purple1953reading

Consider where the pill is put, MOUTH, enough said. Alhtough, there will be the patient who finds it offensive, or family member, if done none chalantly , no one will probably even notice. I have seen it done numerous times, nobody batted an eye. I have asked that the aides keep the bedside table clean and uncluttered, as this is where they eat. One of the things I do everytime I enter a room, while talking with, or answering questions, bringing meds etc, is cleanup that table. HANG IN THERE

Sounds like the familly saw BIG DOLLAR SIGNS. The hospital writing off a bill was , in reality, probably, ONLY the part that the family would have been responsible for, and if that patient had Medicare and a supplement, was NOTHING> I was charging ICU and we had a longtime nurse on Step down, who was throwing a big fit about me being in charge and she had been a nurse for 40 years, yadadada. I was on to charge, (as I almost always did) but took care of HER patients, just so as to keep them up to date. Administration stepped in when she said if she had to take the step down patients she was walking out, and said that was up to her, BUT I got moved back to charge in the unit, and her two patients. This is a person WHO always took only vent patients, or comatose patients, as she did NOTHING all day, but charted up a storm( another story) so when I got her patients, I went in with meds, and was told by the coherent patients "IT was nice to get her own meds for a change" Evidently this nurse had given the wrong meds twice to this patient, then went back and gave her her own on two previous days. The roommate had no clue what she took, and just took what was offered. IT IS AMAZING to me that patients have NO IDEA what meds they take, and would not question receiving a handful of different meds then they were accustomed to getting. That is why is it so important for us to give them the meds with the name of the med, and the reason they are taking it. I might do this a couple of times and then ask patients to tell me which is which and why, just a way of educating them. THEY NEED TO KNOW the names of the meds and WHY they are taking them. People who don't will take the wrong meds. Just as a source of support, I worked with a prnRN who went on to become a travel RN (Always wonder how) and she would come on at 7pm and go to the med room and MARK ALL meds for the shift on EVERY patient she had to pass off as given. (with the appropriate times) DID She give any ? WHO KNOWS, maybe if she wasn't asleep in the bathrrom, where she spent most nights, as she also worked fulltime as a home health and nursing home nurse. I did report her, and the DON said "WE don't know that for sure" and I told her I JUST TOLD YOU IT always amazes me that the people who own up to their mistakes, or report others for gross negligence, are the ones who seem to suffer. I would bet that you will be very diligent about checking now, and have learned from this. I don't even understand how you can get a final warning if there is no pre warnings, as it usually is a third deal type thing. This will blow over, and they should be proud of you for owning up to the mistake rather than covering it up

No scrubs here, just WHITE ONLY UNIFORMS

Perhaps,it IS the years of experience speaking, when others don't seem interested. Along with years of nursing experience, and skills, many look at other types of qualifications, including the personal, administrative, how you interact with those you are working with now, whether your co workers have lots of respect for you and trust you to make a splitsecond decision in a life or death situation. Even your personality, whether you handle things effectively in a calm manner, or become flustered as things go wrong. IF I were questioning my ability or whether or not I should apply, I definitely woud NOT do so. GIVE yourself time to be SURE you are the one for the job. There will always be another position opening up. CN wear out easily, and often with the administrative worries, long to go back to floor nursing.

At most associate or jr. colleges, the program is two years, in our state, and after the first year, you can take LPN boards, and then the second year, qualifies for the RN boards. GOOD LUCK

