Callinurse

I recently went out to a home vent case and the plan of treatment included a procedure that I have never heard of and I would like to know if any of you have experience with this. It was explained to me that if I push manually on the bladder area that it will expell urine. This patient is semicomatose, & experiences no pain during this procedure. She is place on the bedapin then the crede procedure. I have tries to search this on line and can't find any information on this procedure. Please reply if you know anything related to this. Thank you, Callinurse

I would ask her exactly why she couldn't interview you. Just ask her like you are asking her "How are you?" "Can you tell me why you will not be able to interview me?" See what she says. She may have forgotten to tell you that she'll have to get back to you, or perhaps JCAHO just showed up and she lost her mind. Hopefully its not what you are thinking. If it is look for hospitals with a new grad program. Good luck, Calli

Ok, this is one from the Rahab setting ..... "If you can pick your nose and feed yourself then I will not put your member in the urinal. You will have to do this yourself!"

www.wculearning.com I received ad advertisement from them today.

Is this a LTC = Long Term Care Facility or a ALF = Assisted Living Facility? In California in an ALF staff that have been trained to state specifics can assist in giving meds. If the pill or liquid needs to be put in the mouth they have to call the lvn/rn. The resident needs to be able to put the tablet or liquid after it is poured into the mouth. My sister does this and I was very nervous for her in the beginning. However, I had no ALF experience and was not aware of the regulations that govern ALF'S. Calli

I am not sure but I have heard if the facility is less than 99 beds they are not required to have 24 hour RN coverage in the building. Calli

Man if you held down a 320 bed facility does that mean 4 assessments a day with every 4th one a comprehensive??? My hats off to you ! Calli

It is a violation of the hospital policy if the policy is updated and it is a HIPAA violaition. It doesn't matter if it is a test result or any other part of your medical record. Check out this link: http://www.hhs.gov/ocr/hipaa/ HIPAA itself is quite lenghtly. The federal regulations = laws also have a standard you might say dictionary to tell you what certain words mean EVERYTIME they are used. You should know how to read these. Like when "must" is use, it means that there is no room for intrepretation or flexability. It must be exactly what they write. This site also has a link to file a complaint if you think you records have been violated. The best thing is to not go against your hospital policy. If the policy is at fault the hospital will be held liable. If you are at fault for using the policy then you can be find. I dug a little further and this is the actual HIPAA regulation: http://aspe.hhs.gov/admnsimp/pl104191.htm it also includes the definitions. The fine can maxes out at 25,000 per calendar year. However, this what not meant to keep your record from you. It was meant to protect you record. I think one of the first sections of the regulation states the purpose. If anyone could get your info can you imagine how a health insurance company might reject your policy renewal if they new you had Diabetes or HIV? There has been a system for accessing your record for years. Its like everything else we have to respect the systems. All or nothing. there is no inbetween. I think I am going to sign off on this thread. I just hope that students don't get the wrong impression from others opinions. As new nurses it is common to assume what you see others do to be correct. Keep your good habits because you will see plenty of lazy or poor habits. I hope these links will help those of you who are truely interested in looking at HIPAA. Have a happy New Year ............. Calli

Yes, this is a HIPAA violation. I used to teach the classes when we first introduced this to all staff. It is even against HIPAA to look up anything on a patient on your floor that you do not work with. Please don't give the wrong impression to some one here that do not know for sure what the law states. A facility will doubtfully terminate you for this unless the doc complains about something or if they are trying to get ride of you anyways. When you are admitted to the facility or go to have blood work or even pick up a prescription for the first time each year they often give you a copy of HIPAA. Take a look at it. I was involved in damage control for the facility I worked at in 1996. That was when it was first passed but there were so many components to the law that it was not enforced until hospitals had time to correct many different systems. This is the same reason you must always use a fax cover sheet even if you are just faxing to another department in the same building. I would not comment if I didn't know it for fact. Calli

If you accessed your file in medical records it was probly according to HIPAA regulations. What you refer to as "presonal impressions" are actually part of your physicians assessment of your presentation. Just because you were anxious at one contact doesn't mean your doc is going to expect you to be anxious everytime he sees you. If you are truely an anxious person all the time then you already know this and know how this can affect your health. He/She has a responsibility to note this in the physician's assessment. It doesn't mean its a negative attribute. I hope that you are your 100% self when you go to the doctors. If you are not comfortable with him/her maybe you should get a doc that you at relaxed with. Just a suggestion. Calli

Just remember that care plans must be individualized for each patient. Example: two patients with kidney failure might not have a fluid restriction. If you get the preprinted ones make sure before you use them that you cross out anything that is not current for the patient. If you have specific care plan you need you might think of posting them and maybe nurses or students on here will send them to you. Good luck! Calli

Wow, I never thought my restraint skills would be used at home. I might have to try this one. Calli

you need to remember that reason for covering them must be related to the 3 day stay. if this resident goes our for pneumonia then the g-tube at this point which is no longer a new g-tube and is not related to the 3 day stay. this is an excellent reference: for consumers medicare coverage of skilled nursing facility care pp 14-15 for consumers medicare coverage of skilled nursing facility care pp 14-15 as posted above. if you are in doubt and need someone to confirm your decision making you can always call your state rep. the admissions coordinator or marketing person should also be up on this. check out the reference it is what medicare recipients receive to read to know what their benefits are. calli

Part of the HIPAA ensures that each facility will keep of log of who has had access to your medical record or any medical record. How can they do that if they don't know you accessed it. A lab result it self or an xray result it self is not the total answer. It takes a doctor to state the final diagnosis. Sometimes it takes more than one test to give the entire picture. The law is the law ..... I am sure that by now you have signed and will sign each year that you will adhere to the HIPAA laws. If not I hope you will soon. Its a requirement for the hospital to do so. It seems stupid but its the system we work in. When you sign in to the computer with your password they can track what you looked at. It would hate for you to loose your job because you did something so silly. This will be a popular thread. If you are a Kaiser patient you can get an email as soon as your test are complete. I love this because I don't have to wait for a call or follow up. Just thought I would mention this in case you worked at Kaiser. Calli

If you check your local library you may find nursing care plan books. You may also check your local hospital. The library is often open to the public. Hope this helps... Calli