tlf91

Latest Activity

1. Bowel Protocol

   tlf91 replied to Kimmyjc's topic in Geriatric

   In our facility we use "Power Pudding". All natural. bran, prunejuice and applesauce mixture. The residents love it and can not get enough. Ask for more. We use it in out protocol and boy is it effective. We give it at night and the next morning "loo...

2. Anyone doing disease management with Optum/UnitedHealth Group?

   tlf91 replied to SWRN84's topic in Case Management

   I work for a company that was purchased by UHC last year. We function much like Optum. When training with UHC, I had the pleasure of visiting two different Optum sites. One was in Plano Texas, the other in Rhode Island. Both sites were very impressiv...

3. 8:1 ratios in the ER???

   tlf91 replied to jaimealmostRN's topic in Emergency

   This is very true and good advice. At the very least, you have it in writing. Make sure you go through the chain of command and notify someone of the situation at the time it is occuring. Most of the time, the administration will at least get the inf...

4. customer satisfaction in the er

   tlf91 replied to ensense's topic in Emergency

   Boy, you have had a long week........ I had to change the way I looked at these people to keep out of the homicidal side of my personality. Yes, I know it sounds silly but I turned it into a game. Sickest patient of the day. Most pitiful acting job o...

5. customer satisfaction in the er

   tlf91 replied to ensense's topic in Emergency

   I do not think there is an ER Nurse that can not feel your pain. Most of the time the answers to fixing this problem are process related and require administrative intervention. We know how that goes!!! When I managed the ER, I had the joy of talking...

6. hostile chargenurse

   tlf91 replied to maxinefrancine's topic in Emergency

   Thanks. You are absolutely right. In some situations it is better to rotate charge. I was very slow in placing fixed charge nurses in my department. When I did, they were held to the highest standards and expectations. Disrespect was not a part of th...

7. hostile chargenurse

   tlf91 replied to maxinefrancine's topic in Emergency

   I applaud your knowing when to take a breather. I'm sure your coworkers respect you for that. I try to live by one rule. If I can not come up with something to say that is respectful I dont say anything at all. ER nurses go to the trenches everytime ...

8. Why reverse sedation?

   tlf91 replied to Jolie's topic in Emergency

   If you were awake and talking , there was really no need for reversal. The beauty of Narcan is that it works fast but the down side is that it is short acting. So it would probably not affect the Vicodin. At times you have to repeat the dose because ...

9. managed care,HMO,rationing health care

   tlf91 replied to jbresolin's topic in Case Management

   At present the company I work for pays out 97 cents from every dollars brought in. Very good response. Could not have explained it better.

10. How do you protect yourself in unsafe situations in the ER?

    tlf91 replied to RNin92's topic in Emergency

    If you have hospital email this is a good way to document that can not be placed in the trash or disappear. remember to make a copy and take it home for safe keeping. The quality aassurance/ incident report is another avenue to think about. The are r...

11. hostile chargenurse

    tlf91 replied to maxinefrancine's topic in Emergency

    As a former ER Manager I can tell you the problem is not uncommon. The best advice I can give you is to document every event. In the time of confrontation or in discussion with the Manager or Director you will need this to reference. The problem is e...

12. Pill identification--need help

    tlf91 replied to my2sons's topic in Emergency

    There is a depakote fitting a description. Only other one I know of is Phenteramine (diet pill). Fits description pretty close. It is a generic brand I think.