I think many of these families exploit their kids, and would NOT turn down any help as they WANT the attention, and the free stuff. The Iowa Septuplets, were born to nice parents, BUT they did get a new house, Provided by the city where they live from materials to construction all donated, the church family provided the in home help, WHICH we admit anybody would need help with that many babies around the clock. They also got free college educations at birth for all seven. NO qualifiying there, just given to them. A big 15 passenger van , that was for at least 3 years,I think.BUT the father quit his job, and then months later became a so called professional speaker, and talkes to groups about raising multiples. IN addition, the state picked up their medical bills from birth on. His work provided their insurance, but remember he quit as he was now a expert on something . Also, they have a contract with Journal magazine, where they do Christmas issues, and I don't know what else for so many more years yet to come. Read a big article in the Des Moines paper, where they were offered many contract with many companies for the pics, they picked the one they wanted. Also got free baby food, from Gerber for a couple of years, Diapers for two years, clothes from Carter for two years and the list goes on and on. IT makes me angry, that YES THEY almost all took fertility drugs, and chose this life for themselves, and then expect everybody to be amazed and wowed. I have 5 kids, never had anything free, esp. college educations they did not have to earn, and I LOVE them every bit as much as the parents of multiples, and wishe they could have had all the things provided to the parents of these MEDICAL WONDERS> IF they were natural, and truly extraordinary, that might be different. They did a documentary a few years back about which parents and what number of babies it took to get FREE RIDE. At that time, quads were no longer in demand, and there was one set of black quads, that had never been offered anything, used own health ins, from job, moved back to small apartment, had to apply for food stamps or something. It did not necesarrily inspire pity in me for them, as WHY , should people expect us to pick up the tab for their kids, but it did illustrate that the criteria stinks. Sorry pet peeve of mine. But it does not extend to just the parents of multiples, goes for the single moms, who never marry, yet have kid after kid, and milk the system for all the free stuff, Wick, Medicaid, FoOd stamps, HUD, etc. My niece fits here with three of her own, and told me recently that she would work a few more hours a week, but then they would take more of her money towards HUD and give her less Food stamps, etc, and I just looked at her and said WELCOME TO THE REAL WORLD As for Jon and KAte, makes you wonder how long this will last. MYfavorite, the time the wife of plastic surgeon, got her husband to donate free surgery, and then the make over. PLUS they are making a fortune on each episode, as they each get a salary for each of them for each episode. Wonder how much is being banked for each of the kids . I watched the one at the grocery where she spends $600 or so week.ly on ALL HEALTHY NATURAL food, no frozen, or processed for HER kids, and thought if you were not on TV then you sure would not have that choice, as his job does not provide that kind of money. There was another about the kids where Dad lost his job andhealth ins, andhad to rush to have surgery done on two of the kids the day before. And on the other hand, once they quit being a cute age, they seem to fall off the face of the earth and all the free stuff ends, so don't know if the kids are prepared for that psychologically or not. OH well, enough of my griping.

Sorry for your accident.( OR WAS IT) Anyway, we had a little old lady that wore this pink striped hood like night cap, and called to everybody, HONEY

Part of every initial interview we do includes the question"Do you feel safe in your own home/" "Does anyone there cause you harm and in what way?".. Most patients are shocked at the question, but when you get that teary pause, you just know that you need to explore and come back and maybe try a different approach to gain confidence. One of the biggest discussions right now is whether doctors are at fault if their patients are found to be a victim of elder abuse. Most seem to feel that they should recognize not only the physical signs like excessive bruising, falls, etc, but the psychological ones, like looking down, and not answering direct questions. Many physcians reply that the victims are often accompanied by the people who abuse them so it is hard to diagnose. Just remember that mandated reporter.

What did you find out, is this straightened out now?

I have coached lots of OBs through labor, and find the ones who need it most often do not have a partner to help them through. One was only 13 years old, and she was enough of a child to just listen to me, (and her body) >This was early in my career, and we did not do epidurals, just spinals at the end. She was out of control, screaming, not knowing what was to happen, and just needed somebody to support and lead her in the right direction. She did great, stayed around and married the guy, and had two more children. Another time I was called in by the dr delivering as the mom was out of control, the nurse in l&d , he did not trust or think knew what she was doing. I felt like a A** to the other nurse, the dr. basically threw her out, and I just had to deal with an out of control patient, get things under control, gain her confidence, and get a good delivery with a good outcome which is what happened. She JUST NEEDED somebody to trust, and take control. I agree that it is dependent on the situation, and how everybody reacts to each other, and the rapport of the room and delivery. I had 5 deliveries , none less than 17 hours of labor, no pain meds, no epidurals, I did not particularly have a birth plan, but didn't want the narcotics to reach my baby. Was I trying for sainthood, NONONO, For some reason, it just seemed the right thing at the time.

A turkey, hunk of cheese, sweatshirt with deer drawn sleigh and hospital logo, (most went to goodwill) and$100 cash. This was all in one year.IT seems the smaller the hospital, the better, the gifts. Bigger hospital. CARD IN THE MAIL>

The one I wore at home, was about the size of a holter, and it recorded 24 hour periods. It had a band and you could wear it around your neck, or waist. Did not really bother, except at night, when it goes off more, or with exertion.

