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herring_RN

retired registered nurse
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Content by herring_RN

  1. More information and opinion. I quoted a fraction of the information needed to begin understanding single payer healthcare.
  2. herring_RN

    California RN to tele PT ratios

    I think you are correct. Before the ratios our hospital had telemetry and step-down patients on the same unit. After they created a step-down unit where so called "stable" patients requiring mechanical ventilation, pulmonary artery catheter or arterial line, non titrated Dopamine and other vasoactive drips are staffed at three or fewer patients per RN. "Stable" patients with continuous cardiac monitoring are classified as Telemetry patients and staffed at four or fewer patients per RN. Acuity can decrease the number of assigned patients for other reasons than severity of illness. A patient with decreased ability for self care or with a high potential for a fall or self harm often needs more tome than a four patient assignment allows so the assigned nurse may need only two or three patients, OR a sitter or other additional nursing staff would be appropriate. Link to the ratio regulations: https://govt.westlaw.com/calregs/Document/I8612C410941F11E29091E6B951DDF6CE?viewType=FullText&originationContext=documenttoc&transitionType=CategoryPageItem&contextData=(sc.Default)
  3. I know Representative Karen Bass. We once worked at the same hospital. She was an LVN before becoming a physician's assistant (PA) and then an instructor in USC's PA program. She also worked with us in our struggle to finally achieve safe nurse-to-patient ratios in California. She is as personable as she seems. She one of those smart, hard working, and high energy leaders. It is great to have Representative Underwood in congress now too.
  4. herring_RN

    "Like" Limits

    I clicked "like" because I was glad the member posted a study, but when I clicked "disagree" my Like turned red as if I didsliked the post. Then I couldn't click "Like" again. So left no response at all. Maybe I'll just respond with a quote and type what I mean.
  5. herring_RN

    A statistical death

    Although numerous studies have statistically shown that the hospital nurse staffing ratios mandated in California are cost effective and associated with lower mortality too many refuse to provide sufficient nurses to ensure that patients receive needed nursing care.
  6. herring_RN

    "Like" Limits

    Thanks. I also plan to only click "disagree" when posting why I disagree.
  7. herring_RN

    Welcome Home!!!! - Home Sweet Home

    GLAD WE HAVE OUR ALLNURSES.COM BACK. Thanks for the welcome!
  8. Thank you for this! I didn't know about her. I did find some photos of her.
  9. herring_RN

    Why I cannot hate the Affordable Care Act (ACA)

    I think if most Americans really learned and thought about it they would support a single payer system, expanded Medicare for all of us. All of us including elected politicians and those who lose the election too. For people between jobs, babies, children, and young adults. Not just 80% coverage for us old people. We won't have to spend as much when we eliminate the advertising costs, shareholder dividends and/or speculation, and enormous insurance company executive compensation especially stock options.
  10. Thank you Farawyn. I think nurses should be aware than some people are intersex. All people are not one gender. Some people are intersex. I know two of them. One is a family member. The midwife who delivered her at home 80+ years ago registered her a male. She didn't know this until she applied for Social Security when she retired from her job. She was born with a clitoris that now looks like a little boy's penis. She married a man and had four children. She is a woman with an unusual anatomy. The other person confided in me that he didn't know until puberty. I don't know what he looks like because he neither told no showed me. He told me of the confusion, depression, and mental anguish for several years until deciding to remain a man. I've cared for a few intersex people. I don't know whether or not they knew. It wasn't on the chart. I cared for one transgender woman. I saw that in the chart after having given her a bedpan and noticing nothing unusual. She had adult children. She was once their father and is now their "aunt". She is good friends with her ex wife who calls her "sister". It seems very odd typing this, but my patient seemed like a normal woman with a nice family.
  11. herring_RN

    Why I cannot hate the Affordable Care Act (ACA)

    My daughter doesn't get a subsidy for her Bronze plan, she pays almose $250.00 a month. She has the nearly $6,000.00 in savings in case of an expensive illness or accident. If she has to go to the hospital she will not have to pay more than a maximum of her deductible minus premiums and deductibles already paid. Without insurance she would have to pay whatever the hospital charges. Of course she is hoping not to get sick oe injured.
  12. herring_RN

    Why I cannot hate the Affordable Care Act (ACA)

    A silver plan for a 30 year old in Los Angeles working full time for $9.61 /hour ($20,000.00 a year) costs $82.00 a month. He or she would have a $500.00 yearly deductible and $50.00 brand name drug deductible. Possible total yearly out of pocket for premiums and copays is $2,250.00. A shop and compare to find information on different plans for a person's age, income, and location. Even though the link says, "Bad Request' it works for research purposes. Bad Request
  13. herring_RN

