ERN

Having both MSCS and MSN degrees certainly gives you flexibility! My desire is to have the flexibility to move with the healthcare arena and possibly to the more technical side of IT. I don't wish to put myself in a position where an MSN that serves well for nursing has little impact on the rest of the IT world. Like many nurses, I am looking to move away from the bedside, but don't wish to throw away my experience and knowledge base in nursing. On the other hand, I don't want to be locked into nursing by my education either........is it possible to have your cake and eat it too? I really appreciate your comments. They were very useful in helping me focus to further define my goals. I am discovering that as you stated in your post; computer science, information systems, and information technology degrees are not the same. And each program may differ markedly in their focus as to what is relevant and necessary content especially within IS and IT. It made me wonder how general the CS/IS/IT course work was within a MSN/NI degree where the primary focus is nursing. As I posted to Angela, I am looking into the IST program offered at Penn State University. They appear to have some flexibilty and are telling me that they work with all disciplines to make their degree more functional in the real world. Thanks again for the imput, ERN

Thank you Angela for your reply. I have been looking for a formal program at the graduate level that can help me blend my nursing background with an IST type preparation to allow me the freedom to utilise both disciplines. I have reviewed many programs but none seem to have the ability to give me a strong preparation in both within the same program. I recently have looked at the new IST program offered by Penn State University. It looks very promising on paper.....I have an appointment next week for an informational meeting with the head of the IST dept. Again thanks for your input. ERN

Hi Sharann, You are quite right to be worried that unreasonable wait times and abuse of ER staff limiting access to ER's. The reality is that truly emergent and critical needs are taken care of immediately in a good ED and the rest are reassessed and treated as they need attention. You and your family will never wait 8-9 hrs if you truly need emergency care. The closings and diversion you speak to occur because ED's are overwhelmed, staff get burned out with the abusive environment, and hosps. can no longer afford to treat uninsured/underinsured non-emergent cases. These folks clogging the ED's needlessly are there because either it's convenient to be seen that day and/or their insurance will pay for a 2 stitch (OH MY GOD!!! The Blood was Gushing!!!!) emergency or a headcold and won't pay their regular GP. I have had people tell me what to write down so their insurance will reimburse them for something that didn't need an ER. Believe it or not, some people use false ID and addresses and the ER bill gets sent to an empty lot in a city in another state. The patient never has a credit card and can only put ten bucks down on the bill at that moment. Many specialty Doc's are refusing call or rearranging their practice to exclude ED patients because they have to leave a long time paying office pt to see a nonpaying pt in the ED. Hosps. and ED MD's are loathed to turn people away for fear of bad community PR and loss of revenue (if they can collect it!) A good friend of mine tells me that as an ED MD in his group of 9 Doc's working full time, they collect 40-50 cents per dollar charged......less for welfare/medicaid pts. Solutions are cash/credit card only (Doc in the boxes) minor care free standing clinics. Hospitals/ ED MD's hate them unless they control them and collect revenue. Good place for CRNP's Tort law is a killer.....people sue because the scar on their little girls head under all that hair is UGLY.....she will never marry that Senator now.....her life is ruined.....I quess she should have thought of that before she lied to her parents and stayed out all night at a rave and them fell in a drugged stuper fighting with the police that raided the place. Malpractice suit threats are causing hosps.to treat everyone as if they were patrons on the Queen Mary. Just ask ER folks on this forum how they like Press Gainey and hospitality rules in a busy ED. Tort law/malpractice awards need to be changed. Hospitals need to separate the truly emergent pts from the "clinic" pts and provide a clinic for them away from the ED. Then conduct a community education program to get folks to use both care facilities appropriately. Sorry for the rant......I too have been both a pt and practitoner in the ED, discussed this subject at length with colleagues and attempted to change it. ERN

Hello All..... I am interested in the changes occuring in information and computing that are gradually changing our health care environment. I am planning to obtain an undergraduate IST degree while continuing to work (part time) as a Trauma/ER RN. I am currently 6 credits into a MSN/FNP program. I have two questions for any of you NI veterans kind enough to share your expertise and knowledge. #1] How does a MSN in NI differ from a BS in IST? I understand the nursing aspects of the MSN. I am principally interested in the comparison of IST knowledge inherent in both types of programs. #2] For those of you with your finger on the pulse of the current IST/NI environment within nursing/healthcare; What, in your opinion, are the immediate (3-5 yrs) and intermediate (5-10 yrs) NI/IST needs or changes that will be priorities moving forward as health care adapts to electrons from paper & pencil? I am interested in staying within nursing in a NI role but quite frankly, I could just as easily move from nursing to IST after 18 yrs in ER's and enjoy the same stress and long hours minus the bad handwriting. Thank you in advance for your responses. I look forward to your posts. ERN

