TDCHIM

Yes, that's what I'm wondering - was it a failed joke? Part of a speech about the cost of nursing care and/or the lack of specific reimbursement for that care? I'm really curious about the context.

Wow. Er, what was the context of that remark? I can't imagine what could prompt any senior management officer of a hospital to say such a thing in a public meeting. (Thinking it, sure - but saying it, no way!) Was he talking about the financial side of nursing care or something along those lines?

Oh lord. This again? Every generation blasts the ones that follow it (and there are always members of those following generations that swallow the argument whole and enthusiastically disparage their cohorts). As a result of my birth year, depending on your definition I'm either the youngest X or the oldest Y and I heard the same accusations about my age group growing up (despite the fact that I worked at least part-time year round and full-time every summer from the age of 15 on and was hardly unusual in doing so). My mother heard the same things about the boomers. My grandparents have told me how disapproving and disparaging their coal mining parents were about the "rowdy" and "feckless" behavior of the "Greatest" Generation, and how they thought the girls had no business selfishly moving to work in the factories rather than staying at home to help their parents and younger siblings. Any young generation is going to include a large percentage of individuals who display entitled behaviors; younger people (let's say especially those under 23 or so) are naturally inclined to think themselves the center of the universe. It's something that is usually knocked out of you as you emerge into true maturity. Of course there are people who never emerge from that entitled cocoon of adolescence, but I've seen nothing that makes me think either Gen X or Gen Y is more prone to this sort of thing than those from previous generations. There will always be roughly the same proportion of shiftless, selfish, and/or entitled people in every generation. As a parent of a child from whatever the heck the next generation has been christened (I've heard Gen Alpha tossed around), I'm sure the same things will be said of his generation. It's like the song from "Bye Bye Birdie" says: "What's the matter with kids today?"

Wow. This whole scenario reminds me of the old Scooby-Doo episode where Don Knotts changes into different costumes (maid, butler, housekeeper) to do different duties and eventually gets them all mixed up because he goes crazy trying to keep up. Trying to juggle competing duties is usually a recipe for disaster and what they're asking is demeaning as well as demanding. Go with your gut and run!

This might be a bit out there - but what about asking to do your interview via Skype? If you own a laptop or netbook, you could pop by a public wi-fi hotspot (for instance, libraries and universities are often wi-fi hotspots) near your orientation site, find a quiet location, and conduct your interview that way. Now if the interviewer can rework an in-person interview around your orientation schedule, that would obviously be better. However, if that proves to be a problem, you could throw a Skype interview out as an option. If nothing else, it might make you look like you're an innovative type who isn't afraid of new technology!

I cannot comment on the other parts of your post, but as for the operators listening in on phone conversations between patients and their healthcare providers and then gossiping about them - wow. Yes, what they're doing violates HIPAA. One way to present it might be to use the "need-to-know" line. HIPAA dictates that you access only the information you require to provide care or otherwise fulfill your role in the healthcare chain. So if you don't need that information to do your job (direct care, coding, billing, whatever), you should not access it. Those operators clearly do not need to listen in on confidential phone calls between patient and provider to do their jobs. While I could understand the need to track basic details (i.e. patient name/contact info, brief description of the issue prompting the call, etc.) the conversations themselves are emphatically not any of the operators' business and are not meant for their idle consumption! If your organization has a privacy compliance officer, I'd report the problems to that person. If not, try contacting your health information management or legal department. The people you're supervising are obviously in need of some extremely thorough privacy (re?)training, which I hope will include details about the possible punishments for breaches of HIPAA and recent cases in which unscrupulous individuals have been given substantial fines and jail time for flagrant HIPAA violations. If the operators think it's acceptable to listen in to what should be private conversations between providers and patients and gossip about them afterwards, heaven only knows what they're saying about those conversations outside the office and/or online. Your instincts are right - this problem needs to be addressed quickly!

The worst scrubs I ever saw were on an MA at my pain doc's office. Have you ever seen pictures of those creepy kewpie dolls from carnivals back in the 1920s-30s? The ones where the eyes just seem to follow you wherever you go? This woman had a scrub top made of dozens of pictures of those kewpie dolls. The coup de grace? SHE WAS WEARING SCRUB PANTS OF THE SAME MATERIAL. She was nearly head to foot in creepy kewpie dolls! Those scrubs were enough to give anyone nightmares. They must have been home-sewn!

