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LaurieCRNP2002 MSN, RN, APRN

Hospice and palliative care
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LaurieCRNP2002 has 27 years experience as a MSN, RN, APRN and specializes in Hospice and palliative care.

LaurieCRNP2002's Latest Activity

  1. Thanks to all who have contributed to this thread. I think it is great that there are nurses who feel comfortable doing med-surg, LTC, and many of the "non-traditional" specialties that nurses seem to eschew in favor of the "glamour" of ER or ICU. Before I became a nurse, I did prehospital (EMT). When I got to nursing school, I felt pretty comfortable dealing with patients as I had the experience of being in some emergent situations. As a nurse, I've done telemetry/stepdown and ICU and as an NP of 15 years, I've done cardiac, pulmonary, infectious disease and currently, hospice and palliative care. I love my patients but the traveling is tough. I do feel like I am helping my patients but I'm not sure I can continue the brutal traveling that is required of me in my current position. I guess my message is that everyone is different and has their own talents and interests and should pursue the path that they feel will give them the most fulfillment. That path may change over time and that is OK. God bless everyone of you who are on the front lines and caring for all our patients, whether they have become infected with COVID or not! Please take care of yourselves and your families!!
  2. LaurieCRNP2002

    Insulting pay raise

    In reference to the last sentence...yes, in their eyes we aren't "valuable" but if they didn't have us at all, they'd be up s*** creek!! 😡
  3. LaurieCRNP2002

    Marketing Question

    I currently work for a hospice/palliative care company and we do have marketers but to date (and I've only been there about 2.5 months) I have NEVER seen our marketers "fish" for patients as far as looking in their charts. They go to different facilities to educate the staff as to the differences between hospice and palliative care. It is left to the clinical staff (myself and my fellow NP) to evaluate patients on our palliative service and if they are appropriate for hospice, we then refer them. Having previously worked for a company that did house calls, I would say that if this "marketer" is looking in patient charts, that would be a red flag to me--as in a potential HIPAA violation. It's one thing if the NPs or MD refer appropriate patients for hospice eval but to have someone with no clinical background looking thru charts to find "hospice-appropriate" patients strikes me as very unethical, at the very least.
  4. LaurieCRNP2002

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    (Reply to comment #9) Me too. A sad situation for everyone involved
  5. LaurieCRNP2002

    Stroke Meaningful Use questions

    Good evening everyone! :) I wanted to ask my fellow NP's, who in your facility answers the "meaningful use" questions on discharge related to stroke patients? Is it the neurologist or NP/PA who has been involved with the patient's care, your facility's stroke coordinator or an internal medicine attending MD? Thanks in advance! Laurie L Dougherty, MSN, CRNP, BC
  6. LaurieCRNP2002

    Stroke Meaningful Use questions

    Good evening everyone! :) I wanted to ask my fellow NP's, who in your facility answers the "meaningful use" questions on discharge related to stroke patients? Is it the neurologist or NP/PA who has been involved with the patient's care, your facility's stroke coordinator or an internal medicine attending MD? Thanks in advance! Laurie L Dougherty, MSN, CRNP, BC
  7. LaurieCRNP2002

    Being Pulled into the Office for calling CAT

    I agree, it sounds like you were on top of things and the resident was very slow to respond. I hope the resident gets a chewing-out by his attending!! Although I agree you did nothing wrong, if you have a union, I hope you had a union rep with you. Clearly the clinical coordinator was NOT on your side! Unbelievable! Sounds like you need to move on from that unit, whether to another unit in the hospital or another hospital altogether! Good luck!
  8. LaurieCRNP2002

    Woohoo...Denver 2014~!

    Nervous1 If you go to AACN's site (American Association of Critical-Care Nurses), then go to the NTI section, they have a portion of the site that talks about "return on investment" and how to convince administrators to allow nurses to go to NTI and even get them to help pay for the conference. Check it out! I wish you the best Laurie
  9. LaurieCRNP2002

    In-home NP Medicare Assessments

    Sob24 Sorry for the delayed reply-I usually get notification about a message but somehow didn't this time. I work for a company called Univita and in general, I don't mind being an IC except that I am paid per visit and if patients cancel their visits, I am out of luck paywise. I am at the mercy of the scheduling team--if they get visits scheduled, I'm ok but if not...it hits me in the wallet. I usually do my own taxes. I keep track of my mileage and able to deduct that amount as I do not get reimbursed for it by my company . So if you are really looking to do this work (which is not difficult but also not very challenging), I would recommend finding a company that offers a salaried position. That way you know you will have a steady income. I know United Health Care offers salaried positions for this work. Good luck and please don't hesitate to write back if you have any other questions :) Hope you and your family have a Happy Thanksgiving :) Laurie (lld1026@comcast.net)
  10. LaurieCRNP2002

    ok, tech geeks, PDA?

    Rokidog Earlier this year, I switched to the Palm T/X and have been very happy with it so far. It has a decent size hard drive (32 MB) plus a slot for an SD card (There are 16GB size SD cards, not sure if there's anything higher but there may be). You just have to see what's out there and decide what you will be comfortable with. A Blackberry, as the other poster mentioned, is another option. I wish you luck and please don't hestitate to contact me if you have any other questions! Laurie :typing
  11. LaurieCRNP2002

    What kind of NP would this be?

