mountainnurse

Does anyone know if we were able to qualify for an individual policy and have continuous coverage during the next 3 months if the new policy I get at my new job would be able to deny coverage based on pre-existing conditions? If so this might be a less expensive option....

Thanks everyone... We will just have to bite the bullet and pay the $$ for a few months. The good news is I will be making more money and the cost of living is significantly lower so it will be do-able for a little while. Do I ask HR about COBRA at the job I am leaving, or the job I am getting?

Hi everyone! I am curious if anyone out there has used COBRA to bridge their health insurance between jobs. I have been offered a great new job closer to my family and my husband and I are moving the 1st of next month. Both of us are young and had no health problems so had planned on getting major medical insurance only for the next 3 months until my new insurance kicks in.....BUT.... My husband just injured his back playing soccer and has a pars fracture . he is going to need a CT and MRI and bracing and PT for the next 3-4 months. If that doesn't work he needs surgery. We don't want to risk him getting denied coverage based on a pre-existing condition so we are thinking COBRA is the best option. Does anyone have any advice? How do we apply and how much should we expect to pay? The most important thing to us is that he is treated well for this injury and that the insurance is continual. Any thoughts are greatly appreciated!

Thanks for everyone's replies. I think I will try to speak to her and try to find some resolution between us and if she is not receptive then I will ask her to sit down with one of our CN or admin and figure it out. I am not sure if the CN talked to her about it since it was CRAZY busy that night and there were a lot of other things going on in addition to this situation but I felt like she should have. I don't think it will come to me having to leave the unit because of her. We are a very busy ER and have lots of staff so hopefully we can work together more peacefully and avoid each other in the meantime.

I have been working at this hospital for 1 year and from the very first day I met this person it has been clear from her end that we are not going to be friends. She was very cold when I attempted to get to know her, and commonly rolled her eyes while I was talking. I realize that I am not going to get along with everyone, and I figured she had some issue with me being a new grad and just let it go. She has lots of friends on our unit and so do I and at first we just ignored each other. The problem is I feel like lately I have to let something go every time I am unfortunate enough to work in close proximity with her. She is rude and condescending and it seems to be escalating. The last time I worked with her we had a situation with a pt and a code was called. The pt condition improved by the time she had come over and in the middle of this situation she proceeded to tell me that I should not have called a code (pt was not breathing) all of this while several people including my charge nurse were trying to help the pt. A couple people asked what her problem with me is, and I have no idea! We never even talk to each other unless we absolutely have to and I am always pleasant and professional. Instead of helping us with the pt, she stood there and degraded me on exactly why she thought I shouldn't have called the code in a non constructive manner. I tried not to react, but I am sure I snapped back. At this point I feel like it has gone beyond just not liking each other and has begun to affect pt care and I need to say something to her, but I am not sure how to approach the situation. I don't need her to be my friend I just want to have a professional working relationship. should I sit down with her and try to clear the air?

Where I work we always have two nurses, MD at the bedside, crash cart at the bedside and in certain cases pads placed on the pt's chest. The adenosine is pushed rapidly into the closest port, ideally in an AC vein and immediately followed by a 20 ml NS flush and in addition running NS fluids and the pt's arm is lifted to facilitate delivery.

Our ER calls security when a patient is placed on an 8 hour hold and within minutes a security officer is at the bedside. The problem is what happens next. A recent policy change states that the security officer is not allowed to touch the patient so if the patient attempts to leave we have to stand back (unless they have given us a valid reason to restrain them), allow them to walk out and then call the police to pick the patient up. Many of our psychiatric/detox patients have no medical insurance and come in grossly intoxicated so while they wait to get medically cleared to get a psychiatric evaluation the police leave. The next step is placement in a psychiatric facility. If they have insurance we have to wait until their alcohol level is less than 150 for an eval and then for a bed in a nearby facility. Our county psychiatric facility is overwhelmed and patients with no insurance end up staying in our ER for days (the most I have seen is four days). This is not an appropriate situation for the patient who needs a different level and type of care which we are not equipped to offer being in a busy ER with medical patients with immediate need. They are often forgotten and/or ignored (not on purpose) and are a strain on our ER resources when they return every other day to repeat the process over and over again. As to your question, your hospital should provide security or a sitter as you physically cannot be there 1:1 with the psych patients if you have other patient assignments, so it is an unsafe situation for both your patients and yourself.

