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?