core0

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All Content by core0

  1. core0

    Vent management and sedation/pain management

    core0 replied to MaxAttack's topic in Critical Care

    We used the PAD guidelines did extensive education before we went live. That included provider education and nursing education. It went surprisingly well and quickly became part of the culture. It...
  2. core0

    Precedex vs. fentanyl/versed vs. propofol

    core0 replied to RNSAC's topic in Critical Care

    Caveat, I work in a surgical/transplant ICU so things may be different in other ICUs. Separate out the drugs by what they do. Fentanyl is an opiod so it affects the opiod receptors and provides pain...
  3. core0

    The Decline of Physicians: Do we really need them anymore in Primary Care?

    core0 replied to AAC.271's topic in Nurse Practitioners, NP

    Not sure where you work or what general family practice physician is. It sounds like you are combing general practitioner and family practice. For the record a family medicine is a three year...
  4. core0

    NP vs. PA, how is the military role different, and which is the better option?

    core0 replied to Star_Couch's topic in Government, Military

    The OP will probably get a better idea of the PA role at http://www.physicianassistantforum.com/ There are several Army PAs or former military PAs that routinely post. The Army routinely uses PAs at...
  5. core0

    x-ray interpretation

    core0 replied to Jeremy G's topic in Nurse Practitioners, NP

    here is the direct quote from the rule: "If the delegating physician authorizes the APRN to order an X-ray, ultrasound or radiographic imaging test, the nurse protocol agreement shall contain...
  6. core0

    sutures

    core0 replied to ovy32's topic in Nurse Practitioners, NP

    I've scanned plenty of wounds and never seen suture. When we US the liver transplant you can't see the suture and that's much larger than what the OP was talking about. Also, why would you use Vicryl...
  7. core0

    sutures

    core0 replied to ovy32's topic in Nurse Practitioners, NP

    The sutures won't be visible on US. Its unlikely they are there at all. More likely this is scar tissue or early keloid formation. I've never seen a vertical mattress retained if it was taken out in...
  8. core0

    reading EKGs- an advanced privilege?

    core0 replied to NPmimzy75's topic in Nurse Practitioners, NP

    We have very broad privileges. EKG is a separate privilege. The usual issue is the report not people reading them. I had a patient with a STEMI treated sent to cath lab. Got a phone call the next day...
  9. core0

    Calling all ICU/Critical Care NPs!

    core0 replied to intensiveNP's topic in Advanced Practice

    We have 9 ICUs in three hospitals. Around 90 PAs and NPs. We work 13.5 hour shifts (6a to 730p) with an hour overlap on each end for sign out. We are salaried so we don't get overtime. We pay extra...
  10. core0

    Acute renal failure alert?

    core0 replied to Chisca's topic in Dialysis, Renal, Urology

    Probably not. The real answer is that when the patient had an indication for dialysis (hyperkalemia, acidosis, or volume overload) they should have been transferred to a center capable of doing CVVH....
  11. core0

    Best path for more work options post MSN?

    core0 replied to ghillbert's topic in Advanced Practice

    I'll say as a PA it doesn't make sense. If you look at the time you are looking at 24-29 months full time (ie little to no outside work). In addition its unlikely you have all the pre-reqs so factor...
  12. core0

    Billing questions (and other cures for insomnia)

    core0 replied to Alicia777's topic in Nurse Practitioners, NP

    The issue is the hospital employment. If you were employed by the surgical group then the group could bill for your services. If you were independently employed then you could bill for your services...
  13. core0

    No more fingersticks in ICU?

    core0 replied to ccer99's topic in Critical Care

    Dumb rule. There is a lot of confusion on this. The FDA correctly pointed out that POC glucometers have not been tested in critically ill patients. They proposed a rule that basically took POC...
  14. core0

    California NP's - Scope of Practice Advice

    core0 replied to amalay's topic in Nurse Practitioners, NP

    With a large organization there should be two departments that can help you here. The first is credentialing. They should be doing the paperwork for licensure and making sure everyone is following the...
  15. core0

    Need some help from my fellow APNs - interviewing for hospitalist position....

    core0 replied to traumaRUs's topic in Advanced Practice

    You are correct. It isn't a Medicare term. I'm guessing that its either their term for shared billing or trying to bill under the physician NPI without seeing the patient (ie
  16. core0

    Need some help from my fellow APNs - interviewing for hospitalist position....

    core0 replied to traumaRUs's topic in Advanced Practice

    For what its worth, shared visit allows the physician to participate in one part of the E/M then bill the entire visit under the physician NPI at 100%. Shared/Split Service - The Hospitalist The ins...
  17. core0

    Need some help from my fellow APNs - interviewing for hospitalist position....

    core0 replied to traumaRUs's topic in Advanced Practice

    For Medicare to bill shared billing you have to have a 1099 or W-2 relationship with the same group that employs the physicians. Most private insurances do not credential PAs or NPs so billing is done...
  18. core0

    Need some help from my fellow APNs - interviewing for hospitalist position....

    core0 replied to traumaRUs's topic in Advanced Practice

    There are a number of problems with this. The biggest problem is you won't be able to bill. You need to have a W-2 or 1099 relationship with the physician group to bill. Also there a number of issues...
  19. core0

    FNP - PMHNP required vaccinations

    core0 replied to 3**835Y's topic in Student Nurse Practitioner

    I'll point out that this does not support your claim that the elderly have a higher rate of pneumonia related mortality, only that the vaccine does not appear to change that mortality. Also I don't...
  20. core0

    ID NP Market

    core0 replied to Work2Live's topic in Nurse Practitioners, NP

    I would add always have a plan B. What if you can't get a job as an ID NP? Would you be satisfied with something else. If not you may spend a lot of money for a job that isn't there. ID is a very...
  21. core0

    wRVU bonus - am I calculating this right??

    core0 replied to anh06005's topic in Nurse Practitioners, NP

    This seems somewhat doable. Its going to depend on your case mix. If you are being shunted all the URIs etc then you won't have as many RVUs as if you have more complex patients (although if you can...
  22. core0

    North Atlanta Market?

    core0 replied to 42346_nurse_'s topic in Student Nurse Practitioner

    The market is pretty limited up there. There is only one hospital in Cumming and its a smaller community hospital that does a lot of L&D. You have to go a ways toward the perimeter to find more...
  23. core0

    OGT securement in intubated patients

    core0 replied to JeffTheRN's topic in Critical Care

    Why does anesthesia get any say in an ICU patient? How does anesthesia secure OGs when then send them from the OR? I would bet its taped to the ETT. We have a tube holder to secure the tube and then...
  24. core0

    Should I take a job that pays less in order to be home at night with my child?

    core0 replied to kathrn's topic in Nurse Practitioners, NP

    One of our centers now has a night shift. It goes from 10 to 3 AM or so. The thought is people can sleep in the chair and still get to
  25. core0

    FNP or AGNP

    core0 replied to Nurse8486's topic in Advanced Practice

    I was actually replying to a previous post that listed ER and hospitalist. Our hospitalist group only uses ACNPs. There are a few family medicine programs out there that admit adults and kids to the...