I work in the ER and a patient came in from a SNF with an infected fistula with an opening to the lower abdomen. When we removed the bandage, the weight of my hand above the opening caused purulent drainage to POUR out:eek: and quickly run down in between her labia before I could grab 4x4's next to me and stop it. Without forcing it, the wound drained about 800 ml and the smell was unbearable. I had to get a mask and leave the room several times to stop myself from vomiting. The only blessing was that the pt thankfully was totally unaware of what was going on due to advanced Alzheimer's. This among the long list of disgusting things I have seen and done still is at the top for me for some reason, I think partly because I was totally unprepared for what was underneath the dressing.

I am a new grad working in the ED and while I was nervous about the skills I hadn't had much practice with, I got plenty of time to practice with my preceptor and if something comes up that I have never done before, my co-workers are ALWAYS there to help. I am now after 4 months finding that I wish my nursing clinicals had focused less on the paperwork and more on the patient care. I go home everyday and reflect on my day, what did I do right, what do i feel good about, and what do I feel like I could have done better. I find the times that I feel like I could have done better are when I get overwhelmed with heavy patients or have to watch over my partners patients in addition to mine while they transport a patient to ICU or CT or MRI. ( I always ask for help and never forget about patient safety) After the first few semesters the paperwork got very repetitive and it felt like we were jumping through hoops with more emphasis on APA formatting than actual content. I actually had a clinical instructor tell me he didn't read my careplans anymore because he knew they would be perfect. I wish my clinical instructors would have pushed us out of our comfort zones to take on more patients as they felt we were safe to do so. I have gotten great feedback from my charge nurses and patients, but had I not done a preceptorship in the ED in my last semester of nursing school I don't think I would have been able to do it. For example, we would do our pre-planning the day before clinicals, writing 30+ page care plans with pathophysiology of each co-morbidity down to the cellular level, nursing diagnoses with interventions and rationales, serial labs and descriptions of the abnormal values, med tables with action, rationale, side effects, contraindications, interventions and administration guidelines, and different variations depending on the area (med-surg, critical care, peds, etc). We would generally take 2 patients, except in critical care where we took only one patient (and had longer care plans). These care plans took about 16 hours to complete. This all helped immensely to put together the big picture and see how all the comorbidities affected the patient and their treatment, and for me being in the ED, how to assess patients, what questions to ask, etc. NOW FOR MY POINT If we came in on the day of our clinical and were not able to take the patient for some reason (discharged, too many students with one nurse, etc) we would have to choose a new patient and write another care plan instead of caring for the patient. I see the point to the paperwork, but in our limited clinical time I do not see the benefit in doing more paperwork instead of getting the experience you cannot get from books. I know it takes time and I don't think that nursing school has to get us completely ready, but something my mother told me sticks with me. She was a nurse for 37 years and went to a hospital run school where she worked for the hospital during school. She noticed that as nursing schools moved from the hospitals to the classroom that new grads were less and less prepared for actual nursing. I feel like we needed more clinical time. (I was in a BSN program if you need to know)

toothache x 30 minutes brought in by medics, nothing wrong with the tooth, he later admitted he was bored and wanted to get out of the house

My school has integrated the ATI tests into our core classes as our final exams. We had to take the comprehensive ATI before graduating and pass with a 95% probability rate of passing NCLEX (I think this translates somewhere in the high 60% range). If we pass we are placed in a two week review course and if we don't pass we are placed in a month long review course for the NCLEX. Ultimately they are preparing you for taking your boards and I am grateful for that. However, I do think it is unfair of them to change the requirements on you so late in the game. If you have not already taken this test I recommend studying from the Saunders NCLEX review book. This is how I studied for all of the tests and I did very well on all of them and passed the BKAT (critical care general knowledge test) for the hospital I will be employed at after graduation. Good luck, at this point complaining may not get you too far, so I would start preparing so you will do well.

Interesting... ISFJ here, so according to this I am in the right profession!

HI, I am doing a case study for my last semester of nursing school and I am looking to see what connection there is between spontaneous pneumothorax and metastatic lung cancer. I need to find articles in nursing journals to back up my research from textbooks and would appreciate and recomendations you can offer... Thanks!

I know how that feels Thanks for the advice, I definitely have been seeking out other experiences and the other nurses have been warm and extremely helpful. I have so much respect for the nursing profession and most of the nurses I have worked with through my program have been exceptional, so I am not going to be influenced by her behavior. And I know now the type of nurse I DO NOT want to be! I hope that sometime down the road I have the opportunity to work with students and can make their experience a positive and productive one! Now I just have to find the best solution to my current situation. Thanks again for everyone's input, since this is my first preceptorship I did not know what to expect...

Thanks for everyone's input. Triagethis, I don't see your response, did you mean to write something else?