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lamazeteacher

OB, HH, ADMIN, IC, ED, QI
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lamazeteacher specializes in OB, HH, ADMIN, IC, ED, QI.

35 years teaching childbirth

lamazeteacher's Latest Activity

  1. lamazeteacher

    Ebola: What About The Children?

    As a retired "pediatric nurse consultant" and health (PHN), I'd like to share experiences I had at a hospital for communicable diseases in Montreal, Quebec.
  2. lamazeteacher

    Fired for refusing??

    I would prefer a more positive way of dealing with those who refuse to be vaccinated. A reading list of reasons for being vaccinated, directed at most educational levels, might deal with those with "I don't believe in it" or "you get the flu by being vaccinated", and reasons why vaccines for flu change yearly, for those who say "I got it last year, and it didn't work", reasons for refusing vaccines. Offering an EMLA patch or nasal inhalation when that's appropriate, will take care of the phobic shot refusers... a lot of damage has been done through not acknowledging infants' and children's aversion to pain. it's not wise to take punitive action alone, against refusers, as distrust in administration becomes more rampant; and self fulfilling prophesies abound and waste a lot if time. Also those who become angry, spread misinformation. Staff turnover is quite costly, too.
  3. lamazeteacher

    Therapeutic rationale for saline bag stapled to pt's leg?!?

    Hopefully the ICN was informed and able to do the investigative work necessary to explain this. She/he has the time and incentive to call the former physician and find out his/her rationale. A teaching conference might be arranged that explains what that is, so medical and nursing staff have information from the source of the concern. This would be a great opportunity for interfacing with IC and developing a coordinated plan of care.
  4. That was not an optimistic or a credible post! First of all, I don't know where you have come up with the opinion that "Obamacare" has failed. It isn't even in place yet! It looks like you've gone to too many "tea parties"! The enrollment process had glitches, one of which may be about calculating peoples premiums and up front payments (deductible). The latter may be what your present insurance company has. The insurance companies have been escalating consumer costs wildly, hoping to scare people with their costs. However that's what is sending them to ObamaCare, and then decrying it before it even gets started. As a senior on Medicare for the past 9 years, I've had to pay ridiculously high amounts for medications I've taken for 30 years! (Like $10./ dose) for 2 of them!), and not having either would be fatal! I've hemorrhaged twice from gastric ulcers caused by taking Aleve, and the only proton pump inhibitor that works for me, cost that much before Medicare D's deductible kicked in. Fortunately there's a program within Medicare that covers medications without a premium, called "Extra help", for which you must be indigent, which I am now. The cost of my divorce is much greater than I had been led to believe.. since the "mood" of family courts these days is to eschew lifelong spousal support - even when said spouse is well able to afford the payments provided in that court's final decree judgment! As most of you should realize now, 401Ks aren't the pensions they were touted to be! When you support Obamacare, it will turn out to be a solution to a very bad medical system that allowed hugely inflated hospital bills, doctors' fees and insurance premiums, as well as "double dipping" pharmaceutical companies. It took a very long time to get this far, to at least have a plan that's not predicated on profits for big businesses. To scratch this and start over, could mean that you'll not see any progress toward affordable healthcare in your or your children's lifetimes! We can't afford to wait (literally) People are dying prematurely due to the (hopefully) past faulty practices! NOW IS THE TIME FOR THE MIDDLE CLASS TO SAY, "ENOUGH!" TO PREVAILING AVARICE IN THE HEALTHCARE INDUSTRY.
  5. Medicare only kicks in for young people once all their money has been spent, and they are in dire financial corcumstances. I'd like to know how you came up with that high premium for Obamacare, if you're making an average nurse salary, and what insurance you have presently. Your post looks faulty, to me! I wonder why you'd want to mislead us.....
  6. I'm here, still jubilant about Obamacare - which had some computer glitches for enrollment, but otherwise is on schedule! Only stupid maysayers use those adjectives about it for their own gain! Keeping your own insurance would be possible, had the insurance companies not tried to "make hay while the sun shines", increasing their premiums and generally excluding people from their programs! That's all done in an attempt to dis Obamacare - by saying without any explanation, that people can't continue in their old coverage, because that no longer exists!!! Give this a chance, folks. Better still, read the Affordable Healthcare Act as it is written, not just what opposers want you to believe so it would fail!!!
  7. lamazeteacher

