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grouchy

grouchy

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  1. grouchy

    need health insurance-help

    https://www.ehealthinsurance.com/ehi/Alliance?allid=Adt24091&type=IFP&sid=SLIH1-117597 http://www.healthinsurancesort.com/health-plans/fortis.htm http://www.medhealthinsurance.com/goldenrule.htm Insurance - To ensure your family's well being, AAA also offers life, health, homeowners and automobile insurance to meet your every need. Even an earthquake is not outside AAA's ability to provide assistance. To find the AAA office nearest to you, enter your zip code in the box on this page and follow the prompts. AAA is always ready to help you with your home, automotive, financial and travel needs. It's a benefit of membership! http://ww2.aaa.com/AAA_Travel/MemberServices/member_services.htm http://taxes.about.com/od/deductionscredits/p/HSA.htm
  2. grouchy

    need health insurance-help

    You can do what I did - buy what is called "catastrophic" coverage, which is much cheaper than standard insurance. This is a good deal if you are young and healthy, but not a good deal if you have chronic health conditions requiring frequent doctor's visits and expensive prescriptions. Catastrophic coverage means that hospitalization and inpt rehab is covered, but outpatient doctor's visits and prescriptions are not. I did this in 2000, through a company called Fortis. You can easily find them on the web. At that time, I already had a few strikes against me in terms of age, and pre-existing condition(hypertension), and I lived in an area where insurance costs tend to be high. I paid a couple of hundred dollars for 6 months of coverage. I was just on generic dyazide, which at that time cost me eleven dollars a month, out of pocket, and I was able to afford the occasional checkup, and dental cleaning. Fortis allowed me to buy 6 months coverage, then extend for another 6 months, for a max of a year. Then, you have to be off their insurance for a year before you can buy it again. There are other companies that offer such coverage. Your AAA club may offer it, as may your alumni association. You can also check out plans on e-healthinsurance.com, where you can chose from policies like that or traditional coverage. Some companies like Anthem BC/BS are starting to sell traditional insurance directly to individuals are fairly reasonable rates. There have been several changes in the intervening years, which I am not fully versed on. You might be able to write off part of your costs, without having to spend more than 7.5 percent of your income - I'm not sure. There are now medical savings accounts that you can purchase with high-deductible insurance - it's pretty complex. I'll try to post some links here in the future. Anyway, just keep all receipts, as you may be able to reduce your taxable income by deducting some of the costs. It is definitely doable. I did it. I never had to use my catastrophic insurance, but I read the policy, and it seemed pretty good - it covers chemo, organ transplants, pregnancy, etc. I was told that Fortis has a good reputation. Also, on a related note, I just read in Arthur Frommer's "Smart Shopper" magazine that Costco is legally bound to let anyone, even non-members, use their pharmacy. If stopped at the door, tell them you are here to use the pharmacy. I don't use Costco now, but I read that they have some of the cheapest prices - important if you choose a plan that requires you to pay for meds out of pocket.
  3. grouchy

    Please recommend fun, different travel opportunities

    BTW, Wilmington does sound awesome! It's funny, because I've been meaning to watch that classic movie "Cape Fear".
  4. grouchy

    Please recommend fun, different travel opportunities

    Thanks for the advice. I never even thought about Cape Cod Hospital - duh! Does anyone have any advice on specific reservations in terms of assignments or regional areas that they enjoyed? That's something I've thought about doing for years.
  5. grouchy