You mentioned that funds are getting tight. Are you an established client of your state's Bureau of Vocational Rehabilitation? Given your educational level, they won't be able to do much to help with your tuition or school fees, but they can help with many other aspects: supplies, equipment you may need to help you work more comfortably and effectively both at home and at work, headhunters who can help you search for jobs and market you to potential employers, even the occasional money for vehicle repairs. In some cases, BVR reps can offer tax credits to employers who hire BVR clients. A good BVR rep is worth his or her weight in gold. Keep up the good fight! I'm considered fully disabled (not from any sort of work-related incident, just genetics and bad luck), but accepting a life on disability just isn't in my nature. I may never be able to find an employer who'll accept me, but I'm not giving up without a major fight. Feel free to PM me any time. I wish you the very best of luck!

Do you have a link to it by any chance? I haven't seen the new one yet.

Well said. As someone who has taken an ungodly number of classes on HIPAA, I'm often horrified by the way some people seem to misconstrue its tenets.

My understanding is that employees do have the legal right to discuss certain topics without employer retribution, working conditions being one of them. Here's an excerpt from a New York Times story on the recent "Facebook case" pursued by the National Labor Review Board: The labor relations board announced last week that it had filed a complaint against an ambulance service, American Medical Response of Connecticut, that fired an emergency medical technician, accusing her, among other things, of violating a policy that bars employees from depicting the company "in any way" on Facebook or other social media sites in which they post pictures of themselves. Lafe Solomon, the board's acting general counsel, said, "This is a fairly straightforward case under the National Labor Relations Act- whether it takes place on Facebook or at the water cooler, it was employees talking jointly about working conditions, in this case about their supervisor, and they have a right to do that." That act gives workers a federally protected right to form unions, and it prohibits employers from punishing workers-whether union or nonunion-for discussing working conditions or unionization. The labor board said the company's Facebook rule was "overly broad" and improperly limited employees' rights to discuss working conditions among themselves. Moreover, the board faulted another company policy, one prohibiting employees from making "disparaging" or "discriminatory" "comments when discussing the company or the employee's superiors" and "co-workers." Now, this case has been settled out of court and as a part of the settlement the employer involved had to revise its broad social media policy. However, I'm sure the NLRB and other groups will eventually pursue other social media cases. I agree that it's smart to be cautious online. However, the notion that employers can control so much of our non-working time and activity is a little too Orwellian for me. I will be glad to see the eventual establishment of legal signposts clarifying rights for both employers and employees with regard to speech via social media.

What court ruling? The only recent social media-related matter I've heard of lately was the out-of-court settlement of the case in which the National Labor Review Board sued a Connecticut employer for firing a paramedic after she made critical remarks about a supervisor on Facebook. I was actually disappointed it was settled, because right now the law doesn't cover what rights (if any) employees have with regard to employer-related speech via social media. On the other hand, it wasn't the world's strongest case for the NLRB and there are certainly plenty of other such instances that could be challenged.

Thanks for trying, OP.

Obviously computer charting is going to be more legible than either print or cursive, but we'll set that aside for now. For the sake of all the people down the line who will have to review your handwritten notes (not just other nurses/clinicians but coders, clinical documentation specialists, etc.) I'd probably argue for printing. It's the handwriting style with the highest probability of being legible to the largest number of people. You may think your cursive writing is very clear, but others who aren't used to your handwriting quirks may have difficulty comprehending it. So why take the risk when accurate written communication is so vital?

OP, is your facility in the process of switching over to an all-computer charting process? I have heard about many places using CPOE as a "dipping a toe into the water" approach towards a larger medical recordkeeping changeover. Is that the case at your hospital?

Other posters have listed some great study tips. The one that works for me is combining visually reading a chapter and my notes or the instructor's notes with reading parts of the same material out loud to myself on the second time through. It sounds odd, but by doing so I'm combining two forms of learning (visual and auditory), so I'm making cross-connections in my memory. Finding the willpower to make yourself study is a harder task. In many ways it depends on why you're having difficulty getting yourself to study in the first place. From your description of the heavy reading and workload, it sounds as though you're feeling overwhelmed by your studies. I'm guessing that as a result, you're allowing yourself to be distracted because you just don't know how to tackle this overwhelming amount of complex material. If that sounds about right, my advice would be to try to break the material down into more manageable segments. Trying to cram eight chapters into your brain all at once isn't going to work very well. Try to set a study schedule that allows you short breaks: maybe 45 minutes studying, 10 minutes off, repeat. The study group idea also has the potential to be useful for you - you'll be more motivated if you feel you must keep up with your group. But I definitely agree with MouseMichelle that you should be cautious and choosy about the group you join. Working with a group of students who are lazy or slackers will do you nothing but harm. Good luck to you! We all hit the studying wall sometimes. :)