    Boundaries in pediatric PDN/home health

    It was great that all the nurses (except D) were "on the same page". It seems that no interface in regard to the party and agency guidelines occurred prior to the occasion. It would have been wiser for the Nurse Manager to communicate the boundaries expected of personnel, and invite discussion of same, before the event. Then all the nurses would be informed and crossing the boundary would have been unwise. However that didn't happen, so Nurse D can't be chastised for her (unprofessional?) choice. I've been a Pediatric Case Manager, and no situation such as this came up. I'm glad that it did here, so that I had the advance opportunity to look at what my role would be if one occurred.
  8. lamazeteacher

    Is it covered under Obamacare? - Cartoon Contest Winner

    The north-south divide has no geographical recognized line on any map and is known historically as the "Mason-Dixon" line. However I think it's mostly in the heads of those who were brought up in families that actually think there's nothing wrong with slavery! Since I moved to the USA 50 years ago, much culture shock occurred for me! First there was all the bally-hoo associated with elections here. Then the unbelievable tax advantages enjoyed only by the very rich... When I was the Nurse Supervisor in a Home Health agency in southern VA, I received a call from my supervisor from another city more south of mine. She told/demanded of me that I notify one of our best nurses' aides that she was not to go to any of her patients that day! No reason for that was forthcoming, and no other aides were available to give care to the patients, since most of their families went out around the time they expected the aide, to get other things done. These patients were all bed-bound and could do nothing for themselves...... Flabbergasted, i inquired why this was happening, and was told that it always was done when the agency was being audited by the administrators from its central office. This very pleasant nurse explained that the aide's certification as that, had been lost in one of the many recent changes in ownership it had experienced! We would be closed down, she said, if it was discovered in the personnel files. I asked if anyone had called the school where the certification had been given, and was told that it was probably closed long ago. I called the Nurses' Aide, one of the best we had, and asked her what school had bestowed her certification, found that she had gone to one at an existing prestigious hospital nearby, and called to see if another copy of that document was available. The result was that it certainly was, for no cost. So I asked Mary (not her name) to go to that school for it, have our office make 10 copies of it, and told her to keep 5 of them in a very safe place, in case she ever needed them again. Mary told me that this had happened every year for the past 10 years, and the loss of income and result of her patients having no care was considerable. It didn't even occur to me that these events might have happened due to her and her patients African American heritage! I am rather color blind. However that became a distinct possibility when I reported the way I'd handled the situation to my supervisor. She snapped at me, " Now she and all her kind will want more money"! After I'd changed my employment, I saw one of the office workers from that agency years later, who told me that Mary was indeed making more money...... She went to school to become an LPN, and having obtained that, was thinking of going back to school to have more education to become a R.N.! I was delighted too, to know that she no longer looks at her feet when someone of a higher position talks to her..... Those who would like to know more about circumstances in the south of the USA (still there to some extent), would benefit from seeing the movie or reading "The Help", by Katherine Stockett.
  9. lamazeteacher