    Please recommend fun, different travel opportunities

    BeautifulB, Thanks for your response. I've seen ads for the hospital in Martha's Vineyard in Nursing Spectrum Magazine. It does sound great, but they are looking for someone who can do medicine, icu, er, and labor and delivery - beyond my skillset. :-( What specialty did you work in Wilmington? Is there a hospital you would recommend there? Again, thanks for your input.
  6. Hi, I'm an RN. My background is mainly hospital (tele, ICU, med-surg) and some home health. All adult, no kids or OB/Gyn/L&D. I've always worked in an urban or suburban setting, usually in a large, beauracratic organization. I would love to try something different when I travel. I don't care if it pays poorly. I just want it to be a good experience. This could be anything from working in a rural hospital in Alaska, to working on a reservation, or doing ambulatory care for migrant workers, or those still displaced by Hurricane Katrina. It could be working in a really great area, or working at a really great job(with great meaning enjoyment and/or making a difference, and meeting great people, not financial gain). I'm pretty adaptable, and I think I work well with people from other backgrounds. I'm willing for the experience to be "challenging" - to feel like an idiot, to not be initially accepted, to go outside of my comfort zone (although not my skill zone - at least, not without training.) Has anyone done anything like this? Any experiences or opportunities you would recommend? I'd love to hear your stories.
  7. I'm so glad I read this thread! Many of you have come up with excellent verbal replies to defuse or counter the situation. The kind of stuff I wish I'd been smart enough to think of myself. I would just add that it is my understanding that not only does someone have to prove that you deviated from the standard of care, but they have to prove that you actually caused harm - not a potential to harm. This gets rid of alot of garbage lawsuits. I'm pretty neurotic, and I still tend to get pretty worked up about the risk of being sued, even when I've done my best, and no threats have been made. Working in understaffed, dysfunctional situations means that even my best may not be enough to truly meet the standard of care. To calm myself down, I try to think about the situation in the following terms- stuff I've garnered from my reading. First, I've read that even when harm is done, many lawyers will not take a case unless it is a big money case. They feel it's not worth their time. Second, even though a lawyer may take a case on contingency, that only applies to their fees, not any costs associated with discovery, subpoenas, etc. Very few people have the financial means to front the money for the costs associated with a case, especially as it may take years to wend its way through the courts. Third, people are going to go where the money is - which means they are going to target the hospital first, the doctor second, and you third, assuming that you have not grossly neglected or abused a pt. I carry my own malpractice insurance, because hospital-supplied malpractice insurance will do nothing for you if the hospital argues that the blame falls on you because you failed to follow their protocols - even if it was impossible to do so because of lack of staff, equipment, etc. Never assume that the hospital's lawyers will protect you - they are there to protect the hospital, and the easiest way to do that is to pick on someone like you. I chart the stuff that I think actually could apply to failing to meet the standard of care. For example, when there have been repeated problems getting stat labs drawn in a timely manner, I chart when I called phlebotomy. Charting to protect myself sometimes wins me little talks from my manager, but I'm not charting for him or her - I'm charting to convey information accurately to other members of the health care team, and for the jury that might be reading these charts someday. If confronted, I don't say this - I just play dumb. These kind of threats are very upsetting, and will really keep you up at night. It's tough when you're new, and you're nervous about doing an adequate job anyway. Nobody prepares you for this, or talks about this in nursing school. Nor do you get the impression from TV that unfounded threats happen. I think it's something that none of us ever expected, and we feel truly hurt, as we have usually been giving 110% in unimaginable situations, going without meals and bathroom breaks to try to keep our patients safe. Even when we know that the situation is beyond our control, we go home at night blaming ourselves, thinking that maybe we could have somehow managed to give 120%. It's even worse when you're new. I think everybody feels like a bad nurse for the first year or so. We need to realize that the first year of nursing is kind of like being an intern after medical school. Try to remember that most of the anger that fuels these remarks comes from people's experiences with the health care system overall, not something you did. It also reflects what I think of as the "Jerry-Springer-ization" of social norms. These situations will happen to even the best professionals, given the cutbacks in Medicare and Medicaid, and other financial pressures affecting hospitals. All you can do in an imperfect world is to do the best you can do and "leave the rest in God's hands", to put it in religious terms. Meaning, don't beat yourself up for situations beyond your control. My advice is intended to help you feel less anxious - not to take the place of other advice offered on this thread. Many of the comments, such as talking with your manager and risk management, are excellent, and are also part of what I do in this kind of situation.
  8. grouchy

    Any cool protests coming up?

    Hi, I'm an RN who just quit my job, and will be taking the summer off, before getting a travel position. Would like to do some traveling, and plans are wide open. Would love to attend any events/conferences/protests/strikes/whatever, that focus on issues of safe staffing, access to health care, or related issues. Also, into any antiwar or typical "left-wing" events. I would like to alternate these types of activities with sight-seeing, day hikes,camping, etc. Not currently a union member, but pro-union. Am on East Coast, am trying to keep costs down, but potentially open to traveling just about anywhere. Also interested in volunteer work(nursing or non-nursing), but it can't involve 20-hour days or other types of extreme physical/mental stress. Health problems (obesity, hypertension, being middle aged and out of shape, recuperating from burnout) would preclude that. Thanks in advance for any suggestions!
  9. grouchy