    Why I cannot hate the Affordable Care Act (ACA)

    My dermatologist only takes Medicare. Before I was 65 she gave me a detailed receipt to mail my insurance company for reimbursement. Much of her practice is cosmetic that insurance doesn't cover. I know a family practice physician who does the same. Most of his patients are old enough for Medicare. he took over his father's practice and owns the building his office is in.
  14. herring_RN

    Why I cannot hate the Affordable Care Act (ACA)

    FAQs about Affordable Care Act Implementation May 11, 2015 ... Plans and issuers must cover without cost sharing at least one form of contraception in each of the methods (currently 18) that the FDA has identified for women in its current Birth Control Guide.(12) This coverage must also include the clinical services, including patient education and counseling, needed for provision of the contraceptive method... ... The plan or issuer may not impose cost sharing with respect to anesthesia services performed in connection with the preventive colonoscopy if the attending provider determines that anesthesia would be medically appropriate for the individual... Frequently Asked Questions - The Affordable Care Act Implementation Part XXVI
  15. herring_RN

    Why I cannot hate the Affordable Care Act (ACA)

    I agree with you. It is not easy. That is why I stayed with more few people as they called doctors listed as accepting the plan. One woman made many many calls to be told, She is not accepting new patients at this time." After the first two she asked if another doctor in the practice was taking new patients. Finally she had an appointment for the free yearly preventative care visit. She now had a primary doctor. If she gets sick she can go to one of our best hospitals where he is on staff. Of course she hopes not to need hospitalization. I made sure to show each person who was happy for my help to point out the urgent care clinic they can go to if they can't get an appointment when sick. In my area the plans I know send a booklet with all available primary practitioners and hospitals. An updated list is on line too. I wouldn't help a person call a practitioner who is not in the plan, but many accept the insurance who are not taking new patients. Two people I know have the same doctor who is new to to his city. I'm just saying that sometimes nurses can help our friends, neighbors, and family members access care. If they want the help.
  16. herring_RN

    Why I cannot hate the Affordable Care Act (ACA)

    My daughter chose a Bronze Plan with a total possible yearly premium plus deductible of $6,500.00. She is gambling that she will remain healthy. If so she will save compared to the silver plan premiums. She keeps more than enough in savings to pay up to the yearly maximum if she ie sick or injured. After her hours were cut 13 years ago she could not get affordable insurance at all because she was overweight. She lost that weight in 2005 and has kept a normal weight since, but was considered to have a pre-exhisting condition. Any policy she could get had premiums higher than her income. Because her job has been part time for more than a decade she also walks dogs. She has keys to peoples condos and apartments and walks their dogs when they want her to. With her total income she can get a Bronze plan. It is not available for people who qualify for a subsidy. They must purchase a Silver Plan with lower deductibles. The total yearly maximum would be the same. For individuals and families with any equity such as a home, business, savings, and/or investment income having insurance will likely prevent bankruptcy if they have an expensive illness or injury. I encourage and assist my friends, neighbors, and family to have a primary care provider they trust. That person will be such a blessing if there is a serious illness or emergency. I sometimes give them phone number, sit with them while they are on hold, encourage them if the provider is not accepting new patients, and go through the process until they have an appointment. If they ask I go with them for the first appointment, once even into the examination room. The listen the what they want to tell me and try to answer any questions they have. After the first visit most providers have email appointments and email communication with the provider. I think too many people who lived without insurance for a long time need help accessing healthcare. Sometimes they help others after establishing a relationship with a nurse practitioner or physician.
  17. herring_RN

    Nurses Eating Their Young- A Different Perspective

    I believe that nursing requires respect for the human dignity of each individual. We must demonstrate this to students and new nurses. Honesty is essential so we need to be truthful with our patients, each other, physicians, and management. No bluffing. If we don't know something we must ask. I am so very proud of the fine nurses who taught me when I was new. The younger nurses I've oriented and mentored are now fine nurses. Many are leaders who help the rest of us advocate for the highest level of safe, effective, therapeutic compassionate nursing care delivered with compassion. Is technique without caring nursing?
  18. herring_RN

    URGENT: Are CDC Ebola Guidelines 'Good Enough'?