    40 years of Nursing, and still learning---until my own death

    You are very fortunate to still be working! I started to lose jobs after I was 55 years old. It never occurred to me to be silent about that, as I've had breast cancer (2 different primaries) twice and consider each day a gift. So after I lost that job, not knowing why and not understanding what the term "at will" was all about, I quickly got another one. That was challenging, as the work was different than it had been 10 years before, when I was given the role of Infection Control Nurse when that first came into being (added to my "Inservice" Nursing educator role). I love challenges..... I left that to go to a faraway state, where my daughter lived. She had just been diagnosed with MS. I took a part time job in Home Health Nursing there, supervising nurses giving care. Most of the patients had longterm disabilities, and I'd had some experience in the past, as a Pediatric Consultant Nurse at a Regional Center. (Another job which I'd lost, due to "at will", after I was 55). I was aware that both jobs had been "lost" shortly after I'd been asked to complete an application for health insurance, despite my assertion that I had that coverage (COBRA) and didn't need it from my employer. Both applications required that I fill in my birth date, which I did, sublimely unaware of any consequences that might have. Realizing that COBRA's cost was quite high, I asked how much the policy provided by the Home Health agency would cost, if I was eligible for it. Well that opened a whole new vista of the state of insurance that had become the norm everywhere. Nurses were being hired part-time in positions that really needed at least 3/4 time hours! Because of that, constant admonishment to work fewer hours was given, despite the heavy work load. No one seemed to know what was covered by the health insurance policy there, yet most employees were paying for it themselves since they weren't working (supposedly) over 32 hours a week. To say I was surprised to find, finally after a lot of digging by the administrative folks in another state, that the $325./month that was paid to the insurance company, had a $1,350/ year cap put it mildly!!! No, I didn't leave off any zeros in that figure..... Flabbergasted, I gasped, "That's absurd!", I received the "cold shoulder" treatment thereafter. Not surprisingly, a new Nursing Director there took over the supervision of my cases, and then told me that my services were no longer needed. Until then I'd had very good written evaluations. None were forthcoming from the new DON. So my next position was as a "Disease Nurse" for Obstetric patients at Wellpoint (the parent company of Blue Cross/Blue Shield/Anthem Insurance Company. I'd been on Medicare for 3 years by then. Did I say that my appearance is that of someone far younger than I am? After working there for 3 months with excellent written evaluations, I was continually asked to fill in another health insurance application. That seemed a "conflict if interest" to me and I refused. My supervisor told me point blank that if I wanted to continue working there, the completed application had better be sent to HR STAT! I sent it to HR without my birth date. It was returned with a demand that I put that in it. I sent back the month and day, and the same thing happened, along with a warning that I wouldn't have my job if I didn't add the year if my birth. A few hours after that was reluctantly included, I received a call from Administration, telling me to report to Security where the ID badges were made up, to have another one with a new photograph taken, underneath which my FULL BIRTH DATE would be printed! Oddly enough, while I waited for that to be done at the main building 5 miles away from my office, a magazine called "Hospital Administration" in the lobby there, had an article about age discrimination that gave my employer as a company in a class action lawsuit for that reason. When I returned to my office, a message on my phone from my supervisor indicated that I was "being terminated". Furthermore, I was told to write my own letter of termination. I replied that I would write a letter of resignation only (who writes themselves a letter stating they're being fired?). The Supervisor said he'd only accept what had been demanded, and I realized that as a non-Nurse born and brought up in the United States, his written English skills were probably worse than his verbal ability. I'd had next to no interaction with him previously...... So I called the lawyers referenced in the article about the class action lawsuit. I was told that their focus, having won the action against my recent employer, was now on getting their $80,000,000 fee from Wellpoint/Blue Cross/Blue Shield/Anthem! That is the correct number of zeroes!!! After being asked to call back many times, I was told that I hadn't worked there long enough to be considered part of the "class"! Jobless again now, I couldn't seem to find another job in any of the specialties in which I'd previously been employed. A good friend who owned a small business with her husband, explained how the health insurance industry had affected them. Once her husband was 55 years of age, Blue Cross was their insurer and charged $1,000/month above the standard premium for their younger employees, for his coverage! They paid it, and 10 years later, when he could have been covered by Medicare they were informed that Blue Cross didn't allow that to be the primary insurer, and the new premium for him at his age, would be $2,500/month above their younger employees' premiums. He quit his position in his own company, and became a "consultant", instead with Medicare coverage.... Well you probably have the same opinion now, that I finally got. The insurance industry is not only in charge if what treatment is appropriate (financially) in addition to who can be employed in all industries. Who knows if their action is backed up by statistics about the effect of age on capability for employment? It's certainly clear that older people have lived long enough to have diseases of genetic origin and bodily perfidy. So they're left without earnings, their health, or a decent pension, not to mention the refusal of Medicare D to cover medications they've been on for decades, needed equipment and surgery....! Shortly after my experience with that planned obsolescence of the previously employed, I awoke one gorgeous morning without the strength to get out of bed. So I rolled over and went back to sleep several times, until I found it was 2PM! Trying very hard, I managed to get my feet to the floor (by then my dog and my own bladder had reached their capacities), but each time I tried to stand, I collapsed. I had only my cellphone at my bedside, as having a landline along with it was above my means, now. In a stupor, I saw that the battery wasn't charged sufficiently to call 911. By then I was aware that I was quite ill, and guessed that gastric hemorrhaging was probably the cause. as I could no longer afford the proton pump inhibitor that I'd taken after a previous episode years before. I'd been taking Aleve for knee pain too long (under medical supervision), then. Busy with work and caring for my daughter and her family had taken my attention away from my own needs for medical monitoring. Now panicking, i crawled to a window and yelled as best I could, for help. No response. The whining of my cocker spaniel inspired the supreme effort to crawl to the stairs and slide down them to the front door of my condo, opening it for him to go out and relieve himself. No one came along to help, as the front of my place faces a wooded area, not the street. Finally at 4PM, a boy coming home from school using the back path of the neighboring apartment complex, came up with my dog following him. By then I was barely conscious, and asked if he had a cellphone. Of course he had his charged phone, and I asked him to call 911. Then he ran home to get his mother, who he said was a nurse. I described my location and felt some deja vu, as I'd pleaded with the Homeowner Association years before, to allow my unit number to be displayed at the street outside it, above my garage. I was told "no", as the by-laws clearly state that they must be at the front door. Sure enough, my point was validated when the ambulance couldn't find my place! I croakily gave the EMTs my history, which was duly given to a nurse in the ED, and she called my daughter who came to be with me. we slept. I continued to be semiconscious for 4 hours there, before anyone assessed my condition! Days later I asked my daughter why she hadn't summoned someone in all that time. "I didn't want to make trouble for you", she said. Damn the south!!!! Turned my willful daughter into a wimp!!!! There was no explanation for the delay in my care, no accident or epidemic brought in many patients that night..... I didn't have any blood taken for testing when someone did hear my barely coherent account of the day's events. A nurse working overtime, had me as his only patient, in a very dark "step down" unit that I found frightening. We both slept, and my daughter went home. Then a hospitalist saw me in the morning, and was unconcerned that I'd almost bled out! He did manage to have 4 units of blood infused as quickly as possible after my Hgb was called up as zilch...... I refused the Benadryl they said I must take in case of an allergic reaction. What the hell!!!??!! So these days with preventive medicine reaching its heyday, they don't stop transfusions to which someone is allergic? Why bother even cross matching? Older nurses are treated as dirty tissues, and lawyers are more interested in their exorbitant charges than fairness. Am I angry? YOU BET I AM!! What can be done about this, as new generations clammer for social security to stop, and knowing insurance companies are corrupt, they'd rather see "Obamacare" die, than pay for older folks' abd their own care? It's your time, younger caregivers. You'll get what you deserve. I don't believe that I deserved what happened at all, except that I left Canada to be here...... Maybe as a warning to other Canadians to stay there, where healthcare is a right, employers don't discriminate due to insurance companies' greed, and providers of healthcare do that.
  10. lamazeteacher

