to the reporting system for vaccine reactions? Thanks for your expertise!

I'm sorry you didn't get the job you wanted, but I believe you are over-stating things just a bit. You said you were not interested in rotating shifts. That is a far cry from disclosing a disability. Plenty of nurses reject rotating shifts for plenty of reasons: they don't want to mess up their sleeping habits, they need to accommodate spouse's or children's schedules, they take public transportation which doesn't run 24/7, they want to be able to maintain other commitments like school, second jobs, volunteer positions, etc..... As a hiring manager, I would tend to assume a candidate was declining a rotating shift job for one of these reasons, not because of a disability. So please, rest assured you can move on with your confidential information. I doubt anyone in HR gave it a second thought.

What is a "nut aware" school? I can think of a couple of working definitions that have nothing to do with food consumption.

This little Irish woman agrees with your grandmother! And my hubby's name is Todd. So "Hot Toddy" just makes me giggle, whiskey or not :)

The first thing I noticed about this post was: "Patient is 21 years old tells the psychiatrist she has OCD." My thought: Starting off an initial visit with a new healthcare provider by informing the provider what one's diagnosis should be will probably not end the way the patient had planned. Secondly: Young adult psychiatric patients are often poor historians. I'm not being judgmental, just stating an observation. Including the patient's mother in the discussion was necessary for the physician to gain information as well as perspective. As a legal adult, the patient did not have to allow this, but without the mother's information, the physician may have chosen not to treat the patient, rather than attempt to do so with inadequate information. Thirdly: I find psychiatrists who don't automatically reach for prescription pads to be worth their weight in gold.

Please correct me if I'm wrong, but I understand that the OP chose to transfer care to the clinic where her former friend is employed after knowing that the former friend shared news of her pregnancy, yet wants to report the former friend for a non-existent HIPAA violation. If I were the manager of this clinic and the OP came to me with this story, I would respectfully decline to accept this patient. In the real world, there are clients who are simply not worth the trouble they bring to a business. This is one of those instances.

I agree that taking care of yourself is the key, and don't believe that seeing a doctor is the only way to accomplish that. What I do believe is that calling out (typically on short notice, when one is taking a mental health day) IS abusive if nothing is done to address the source of mental distress. So if you're staying home from work using sick time to sleep in, down a six pack, and watch Netflix, that's a different story than researching support groups, taking yoga, getting a massage or seeing a therapist.

If your physical or mental condition prevents you from performing your job duties, then it is appropriate to call out sick. However, just as you would consult a healthcare provider for a physical illness, it is your responsibility to seek appropriate care for your mental health. If you fail to do so, you are just taking time off, which is an abuse of your sick time.

Please accept my answer in the spirit it is intended: as a practical response, not a harsh one. It doesn't matter a whit which rotation you do first. Not a single patient, faculty member or future employer will ever ask or care. Please don't stress yourself out over this non-issue, when there are so many real concerns in life. Good luck to you.

It sounds to me like neither the family nor agency are bothering to address a problem that is not yours. I have worked NICU in a number of different cities and was responsible for planning discharges. That often involved setting up homecare, including equipment and staffing. I don't ever recall a situation where we were unable to make arrangements in advance for designated parking, coordination with EMS, and guarantee of utility service for families with medically fragile children. If this isn't happening, I believe it is because someone isn't bothering to request it.

You need to contact the MD BON to clarify their requirement. Does the practice requirement begin upon graduation or upon receiving your initial license? Since you just passed NCLEX and received your first license, the continuing practice requirement may just be beginning, in which case you would be eligible for a MD license, providing everything else is in order. Or do they go back to your graduation date and begin the continuing practice requirement then, in which case, although your license is new, you have not met the requirement. If MD says that you do not meet the continuing practice requirement, you can either take a refresher course, or find a state in which you are eligible to practice and get 1000 hours under your belt before moving to MD.

Frankly, I wouldn't see a medical aesthetician with long fake nails, either. The same infection control concerns apply here as in the in-patient setting.

You left the workforce to attend to personal and family matters and are now eager to return. Best of luck to you!

I absolutely agree that the full cost of attendance without financial aid or scholarships can easily reach $250K for college. Just wanted to clarify that figure is not for tuition alone, even at the most pricey institutions. Good luck to your son on his search :)

Hppy, Please clarify: You state that the average tuition for a Bachelor's Degree in the US is $110K - $250K. By any chance, do you mean the total cost of attendance at a private US college? I believe you may be mixing apples and oranges. My daughter is attending a private university. On paper, the yearly cost of attendance at VEU (Very Expensive University) is $65K, falling in the upper range of your quote above. Tuition amounts to $45K. The other $20K is mostly housing, meal plan, travel, and some other optional charges such as supplemental student health insurance. I suppose someone there may actually be paying $65K, but I highly doubt that accounts for many students, as virtually everyone there receives financial assistance of some sort that doesn't have to be repaid (grants, scholarships, work-study, etc.). Expenses not covered by these means are paid out of pocket or financed by loans. With the savings we already have in place, Dear Daughter will graduate without debt. She considered a state university in our home state, with much lower tuition, housing and fees, which would have actually cost her MORE out of pocket than she is paying at VEU, because she was not offered any significant financial assistance there. So while I applaud your early research and fully support any student's efforts to graduate without debt, please don't be put off by sticker price tags. If your child is genuinely interested in a particular school, I highly recommend establishing a relationship early on with the recruitment office and learning what kind of financial assistance is available. You may be pleasantly surprised.

Houseplant, bouquet of cut flowers, home made cookies or brownies, a recipe mix in a Mason jar, hand cream, foot soak (you can home-make this in a Mason jar, too), a small journal or pretty calendar book, scented candle, coffee mug, nice hand soap, etc. Basically, any small luxury that s/he might not take the time or money to buy her/himself. Thanks for being thoughtful :)

I was oriented to my second nursing job by a nurse who had submitted her resignation. By the end of the first shift, I was enlightened on all of the internal problems of the unit and the hospital. She was 100% right about everything but those are not details that need to be shared with a wide-eyed newbie. With this information to jump start my career, I quit not long after orientation. Working the "notice" period can be undeniably awkward, but rarely have I known co-workers to mistreat a departing staff member. I have known a handful of people who called out on their last day and missed their own parties. Served them right.

This sounds a lot like home health nurses who set up weekly meds for clients to self administer or family to give at home. I don't think it amounts to dispensing, but I guess your BON should answer that.

If anyone here would like a good perspective on the categorization of psychiatric meds and the attached stigma, I highly recommend reading "A Spectrum Approach to Mood Disorders" by James Phelps, MD. He also maintains a website with much of the same information. I wish I had been introduced to these concepts years ago. PsychEducation | Treating the Mood Spectrum