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MattiesMama

MattiesMama

Community Health
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MattiesMama's Latest Activity

  1. I totally agree with you on all of this. I think this administration has failed miserably at making healthcare reform something the average person can understand. Hence people were showing up to the doctors offices the day after it was passed thinking they automatically had insurance, and on the other end of the spectrum there are still people who think that we have death panels. I think that overall we do have great facilities, great providers (especially nurses ) and our level of innovation when it comes to developing new treatments and technologies is argueably the best in the world-the problem is that only a portion of our population gets to benefit from any of it. A perfect example-I work at a community health clinic that is down the street from one of the best hospitals in the country, and yet I routinely see people who haven't seen a doctor in years, decades even, because they simply can't afford it. They put off seeking care until it becomes an emergency, and then they usually go to the ER at said hospital, which then usually has to write them off as a charity case, and the patient will usually end up needing to undergo the more expensive aggressive treatment for a condition that could have easily been detected early or prevented if they had been seeing a primary care provider on a regular basis. So it's good that we have resources, but the challenge is making them accesable to everyone and allocating them in a way that is both logical and cost-effective.
  2. MattiesMama

    "Time to Talk About Death"

    Frontline just did a great documentary about this and it's available online: http://www.pbs.org/wgbh/pages/frontline/facing-death This is such an important issue and I think the biggest problem is people (clinicians, nurses, patients, and their families) put off that conversation until the last possible moment. We really need to create a culture where we talk about issues of death, dying, and end of life care long before the big decisions need to be made. If a patient is not told they are dying, it robs them of a chance to really come to terms with their fate and go through the stages of grief. I know that if I was dying, I would want to have a chance to tie up my loose ends, make funeral arrangements, have a chance to contact all of my friends and family...all of that takes time. More than a couple days. I can't even go to sleep at night if things are left undone, I can't even imagine what it would be like taking my last breath in that situation
  3. Sometimes I have a hard time distinguishing between the 2
  4. The US ranks low partly because the questions they asked... They didn't ask how many thought they could afford the taxes that pay for health care in the other countries. The difference between the tax rate here and in Canada is about 10%. American's spend an average of 6% of their total income paying for healthcare. And that percentage is disproportionally higher when you look at certain populations-the elderly, families below the poverty line, people with serious illnesses, and of course the uninsured. They spend an average of 16% of their income. So those who are most vulnerable and who can least afford it pay the highest "tax" on healthcare, as it stands right now. Sound fair? It is hard to get caught in insurance snafoos when there is basically no insurance. I'm not sure what you mean by this. When the bill is paid through taxes, of course they aren't going to cough up as much from their own wallets. Right, because I'm sure every single person they interviewed doesn't pay taxes. They didn't ask about shortages of resources, wait times, degree of innovation/research(http://content.healthaffairs.org/cgi/reprint/20/3/233.pdf ) http://www.americanthinker.com/2009/12/public_option_great_britains_w.html Right, because those kinds of things never in our system Or access to care that government agencies deem is not cost effective http://www.unionleader.com/article.aspx?headline=Karol+Sikora:+This+health+care+'reform'+will+kill+thousands&articleId=46dca304-6d08-432c-84e4-f7992e75e77f Right, because insurance companies NEVER deny payment for a treatment based on cost :rolleyes: They didn't ask concrete numbers or ratios, they asked feelings about them. For perspecitve, the level of taxation that precipitated wars in the early years of the United States was 3%. However, when a population has paid 50% or so in taxes for a few generations, it feels normal to do so. What country are you talking about? The tax rate in the highest income bracket doesn't even come close to 50%. As for why we have chosen to keep our system: I don't know about anyone else, but when I research the moves toward socialized medicine that we've taken so far I see they haven't done what their advocates said they would and have resulted in either more or bigger problems. Also, when I look at the systems other countries have, I do not think they are better. In several case, other countries have moved toward a free market system. We have not made any real "moves" towards "socialized medicine", so what "bigger problems" are you talking about exactly? I'd like to see employers taken out of the formula altogether, a move away from a third party payor systems (either insurance companies or government) for minor routine health issues (like this: http://www.patmosemergiclinic.com/HealthcareColutionthatWorks.html ), and true insurance for catastrophic health issues. That's the nutshell version. That doctor is able to operate at half cost because he only accepts self-pay patients who, I would assume, pay for their services upfront. So he does not have to absorb the costs of treating patients who are unable to pay. The same patients he says "will need a safety net"-although he conveniently leaves out any ideas about how they will be adressed in his "solution"
  5. MattiesMama

    Frontline: Facing Death

    This was one of the best documentaries I've ever seen on death, dying, and our healthcare system. It airs on Nov. 23rd but the full episode is available online here: http://www.pbs.org/wgbh/pages/frontline/facing-death How far would you go to sustain the life of someone you love, or your own? When the moment comes, and you're confronted with the prospect of "pulling the plug," do you know how you'll respond? In Facing Death, FRONTLINE gains extraordinary access to The Mount Sinai Medical Center, one of New York's biggest hospitals, to take a closer measure of today's complicated end-of-life decisions. In this intimate, groundbreaking film, doctors, patients and families speak with remarkable candor about the increasingly difficult choices people are making at the end of life: when to remove a breathing tube in the ICU; when to continue treatment for patients with aggressive blood cancers; when to perform a surgery; and when to call for hospice.
  6. MattiesMama