I WOULD NOT GET THE LAWYER FIRST. I would FIRST find out if I really have health insurance or IF I have what is now called a third party payor. Unfortunately for us, almost all big companies have now gone with the third party payor route. THIS Means that they LEASE a list of providers, and that is the part of the plan that decides if it is covered, and how much they will pay. The other part of the plan is the payor. IN the state where I live, and I imagine this is all over, third party payors are NOT responsbile to follow the guidelines of the insurance comission of the state. BECAUSE THEY ARE ESSENTIALLY NOT health insurance. I found this out a long time ago because I was in a car wreck, and in our state, as long as you don't have MEdicare or Medicaid then you can collect from the drivers at fault's insurance on the car, AND your health insurance. I had ins. and my husbands ins. They paid all the claims, but then turned around and filed against the money I had coming from the other drivers car ins. IT took over 2 years to get that money back. The state insurance comission told me that I did NOT have health insurance as the company called it, but a third party payor, and the only thing they are governed by is the federal court system. THey do NOT have to comply with any type of insurance regulations of your state. Up to that point, I never heard of a third party payor. I urge all of you to call the insurance commission of your state and CHECK OUT your own "health insurance".Many of you will find,like I did,that I do not have health insurance. I fought the employers to no longer advetise that our"health insurance" was such a great benefit of our employment. I was told by several attorneys that had gone against third party payors, because they did not pay in accordance with the insurance commission, that USUSALLY judges will hold them to the standard of what health insurance is required to do,but they do NOT HAVE TO DO SO> As for "registered letters",believe me they do not send anything registered, in fact many disguise the way they send it out, so if you are not careful,you may not even open it, when you get the Cobra letter. I believe that you have 60-90 days to decide to go with Cobra IF you are offered it. BUT the cost is prohibitive. For example, you pay around $150 for family benefits monthly at work,but you pay $1400 monthly on Cobra.SO even though it is offered, without a good job, many cannot afford it. In addition, if you apply for health ins, through another provider during the time limit, because you were insured longer than a continuous year, they have to pick up WITHOUT a pre existing clause. IF you don t do it within this time, they can add any clauses, and you may have to work months to get health insurance. I wish you the best, but it is not as easy as get a lawyer and sue. I would think that a hospital would not enter into something like this, without having done their homework. IT makes no sense. They no somebody would turn around and try to sue. IS your job secure to come back, you have had accumulated vacation, etc, or are using FMLA? IF you have not taken the proper steps. this will prove much more difficult. What did you find out today?

Number One. I think that you should contact other employees to see IF ANY of them received any type notice about insurance being cancelled, or changed, or whatever and new paperwork required. As , if they did, and you did not turn yours in, then that may have happened. Two. Open enrollment is usually held in October every year, and if people don't make changes then, then they have to wait another year to do so. 3. IF you were cancelled, then the company , at least in my state, by law have to contact you and offer you Cobra coverage for the next 18 months, as you have been continuously covered for a year. The problem being that since they did NOT contact your company until Nov.6, the company probably had no reason to contact you as they thought your were covered, and in additon, probably gave the OK for your surgery, and have probably already paid for it. When you were preadmitted, IF YOU HAD NO INSURANCE coverage, then they would have told you at the time, as they precertify EVERY admission prior to admitting you for the surgery. Also, they evidently have been covering all your meds up till now. IN addition, if the manager knew you planned surgery, and asked that you wait, then maybe they are trying to pull something. I don't think they can cancel insurance two months after the fact. Perhaps when you went on medical leave, you did not have enough time to pay for your time off in vacation, sick pay, etc, and you should have filed for FMLA, to keep your job. UNLESS EVERY employee had their insurance terminated at the same time or changed, you cannot be singled out, UNLESS You don't pay your premiums. While on medical leave, (FMLA) you are required to pay for the health insurance IF you do not have enough timebuilt up to pay you to be off the entire time. BUT for the 12 weeks of FMLA, you only have to pay your portion to keep it. Have you received checks the whole time you have been off? When did you plan to return? did you give them your drs. excuse? There are many things that enter into this. I would go to HR. and ask them to explain, and if they can't get the person you can, and get it straightened out. Check any EOBS you have gotten from the ins. co saying they have paid for the surgery, meds, etc. The company contracts with all the providers, and EVEry provider checks with the company before handing over services at the insurance pro rated rate. Post more, and I wll try to help. We had to get the Dept of Labor to settle my husbands FMLA>

Not only are people undermedicated, they are not properly medicated. Years ago, almost every patient had orders written for fever, pain, and pain not controlled by the first choice of drugs , i.e., Tylenol #3 , two tabs q 3-4 hours, prn pain, If not controlled by T3, may give Demerol 50 mg IM q4hrs prn. In addition, EVERY patient needs to be medicated for that acute pain due to trauma, that is not part of their chronic pain. Also, many meds don't work for some patients like they do others. Morphine, for example,has no effect on me. I found this out after a TKR, and was told the PCA was all I HAD. Most patients prefer Percocet or a oxycodone based med, then Codeine, or hydrocodone. We all know it is now the most abused drug, but , in addition to controlling pain, that drug also has an UPPER effect, where the patient FEELS BETTER, in additon to pain control that does not come with Vicodin. I prefer Vicodin, as I don't like the out of control feeling. BUT NO MATTER we MUST not let our patients lay there and cry and scream in pain. IT IS RIDICULOUS, and why should they be in a hospital, if it is not to be helped. I believe that as the advocate, we do everyting we can for our patients, but unless medical staff cooperates, we are often at a loss. Too many drs. are now afraid to prescribe adequate pain meds. IT is funny how if a dr has experienced the same type pain he is treating, the difference in the amount of pain control he offers his patients.