bluelion

What sway does a review have if all arrant there to participate. There is no delineation between the govt and a private entity because at that time they are paid to do the bidding of the one who pays they. I do t know if these studies are good or bad...maybe those studies are perfectly fine.... My contention is there are usually entities left out ...a pretty frequent happening in a centrally controlled system. A free market would police itself...much like underwriters laboratories did with products it dealt with for decades. In other words there were independent reviewers instead of one centralized entity enforcing one standard. I think it best that we have an equal voice for all standards and let the best be duplicated and the worst be trashed

Libertarianism is not capitalism...it's a free market. If you have questions...I can answer, but. I'm not making a JUMP from core measures libertarianism...I'm not quite sure you grasped my lament that the way core measure came to "best practice"is that they have left out the free market in determining what true best practice is. We only have either govt studies or private companies where govt funded and/ or approved them to study! We don't impose...we refuse to implement a system that has messed things up from the beginning! Nullify!

This is probably where we part. Good day! There is no way I agree that the govt is not the root. Most hate that thought because it makes them feel helpless as THEY elected these clowns. Truth is there is much less chance of a monopoly in a free market than in what we have or had in the past. Sorry....good luck!

I agree...the govt has done an awful job of the last few decades running healthcare. Because of this we have big pharma and insurance...it's hard to know if I free market would have done better in the last few decades but the problems we have in healthcare rival that of big biz...and that is they got big from cronyism. Regulations are truly needed in our line of work but not one that put too many barriers to entry and participation in smaller markets. These small markets are being swallowed up by big government crony biz's and hence our current healthcare system. We may want to try some free market as we haven't had one in the U.S. In decades

Government is pretty much in control of healthcare in this country. We don't need to worry about socialized healthcare because we have had govt run healthcare for years. Please do t tell me what a libertarian believes...I know we are for decentralization of govt. most of you do not realize that the corporate structure is a govt invention. When you speak about corporate control of healthcare without holding the govt culpable for its poor management and subsidization of big pharma and many large corporate insurances you miss the root of the problem altogether. That is not decentralization. Many of use work in the system because there is little choice but tend to volunteer our time for charities. I'm not quite sure if you were referring to my comment tedwood, but it's clear you must have been referring to another poster. There is nothing in that statement that was not clear as to libertarian thought. I'm not sure where I gave support for the current system. I will continue commenting and YOUR questions as always are quite welcome.

Thank you so very much! I have a bit of Quality Improvement experience with core measures and process improvement but I was actually approached to apply. I always wanted to work in risk when I grew up....I guess sooner than later. Thank you for offering to be a resource and thanks for the nudge in the right direction!

I just accepted a new position in a small hospital (California) for risk management with our rural health clinics. I have been working in core measures for the last two years but I have 13 years of experience in our clinics before I became an RN. Is there anything I should read or become familiar with as I have 30 days before I begin?

I am wondering if there exists any opposition to core measure standards and what Libertarian Nurses think? I have been a nurse for several years and I am currently a core measure abstractor. There are huge manuals that guide what we do and they site studies at the end of them. I am starting to lean politically Libertarian after years of believing health care has been ruined by the private sector and that there needs to be more private sector control over it. After 20+ years in the biz I've come to see that medicine is the most heavily regulated industry along with banking, and things have just gotten worse. Even the studies from these manuals that I have been able to trace funding back to either are directly done by the govt or directly funded by the govt. I come to also realize we haven't had a free market in health care in decades. I am not completely against many of the core measure standards, but Ive seen too many cookie cutter scenarios that seem too punitive. Through my lens, we have govt trying to solve problems that are main caused by govt involvement.

i'm a new graduate from an lvn/rn program working in a med/surg unit because i was told it was a good idea that i get a year of med/surg before moving on......but i hate it! i have always been interested in psych since i can remember (i was an lvn for 13 yrs), but never actually worked in psych. the closest ive came to psych was a registry job at the local prison, which i hated. i got into nursing because i was told over and over again that it's a stable profession. i always wanted to run therapy groups and support groups. my favorite part of my job as a nurse is talking to the patients, which i don't get to do much any more. i was wondering about becoming a psych np, but i wonder if they do any kind of therapy. what areas other than prison or jail do they work, what are they're day to day tasks, what type of meds do they prescribe, what type of schooling is needed. i think i need to find one and see interview him or her, but i was wondering if there were any on this forum. thanks!