    Where Do I Go From Here?

    This thread is proof of the sayings: "Ask and you will receive" and "Seek and you will find"!
  11. lamazeteacher

    Visitors that are drinking in patient rooms......What do I do?

    I was tempted at first, to go the "call security" route. That would have gotten them out of my hair. However that could lead then, to a "driving under the influence" citation (best case scenario); or worst case, there's an accident and someone also dies..... Hospitals need to have a crisis intervention plan for this, and a set procedure for best outcome. The dying patient's needs aren't for decorum in the room, or to have a hushed, reverential gathering of their clan. There is a need for consideration of others. ETOH is an illness, and other illnesses have a procedure called, "stay home if you're acutely ill". Since most people deny being very ill, a family member (who isn't "under the influence") needs to call a family friend to arrange to drive "partiers" home, separately for safety's sake. Tell them that the choice is a police escort to jail, or a friend who will take the drunks home. Use security for backup, if needed.
  12. lamazeteacher

    Where Do I Go From Here?

    My heart goes out to you! Everything you know, love, and want is being challenged at this turning point! Life can present one hurdle (when things are more stable), to one heck of a battle. In a parents of teenage drug users' program I attended many years ago, the concept that "God never gives us more than we can handle", came up. We who had followed our children down what I referred to as the "rabbit hole" (think "Alice in Wonderland") of our children's and our own turmoil, looked at the possibility of a grand plan set by our super power for us to learn about our strengths and weaknesses. That I had been given this wonderful, beautiful inside and out daughter for adoption, was a miracle in itself. That I am a Nurse, saved her life several times while she was an infant, due to physical challenges no one could have predicted, was one thing. Finding her in the jungle of predatory drug dealers was quite another! Time and again shen I thought that I could go no further in that quest, miracles occurred that assured me of God's support. I'm no bible "thumper", and thought such belief was only in the realm of Christian evangelism, and I'm Jewish! However since on many occasions nothing other than divine intervention could explain circumstances in which I found myself, and her, cemented that belief! By recognizing and knowing that God was on the journey with us, I was able to persevere. Since then that wayward child has found her "natural" mother who, had adoption agencies in the '60s been honest enough to share that background information, we might have been better prepared, or possibly done things differently. But life often doesn't come with a "bill of fare", and things just happen..... We use what we can and hope for the best. For my daughter, the "best" was finding her full sister who is one year younger than she is, and so like her, it's shocking. She lived the life my daughter could only imagine might have happened. For me, it's knowing that I did my best and more, to bring about an outcome that is far from the one that might have been..... Her "natural" mother refers to me as her "hero", and my daughter has delighted me by thanking me, over and over, for adopting her. It was a very tough fight and everyone won. You, Marla, also need to appreciate support whenever and wherever it appears. Sometimes it's quite ethereal. Yet it's there. Perhaps not quite as you envisioned it....
  13. lamazeteacher

