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  1. Mijourney

    Yikes I'm Getting Old!

    You know what? I'm actually grateful for being at an age that I can sit back and appreciate life and its many wisdoms. I can only wish that the wisdom that I have now, I could have had 20 years ago. But hey, life is a journey and growing in wisdom is what it is about. My hats off to those of you who have incorporated exercise and especially strength training into your daily routine. I wish you health, strength and longevity.
  2. Mijourney

    Nurses: Oppression Can Stop With You

    Very relevant article. Unfortunately, many nurses come from a unwholesome foundation and environment into the discipline or profession depressed and oppressed. Managers at every level exploit this to their advantage. It's much like leaders of a country, whether political or non-political, exploiting the masses to their benefit. Recognize if your leaders are also unwholesome and dysfunctional, then things will be chaotic. The silver lining in this is that there are good-hearted nurses out there willing to do their best for the best outcome of the patient and family and their co-workers or subordinates. All is not completely lost. Nursing should hold these shining examples up as often as possible. They're out there.
  3. Mijourney

    The 'De-Skilling' Of Nursing

    Actually Asystole, the MSN model seems to be similar to the physician model of education. Most MSN programs do the theory prior to the practicum. Usually, the practicum is done last in the MSN program. Generally, this practicum is a real world experience.
  4. Mijourney

    The 'De-Skilling' Of Nursing

    Brandon, I agree with you that nursing school typically does not provide real world experience. However, at least in my state to my knowledge, one is not required to have prior nursing experience to become a nurse-particularly at the ADN, BSN, or MSN levels. In fact, as I write, there are people entering the nursing profession that have no intention of "wiping butt" beyond their schooling. They seek to go into administration or specialize in non-physical contact areas. It's all about getting that buck for many people who enter nursing. Even though most bedside nurses do not feel they're getting well-compensated, nursing does provide a decent wage and some measure of security depending on where you work and who is in top management. To mitigate any problems with your step by step recommendation, nursing could go back to the days of old when nurses worked as "techs" in between semesters (back then it was a source of free help; I would not recommend no pay today) or nursing internship programs could be established.
  5. Mijourney

    The 'De-Skilling' Of Nursing

    Many nurses may not want to take on the responsibility of independent billing when they learn what they may face. Independent billing still would entail adding to our skill and knowledge set as I pointed out earlier in a post. To bill for services, you would have to know about clinical code sets and reimbursement; you would have to make sure that you are performing evidence-based practice to prevent being overly scrutinized by third party auditors; you would need to know a third party payer's policies, and I can tell you Medicare/Medicaid is very complex; you would need to be willing to talk with third party payers and auditors when they deny your services; your documention would need to be stepped up several notches in order to meet the criteria for payment from third party payers and demonstrate quality care; your malpractice insurance rates would skyrocket; you would become even more exposed to litigation. Is this something you think the average RN or LPN at the bedside could deal with or afford? Would the current scope of practice for LPN/LVNs and RNs warrant these additional headaches? I realize the scope of practice varies from state to state. I stand by my mantra that standardization is one way to address the conflicts that nurses face. Yes, let's grandfather whoever needs to be grandfathered, but we need unification through standardization.
  6. Mijourney

    The 'De-Skilling' Of Nursing

    Great article! Many good points. It's not clear to me that nursing is necessarily being de-skilled. It's just that we need to continually update our skill sets. As other posters have pointed out, what nurses do today, physicians use to do. In many cases, nurses have invaded other discipline's territory as it were and become the bain of that other discipline's existence. Health care facilities are in the money making business, for-profit or not, and if they deem their reimbursement levels to be too low to pay wages and benefits for licensed workers then unfortunately caregivers and our patients suffer. I do agree with some of the assessments that point out that nurses may need to make an effort to become independent practitioners while providing care at the bedside. I think those of us with graduate nursing degrees can make that case as long as the scope of practice supports it. Some nurses feel that the problem of de-skilling is as a result of too much focus on enhancing the educational requirements for nurses. I contend that the fact that our profession is so fragmented is the cause of much of our agony. We have unlicensed nurses, ranging from CNAs to RMAs, as well as licensed nurses, RNs and LPNs. Practically anyone calls him/herself a nurse, but you don't hear much of that with therapy or pharmacy. So, I contend (I know darts will be thrown in my direction) that part of the problem with de-skilling lies with us not accepting that we need to standardize nursing educational requirements. That will partly solve the nurse educator shortage as well as the de-skilling problem. Alright, let me have it!
  7. Mijourney

    Your Input is Needed

    I'd like to know about the following topics: Regions of the country favorable for NIs NIs relationship with other members of the informatics team or IT-in particular, the relationship between NIs and physician informaticists Barriers preventing NIs from performing their work Roles that NI can serve in (can a NI be a CIO, for instance) The impact of accrediting agencies like The Joint Commission on an NI's work (are NI's directly involved in surveys) Typical hours of work for newbie NI vs those in the field five years or longer I don't know if my topics make sense or are bloggable, but I am hoping you can do something with them.
  8. Mijourney

    Productivity in NI

    So, serving as a NI is more like being a project manager? Is that correct?
  9. Mijourney

    Should I run away screaming?

    50 cases is fairly steep when you think about having to study each case, the call itself, and all the documentation you have to do for the case. I've never done weekend case management in the corporate setting so I'm only taking my best shot. You will have to ultlmately decide. For a twelve hour shift, you will have about 24 minutes for each case. For an eight hour shift, 16 minutes each case. That may be doable because some cases will require more time than others. However, this does not count breaks and etc. With the UR portion, navigating the insurance company's phone system or web system can be a pain. Again, you will have to decide if you want to give it a try. If you were hoping to work just the weekends, it may be worth a shot just to see how it goes.
  10. I am interested in obtaining more information about the MSN program in Tuscaloosa. I have the following questions for those who know the program: 1. What UA MSN program would you recommend for those of us who simply want an advanced nursing degree? 2. Are the online courses more difficult than the face-to-face courses? 3. What is the typical nursing professor like? 4. Do you feel that these professors have your best interest at heart? 5. In hindsight, did you feel that you made the right decision in chosing an MSN education at UA? 6. Do you feel that you were adequately prepared to perform as an advanced practice nurse by the Capstone School of Nursing? 7. How difficult was it to find a position in your chosen specialty after graduation?
  11. I am looking at an in-state university program for an MSN in informatics. The costs seem to be more reasonable than private institutions.
  12. Mijourney

    2010 HIMSS Virtual Conference

    HIMSS Virtual Conference & Expo You have a little less than a month left to register and review the site. Hope this helps.
  13. Mijourney

    HIMSS 2011 in Orlando, FL

    No, I do not plan to attend either the HIMSS conference in Orlando or the ANIA-Caring conference in Las Vegas. Traveling, especially on planes, is not my strong suit unless I can drive within a reasonable distance to a conference. I am looking forward to these conferences coming back to the southeastern section of the country.
  14. Mijourney

    nursing case management admistrator certification

    Hi again, Helen. You did not indicate where you got your info from. However, I do find that the center for case management has answers to many of your questions @ http://www.cfcm.com/resources/certification.asp.