Today, one of my favorite ways to de-stress is reading, preferably with a cat nearby. There's something very soothing about reading while a cat purrs on or near you. :) My other favorite way to relax today is to read to my little boy and then spend time cooking with my husband. I love nights like that. In my younger days, when my body still worked properly, I loved to run and swim. After a good hard practice with lots of kick drills, I always emerged from the pool feeling as though my stress had been washed away. Both swimming and running are great ways to get rid of your stress - you can wear yourself out till you can't even remember what you were upset about in the first place.

Other posters have supplied you with some good recommendations regarding nursing opportunities. I just wanted to add a suggestion that you contact your state's Bureau of Vocational Rehabilitation/Rehabilitation Services Commission. In my experience, the people there are excellent advocates who can help you obtain assistive devices/software so that you can do a given job properly. They also help you obtain employment by offering tax cut incentives to employers and assist in the creation of an appropriately modified workspace for you. BVR employees really know the laws relating to disabled workers and they're wonderful people to have on your side in this sort of situation. I commend you for wanting to keep working despite your injuries. I feel the same way about my disabilities, though it sounds like you're dealing gracefully with a much tougher situation than any I've had to face. I wish you the very best of luck. :)

You took the words off the tips of my fingers. Many states have regulations that are more stringent than the standards set by HIPAA, but HIPAA is the minimum national baseline for standards and privacy regs. While I agree some people have misconstrued HIPAA, the fact remains that privacy is - and should be - a very big deal when it comes to health care, no matter what agency or entity is providing the enforcement.

You need to talk to an attorney. I'd also look up your state's Bureau of Vocational Rehabilitation/Rehabilitation Services Commission. It sounds as though you would qualify for their services and their people can be very helpful in negotiating/disputing with schools and employers over such issues. Best of luck to you!

I have never understood why that is the case. I mean, payers reimburse separately for just about every other type of service, so why is nursing care just a part of the package deal? Obviously different types of patients require various levels of nursing care. Yes, the reimbursement matrices take into account the level of the patient's injuries or illness, but that doesn't necessarily capture the level and amount of nursing care required for any given patient. It seems to me that nurses will never be valued, recognized, or reimbursed for their true role in patient care until the reimbursement process changes. Am I missing something?

Thank you all for your ideas! Is it okay to get someone scrubs before they know where they're working? It seems as though many places have specific requirements about what one may and may not wear (color, style, brand/source, even embroidery). I like the idea of getting him something practical, as he's a very practical person; I just don't want to jump the gun and get him a practical gift that isn't applicable to his first work setting (which looks likely to be in LTC).

Okay everyone, I need to pick your brains for a moment. My stepfather will soon be graduating from his LPN program. I am incredibly proud of him - it isn't every 54-year-old man who can gut it out through a nursing program, especially after having been out of school for 25 years. I have been researching gift ideas on All Nurses, but most of the threads I've found have included ideas that are aimed more at women (mani/pedi, a spa outing, jewelry, nursing-related figurines, etc.) My mother already called the engraved stethoscope, so that idea is out, and he has a smartphone that basically functions as a PDA. If anyone has any ideas they'd be willing to share, I'd be very grateful. Thanks! :)

I'm guessing HIM people would probably play a role in this somehow, particularly with regard to implementing the system and/or monitoring/evaluating the data. This type of thing has come up several times in my classes. OP, I thought you might like a link to a thread I started a while ago about a story involving state of the art computer software and devices that can track and evaluate everything from vital signs and hand-washing to emotional responses. The story itself (there's a link to it in my initial post on the thread) is quite interesting and specifically references software that actually breaks in and reminds you about hand-washing if it thinks you've overlooked it. I have some serious reservations about this sort of thing. https://allnurses.com/nursing-news/technology-evaluates-peoples-523988.html

Student version: Stop asking me for help with notes, papers, assignments, etc. a day before the given item is due and then never thanking me for my help or even acknowledging my existence (until you need something once again, that is)!!! I'm stupid enough to fall for that trick once, but never a second time.