delta32

I would just watch for positions for the case management positions for your hospital. The training for the position will include your community resources for items such as DME, Home care, Home infusion, etc.. You will also be trained in InterQual or Miliman depending on what criteria that your facility uses. Both of those systems are nationally accepted criteria to establish various levels of care. Some hospitals will train you in this or others may send you to a class.

Come to the dark side....we have cookies lol Seriously I have worked both hospital CM and Insurance and I will take insurance anytime!

I work for an insurance company the reviews the appeals through EHR :)

you should read the H&p section of the chart, this will give you the complaint and that was done such as testing with a impression listing what the possible dx is. now looking at no bm x 3 days causes can be: dehydration illeus bowel obstruction etc the labs are really not going to tell you too much with this case. you can look at the bun/creat for dehydration and wbc for poss infections, but your answers are going to be with the xrays and ct scan of the abdomen.

:) not a problem :) I really enjoy lungs, i did not want to confuse him.

Actually a lobectomy is removal of a lobe of the lung, not the entire lung.

When a patient comes out of the OR from a pneumoectomy, they will be on there back at 30 degee's HOB elevation. These patients will be on a Ventilator and have Chest tubes in place. As for laying the patient on a particular side you are going to be limited in the amount of turning with this patient d/t the tubes that the patient will have. it is important to make sure the the remaining lung is able to fully expand but you also need to ensure proper drainage of the previous cavity of the removed lung.

i have to really wonder about her common sense, and why in the world would she give them her business card? i think that you may want to bring this to her instructor this sounds a little to bizarre to be innocent

beware of sign on bonus's the higher the amount the higher the bad stuff going on there. They will give a higerh bonus to lure in new staff but high chances are the working conditions are bad

ekks, you need to speak with your manager this will not work. depending on what your position is you need to know the in's and out's of insurance. Are you doing concurrent reviews or the actual case management for diseases?

Hi just becareful with your drinks, keep to the diet drinks, no calories no easier said them done :) I am just over a year out and i am a abinger and will talk myself into eating that smalll ice cream just to toss it back up in 5 minutes so i completely under stand your pain. it sucks dosn't it, I had hoped that my having the bypass htat this would go away and that i would no longer have food issues. take care! Jamie

first of you did everything right, **you do not code or do CPR on someone with a pulse, that is BLS 101**. you do CPR on a infant if bradacardic not a adult. someone that hemodynamically is shutting down and loaded with pressures such as levo, vaso, neo and there BP is still not reading is SOL. you just keep the gtts going till the heart stops then you code then. you doing CPR on some with a pulse is whats gonna get you in a sling, i have to say susan that scares me you wrote that. Jamie

Hi silverdragon! I deal with this everyday as well. I also had gastric bypass and struggle with binging issues. it sounds like you are in a binge. its very hard but you have to drinks lots, i like the diet green tea. bring some frozen grapes around with you and suck on them ans slowly eat them, they will help some with the cravings. start bringin gyour food with you again when you goto work and watch your portions. again, this is not easy, yiu have to take it one minute or step at a time. :) Jamie

HI, you can do work as a nurse for insurance companies or you can get into case management thru the hosptials are well. My laminectomy left me unable to do bedside as well. I love working with the insurance industry, you get to do more of the fun side of nursing. you get to watch thru there charts about what is happening with the pt but you don't have to touch them or deal with them unless you are calling in a denial

here is a great site for new ICU nurses: http://icufaqs.org/ it has everything very simple and easy to grasp HTH jamie p.s another idea is a book called Critical Care made incrediably easy

When people have COPD the act of breathing alone burns alot of calories. People with COPD need about 1000 calories more than the heathy adult. The only thing that i can think of is that the cholocate is a easier an quicker way to get the calories in with out having to chew and eat large amounts of foods. HTH Jamie

While I am told that I am not carry my cell phone, i do anyways, my child has very bad food allergies and asthma. If the daycare needs to get ahold of me I am not going to risk them not being able to find me in an emeregency. you know some one had posted earlier in the week about nursing being a indentured servent. I have to agree, its salvery in a modern form. they can make what ever rules they want but I am going to do whats best for my family. There is plenty of nursing jobs out there! Jamie

here's just a guess, i have never tried it and have no idea if it will work but what about the cling wrap like you put on your dishes. maybe wrap it around the body, have the child ALWAYS with supervision but maybe it might work. it does sounds kinda scary but i can see it working Jamie

you totally hit it on the head! 1. I am not your maid 2. I am not a slave 3. i have feelings. 4. I will not deal with your temper tantrums I work in the insurance industry now and i love it, no more beligerant families to deal with anymore, no more whiny people. it blows my mind how the public treats nurses. they want to critized everything and be nasty than fine heal your self! Jamie

take a look at your local insurance companies. many of them have nurse case management at this time and some of the postions are work at home after about a 6 month period. I went to insurance nursing after i had a laminectomy after 4 years of being a nurse, oh course i was a EMT with a comerical ambulance service as well ( this did not help matters much) My job sitting in a little cubicle and reviewing pts inpt request or current stays and playing policey or miliman standards to make sure that the services rendered are approprate.

I love what i do! I do not deal with patients person to person, i do not have to touch them or deal with there families. NO weekends, No holidays and normal 9-5 hours! I work for an insurance company doing concurrant case review. to basically explain this I am the person at the insurance company that approves inpt hospital stays for certian lengths of time, I also do pre-auths and all other sorts of nice cubicle don't have to touch the pt related things... lol Jamie

The first rule of ACLS is know thy drugs! when you have a understanding how what they drug is and what the actions of the drug is then the alarhythems will make sure sense. you can try to remeber the algorhythems but it will come easier with knowing the drugs. the questions you want to ask yourself is who, what, why who: an example is your pacemaker gone bad what: the patient is brady give them atropine why: atropine is will increase the HR HTH Jamie p.s. if you find some neat ACLS simulators online for free, i think but dont hold me to it that the american red cross has one too.

I wanted to add to my previous post. If you have to force a family to call her then they most likey are sick of her behavior as well. There usually is a reason why families don't visit or call Jamie

are you sure your not in NY? it sounds like my unit that i just left 3 weeks ago. I was the nurse manager on that floor for the rehab unit. it sounds like your on a rehab unit as well. this is what i would suggest: -keep a list of times and demands that the resident makes and document them in your chart and keep a record for your self as well. - re consult psych- even if they don't diagnose her as having a mential illness thay can gove recomendations. it deffinatley sounds like she has borderline personality disorder. part of the disorder is manipulative personality and they like to devid and conquire. The unit needs to present as a united front with this patient and call her on her behavior. she trives on turning you guys against each other. the last recomendation is to stop playing her games. If she wants to complain in her wheel chair let her. nothing says you have to listen to her abuse. if she wants to yell neglect to another staff member you too MUST confront her on her behavior. please talk to your DON if you need too so that the team is not the same page. No matter what you do she is not going to be happy so don't stress it. if she wants to be nasty turn and walk away. you do not have to take abuse. Jamie

you can actually get that book over at barnes and noble in the medical/Nursing section :) here is the link that i promised you. http://icufaqs.org/ Jamie p.s. the basics that you will need medication wise is: *Neosynephrine ( increases BP) *levophed ( increase BP- try to use as last resort0 remember- levophed=leave them dead....finger and toes die off. its a good med don't get me wrong but thoses are the effect. *vasopressin (increase BP) you can look at EKG's, CVP's, A-lines, I would not worry about swan gans cathitors they are not using them to much anymore but its a hands on learning thing anyways :) good luck to you!