TRichter

HI. There are a lot of opinions here. The Accountable Care Act is trying to make medical care available for everyone, regardless of age or pre-existing conditions. As it stands, many people who have chronic illnesses cannot afford the insurance to help them recieve much needed treatment to prevent them from having to visit ER, and admissions. Currently, Medicare has chosen large organizations and hospitals as Accountable Care Organizations. Their role is to try to "manage" and control cost for medicare patients who have straight medicare, which allows them to see any specialist any time they choose. Accountable Care Organizations (ACO) need to find ways to educate these patients on managing their care better and on their illnesses, allowing patients to manage their health much better than they are currently. IN so doing this, the thought is it will lower costs of care for these patients because they will learn how to stay healthy, and how to limit the tests and procedures they have. THis program is in it's infancy stage, so the ACOs are still trying to figure out the best way to help the Medicare patients. If they do figure it out, and lower the yearly costs spent on Health Care for these patients, this could "bench mark" new standards of care for all patients. In no part of the ACA is there any stipulations on limiting care patients receive. It is limiting unnecessary items, or repeating things unnecessarily. I have friends who live in England, and their health care is in no way limited. They recieve great care, they just pay higher taxes. So instead of higher taxes, which AMerican's have voted against, the government has found a way to make insurance affordable for everyone. I believe it is a win/win situation if we all work together. From what I understand, the only way Health Care providers, nurses and such will be directly effected would be in salary. We need to think about why we entered into this line of work.

Regular insulin would work almost immediatly, so yes, glucoseglycogen would occur faster than the liver can convert glycogen back to glucose. That said, if the patient is not receiving insulin, and is relying on the body to regulate, the hypoglycemia occurs a little slower.

When you have low blood sugar, the pancreas secretes the hormone glucagon, which stimulates the liver to turn some glycogen back to glucose for use in the body and brain. Glycogen is stored in the liver and the muscles. Glycogen stored in the muscles cannot be converted back to glucose for use, glycogen in the muscles can only be used by the muscle for energy. Hope this helps:nurse:

California pays $28-40 and up, depending on experience, education, position you are in.

I have seen these reports, but lets not forget that this happens in any college. There aremany fake degrees floating around, the head of FEMA just got canned for this exact thing. My credentials were really scrutinized. I am currently in the MSN program, and after getting my BSN at a private catholic school, I see the work load as almost the same, only at UOP the instructors are willing to work with the class a little.

Welcome to Nursing!!!!!! I live and work in LA. Most of the nurses I work with are either married or have a roommate. It is expensive here. UCLA is a wonderful hospital. You will probably have to commute, but you get used to it after awhile. THink it through carefully before making the big jump.

If you don't take care of yourself, you will not be able to take care of anyone else. If your coworkers care about you, they will not gossip. Everyone needs a break after so long, it sounds like you are well over due, you just needed permission to take it. Take Care of yourself. "Let Go, and Let God". . . you finish it.

I am currently taking the MSN course with them. Though I am doing the campus classes. The couselors I spoke with stated the online only program was much harder. My manager at work teaches for them and agreed with this. So far I am happy with the program.

Hire a maid to come in once a week if possible. Realize that there are somethings that just won't get done. Prioritise. If it can wait. let it. I also taped all lectures and listened to them while doing house work, and while driving to and from school. Get used to surviving a little sleep, before school starts. Good Luck. You will do fine. Oh, I just started a Master's program, so I am right there with ya.

Didn't know that about liver patients and LR, don't work with them much. Thanks for the tidbit.

I am a pediatric nurse and preceptor. I worked along side by boss while doing a management rotation in school, years ago. Her main thing was if the nurse could look her in the eye when speaking to her. Other than that your answers are great. Be honesst and true to your heart.

We have changed some things at work due to research, such as using the alcohol based hand cleanser instead of soap and water if there in no fluid on hands, there are also some medical practices that have changed and according to the docs they say it is due to research. How would you suggest we increase our use of evidence based practice?

Thank you for your reply. Where did you go to get your PhD? Do you have any thought on how to improve our use of evidence based practice?

Thank you for your thoughts. I agree, we like to stick to what works and only change when forced to. Any thoughts on how to improve this?

WE currently use FLACC for children under 2 or so, for those that can't communicate, and those mentally challenged. Faces until they reach around 7 or 8, then the numerica scale. This time frame was develped by Pain Management team consisting of MDs and NPs and RNs.