moffist

I am wondering if any other Foreign nurses have had this problem. I was educated in the UK in the early 1980's and am unable to get transcripts as my Nursing School shut down and did not keep any records. I went through the CGFNS process, who did manage to evaluate my education and also sat the CGFNS exam. I went on and sat NCLEX in MI. Since then I have held 5 RN licenses, I am trying to get licensed in a couple of States now that won't accept my CGFNS CES that they send and won't license me unless I can have transcripts sent directly to them. Having jumped through all the hoops I needed to when I first arrived here I feel this is wrong. As I said I have worked in several states with no problem. Any ideas as to how I can get around this or who I can appeal to?

I am working for HMA a TPA. Yes still in the honeymoon phase but never enjoyed hospital case management this much OR felt so supported!!

I have now completed 3weeks in my new job. I am very excited with my prospects of tele work. I now know I just need a room with a door that closes (does not need to be locked). Great company who are working hard to make sure I succeed in this role. Definitely the BEST move I have ever made!! They do home checks but I believe I will be notified when they come out to check!! This is a TPA and I love their ethics. Best job I have had in a looong time!!!

I have been in Case Management in the hospital for 5 years. Just took a job as a Telecommute RNCM. I will be training for 6 months in house. Can anyone tell me a typical day for a RNCM working for insurers. Also, when they say you have to have a dedicated office with a locked door.....How do they check on that? Thanks

First this was a chronic condition. Secondly her pain was controlled by po meds. She needed the speciality bed because she was unable to get out of an ordinary bed easily. MD decided HH then OP PT was all she needed. There is no such thing as a 23 hr Obs admission. Dealing with Medicare denials on a daily basis this was absolutely prime to be denied.

Lol yes I meant busy!!! I am a Case Manager. These are patients that do not meet criteria to admit!!! 23c Obs not appropriate

We were discharging to an ALF but patient was unable to get in and out of a normal bed. Needed a hospital bed temporarily. For a safe discharge we needed to order a bed to be at the ALF before the patient arrived. BUT with the new CMS rules I had to get a very busty ED doctor to write a long progress note ONLY to be told by DME company that it didn't make criteria. Spent hours on something that should be so easy!!

Our hospital is piloting having RN case managers in the ED. Yesterday for the first time I had to order a hospital bed and wheelchair for a Medicare patient. This was an unbelievably difficult procedure ending in failure. There MUST be a better way than having to get our all ready overburdened ED doctors to write a great long progress note for these patients NOT being admitted. Anyone know of a form that has been developed OR an easier way than having to write a "story" for Medicare??? It doesn't help an already overburdened ED OR help the patient very much!!! Any advice appreciated.

I work in a very small hospital and we are trying to improve our nursing procedures. Lippincott Nursing procedures and protocols (book and online) have been suggested for us. BEFORE we make that investment I wondered if anyone uses this on their floor. Most of our nurses are experienced but standards are not as high as we would like them. We have a very new educator. I work Med Surg. Thoughts?

Thanks Diane. It is just a general inspection. So sounds kind of like Joint Commission visit. Not been involved in either but I appreciate your reply!!

This will be the first time I have worked when there is a DOH visit. What should I know?

Absolutely and that is what I did. Followed the dr order and drew the blood anyway!!! Great replies everybody and thanks!!!

Well I'm grateful for all the replies. I guess if hospitalmpolicy says DO NOT DRAW COAGS then I have no choice but to follow it. It may be outdated but that is the hospital policy. I will talk with our educator about this policy. Also is hospital policy NEVER to run or y tube ANYTHING with a heparin drip EVER!!! Guess it is an outdated rule but I will ask our educator exactly why we can't (any evidence based practice etc). I did flush well and did draw the cooags.

I did the draw. adjusted the heparin drip as per nomagram. Pt was gradually going unconscious and dr wasn't sure why. I haven't been back yet to see the outcome!!! I realise heparin is compatable with other drugs but with an overdue PTT, a heparin drip running without being checked I was not prepared to add insult to injury especially as pt wasn't or didn't seem to be doing well!!! Hopefully they are ok. Was just unhappy with the way the heparin was being managed (or not managed).

Not all PICCS are flushed with heparin. My last hospital policy was NOT to flush with heparin but to put to saline lock!!! NEVER drew coags if heparin was used. Skews the results they claimed!!!