MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    Looking at a chart of a previously cared for patient, HIPAA violation?

    MunoRN replied to StaceyTr88's topic in HIPAA Challenges

    It's not actually a HIPAA violation so long as you are looking for the purpose of evaluating your care. Differentiating between evaluating the care you provided vs simple curiosity is the...
  2. MunoRN

    Asked about citizenship during triage

    MunoRN replied to inshallamiami's topic in General Nursing

    It's extremely rare for an uninsured person to be able to pay their entire bill by private pay, what billing offices typically do is to calculate a much smaller amount that the person might actually...
  3. MunoRN

    Asked about citizenship during triage

    MunoRN replied to inshallamiami's topic in General Nursing

    Deleted, wrong
  4. MunoRN

    Asked about citizenship during triage

    MunoRN replied to inshallamiami's topic in General Nursing

    You may want to re-read the article, it doesn't say that a hospital staff member called ICE because they found out a patient was undocumented, it says that a sick infant required a transfer to another...
  5. MunoRN

    Asked about citizenship during triage

    MunoRN replied to inshallamiami's topic in General Nursing

    That's loosely related to your statement that nurse's are calling ICE on patients, but not really an example of what you were claiming. In the linked article, an infant required life-saving surgery...
  6. MunoRN

    Asked about citizenship during triage

    MunoRN replied to inshallamiami's topic in General Nursing

    The reimbursement that goes along with treating undocumented immigrants, and results in patients being asked about their immigration status, has been around for 13 years, and yet the ACLU hasn't been...
  7. MunoRN

    Under the Covers: My Experience With Post-op Pain Control

    MunoRN replied to Brenda F. Johnson's topic in General Nursing

    You were on 1mg of fentanyl q 2hrs? That's roughly equivalent to 100mg of morphine every 2 hours, that is an impressive amount, and while dosing is all relative, I can see how that would raise some...
  8. MunoRN

    Asked about citizenship during triage

    MunoRN replied to inshallamiami's topic in General Nursing

    At least in the four EDs I've worked in, and the others I've 'visited', it hasn't worked that way, and I'm having trouble imagining how it even would work that way or how there would be any advantage...
  9. MunoRN

    Asked about citizenship during triage

    MunoRN replied to inshallamiami's topic in General Nursing

    Triage and admitting often occur simultaneously, and it wouldn't make much sense to intentionally leave part of the admissions process until later unless there's some actual evidence that it's...
  10. MunoRN

    Asked about citizenship during triage

    MunoRN replied to inshallamiami's topic in General Nursing

    Hospitals are required by federal law to provide emergency and acute treatment to everyone, regardless of immigration status, so as a result they reimburse hospitals for these services based on how...
  11. MunoRN

    help! What would you do!?

    MunoRN replied to Newbie_90210's topic in Patient Safety Issues

    I assume the OP is referring to a subcutaneous infusion set, which I've only ever seen used for insulin pumps and palliative care. Why did the patient have a SQ set in place
  12. MunoRN

    Under the Covers: My Experience With Post-op Pain Control

    MunoRN replied to Brenda F. Johnson's topic in General Nursing

    You've made some good points, particularly the importance of early adequate pain control as this reduces the cumulative amount of opiates required to control pain and improves outcomes, as well as the...
  13. MunoRN

    CMS CJR Bundled Payment - CA LVN's

    MunoRN replied to Sarah8strong's topic in General Nursing

    It's usually 3 nights total, I think the national LOS average is around 3.1 days, and that's total length of stay, 3 nights and then home. So if your mom got 7 nights in combined hospital/SNF...
  14. MunoRN

    CMS CJR Bundled Payment - CA LVN's

    MunoRN replied to Sarah8strong's topic in General Nursing

    Was her hospital stay 6 days? Typically the hospital stay for a knee replacement is less than 6 days, if for some reason they still need ongoing nursing care/rehab then they are initially sent for...
  15. MunoRN

    CMS CJR Bundled Payment - CA LVN's

    MunoRN replied to Sarah8strong's topic in General Nursing

    Was she discharged from the hospital or SNF after six days? Is the same LVN supposedly deciding when patients get discharged from both the hospital and the SNF? What was the plan before
  16. MunoRN

    CMS CJR Bundled Payment - CA LVN's

    MunoRN replied to Sarah8strong's topic in General Nursing

    It would be helpful to know why it was an unsafe discharge. Rehab stay coverage is well defined, if at the end of the rehab period the patient is not safe to go home then they might be admitted to an...
  17. MunoRN

    scope of practice, the EKG/ECG?

    MunoRN replied to wtpsych's topic in General Nursing

    To clarify, I would assume you're referring to very basic interpretation; basic recognition of arrhythmias, STEMIs, and the like. I don't think complex 12 lead interpretation such as differentiating...
  18. MunoRN

    Accused of a HIPPA VIOLATION

    MunoRN replied to Mpena1978's topic in HIPAA Challenges

    What specifically are they saying was the HIPAA violation? Did you disclose specific medical information about this patient to your husband without their
  19. MunoRN

    Lvad patient in cardiac rehab

    MunoRN replied to Chanda1234's topic in General Nursing

    There should be a VAD coordinator associated with these patients, if your cardiac rehab is affiliated with the institution that is placing or managing these VADs then you should be able to ask them...
  20. MunoRN

    Crohn's Disease P/t

    MunoRN replied to Stephanie5160's topic in General Nursing

    The first issue is that if the patient truly does have Crohn's, then opiates should generally not be given, the common view of the GI docs I work with is that they consider them to be contraindicated...
  21. MunoRN

    Ethical Issues

    MunoRN replied to ShanHK's topic in Critical Care

    (Bolding mine), I'm not sure what you're basing the idea on that 4mg morphine at really any interval is by definition excessive, it well could be excessive for some patients, but there are definitely...
  22. MunoRN

    Capped Salary?

    MunoRN replied to cicugirl's topic in Critical Care

    salary.com is usually pretty reliable in their pay rate surveys, and for White Plains for instance it appears you are being paid well above the mean rate for nurses in your area with similar...
  23. MunoRN

    Dealing with patients

    MunoRN replied to Babynurse1992's topic in General Nursing

    It's not unusual for patients to get the impression at some point that they will have absolutely no pain, although this isn't always realistic, so defining what the reasonable goals are is important....
  24. MunoRN

    Is this Facebook status Hipaa compliant?

    MunoRN replied to musicmouse44's topic in HIPAA Challenges

    It's not a HIPAA violation, but as a student it's not HIPAA you really need to worry about, it's not unusual for schools to discipline or remove you from the program for any posts that mention of what...
  25. MunoRN

    IV bags and overwrap

    MunoRN replied to MDONER's topic in General Nursing

    The purpose of the overwrap is that the type of plastic that the bags must be made out of allow the osmotic transfer of some fluid through the plastic over long periods of time, so the overwrap is...