    Imastudent If you want to work in med/surg, your best bet is to try to get a job with a physician's practice who are looking for an NP to do hospital rounds. You could also try to get a job as a hospital-based NP. In general, specialty practices tend to pay higher salaries vs hospitals that hire NP's (there's always exceptions, though). I truthfully couldn't tell you if a surgical practice pays higher than a medical practice--I would guess every geographic area is different. Either way, if there is a school near you that offers an acute care program, this would be your best bet if you want to work with hospital inpatients. If you want to work in the ER, from what I've heard, it's better to go through a family nurse practitioner program (FNP). You would be exposed to working with both adults and children, and you could probably arrange to do clinical time in the ER (if there are any in your area that hire NP's). Good luck to you and feel free to IM me if you have any other questions Laurie
  12. LaurieCRNP2002

    Does your employer recognize "Nurse's Day"?

    Our hospital had a ceremony honoring the "Nurse of the Year" from each unit, along with cake. The docs in the cath lab are providing lunch for us tomorrow and there is something on Tuesday as well (combination of Nurses' Week/Hospital Week). Although it is nice to be recognized, I feel that the recognition should come more often than just once a year. Regardless of specialty or location (hospital, nursing home, wherever), nurses are the backbone of healthcare and so many places would fall apart if we weren't there. I hate when administrators drool over us for the week then forget about us for the other 51 weeks of the year! . On the bright side, I think our current CNO does truly value nurses and our contributions--so maybe she can soften my cynical attitude :wink2: June55Baby--I'm very glad that you work in a place that values its nurses :). If only all places could follow your employers' example Laurie MSN, CRNP
  13. LaurieCRNP2002

    Fun way to present case studies..anyone have ideas?

    Maybe you could act it out but involve the class also. For example, the "patient" (one of the group members--"Person A") could be on a stretcher and the "nurse" (Person B) could be a nurse coming to examine them. The nurse would ask the patient if they were having any problems and the "patient" could say "Well, I have numbness in my arm and I'm having trouble speaking". The nurse would then assess the patient but she could also ask the class for input--"What special assessments should I do here?" "What diagnostic test should I suggest the resident obtain"?) As you go through the various stages (assessment, diagnosis, intervention, evaluation) your group can ask the class for input. Then at the end you could have a brief Powerpoint presentation on CVA's--what symptoms you would see, what assessments to perform, what diagnostic tests to do, and treatment options. You could choose any setting you like--ED, ICU, telemetry. I remember when I worked telemetry, I had a patient that had a stroke during the night--she couldn't speak to me at all the next morning and had been fine when I assessed her at first rounds (I worked night shift at the time). When I went through my grad program, we had a semester where we had to interview a "patient" (one of our classmates) and go through a process of determining diagnosis, and we asked the class for input at different times. What I'm suggesting is a variation of this (except you could demonstrate the actual exam components (various aspects of a neuro exam). It is my experience and opinion that people learn better and pay more attention when they are involved, so the more interactive you can make it, the better. Good luck to you! Laurie MSN, CRNP Cardiac cath lab
  14. LaurieCRNP2002

    Why are you a NP rather than an RN?

    Kelli I am a fairly new NP (just started my job about 6-7 weeks ago). I chose to enter advanced practice b/c I like nursing enough to stay in it for the long haul but did not want to stay a bedside nurse b/c of the ever increasing ratios and decreasing support. Going for my MSN seemed to me to offer the most options--if I get tired of clinical advanced practice, I have plenty of other choices open to me. I strongly feel that any RN who wants to move into advanced practice should have at least a year or two of bedside nursing experience. When I started my NP program, I had been an RN for 4 years and continued working through grad school (one of the benefits of choosing NP over PA--most PA programs discourage their students from working much). There were 2 girls in my program who went straight from undergrad to the NP program and did quite well--I know that one of them actually did take a staff nurse position after finishing the NP program to get some of that "bedside nursing" experience under her belt. As for the issue of RN's appreciating/resenting NP's---I think it depends what setting you're in. I am in a cardiac cath lab and while some of the RN's are supportive, others are not. Lucky for me, I get along quite well with many of the CCU nurses (where most of our patients are admitted) and there doesn't seem to be any animosity towards me. I try to communicate with the nurses about the plan for the patients I am in charge of and value their input as well. I feel that the patients appreciate what I bring to the table and I like that I can spend more time with them than I could if I were a staff nurse. Good luck to you and don't hesitate to contact me privately if you have any other questions/concerns Laurie
  15. LaurieCRNP2002

    "Shift goes to the lowest bidder..."

    I just found a recent article (dated 12/7/03) about hospitals that are using "shift bidding" to fill holes. I have the link below for anyone who wants to read about this. http://apnews1.iwon.com/article/20031207/D7V9MBM80.html Laurie
  16. LaurieCRNP2002

    Quick question -- MSN/NP programs

    I would agree that you need to check with the specific programs you are interested in and find out exactly what their requirements are. I went through an acute NP program and although they do not require acute experience, I can tell you that one of the girls who I went through the program with actually took a job as a staff nurse to get some experience when she finished the NP program. I would STRONGLY recommend getting at least 1 year of experience and if possible, to continue working while in school (even if it's only through a "weekend program"). Not only will you keep your skills up but it will (hopefully) be a little less of a financial burden if you are able to have some income while you are working on your degree. Good luck to you and feel free to send a private message if you have any other questions :) Laurie