    All LPNs laid off in a day

    This same scenario just played out at a facility where my friend works as an RN. What ended up happening is they increased the responsibilities of the CNA's to include nursing tasks like g-tube feeds, trach care, and the like. A very unsafe situation for patients and a slap in the face to all the LPN's, many of whom spent an entire career working for this facility. Even though she doesn't feel her job is at risk, my friend is considering leaving-because it speaks to how the company views it's nurses as basically disposable. I would definately take one of those job offers. Good luck!
  7. MattiesMama

    Treating the Muslim patient

    It takes 2 seconds to ask a patient if they have any cultural or spiritual preferences, and most can be easily accomadated. And it can make a huge difference in thier overall experience. Regardless of what paradigm the concept arises from, wouldn't you want to make your patient feel comfortable? (BTW, it's spelled whole)
  8. MattiesMama

    Nursing Interview questions

    found these here: http://www.characterbasedleadership.com/health1.html have any of you been asked these on an interview? if so, which ones? interview questions for: nurses, nurse aids, cnas, lpns character quality: endurance ■ if a friend were to ask you for help in deciding whether to stay or quit a job that was hard work but meaningful work, what would you tell them and why? ■ when you have a lot of work to do and not enough time or assistance to get it all done, how do you handle it? ■ how do you keep from getting burnout? ■ what about your character would help you do this job day in and day out? ■ what does endurance mean to you? ■ would those who know you best say that you endure to the end or move on to other things? interview questions for: rns, nurse aids, cnas, lpns character quality: dependability ■ during the last year, when your replacement hasn't shown up and your manager asked you to stay late, what percentage of the time have you stayed late? ■ everybody misses work sometimes. what are some legitimate reasons to miss work? ■ two hours before you are scheduled to arrive at work, you learn weather is going to be bad and traffic will be worse. how do you respond? ■ if your shift ends at 3 p.m. and your replacement hasn't arrived by 3:15 p.m., what do you do? ■ the schedule shows 8, however only 5 showed up. how does that make you feel? what would you do? ■ you just discovered it's a snow day and your kids have no school. you are scheduled to work 3-11, how would you handle this dilemma? ■ how many scheduled days did you miss during the last three months you worked? ■ it is your lunch break and you see a resident fall. what do you do? ■ what would you do if your car doesn't start? ■ if we were to ask your previous supervisor, what would they say about your attendance and job performance? interview questions for: nurses, nurse aids, cnas, lpns character quality: compassion ■ how do you respond to crabby people in pain? ■ approximately how old were you when you decided to become a nurse? where there any defining moments that help you decide to become a nurse? ■ would people say that you are compassionate? your family? why, give some specific reasons? ■ if you encountered a resident that was characteristically upset and/or difficult what would you do? ■ if a resident has just expired and their family has just arrived at the facility, how would you respond. ■ mrs. jones is in the facility for a fractured hip. she constantly likes attn. by putting on the call light pretending to be in pain. everyone on the hall is ignoring her. you pass by the room and hear her crying what is your response? ■ how would you intervene with a resident who is grieving over the loss of a grandchild. interview questions for: certified nurses aid (cna) character quality: sensitivity ■ you are late for work. you enter the building and notice a non-compliant resident who is drinking a soda but appears to have a wet him/her self. how do you respond? ■ how do you react to a sense of being overwhelmed with unfinished work ten minutes past your shift deadline when you find a new resident in need? ■ do others like to talk with you? how do you encourage others to talk to you? interview questions for: rns, nurse aids, cnas, lpns character quality: cautiousness ■ can you explain in detail how you would appropriately transfer a resident from a bed to a wheel chair? interview questions for: nurses, nurse aids, cnas, lpns character quality: honesty ■ what would you do if a delivery driver accidentally left double the number of an item that his company charges us a lot of money for? ■ what was the last thing you found? ... then ask, where?, ... what did you do with it? [does the applicant take advantage of opportunities of the moment or do they have a heart to restore lost items to the owner?] ■ what would you do if you saw another nurse stealing from a resident? ■ a resident takes off her rings, and hands them to you in the middle of the night what would you do? ■ how do you demonstrate honesty to co-workers? ■ what do you think honesty means to an employer? interview questions for: rns, nurse aids, cnas, lpns character quality: punctuality ■ if we were to ask your previous supervisor, would s/he say that you never, sometimes, or frequently took off early? ■ what are some of the reasons that kept you from coming to work ... promptly? interview questions for: certified nurse aid, cna character quality: initiative ■ your shift ends in 10 min. and you have accomplished all your duties, how would you utilize your remaining time? ■ what do you think initiative is and how have you applied it to your job in the past? ■ tell me of a time that you solved a problem without direct supervision. ■ how often do you think a charge nurse or don needs to be on the unit? interview questions for: nurses, nurse aids, cnas, lpns character quality: deference, discretion, endurance, flexibility, respect, honor, loyalty, meekness, obedience, self-control ■ describe a recent problem you had with one of your manager's decisions. wait, then ask, how did you handle it? ■ after an extremely demanding day with a resident who required much attention, their family member aggressively approaches you, and accuses you of negligence and calls you nasty names. how do you handle this?
  9. MattiesMama

    Is it the time for Nursing School?

