Bibeau1

The average case load ( best practice ) is 20-30. You have identified what every other Case manager has noted. There just isn't enough time for every thing. One suggestion is to look at your case load. You do need to see all managed care patients ( pending on how may days you get from the insurance , ie days approved ) . Your medicare have to be seen w/in 24 hours of admission then every 3 days depending on intensity and severity. If you do your d/c planning on day one . That is..... have an active home care and /or snf/ rehab plan in the works as early as possible then the d/c should go much smoother . That means documenting what the plan is to inform the doctor / staff on day one, That way there is NO question the direction that this patient's going. also place what ever forms you know the Doctor will have to sign and /or complete prior to the d/c . that way you won't have to chase him/her down when the pt is ready for d/c . It will decrease your work load tremendously . Hope this helps .......

Hi try Graceland university, You have the option to pick where you want to do your clinical .

I have used a Palm M515 for 2+ years ( this is my second, I wore out my first :chuckle). I have down loaded the Epocrates program ( about $99/year ) includes meds, 5 minute clinical manager, and now all labs , Take a look at it on Epocrates .com . I can't be without it. good luck ( nothing ventured......:) nothing learned)

Unfortunately hospitals are looking at lengths of stay instead of what is really going on with patients. As a case manager in an acute setting I am continually pressured to faciliate a dscharge on a patient that clearly is NOT ready. prime example is a patient who was recently discharged from a hospital on the drug Zyvox. As you know Zyvox is for the treatment of vre, The cost is >$1500. The care manager ( not me ) asumed that because the patient has a prescription benifit they could afford the copay. Unfortunately the copay was $300 ( which she did not have ) so she went w/o her med for 72 hours until the Doctor that I work with asked me to look int it. medicare would have paid for her to have her medication in a skilled facility ( like the one that your wife works in ) BUt she has used al her mediare days . The hospital case manager was aware of this but discharged her to home with inadequate home support. The question is not why did that patient come to your wifes facility but was there an alternative plan OR was she beyond the DRG so the hospital was losing money by keeping her or him. Please do not think I justify this , I do NOT . Unnfortunely patient care is clearly based on how much money can be made . The hospitals are going under because of the large population of indigent patients ,( that still need care ) and the limited medicare system. I do not support federal medical care . Ithink that if the senate and the house of representatives where all placed on medicare with its lmitations then YOU would see improvements in the system :angryfire

Mea culpa , you are right, "compassion and empathy are aquired traits. Many appologies, I have recently witnessed people in my profession who clearly are lacking in the traits that I admire ........

Hi, I will be graduating from graduate school with a msn /FNP. I always thought there was no difference between the NP role and a PA role , But there are many. One of my preceptors is a PA. She has been a great teacher and role model. We have compared education and this is what we have concluded. PA's do have more actual clinical time then NP's . The focus of an NP program is academics because they feel we are already nurses. That I believe is our short coming. I really feel there should be more focus on actual practicums and less on the profession at hand , ( but that's my opinion ). NP's, on the other hand, bring our compassion , & our hands on in patient care that ONLY an experienced nurse can bring. our caring touch, the fact that we listen is most valuable in a time when time with a patient is so very limited. I want you to look at the how the PA's interact with patients as compared to a NP. Any one can function clinically , but compassion and empathy are clearly a nurses domain.

I'm going to Graceland University in the Msn/fnp program, The course are not easy, definately alot of writing but the convience of going to school and working full time out weight the cost. I will be done this fall . This program has been around for 10 years ( msn online ) and 20+ years (bsn -online), it is accredidated by the NLN and the ANCC, You can't ask for better. :)

congrats !!!!!, I'm finishing my practicums. Have completed all my course work. IT is definately worth it.

If you get flamed then so do I . I am close to completing My MSN FNP. I have been a Nurse for greater then 20 Years. Its what I am and what I do. I feel nursing is a calling and that is what makes Practitioners stand out as compared to PA;s. I am not putting Pa's down but there is a real difference in what we bring to the table. Obviously Physicians are also seeing the difference because I am seeing more physicians hiring Np's over PA's .

Its easy , You pick who you wnat to work with. So if there is a Doc or an N P who you admire . You ask them and the school arranges a contract with the preceptor . I'm doing my adult specialty with a wonderful Doc.:)

Hi I completed by BSN in a traditional college campus about 16 years ago. I am almost done to comleting my MSN/NP on line . I am going to Graceland University. It is not easy ,you have to remain focused and really want it, but it was a wonderful experience and I recomend it highly.I work full time and this was my only way to acheive my goal ..... good luck:)