    Rhode Island is a compact state. I'm not certain how this would affect a nurse's license in that event. I do believe the Rhode Island Department of Health is not clear, but I would interpret their statement to mean that the nurse or other provider must care for an Ebola patient unless there are mitigating circumstances such as the facilities failure to provide proper equipment and/or training. From the Rhode Island Department of health:
  19. herring_RN

    URGENT: Are CDC Ebola Guidelines 'Good Enough'?

    From today's CDC website
  20. herring_RN

    URGENT: Are CDC Ebola Guidelines 'Good Enough'?

    U.S. issues new protocols for treating Ebola patients By Anna Driver and Lisa Marie Garza DALLAS Tue Oct 21, 2014 The United States issued stringent new protocols on Monday for health workers treating Ebola victims, directing medical teams to wear protective gear that leaves no skin or hair exposed when caring for patients infected with the virus. The new guidelines from the U.S. Centers for Disease Control and Prevention in Atlanta come as 43 people who were exposed to the first patient diagnosed in the United States were declared risk free, easing a national sense of crisis over the spread of Ebola. Under the CDC protocols, Ebola healthcare workers must undergo special training and demonstrate competency in using protective equipment designed to prevent their exposure. Use of the gear, now including coveralls, and single-use, disposable hoods, must be overseen by a supervisor to ensure proper procedures are followed. A key element is that no skin can be exposed by doctors, nurses or technicians taking care of a person infected with Ebola, which is transmitted through direct contact with bodily fluids and tissue but is not airborne... ... The old guidelines for health workers, based on World Health Organization protocols, said they should wear masks or goggles but allowed some skin exposure... http://uk.reuters.com/article/2014/10/21/us-health-ebola-usa-idUKKCN0I919B20141021
  21. herring_RN

    Food Insecurity and Child Malnutrition in the United States

    I sometimes buy a veggie burger at a drive thru, but we are doing well. They have good salads too: Sunny Grill - Home I never bought frozen or packaged burgers. i'd soak soy beans over night, cook them a long time, and then mash them with finely chopped onions, a grated carrot and egg. They fry into nice burgers. Other cooked beans do too. I donate large bags of beans, brown rice, onions, bell peppers, and apples to the local food bank along with recipes, soap, tooth brushes, and tooth paste.
  22. herring_RN

    What a Union Can Do For You

    Nurses at Lawrence and Memorial Get Permission to Strike Strike looming after hospital keeps laying off unionized workers and shifting work to shell corporations. Nurses and technicians at Lawrence and Memorial Hospital in New London have voted to authorize their union leadership to call a strike unless a contract agreement is reached. Thursday night's vote came less than 48 hours before the contract expires. The hospital's public relations director, Mike O'Farrell, said the authorization for a strike does not mean one will happen. Notice of a nurses' strike would come at least ten days before it begins. The state requires hospitals make a plan if a strike does occur.... ... President of the Nurses Union, Lisa Dabrosca, says the union does not want to strike, but they will if they have to. She says the hospital has been laying off the union's workers and shifting work from Lawrence and Memorial to their shell corporations. Despite O'Farrell's assurances, Dabrosca says "the people who are replacing our laid off workers are not equally as qualified." She notes that neither pay nor benefits are part of the problem. "We want to be able to follow our work if it moves to a clinic-based setting," Dabrosca said. ... http://www.nbcconnecticut.com/news/local/Nurses-at-Lawrence-and-Memorial-Get-Permission-to-Strike-232127131.html
  23. herring_RN

    What a Union Can Do For You

    Thank you. Well written.
  24. herring_RN

    Sticky Politics

    Before WWII RNs could be terminated for wearing nail polish on their day off. In the 1970s I had to wear white, a cap, and flesh colored stockings. I had to but nylons because they decided the white cotten tights looked old fashioned. Hair above the collar. It is too bad a nurse was disciplined for wearing two earrings. That is not just cause.
  25. herring_RN

    The Stigma of Mental Illness and Suicide

    The actual problem is insufficient staff. When a patient needs a sitter an additianal competent person needs to be provided. This article is about a patient who suicided while hospitalized. That state didn't fine the hospital. I hope the family sued: Illinois hospital oversight limited - Chicago Tribune I've attached a public document of hos a hospital was "penny wise and pound foolish" refusing a sitter. they were fines $75,000 by the state. Often there can be a lawsuit too. This is a bit off topic, but really, we need to keep patients safe! Many wonderful people lived a productive life after trying to kill him or herself. Fall- no sitter-Pomerado Hospital--SanDiegoCounty[1].pdf
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