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Tying Patient Satisfaction to Medicare Reimbursement is Problematic
I have such a strong opinion of these patient satisfaction surveys, but so little space to provide it. What I'll say is...I have yet to find the sign in my hospital that reads "the customer is always right" or "have it your way". I don't coddle people, I don't kiss patients proverbial butts, and I don't waste my precious care-giving time on pillows, lunch boxes, or water. If you need water because you're in DKA, I'll get it for you, and quickly. If you need a warm blanket because you're hypo-thermic or the heat went out in the winter, you got it! If you're boarding in the ER because the house is full, I've got your pillow and lunch box. But if you just got placed in a treatment room, the gown is still folded on the bed, and the doctor hasn't seen you yet, that lunch box you just requested will never become a reality for you. If you want to give me poor scores for that, BY ALL MEANS DO IT WITH A BIG RED SHARPIE. But I will put you in your place when you're demanding a blanket when we're coding the pt on the other side of the curtain.
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Triage complaints- the good, the bad, and the shocking.
Me and you both! If only we could stop coddling these people.
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Triage complaints- the good, the bad, and the shocking.
"I think I'm butt-pregnant" - was concerned after having sex via the out door. Not very intelligence, to say the least.
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What is CEN, or CCRN?
You do not have to re-test to recert your CCRN. You can earn 100 synergy CERPs or re-test. I recerted in April without having to retest.
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Nurse: 'I was fired for refusing flu shot'
There are entirely too many Sheeple in this world who do as they're told rather than doing RESEARCH, naming no names...laidback Al. We are in a profession that prides itself on being evidence-based. Where's the evidence that vaccines are beneficial? And I'm not only talking about the stupid flu shot, I'm talking about them all. Do the research, get your facts straight and then join us here for an intelligent conversation. You may wanna check out vaclib.org. And yes, I'm one of those evil parents who have chosen to send their kids into this world sans vaccines.
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Nurse: 'I was fired for refusing flu shot'
Last year my hospital said get the shot or wear a mask. This year they are saying the mandatory flu shot is a condition of your employment unless you have a medical contraindication to the vaccine. I have worn the mask 2 years in a row, haven't gotten a flu shot since 2008, and didn't get the flu all those years. If an employee wants the shot, by all means, but if I don't... This bites!
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Vent: "I should warn you, I'm a tough stick..."
"I'm a hard stick" is like nails on a chalkboard for me. Starting lines is my favorite task, and I'm pretty good at it, if I do say so myself. I'm an ER nurse, I do this day in and day out. I don't use a 22g unless I HAVE TO!!! A 20g is my go-to, and of course an 18g if its necessary, aka CT PE, CTA/CTP, blood, fluid resuc., etc. And then, you have the lovely 16g for traumas and the level 1 - those are fun! And I educate my patients on the difference between a butterfly and the needle necessary for an IV when the former is requested. I have had patients who tactfully tell me they have difficult veins and it didn't bug me at all. You can warn your nurse that others have a hard time getting IVs on you, however, you don't have to direct the show. When I tie on the tourniquet, I'm gonna see what I'm working with. I am gonna first look where I need to to get a line. If I don't see something there, I will look in the next best place. I don't stick what I can't feel or see, and while I love the AC (its usually a fail-safe), I will first try for the upper inner forearm. That's where I stick first. I don't do hands, period. Shoulders are good too, in a pinch. On another note... Holy Moly! Its super annoying to come here to get release from frustrations with your job (by posting or reading that you aren't alone) and have people who aren't in the trenches with you trying to put in their . Well, here's my ...until you've been an ER nurse for longer than a week or two and understand what we deal with on a daily basis, shhhhhhhhh! The OP was probably looking more for "Oh, yea, I feel ya" or other encounters and how that nurse dealt with it. Its not a free-for-all for just anyone's comments. Great, you're a hard stick ...by all means, come be MY patient!
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University of South Alabama MSN program
Does anyone know anything about the Advanced Emergency Nursing program at USA? Or the CNS with Nursing Education subspecialty program? (The AEN is a dual specialty FNP/Adult-Gerontological Acute NP program.) Any info would be greatly appreciated. Thanks
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Number of agencies?
I see, thank you so much.
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Number of agencies?
Hey all! I am tossing around the idea of traveling and, of course, have a TON of questions. But, I'll keep this post to one. When traveling around the country taking 13 wk assignments, is it better to be with only one agency or multiple? Trying to get all my info straight. Thanks a bunch.
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Levophed vs. Neo
I have given Levophed through a peripheral line many, many, many times. There has only been one incidence where a line infiltrated, Regitine was given, and there was no necrosis, at all! In a perfect world all pts receiving pressors would have a central line for infusion. This isn't a perfect world and not all pts have central lines.
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Levophed vs. Neo
While it isn't ideal, Levo can be run peripherally. We have to do it a lot in my dinky ICU.
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How much lorazepam have you given....
I have given a total of 28mg of Ativan IV to a DT patient in 12 hours. And that dose did NOTHING for him - he continued to kick us, spit at us, and call us names. I was also giving haldol per our withdrawl protocol with no result.
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Modifying tasks when pregnant. My boss says "no".
Look, you're pregnant, not injured. Unless you are high risk, with or without complications, you don't need light duty. Yea, you're gonna be more tired than usual, and yea it's gonna be more difficult to sleep, but all that is gonna be whether you are on light duty or not. You shouldn't be pulling on big pts and you probably shouldn't be dealing with chemo, but you should be able to take a normal pt load. Hopefully you have some good colleagues who will help you out in certain situations. When I was preggers, my coworkers wouldn't let me pull my pts up in the bed, they would come in and do it for me. They would help my with my baths and do all the holding and turning. Your manager does sound a bit unreasonable, not even hearing you out, but if there are extinuating circumstances, you need to speak up. I hope everything works out for you.
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pressors and sepsis
Awesome, thanks ya'll!