Thanks for the laugh Nightingale. At the bottom of the list in bold letters. YOUR CONVENIENCE IS MY EMERGENCY

I seldom post here but reading all of your thoughts on PG reminded me how much I disliked this measurement tool. I have used Press Gainey both as staff and manager of a very busy east coast ED. We saw ~65,000pts/yr from the NY/Jersy/PA tristate area. I was "educated" on it's use as a tool to improve pt satisfaction. I personally called and spoke with many NM's around the country about PG and it's use as a "customer satisfaction survey tool" to better understand how and what it could do to help the staff. Believe me when I say that this survey can be anything you want it to be. It is manipulated to say what you want it to. If you learn how to use it to your advantage it's better than a trained pony. No pony chow to buy and alot less poop to content with. The survey questions are tailored to your individual unit by your management team to arrive at a desired outcome. Staff are given the standard song and dance about customer satisfaction and unit of excellence and improved pt outcomes but in reality, it is a behavior modification tool used to make staff comply with the outcomes desired by management. As scores go up, the tool is tweaked for even better results. Courtesy, politeness, smiles, helpfulness, cheerfulness, offering to talk to pt's/families, are what the PG is designed to train you to do. It has no bearing what so ever on clinical care. If you act like a good waitress at a Friendly's restaurant, then you will get excellent PG scores. It is all about being a meeter and a greeter with a smile on your face and a song in your heart. Now, I know what it's like to be out of stretchers, supplies, staff and up to my eyeballs in pee ( cause i haven't gone in 8 hrs) when the 4th rig backs into the bay with the other 3 staring at you. I don't feel like singing or smiling. The survey's are randomly sent to pt's after they have been seen, treated and released from your unit. Doesn't matter if they go home, transfer or get admitted. Some of your surveys are filled out by pt's on M/S units and their response to the questions are directly influenced by how nice those angelic nurses are as compared to those crazed, nasty, uncaring busy ER RN's were (who stuck me 3 TIMES with a needle). Surveys may be sent to all jerks one month then all nice folks the next. Since it is random, there is no way to predict how your monthly scores will change. But you will be "encouraged" to "improve" your scores by virture of random analysis based on the how the average public citizen understands and views nurses. You have to "work" harder each month to make people happy until you reach a threshold and public perception changes in your favor. We all know that the public perception of nursing is not the reality of what we do. So, smile and be the classical public image of a nurse and your scores will go up. Do any of your ED's share the MD's scores with the RN's ? You can bet your little white hat that the doc's review yours. It's not a crock JJFROG, it measures peoples perception of what THEY think their experience was like in the unit. Unfortunately, those same people don't know a thrombolitic from a pigs behind and as we all know, "Your convenience is my emergency". :kiss

Hi OB I managed a busy ER and constantly used agency and travlers. Intelistaf RN's were well liked and professional and they had nothing bad to say about their company or supervisors. I met with district and regional managers for intelistaf and they were very nice professionally and personally. I know nothing about the NP aspect however since my needs were strickly ED RN's. The pay range was competitive, in the $28 to $35 dollar area for M/S to critcal RN's. I have never worked agency/traveler so I can't give you first hand ( insider ) knowledge. Hope this helps :)

poppyrn..... I managed an ER where self scheduling and 12 hrs were in play. It is very difficult to balance a full schedule with the appropriate mix of staff especially in an ED Know and play by all your hosp P/P and then stick to you guns. You are being suckered by the administration. I know. I've seen almost every dirty trick by uncaring managers. Staffing is the managers job and there are tons of nurses to be had at the lift of the phone. NEVER jepardize your license or a pt's safety by being bullied by a manager that isn't a leader. You are in charge of your career, you decide how to practice your profession, you are the person in control of your actions. These are all of the thoughts you must believe or they will come back to bite you when you make a mistake and your manager asks, "Didn't you know what you were doing?"