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!!!

It's a small hospital and no one would try. they all refused. It was the doctor who said flush the PICC.I still say that skews the results!!!! Even with double or triple lumin!!

Ok the heparin was running through the PICC when it was suggested I run the antibiotic with it. No 2nd peripheral by then. My last hospital 's protocol said NEVER draw coags from a PICC (single, double OR triple) after initiating a Heparin drip. You get skewed results. The protocol here was checked. Labs were supposed to be drawn by the Lab (who were refusing) and we would have got the blood from the restarted IV BUT that was MANY hours later!!! Still think 12 hrs was way too long!!!! Thanks for the reply.

I have just started at a new hospital and was very concerned with a heparin drip we were running. It was started at 2330 and no PTT/INR was taken again. Pt. had a peripheral IV and a single PICC. They started the heparin through the PICC and then Lab refused to try blood draws as said Pt was too hard a poke!!!! I took over 8 hrs after heparin was started. Was told to switch Heparin to peripheral IV wait an hour, flush PICC with 60mls Saline then draw labs. Now my understanding is if a heparin drip is running in a Central line you CANNOT draw PT/PTT/INR as you will get skewed results!!! Also the peripheral IV went bad so couldn't switch the lines. In the end we got a new peripheral IV switched heparin to peripheral, waited an hour then did as advised. Result was (greater than) 150. Hmmm I'm wondering how accurate that was? As it is it was over 12 hours before I could get the PTT/INR. Then the Charge nurse wanted to run Antibiotics concurrent with the heparin. I didn't do that but surely THAT is dangerous. Appreciate any thoughts!!!

I have recently moved to the Seattle area and was offered a great job. However they are only offereing me 9 days orientation. I feel this is not enough. I moved from Mi where we did electronic charting to here where paper charting rules!!! I feel orientation should be longer than 9 days (especially as this is a Charge position!!) Any thoughts?

I have an interview scheduled with Valley General. Not seen much on the boards about this one!!!! Anyone want to share any info on this hospital?

I just had a telephone interview with a recruiter at Swedish and considering it's great reputation I have to say that was the most difficult unwelcoming experience I have ever had. I heard they were good to their nurses being a Magnet hospital but nothing in that interview would compel me to Swedish. Has anyone else had an experience with interviews with Swedish. I was surprised to be speaking to a recruiter. All my other interviews after passing through HR were with Managers of the Units?

Hi Nursedani08 Where in Mi are you? I am in Grand Rapids at the mo but will have moved to Wa by end of Sept. Now a question to those already in Wa I have applied to Overlake and Evergreen. My husband will be working in Redmond/Kirkland area and we are looking at a house in Duvall/Carnation area. I have heard it is very difficult to drive into Seattle so would there be any point in applying to Swedish or Harborview if I live out to the East.

I am a British Nurse working in Mi but about to relocate to Washington DC (or that sort of area). I have a Green card and hold a Mi license. I have worked N=Med surg for 4 years here. I am a Charge Nurse and preceptor. what are my chances of being hired in at Bethesda? Do the take foreign nurses/green card holders. Do civilian nurses get to live in Base housing?

Any foreign nurses out there. I am an English trained nurse who has gone through CGFNS and now hold a Michigan RN licence. I have been working in Michigan now on Med/Surg GI GU for 5 years and am a Charge nurse. We are looking to relocate to Va and I am looking at Mary Washington Hospital. My questions are:- 1, Anyone know if it will be hard for me to get my licence changed from Mi to Va even if I was educated in the UK? 2. I see jobs for Infusion nurses. Don't think we have those in Mi. Anyone care to tell me what this is? 3. Pay for an RN with 5 years US experience? Currently I get just under $25/hr 4. Paid Time Off. This was a new experience for me as in UK we get 5 wks a year and that doesn't include sick time. Here in Mi I get just over 6hours per pay period. So how does it work in Va. 5. Any advice or comments on Mary Washington Hospital in Fredericksberg? Thanks for reading!!

Looks like my family and I are moving to Portland Oregon. I am a British trained nurse currently licenced and working in Med Surg Digestive Diseases. I went through and passed CGFNS. 1. Does anyone know how difficult it is to get a licence in Oregon if I am licenced in Michigan. 2. Where is the best place to work. I am currently looking at a job in Hillsboro Or. Any help or advice appreciated!!!