I'm looking for the same thing! I'm in California and I'm not putting up good dues money to an entity who supports things I just can't!

I was interested in psych nursing. I still may be. My psych rotation was the most interesting of them all for me! Is the pay THAT much lower, because I have seen many of the things you have described, but I'm still facinated!

Thank you all for the support! I'm in the process of getting better tx for my depression/anxiety. I have also just decided to ask questions, many questions! I feel a bit better, but most days I still feel lost! Any continued advice is so very appreciated! Thanks! PS, My synaptic connection feel so fried...if they are the at all! lol!

I'm a new grad on a Med Surg unit, and I'm about to go off of orientation....and I'm nervous as hell! I feel like all I'm doing is completing tasks (and not being able to even get to some of them)....and I barley get a chance to interact with any of my patients! When doctors stop me to ask how my patients are doing....I never have any answers...family...the same thing! I hate not being abler to feel I'm making a difference! I also feel that I have no guidelines with my preceptor and organization as to what I'm supposed to have done within my orientation. I hear from most of the nurses on my floor "Oh don't worry...you'll learn,...you'll have no choice"! I just don't feel very supported! I also expected id learn a lot more in nursing school, but school almost seems to have not prepped me very well! What's worse is that I have an anxiety disorder that during school I stopped treating! I feel like I'm getting waves of panic...the kind that makes you feel as if you've just figured-out that you have been buried alive! I'm in my 40's, and you'd think I would be old enough not to be worrying so much about these things and take them one day at a time...but I don't know where if the job is just that tough and that's just the way it is...or am I making it that way! When I try to talk to other nurses about it....They just kindly say...welcome to MedSurg! Can someone give a new nurse some perspective? I would appreciate any advice, and to know that maybe I'm not loosing it! Thanks!

I'm a new grad on a Med Surg unit, and I'm about to go off of orientation....and I'm nervous as hell! I feel like all I'm doing is completing tasks (and not being able to even get to some of them)....and I barley get a chance to interact with any of my patients! When doctors stop me to ask how my patients are doing....I never have any answers...family...the same thing! I hate not being abler to feel I'm making a difference! I also feel that I have no guidelines with my preceptor and organization as to what I'm supposed to have done within my orientation. I hear from most of the nurses on my floor "Oh don't worry...you'll learn,...you'll have no choice"! I just don't feel very supported! I also expected id learn a lot more in nursing school, but school almost seems to have not prepped me very well! What's worse is that I have an anxiety disorder that during school I stopped treating! I feel like I'm getting waves of panic...the kind that makes you feel as if you've just figured-out that you have been buried alive! I'm in my 40's, and you'd think I would be old enough not to be worrying so much about these things and take them one day at a time...but I don't know where if the job is just that tough and that's just the way it is...or am I making it that way! When I try to talk to other nurses about it....They just kindly say...welcome to MedSurg! Can someone give a new nurse some perspective? I would appreciate any advice, and to know that maybe I'm not loosing it! Thanks!

i'm originally from outside of ypsi closer to bellville and milan. i may go there or closer to ann arbor (houses much cheaper there than anywhere in cali). i may go to school in cali (near fresno). i cant really afford to stop my full-time job to go to school. i need the money and my family needs the insurance. this is why i'm trying to find out more about on-line and distance learning. i've read several pros and cons on excelsiar(sp), but i'm really woried about the practical part. i dont know if there are any lvn to rn programs available on-line. there is a progarm out here at pacific union that works with my sched, but it is expensive (about 14 grand). i'm lost!