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Boog'sCRRN246 RN

IPR, Utilization Management
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Boog'sCRRN246 has 9 years experience as a RN and specializes in IPR, Utilization Management.

I am a Certified Rehabilitation RN, currently working in Utilization Management. Until recently, I was working as a Rehab Liaison for a CARF-accredited inpatient rehab unit at a Magnet facility in Central Florida until my facility made the decision to close our IPR unit.

Boog'sCRRN246's Latest Activity

  1. Boog'sCRRN246

    New Grad-Insulin

    What happens when you have a brain injury patient that requires a 1:1 sitter? Does the tech get pulled to sit with the patient leaving you to fend for yourself with the rest of the patients? Brain injury patients can be extremely unpredictable; throw a psych diagnosis on top of that and things can go downhill fast. You'll get the med pass down eventually; what you should be concerning yourself with is how safe you're going to be once you're off orientation. Do you have previous experience working with brain injury patients? It's not really something you can pick up in only three weeks. Is there a system in place for you to call for help if necessary? I don't mean to be negative, I'm just thrown off that a brain injury floor is only staffed with one licensed person.
  2. Boog'sCRRN246

    Floating

    When I was a Rehab floor nurse, my co-worker was floated to...wait for it...the CATH LAB and expected to fully take over the duties of the off-going nurse.
  3. Boog'sCRRN246

    New Grad as a Clinical Liaison

    This job is about so much more than just clinical skills. It also encompasses the "boring" and "political" side of nursing - paperwork, insurance auths, Medicare/Medicaid regulations, etc. Would you feel comfortable denying a patient for admission to your SNF because they would be better served at a different level of care, such as IRF or LTAC or even home health? Would you then refer the patient to that level of care? The SNF Clinical Liaisons in my area wouldn't dream of doing any of that because it would hurt the bottom line of their employers. To me, that is where the difficulty of the position lies.
  4. Boog'sCRRN246

    Sabotage? Failed by 0.1%

    And who paid you to come on here and attack everyone who offered opinions you didn't like? Also, you are sorely mistaken if you think people go into nursing because they are "money hungry." That is just laughable. Education is one of the ONLY businesses where the customer is NOT king. You pay for the privilege of LEARNING and learning requires personal responsibility. You don't waltz into a classroom and demand things just because you were stupid enough to take out ridiculous loans. What happened to the days when a student actually held themselves responsible for their education and didn't expect to be spoon-fed everything or given unlimited attempts just because they paid to be there? And you're absolutely right, we are affiliated with nursing schools - the ones we've all actually graduated from.
  5. Boog'sCRRN246

    What Did You Get For Nurses Week?

    We got a hand-held, battery-operated fan. The fan blades have an LED panel that lights up with the company motto, but the motto is too long, so the fan dies before you can see the whole thing. My co-worker and I also got to chase the ice cream cart down the hall, then go back to our office to get our badges to prove that are, in fact, RNs, even though all RNs wear the same color at my hospital. After that, the cart pushers had a debate in front of us as to whether or not we "qualified" for the ice cream since we are case management RNs, not bedside RNs. So, all in all, a typical Nurses' Week.
  6. Boog'sCRRN246

    New RN, leaving after 6 months unprofessional?

    In my experience, and possibly due to where I am located, traveling for recreation is thought of as frivolous and if you're not working yourself to death six to seven days per week, you're not contributing to society. I feel like this is an underlying theme of American culture. I read articles all the time where a person is just out on a Saturday night, gets in some kind of trouble, and the first thing someone says is "Get a job," or "I was in bed at that time b/c I have to WORK in the morning." Americans are very much obsessed with work, work, work and complaining about not getting a vacation. Also, when it's hard to get just one or two days off because your manager is constantly having to justify positions, the thought of extended travel is laughable (not my personal opinion, just what I'm used to hearing).
  7. Boog'sCRRN246

    How the mind works: Domestic Violence

    Stockholm Syndrome. Look into it.
  8. Boog'sCRRN246

    Sedatives and Stroke

    Reducing blood pressure with antihypertensives in an acute ischemic stroke decreases perfusion of brain tissue surrounding the area of initial insult. Reducing BP reduces the MAP, which can result in a larger area of ischemia. Sedatives are typically used with patients experiencing anxiety and agitation related to the stroke. It is not uncommon for stroke patients to receive benzos, antipsychotics, and antidepressants. As you can see, one class of medication has the potential to do much more and longer lasting harm than the other.
  9. Boog'sCRRN246

    want to join MSF, what's the best way?

    So I will admit that I do not have a clue as to your actual question, but from looking at their website myself, I am seeing an extensive list of requirements, one being that nurses have THREE years of relevant experience, including one year of management type experience. Just wondering if you had seen all the extra requirements?
  10. Boog'sCRRN246

    Kicked off unit when Joint Commission arrives

    Even if you are just on the unit doing CNA duties, you run the risk of being cornered by a JC surveyor and asked questions for which you will likely not know the answers. Count yourself lucky - most hospital employees don't even want to be around for TJC.
  11. Boog'sCRRN246

    AMA safety

    I think your hospital may be grossly misinterpreting what an AMA discharge should be. Even though the patient is discharging AMA, you still want a SAFE discharge. Just letting them sign a paper and be on their way is setting everyone up for failure and repercussions. This is a link to an article on the AHRQ website (it's a bit older than I'd like, but still relevant information): Discharge Against Medical Advice | AHRQ Patient Safety Network. The section titled "Reducing Errors and Adverse Outcomes Associated With Discharges AMA" is particularly interesting.
  12. Boog'sCRRN246

    Do I aspirate too violently?

    Think about this from the patient's perspective - you're giving them an IM injection, which is uncomfortable all by itself, but then you're digging around for an additional 15-30 seconds because, for some reason, you are under the impression that you have to aspirate multiple times. This is causing damage to the tissue surrounding the needle, causing bleeding. Then you STILL have to inject the medication itself. Sorry, but if I was that patient, that would be that last IM injection you ever gave me.
  13. Boog'sCRRN246

    New Graduate looking for Orlando/Tampa area jobs!

    Other places to apply: *Tampa General Hospital *Florida Hospital (same Florida Hospital as in Orlando) *Lakeland Regional Health (Lakeland is between Tampa/Orlando and has new grad-type positions) *BayCare Health System (most facilities in Tampa, but also owns Winter Haven Hospital in Winter Haven, which is also between Tampa/Orlando) Those are all the not-for-profit facilities I could think of; there are quite a few more for-profit hospitals in the area all the areas I mentioned also.
  14. Boog'sCRRN246

    stages of grief

    I'd say the patient has accepted his impeding death. If he was pushing away his meal and saying things like "doesn't matter if i eat or not, i'm going to die anyway," i might think he was in the depression stage. This patient, however, has said good-bye to his family, which to me is more telling than the part about not eating. People who haven't accepted the fact that they are dying don't say final farewells to family members.
  15. Boog'sCRRN246

    Question about hospital transfer policies

    I call that way too many hands in the cookie jar. What is the reasoning for three different departments needing to be involved?
  16. Boog'sCRRN246

    NP gave meds to her married boyfriend

    Wow. Hell hath no fury like a woman scorned.
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