    Reflection: Healthcare Quality and Safety

    FOLLOW THE MONEY! We nurses take the blame when medication errors occur, yet we accept and continue to work understaffed! Our employers prefer to think "bad nurse needs to be fired and another one will remedy this problem". Except it evidently doesn't. They also follow the insurance industry's lead by firing nurses who are over 55 years of age, who have been able to avoid giving incorrect medications, because their insurers have elevated premiums unrealistically for them. After all, $1,000/month added to younger employees' premiums is unfeasable. So we have many more less experienced nurses working in hospitals, who are more likely to make med errors..... As patients, we astutely follow our doctors' orders, giving a correct example of the newly coined word "sheeple". Until my financial world crumbled, I did that, too. However it became necessary to pick which medications I can pay for, and which are not fully necessary. I didn't stop the statin I was on, as it's not expensive compared to my other prescribed meds. Now it seems that decision was " penny-wise and pound foolish". I can hardly walk, due to tendonitis of my ankles caused by that statin and exacerbated by taking cipro for occasional acute bladder infections. Recently a friend casually told me that almost everyone she knows has problems with their ankles. That was corroberated when I made appointments for physical therapy and to be seen by a podiatrist, whose appointment scheduler mentioned that they were seeing people with far more ankle problems. Now as the medical community functions, that could mean an increased number of surgeries are being done, resulting in greater medical costs which could imply that taking cheap drugs is balancing costs.... Add to that, the need for pain medicine and the profits benefit pharmaceutical companies more. So one might conclude that greed fuels adjunctive healthcare costs, then "offs" sheeple whose needs for care cost too much. That macabre situation gives greater credibility to the need to overhaul an already outdated system for delivering healthcare. Surely Obamacare's emphasis on disease prevention will mean that less hospital admissions will occur, making nurses' jobs doable and med errors less frequent. However administrators of hospitals will likely believe they're overstaffed and make cuts in positions, even if they have enough in their budgets for a greater number of staff, and the merry-go-round of firings and more med errors will recur, while profits increase. SO FOLLOW THE MONEY!!
  14. lamazeteacher

    Unusual Names for Medical Diagnoses

    I got to the third page of this thread without seeing PROSTRATE for prostate. Most men & women of my generation pronounced the organ that way, possibly because any damage to a sexually necessary organ would render them prostrate.....
  15. lamazeteacher

    The Best Defense is a Good Offense

    The atmosphere on any unit is set by those in charge of it. If they are into blaming, insecurity results. If they're more like a nourishing teacher, the staff will be open to positive exchanges of information. Rather than phrasing a question offensively, as "why did you do that ?" A nurse who asks, "Would you like to know another way to do that?" might open a matter for discussion, not blaming, critical, and judgmental. Picking an appropriate time for that is essential, as well as keeping it on an adult to another adult level, rather than taking a parent talking to a child demeanor.
  16. lamazeteacher

    NP vs PA vs CNS

    Icy Sage Nurse's comment regarding superiority of PA v NP is erroneous. Having to recertify every 6 years doesn't come near to the requirement RNs have, for 30 hours of approved continuing education, every 2 years! There is much information about both disciplines that isn't known by those in healthcare professions. To begin, a PA is strictly doctor originated and run. That's why it's regarded as mini-med school. The emphasis is on medical care only, without interfacing with nursing. Graduates function as time savers for physicians. Nurse Practitioners need to have performed nursing care, and therefore they are more patient oriented, and know more completely how likely it is that patients will comply with their treatment plan. More time is taken to collect and evaluate patients' past histories, assess their conditions and discuss a plan of care with them that is based on their ability to carry it out. Unfortunately employers of both disciplines have little appreciation of the above nuances. PAs, like physicians, have a more "cookie cutter" approach, treating the illness primarily. Nurses are taught more about patients' abilities to cope and cooperate. As one poster indicated, PAs focus on their success monetarily, similar to doctors. The bottom line is "what am I getting, rather than how much am I contributing to patients' wellbeing.
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