    Covering tele for a non-tele nurse

    What is my legal liability for covering tele for a non-tele nurse? I work on a short-staffed unit, where this is happening more and more often. I don't have time to assess and intervene on behalf of that nurse's pt, as my workload is maxed out. We are told all we have to do is "watch the monitor, and put a strip in the chart". I'm convinced that if something awful happened, and the case went to trial, a good prosecutor would have a field day telling the jury how I should have done more - alot more. Anyway, does anyone know the actual law -or any anecdotes-regarding this? It would be helpful in standing up to this dangerous practice.
  10. I work on a stepdown unit where we send people for cardiac caths, angioplasties, stents, and pacemaker/AICD placements. This place is so screwed up that we do not know what times any of our patients are going to surgery, we can't get that info, this has always caused huge amounts of pt/family tension, but mgmt is unconcerned. I recently told my boss about how Sears gave me a 4-hour time window for my appliance delivery, called to confirm/ called again to warn me they were running late due to the weather(and offered to reschedule if I wanted), called to see if I was satisfied, etc., and if they can do that, we should be able to do something similar. Her response: not posssible, because of the occasional emergency surgeries. (The real problem has less to do with emergency surgeries and more to do with surgeons running back and forth between us and a nearby hospital, and losing scheduled surgical slots to whomever is available in the building when an OR opens up because they are over at the other hospital - thus, the schedule gets rejuggled all day long. Surgeries run over, causing some backup, but getting bumped for emergencies is relatively rare.) I felt like telling her that now that we have multiple new competing cath labs in the areas, that answer is not good enough. You better figure it out, because if you don't, someone else will. I think our pts would be much happier if they had at least some vague idea of when they were going - like morning or afternoon, and would accept that we can't give an exact time, and that there is a slight risk of getting bumped. Families just want to have an idea of whether they should take a full or partial day off from work, when to expect discharge, etc. So, I'm asking you guys how this problem is handled at other hospitals. Doesn't have to be cardiac - just any area where they juggle scheduled and emergency procedures, like inductions/C-sections, for example. A couple of months ago, I had a guy, nothing to eat or drink since midnight, waited all day to go down for a pacemaker, not knowing what time he would go, finally went to the OR at 5 PM, then got bumped (in this case, for a true emergency) while in the holding area, and sent back to the floor, to have the surgery the next day. You can imagine what a happy camper he was. There's gotta be a better way - please tell me what that better way is.
  11. grouchy

    Weird, Odd Nurses Behavior.....

    I work with lots of antibiotic-resistant VRE/MRSA/VRSA/ and C diff patients - which means I'm always convinced that I have the first signs of any or all of the above. ;-) When I get home, I fling my shoes in a special closet, and throw my stethescope, wallet, badge and other "dirty" items into a plastic bin in the same closet. Then, I run downstairs, strip, and throw my uniform in the washer, and 10 minutes in I add bleach pre-diluted in hot water. Then I run up, take a shower. It is only after that that I will unpack and eat any groceries or takeout food that I got on the way home. I may Lysol any doornobs that i touched, if it feels necessary. i I have this new skin, and this skin crack stuff that I paint hangnails and minor skin breaks with to prevent contamination.
  12. grouchy

    ALL NP's PLEASE READ THIS!

    P.S. I had to take Bio, Chem, Anat & Phys., Physics, Statistics, and a special Organic Chem for nurses as part of the prereqs to get a BSN. Check the prereqs for the programs you are considering. I once took a class with a psych major who was thinking of going to med school. I heard from a friend that she instead went straight into a Master's program, which did not require an undergrad nursing degree, to be a Psychiatric Nurse Practitioner, which she is now doing. You could also consider becoming an occupational or speech therapist. You'd probably have more sustained, one on one interaction with pts that way, than as an RN or medical NP, you'd be helping people, and you might not have to take all those science prereqs to get into a Master's program. The salary is probably comparable to an NP.
  13. grouchy

    ALL NP's PLEASE READ THIS!

    As a nurse, you're going to be in and out of people's rooms fast, too. As a hospital RN, I do not have a chance to sit down and talk to people; it's move, move, move to make sure they get the minimum safe care. It's like an assembly line. While I am not an NP, I once worked in a clinic where NP's were scheduled to see one patient every 15 minutes. I have cared for family members, and it is very different from being employed as a nurse. I'm not saying don't do it, but have a realistic picture of what nursing is like.
  14. grouchy

    Things Patients Have Taught Me NOT To Do.

    Thank you! I like your screen name.
  15. grouchy

    Things Patients Have Taught Me NOT To Do.

    Do not tell your cardiac nurse that you are not having chest pain, then tell your son that you've been having chest pain all day, and noone has done anything about it. Your nurse does not appreciate this.
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