    It sounds like the big "selling point" for you is the length of the program-2 years for a BSN? I didn't even know that was possible, unless it's a second degree program. But I agree with everyone else-the cost is waaay too high. Since you do have a job, my advice would be to look around, and find a program that is less expensive, and one that you can do on a part time basis while still working at your current job. There is no need to rush yourself, especially in this economy. Hopefully, once you graduate the job situation will be better!
  10. MattiesMama

    New grad? Here's what you can expect..

    I think the OP was trying to paint a realistic picture of what the market is like for those considering entering nursing school-NOT complaining about his personal inability to find a job. As far as the rest of your post- How do you know we haven't applied for jobs outside of our "ideal"? Personally I have applied for everything from unit secretary to CNA to prison nurse to medical records reviewer-jobs I'm overqualified for and jobs I'm underqualified for, jobs I would have never in a million years thought I would be reduced to, jobs that pay well below what I consider a liveable wage, and still haven't gotten an interview. It's been going on 3 months now and I lost track of the number of applications I've filled out but it's in the hundreds. And I've gone into places in person, stalked hiring managers, had a professional redo my resume and cover letter. I could go on and on...So again, when you say things like "think outside the box", even if you don't mean to you are still being patronizing. And when people like that HR manager talk about those of us who haven't been able to find work 6 months after graduation as being "un-marketable", it is based on the stereotype that people who cannot find a job are lazy, defective, or simply not trying hard enough-and the reality is, for most of us, nothing could be further from the truth. BTW-is your alma mater a for-profit college? Just curious. Good on them for scaling back their program-what I'm seeing with my school (a for profit) is the exact opposite. They just opened 2 new campuses, shortened the length of the program, lowered the passing grade from a 76 to a 70, and continue to advertise every 5 minutes during daytime TV
  11. MattiesMama

    New grad? Here's what you can expect..

    I'm so tempted to print this out and plaster it all over every nursing school campus in my state. They really do have no shame-if I see one more commercial for a school talking about this "nursing shortage" I'm going to scream! As for those of you who say "everyone in my class got a job!!!" thats wonderful, but realize you are the exception and not the rule. And its a little patronizing to be told things like "make your resume stand out!" and "get good grades and certifications!" as if we haven't already tried this. It's all about location, location, location-and if you are in a bad location, it doesn't matter if you graduated magna cum laude and found the cure for cancer, unless you have that magical 3 years experience you are NOT getting hired.
  12. MattiesMama

    Hyperkalaemia and saline

    isn't 100% glucose really thick and hard to infuse? I've never given it but I was under the impression that it had to be given as a bolus, and it takes a lot of elbow grease to get it in someone.
  13. MattiesMama

    I'm just curious...

    Christine just curious, what country do you live in?
  14. MattiesMama

    I'm just curious...

    Thanks, and this is exactly why I'm asking these questions. I've sat on the sidelines on a lot of these debates. I get frustrated...I don't really care about "patient studies". Anyone who's taken statistics knows that you can twist them to suit any argument you want to make. What I do know for sure is that while this squabbling is going on, the very facets of our profession are being sliced, diced, and auctioned off to the highest bidder. It makes me sad to think that 20 years ago (maybe less?) you didn't have "med aides" and "dietary technicians". I've also seen people argue that these tech's make life "easier" for the nurse...and I just have to shake my head. It only makes things "easier" because you have an unsafe patient load, and it takes some of the burden off of your shoulders to delegate a task to someone else. And you only have an unsafe patient load because your employer realized it was more cost-effective to hire 1 nurse and 10 techs than it would be to hire 5 nurses. They aren't doing you a favor And I think deep down, the aversion towards working in SNF has less to do with unsafe patient loads than it does with the fact that many nurses simply don't want to work with the elderly. Because it's depressing, maybe a little boring, and a constant daily reminder of your own mortality. Whatever the reasons are, it's just not all that popular. There is simply no way that we will recruit enough BSN's to work in that setting to meet the needs of the aging population, period.
  15. MattiesMama

    I'm just curious...

    Really interesting to read the responses here... I always like to look at what other countries are doing...I think Canada, for example, has a pretty good approach. Their LPN's now have 2 years of education and graduate with an associated degree. To become an RN you need to go for 2 more years of college, and graduate with a BSN. So while all of their RN's have 4 year degrees, it's not the "entry point" per se. I would love to hear from someone who nurses in Canada to get a perspective on how that is working. I think something like that, along with reforming nursing education just might work...
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